Healthy Behaviors Research Articles

EHealth Interventions of Health Literacy for Stroke Survivors: Systematic Review and Meta-Analysis.

eHealth literacy interventions have emerged as a new approach in management of stroke survivors. Its effect on knowledge and clinical outcomes presents an inconsistent result in literature. We aim to evaluate the impact of eHealth interventions on health literacy, clinical metrics, adherence to healthy behaviors, stroke recurrence, mortality, and health-related quality of life in stroke survivors. We systematically searched six databases (PubMed, Cochrane Library, CINAHL, EMBASE, Web of Science, ProQuest) up to February 21, 2024, selecting articles that meet these criteria: (i) patients with stroke; (ii) intervention with education content; (iii) eHealth interventions included telehealth, mobile phone, internet or computer; (iv) randomized controlled trials. The mean differences (MD) and standardized mean differences (SMD) between groups were measured. Risk of bias was evaluated using the Cochrane tool. From 16 studies involving 9646 participants, we observed that eHealth interventions significantly improved systolic blood pressure (MD = -2.78mmHg, 95% confidence interval (CI) [-4.67 to -0.88], p = 0.004), medication adherence (SMD = 0.28, 95% CI [0.04 to 0.52], p = 0.023), and health-related quality of life (SMD = 0.21, 95% CI [0.04 to 0.37], p = 0.013). Meta-regression found that age modified the effect size of systolic blood pressure (p = 0.027). There was insufficient evidence to conclude effects on other outcomes. The quality of evidence was moderate. Outcome variation may be due to the diversity in eHealth intervention approaches. The limited number of studies precluded the subgroup analysis. More interactive interventions with longer follow-ups were more effective. eHealth interventions may benefit stroke survivors in terms of blood pressure, medication adherence, and health-related quality of life. eHealth literacy interventions could be implemented to improve the management of stroke survivors, especially in the context of resource limitations. PROSPERO registration number: CRD42024502470.

A structural modeling approach to determine the effects of orthorexia nervosa and social appearance anxiety on healthy lifestyle behaviors in young adults

Aims: The aim of this study is to examine the relationship between orthorexia nervosa (ON) and social appearance anxiety (SAA) and to investigate the effects of these variables on healthy lifestyle behaviors (HLB) in young adults aged 18-30 years. Methods: A total of 408 young adult male and female volunteers, with a mean age of 21.7±2.95 years, participated in this study. A structural model was proposed to examine the effects of SAA and ON on HLB. To assess how well the study variables represented the underlying components, we first evaluated a confirmatory measurement model. Subsequently, we analyzed a structural model that allowed for the examination of multiple regression equations involving several dependent variables. Results: SAA had a negative influence on HLB (std β=-0.673; t-value=-8.425), a significant negative relationship between ON, HLB was also promoted (std β=-0.554; t-value=-9.388). It was determined that there is a positive correlation between SAA, ON which is statistically significant (correlation coefficient=0.830; t-value=10.244). Conclusion: It is concluded that the individuals with high social appearance anxiety do not adopt healthy lifestyle behaviors and are more prone to orthorexia nervosa.

Healthy lifestyle associated with dynamic progression of type 2 diabetes: A multi-state analysis of a prospective cohort.

Although the association of a healthy lifestyle with type 2 diabetes (T2D) has been extensively studied, its impact on the dynamic trajectory, including progression, onset and prognosis, of T2D has not been investigated. Using data from the UK Biobank, 461 168 participants without diabetes or diabetes-related events were included. We incorporated four lifestyle factors to construct the healthy lifestyle score (HLS). We employed a multi-state model to examine the relationship between a healthy lifestyle and transition in T2D progression, including transitions from baseline to diabetes, complications, and further to death. The cumulative probability of above transitions based on the health lifestyle score was calculated. The results indicated that adhering to 3-4 healthy lifestyles had an inverse association with the risk of transition from baseline to diabetes (hazard ratio (HR) = 0.966; 95% confidence interval (CI) = 0.935-0.998, P = 0.038), diabetes to complications (HR = 0.869; 95% CI = 0.818-0.923, P = 5.2 × 10-6), baseline to death (HR = 0.528; 95% CI = 0.502-0.553, P < 2 × 10-16, and diabetes to death (HR = 0.765; 95% CI = 0.591-0.990, P = 0.041) compared with maintaining 0-1 healthy lifestyles. In addition, the transition probability of the above transitions can be lower with maintaining 3-4 healthy lifestyles. Healthy lifestyles are negatively associated with the risk of multiple outcomes during the dynamic progression of T2D. Adherence to 3-4 healthy lifestyle behaviours before diabetes onset can lower the risk of developing T2D, further reducing the risk of diabetes complications and death in patients with T2D.

DIET AND EXERCISE HABITS OF NURSING ACADEMICS DURING THE PANDEMIC

This study aimed to examine the effects of social isolation during COVID-19 pandemic on dietary and exercise habits of nursing academics. This cross-sectional study was conducted with 393 nurse academics working in Turkey who agreed to participate in the study. During lockdown due to the COVID-19 pandemic, approximately 10% of the participants received professional support for diet and exercise. The habits such as consumption of foods that strengthen the immune system and the time spent passively increased, whereas the habit of fast food consumption decreased. The nursing academics in this study showed a positive attitude toward diet and exercise because of their increasing age and the presence of chronic diseases; thus, high scores were observed on the diet and physical activity subscales of the Healthy Lifestyle Behaviors Scale (HLBS II) used in this study (p ˂ 0.05). Thus, it is very important for nurse academics to display healthy lifestyle behaviors during the course of the pandemic to be role models for increasing the awareness of the public about the appropriate diet and exercise

Plasma metabolomic signature of healthy lifestyle, structural brain reserve and risk of dementia.

Although the association between healthy lifestyle and dementia risk has been documented, the relationship between a metabolic signature indicative of healthy lifestyle and dementia risk and the mediating role of structural brain impairment remain unknown. We retrieved 136 628 dementia-free participants from UK Biobank. Elastic net regression was used to obtain a metabolic signature that represented lifestyle behaviours. Cox proportional hazard models were fitted to explore the associations of lifestyle-associated metabolic signature with incident dementia. Causal associations between identified metabolites and dementia were investigated using Mendelian randomization. Mediation analysis was also conducted to uncover the potential mechanisms involving 19 imaging-derived phenotypes (brain volume, grey matter volume, white matter volume and regional grey matter volumes). During a follow-up of 12.55 years, 1783 incident cases of all-cause dementia were identified, including 725 cases of Alzheimer's dementia and 418 cases of vascular dementia. We identified 83 metabolites that could represent healthy lifestyle behaviours using elastic net regression. The metabolic signature was associated with a lower dementia risk, and for each standard deviation increment in metabolic signature, the hazard ratio was 0.89 [95% confidence interval (CI): 0.85, 0.93] for all-cause dementia, 0.95 (95% CI: 0.88, 1.03) for Alzheimer's dementia and 0.84 (95% CI: 0.77, 0.91) for vascular dementia. Mendelian randomization revealed potential causal associations between the identified metabolites and risk of dementia. In addition, the specific structural brain reserve, including the hippocampus, grey matter in the hippocampus, parahippocampal gyrus and middle temporal gyrus, were detected to mediate the effects of metabolic signature on dementia risk (mediated proportion ranging from 6.21% to 11.98%). The metabolic signature associated with a healthy lifestyle is inversely associated with dementia risk, and greater structural brain reserve plays an important role in mediating this relationship. These findings have significant implications for understanding the intricate connections between lifestyle, metabolism and brain health.

Daily Limited Future Time Perspective Is Associated With More Health Behavior Within Older Adults.

Cross-sectional studies suggest that individuals who perceive a broader future horizon may be more likely to consider the future consequences of their actions and, as a result, engage in healthy lifestyle behaviors. However, research has yet to consider how this association plays out on the daily level. The present study used daily diary data from a sample of 198 older adults aged 60 years and older (M = 63.34, SD = 3.29) to investigate the relationship between daily future time perspective (FTP) and daily health behavior. Participants reported on sociodemographic characteristics during baseline surveys and completed daily diary measures of FTP and health behavior (e.g., nutrition, exercise, social/leisure activity) across 14 days. Multilevel modeling was used to examine within- and between-person associations between daily FTP and health behavior. Daily FTP was significantly associated with daily health behavior at the within- but not at the between-person level. Counter to past cross-sectional work, results revealed that individuals showed increased engagement in health behavior on days when they reported a more limited FTP. Findings highlight the importance of moving beyond the between-person level to consider how FTP fluctuates from day-to-day and relates to health behavior in everyday life. Older adults who view a more limited time horizon may be motivated to increase that future through healthier activities.

Interaction between economic status and healthy lifestyle in long COVID among Chinese older population: a cross-sectional study

ObjectivesTo estimate the interaction between economic status (ES) and healthy lifestyle in long COVID among Chinese older people infected with SARS-CoV-2.DesignA cross-sectional study based on the Peking University Health Cohort...

INSIGHT responsive parenting intervention effects on child self-regulation at ages 3 and 6 years.

Self-regulation encompasses the ability to modulate behavior, cognition, and emotions. Parents can promote child self-regulation with responsive parenting (RP). RP shapes various components of self-regulation and is associated with numerous developmental outcomes. Here, we examine long-term effects of an early-life RP intervention designed for obesity prevention on later child self-regulation and temperament. Participants were from a randomized clinical trial comparing the RP intervention against a safety control (n = 279). RP intervention content in the domains of feeding, sleep, emotion regulation, and interactive play was delivered to primiparous mothers and infants at four home visits during the first year after birth, followed by clinical research center visits at ages 1 and 2 years and phone calls at 1.5 and 2.5 years. Child self-regulation and temperament were assessed with behavioral tasks and the Children's Behavior Questionnaire at child ages 3 and 6 years. A path model tested whether the RP intervention affected child self-regulation in comparison to the control group. At 6 years, children in the RP group had lower parent-reported negative affect (b = -0.34, SE = 0.15, p = .023) and better observed emotion regulation (b = 0.45, SE = 0.16, p = .007). Findings indicate that an RP intervention designed for early obesity prevention promoted emotional aspects of self-regulation in middle childhood, highlighting RP as a strategy for promoting healthy behavior across multiple domains. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prehabilitation to Enhance Vascular Surgery Outcomes: A Narrative Review.

Prehabilitation, an emerging strategy, prepares patients for elective surgery by encouraging healthy behaviors, including physical exercise and healthy nutrition, while providing psychological support, to improve postoperative outcomes and foster healthier lifestyles. Despite growing interest, there is little research on prehabilitation. Specifically, studies involving prehabilitation in vascular surgery are heterogeneous with small sample sizes. This review aimed to investigate the reported positive impact of prehabilitation on vascular surgery patients, discuss prehabilitation models, highlight prehabilitation program-associated challenges, and suggest appropriate interventions. Prehabilitation improves physical fitness, reduces postoperative complications, and enhances overall recovery. Multimodal prehabilitation programs can positively impact vascular surgery patients, with benefits including improved cardiovascular fitness, reduced postoperative complications, shorter postoperative hospital stays, enhanced overall recovery, and improved quality of life. The currently reported prehabilitation programs are heterogeneous, with limitations regarding patient adherence and lack of long-term outcomes, posing challenges to their widespread adoption. Overall, prehabilitation shows promise for improving vascular surgery outcomes and fostering long-term healthy behaviors. The systematic implementation of prehabilitation in vascular surgery care pathways, overcoming reported limitations, and integrating multimodal prehabilitation into routine preoperative care holdpotential benefits. This review underscores the need for high-quality research to establish best practices in prehabilitation and integrate them into the standard of care for vascular surgery patients.

Body Image and Eating Behaviour in Adolescents Loving Korean Wave Culture

The Korean wave has developed into a popular culture in the global community, especially adolescents in the last two decades. Cultural programs that include idols/bands, movies, dramas, variety shows, and webtoons are in great demand. The image of Korean women can influence adolescents' perceptions of ideal body shapes and eating behaviors. This study aims to analyze correlations between Korean culture viewing habits with body image and eating behavior among adolescents in West Java. This research is a cross-sectional study, conducted in West Java during April 2023 using the online structured questionnaire. The total subjects of this research were 467 adolescents. The results of the study stated that the subjects in this study were women (81.2%), college students (66.6%), Korean show enthusiasts (66.6%), Kpop enthusiasts (68.3%), Kdrama enthusiasts (77.5%), and webtoon enthusiasts (50.3%). Most of them thought that Korean idols were attractive (96.4%), and sometimes they want theirs body shape as their idols (46.5%). There were differences in body image and eating behavior among K-show (p=0.046 &amp;amp; p=0.039), Kpop (p=0.048, p=0.027, p=0.024, &amp;amp; p=0,000), and Kdrama enthusiasts (p=0.026) but there were no differences between enthusiasts of webtoon. Our findings show the Korean wave culture is one of the causes of adolescents experiencing body dissatisfaction, which is an important predictor of eating problems. Awareness of the importance of positive body image and healthy weight control behavior concepts is necessary.

Preventive healthcare practice by allied health professionals: Results from a cross-sectional survey in rural and regional Victoria

ObjectivesTo describe the frequency of preventive healthcare practice (assess, advice, refer for support) provided by allied health professionals (AHPs) practicing in regional and rural healthcare settings to address smoking, diet and physical inactivity. To identify factors that influence the delivery of preventive healthcare practice. MethodsAHPs working in public healthcare services in the Loddon Mallee region of Victoria were surveyed. Clinicians reported on the proportion of clients where they had provided preventive care. Likert scale questions measured factors influencing preventive healthcare practice. ResultsIn total, 115 clinicians completed the survey. AHPs reported that they assess for smoking and physical activity behaviours but not diet. Preventive health practice that included providing advice or referrals for follow-on support was rarely undertaken. Availability of screening tools and automated referral letters increased the likelihood of preventive healthcare practice. ConclusionsGreater attention to addressing modifiable lifestyle behaviours by AHPs might be warranted to match the rates of risk factors in rural and regional Victoria. Integrating support systems, for example, embedding screening questions within clinical assessments can assist preventive healthcare practice. Implication for public healthMany AHPs are not promoting healthy behaviours to prevent poor health. We present some strategies that could potentially improve this.

Secondary school randomized controlled interventions with a minimum dual approach to health and the links to BMI in pupils: A systematic review and meta-analysis within the project From Science 2 School

Introduction &amp; Purpose Health behavior offers a pivotal domain of health for managing current global crises, including physical inactivity and overweight/obesity (Schroeder, 2007). However, adults have limited capacity for adopting healthy behavior into their lifestyle (Prochaska &amp; Velicer, 1997). Schools offer an ideal setting for implementing health interventions considering the breadth of children that can be reached and the amount of time children spend in school (Tanous et al., 2022). The present study hypothesized that appropriately planned physical activity (PA) intervention for pupils and during compulsory secondary school time results in healthier body weight management. Methods A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, a published protocol (Tanous et al., 2022), and a trial registration was completed on the International Register of Systematic Reviews (PROSPEO: CRD4202347770). The databases searched (12/2021) included PubMed, Education Source, and EMBASE. Only school-based randomized controlled trial interventions on PA and/or diet published in English or German were included. The study population included pupils (10-19 years of age) enrolled in secondary schools and without major nutritional deficit or unstable health condition. The study sample was refined using exclusion criteria: (i) no outcome on body weight, body mass index (BMI), or self-reported, (ii) intervention groups only targeting overweight and/or obese pupils, (iii) interventions outside of regular school hours or implemented beyond the school setting, (iv) total intervention duration less than eight weeks, (v) branches of schools specializing on physical exercise/sports in general, and (vi) no control group. Title/abstract and full-text screening, data appraisal, and summary data extraction were completed by two reviewers. Results A total of 5,945 articles were identified by the search process, including 23 studies and 9,441 pupils (of which 4,787 males and 4,654 females) eligible for the analysis. PA interventions ranged from eight weeks to eight months and included jumping (n = 2), strength exercises (n = 3), cardiovascular endurance (n = 4), or a combination (n = 2). For PA intervention implemented in the secondary level school setting for at least eight weeks duration, a random effect size of -0.12 units (95% CI [-0.26. 0.02]) of BMI (kg/m2) was found with low statistical heterogeneity (I2 = 0%; p = 0.60). Discussion Due to the behavioral constraints of the school setting, children are denied from achieving the minimum level of health protection, which adversely contributes to the poor global health status with a major impact. Previous meta-analyses identified a small PA intervention effect for improving BMI in pupils (-0.02 kg/m2 and -0.05 kg/m2; Guerra et al., 2013; Harris et al., 2009) with considerable heterogeneity (I2 = 77% and 54%, respectively). The findings of the present investigation revealed a more precise effect measure than previous meta-analyses (Guerra et al., 2013; Harris et al., 2009) regarding the exclusive power of the secondary school setting over PA levels and the BMI health improvement possibility for pupils (-0.12 kg/m2). Conclusion PA intervention in secondary schools contributes to limited, yet beneficial body weight management for pupils in the ongoing global health crisis (Schroeder, 2007; Tanous et al., 2022). Considering the lack of formal organization at homes, schools are urged to achieve 60 minutes of PA daily.

Does academic stress predict nursing students' healthy and unhealthy behaviour?

The study aimed to examine the effect of academic stress on the healthy and unhealthy behaviour of nursing students. To gain more understanding of the concepts, literatures were reviewed. The study used descriptive assessment and correlational research design. The population of the study was 228 nursing students of the Divine Word College of Laoag. The questionnaires were used to gather the data and weighted mean and analysis of variance (ANOVA) were utilized to analyze the data. The study found that the academic stress of students was high and healthy behavior was also high. While unhealthy behaviour was low. In terms of the correlation between academic stress and healthy behaviour, the results signify that taken together the three dimensions (external pressure and expectations, course requirement overload and examination, and self-efficacy) are not associated with healthy behaviour. However, taken separately, academic stress related to self-efficacy significantly influenced healthy behaviour. Higher self-efficacy predicts higher healthy behaviour. Further, concerning the correlation between academic stress and unhealthy behaviour, the finding reveals that both are significantly correlated. It means higher academic stress leads to unhealthy behaviour.

The interconnectedness of parents’ educational aspiration, academic stress and healthy and unhealthy behaviour of nursing students

The study aimed to investigate the influence of parents' educational aspirations on the academic stress and healthy and unhealthy behaviour of students and the effect of academic stress on healthy and unhealthy behaviour. To deepen the concept of the study, literatures were reviewed. The study used descriptive assessment and correlational research design. The population of the study were the nursing students who were enrolling in the 2023-2024 school year. Questionnaires were used to gather the data and inferential statistics were used to analyze the data. The results found a significant correlation between parents' educational aspirations and academic stress, between parents' educational aspirations and healthy behaviour but not unhealthy behaviour, and between academic stress and healthy and unhealthy behaviour. The study recognized its limitation because it was limited to nursing students only, it needs to expand its respondents to include other courses.

Abstract A111: Leveraging African American women as change agents to reduce obesity-related breast cancer risk: An evaluation of a network-based pilot intervention promoting the Mediterranean diet

Abstract BACKGROUND: Obesity is a key risk factor for breast cancer (BC) incidence, recurrence, and mortality among post-menopausal African American (AA) women. Many older AA women are likely to report fewer healthy dietary behaviors, and those who are overweight or obese are likely to share similar dietary patterns as their social networks (SNs). AA women are also likely to receive information on BC risk from their SNs. Thus, AA women who share information on healthy dietary behaviors are well-positioned to become change agents toward reducing obesity and improving BC outcomes among their SNs. This presents a novel opportunity to increase the impact of evidence-based (EB) interventions focused on reducing obesity-related BC risk. This study aimed to assess the effects of the MedDiet-SN pilot intervention among participants trained as change agents to improve obesity-related BC risk reduction behaviors for themselves and their SNs through EB information sharing. Methods: MedDiet-SN was a 10-week, pre-/post- pilot intervention promoting the uptake of the Mediterranean diet, with participant training on effective EB information sharing. A community-based participant advisory board informed the pilot. Study procedures were IRB approved. Eligible participants were AA women, ≥60 years old, overweight or obese, Chicago area residents, and with no severe health conditions. Sixteen women participated, and 30 of their SN members (age ≥18 years) were recruited through participant referral. Predictors included time from pre- to post-study and session dosage for participants, and participant EB information sharing on healthy eating for SN members. Outcomes for both groups included BC and diet knowledge, dietary change attitudes (motivation, self-efficacy), dietary behavior change, and BMI. EB information sharing on healthy eating was an additional outcome for participants. Bivariate and multivariate analyses were performed to assess outcomes. Results: In crude and adjusted time models, participants showed improved knowledge, behavior change, BMI, and EB information sharing (p&amp;lt;0.05). In adjusted dosage models, participants showed improved knowledge, attitudes, and EB information sharing (p&amp;lt;0.05). SN members showed improved attitudes and behavior change based on participant EB information sharing on healthy eating (p&amp;lt;0.05). In addition, there was a high concordance between participant EB information sharing and SN EB information learned (&amp;gt;70%). CONCLUSION: This research is innovative in that it 1) shows the effectiveness of a network-based intervention promoting healthy dietary behaviors for obesity-related BC risk reduction among AA women, 2) supports the value of scaling up interventions by leveraging participants as change agents for EB information sharing among SNs, and 3) provides a contribution to emerging research on positive intervention spillover effects to SNs. It is anticipated that results from this study will inform the development of future network-based interventions that aim to reduce obesity-related BC risk and improve health outcomes for AA women. Citation Format: Nyahne Bergeron, Mona Strahan, Patricia Hardmon, Marja Stanford- Leak, Anita Stevens, Annie Young, Devyanne Ward, Lois White, Eunhye Lee, Lisa Tussing-Humphreys, Marian Fitzgibbon, Yamilé Molina. Leveraging African American women as change agents to reduce obesity-related breast cancer risk: An evaluation of a network-based pilot intervention promoting the Mediterranean diet [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 A111.

Abstract A047: Neighborhood disadvantage and multiple myeloma risk among Black women living in the United States

Abstract Introduction: Multiple myeloma (MM) is a rare cancer of the plasma cells. Black men and women are at a greater than 2-fold increased risk of MM as compared to other racial/ethnic groups. In 2021, Black women living in the United States (U.S.) were diagnosed with MM at a rate of 13.9 per 100,000 women, and incidence has increased by more than 30% since 2000. Factors associated with the neighborhood in which Black women live and work may be one area to consider to disentangle this racial disparity in MM incidence and reduce the burden of disease for Black women. Methods: We evaluated the association between two neighborhood-level indices and MM within the Black Women’s Health Study, a longitudinal cohort of 59,000 self- identified Black women ages 21-69 at enrollment in 1995. Participant addresses at baseline were geocoded and linked with U.S. Census Bureau and American Community Survey data. We conducted a factor analysis to a create neighborhood concentrated disadvantage (nDIS) score, which included 6 variables: percentage of individuals below the poverty line, percentage of individuals on public assistance, percentage of female headed households, percentage unemployed, percentage of individuals ≤18 years, and percentage of Black residents. A neighborhood socioeconomic status (nSES) score included median household income, median housing value, percentage of households receiving interest, dividend or net rental income, percentage of adults aged ≥25 years who completed college, percentage of employed persons aged ≥16 years in occupations classified as managerial, executive or professional, and percentage of families with children that are not headed by a single female. We used Cox proportional hazards regression to calculate hazard ratios (HRs) and 95% confidence intervals (CI) for the association of quartiles of nSES and nDIS in relation to MM risk. Multivariable models were adjusted for age, body mass index, educational attainment, alcohol consumption, physical activity, and cigarette smoking. Results: During follow-up through 2021, we identified 276 incident cases of MM. Multivariable-adjusted HRs were 1.43 (95% CI: 1.00, 2.03) for women living in the highest quartile of neighborhood disadvantage relative to the lowest quartile, and 1.23 (95% CI: 0.86, 1.76) for women living in neighborhoods in the lowest quartiles of nSES compared to the highest. Conclusions: Black women in the U.S. living in neighborhoods of high concentrated disadvantage have an increased risk for MM compared to women who live in more advantaged communities, even after adjustment for individual SES as measured by educational attainment. Future studies to further tease apart specific neighborhood-level factors (e.g., walkability, chronic stress, environmental pollution, opportunities to engage in healthy behaviors) that might influence risk of MM would be beneficial. Ultimately, community reinvestment may offer an opportunity to reduce the increasing burden of MM among Black women. Citation Format: Etienne X. Holder, Julie R. Palmer, Kimberly A. Bertrand. Neighborhood disadvantage and multiple myeloma risk among Black women living 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 A047.

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 B060: Bridging gaps in cancer care: Evaluating community health worker presence in Alabama on rates of cancer screening and lifestyle-related outcomes

Abstract Purpose Alabama has the 7th highest cancer mortality in the US. The University of Alabama at Birmingham O’Neal Comprehensive Cancer Center—the only NCI-designated comprehensive cancer center in the state—endeavors to reduce cancer mortality and burden. For 25 years, its Office of Community Outreach and Engagement (OCOE) has applied a community health worker (CHW) outreach and engagement model for cancer awareness, navigation to screening and healthy lifestyle promotion. OCOE hired and trained CHWs to provide services in counties with highest cancer burden. CHW presence fluctuated over time due to grant-funding and other extraneous events. This study evaluates the association of CHW presence with cancer screening and lifestyle-related outcomes. Methods We utilized latest CDC PLACES data (drawn from 2018 and 2020 Behavioral Risk Factor Surveillance System) which provides model-based, population-level age-adjusted prevalence estimates of county-level cancer screening (breast, cervical, colon) and lifestyle outcomes (physical inactivity, obesity, smoking). We evaluated change in rates over time between counties with and without CHW presence using linear mixed effects models. Results Compared to counties without CHW presence, those with CHW presence in 2020 had 0.7% higher mammography rate in 2018 (95% CI: -0.8, 2.3) and 0% difference in mammography rate per year change (95% CI: -0.6, 0.7); counties with CHW presence in both years had 2.8% higher mammography rate (95% CI: 1.1, 4.6) and 0.2% faster increase in mammography rate per year (95% CI: -0.5, 1.0). Counties with CHW presence in both 2018 and 2020 had 1.8% lower rate of colon cancer screening in 2018 (95% CI: -3.6, 0.02) and 1.3% increase in colon cancer screening per year (95% CI: 0.5, 2.1). Counties with CHW presence in 2020 had 1% higher physical inactivity rate in 2018 (95% CI: -2.3, 4.3) and 0.3% faster decrease in physical inactivity rate per year (95% CI: -1.0, 0.4); counties with CHW presence in both years had 3.6% higher physical inactivity rate in 2018 and 0.2% faster decrease in physical inactivity rate per year (95% CI: -0.8, 0.5). Counties with CHW presence in 2020 only had 1.8% higher obesity rate in 2018 (95% CI: -1.7, 5.2) and 0.9% faster decline in obesity rate per year (95% CI: -2.2, 0.4); counties with CHW presence in both years had 5.1% higher obesity rate in 2018 (95% CI: 1.9, 8.3) and 0.3% faster decline in obesity rate per year (95% CI: -1.6, 0.9). There were no statistically significant differences for cervical cancer screening or smoking. Conclusion The OCOE CHW model provided access, education and empowerment for AL residents to obtain cancer screenings and participate in healthy lifestyle behaviors. CHW presence (particularly sustained presence over time) was associated with improved mammography and colon cancer screening, reduced physical inactivity and reduced obesity. Further study of CHW presence and these outcomes during and post COVID-19 is ongoing. Expansion of the CHW model across the entire state is a priority to reduce cancer mortality among Alabamians. Citation Format: Mackenzie E. Fowler, Claudia Hardy, Silvia Gisiger-Camata, Francine Walton, Rochelle Wallace, Tara Bowman, Aldenise P. Ewing, Timiya S. Nolan. Bridging gaps in cancer care: Evaluating community health worker presence in Alabama on rates of cancer screening and lifestyle-related outcomes [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 B060.

Examining the Link between Air Quality (PM, SO2, NO2, PAHs) and Childhood Obesity: A Systematic Review.

Background/Objectives: Childhood obesity has emerged as a global health concern with profound implications for long-term health outcomes. In recent years, there has been increasing interest in the potential role of environmental factors in the development of childhood obesity. This comprehensive review aims to elucidate the intricate relationship between various components of air pollution and childhood obesity. Methods: We systematically analyze the existing literature from the past 5 years to explore the mechanistic pathways linking air pollution, including particulate matter (PM), nitrogen oxides (NOx), sulfur dioxide (SO2), and polycyclic aromatic hydrocarbons (PAHs), to childhood obesity. This systematic review examines 33 epidemiological studies on the link between air pollution and childhood obesity, published from 1 January 2018, to 31 January 2024. Results: Studies from counties with low overall air pollution noticed only low to no impact of the exposure to childhood obesity, unlike studies from countries with higher levels of pollution, suggesting that the mitigation of air pollutants can reduce the chance of it being a negative factor for the development of obesity. This relationship was noticed for PM2.5, PM1, PM10, NOx, and SO2 but not for PAHs, which showed a negative effect on children's health across 10 out of 11 studies. Conclusions: This review underscores the need for interdisciplinary approaches to address both environmental and socio-economic determinants of childhood obesity. Efforts aimed at reducing air pollution levels and promoting healthy lifestyle behaviors are essential for safeguarding the health and well-being of children worldwide.

Abstract B053: A pilot study of a digital weight loss program for cancer prevention among obese individuals from four diverse cohorts

Abstract Background: Obesity and physical inactivity increase the risk of many types of cancer. Effective weight management, healthy diet, and physical activity are critical to reduce cancer risk. This pilot study of a technology-based weight loss program evaluated the program feasibility, weight loss, and improvement of healthy behaviors and quality of life among minority and medically underserved participants with obesity for cancer prevention. Methods: Participants in this pilot study were included from four cohorts: 1) Mano a Mano Mexican American Cohort (MAC; family dyads) 2) Project CHURCH (African-American men), 3) High- Risk Breast Cohort (HRBC; women), and 4) Mammography Cohort (women who participated in mammography screening). A 16-week weight loss program using the Diabetes Prevention Program was provided for healthy eating, physical activity, and portion control. Participants received program materials, text messages, Fitbit, and Wi-Fi connected scale. Weight, physical activity, dietary intake, weight-related health behaviors, and quality of life were assessed at baseline and follow-up. Program feasibility including retention and satisfaction were assessed after the program. Changes in outcomes from pre- to post- program were examined using paired t-tests and chi-squared tests. Results: Among 48 enrolled participants, 37 participants completed the program (total=77%; MAC=59%; Project CHURCH=90%; HRBC=90%; Mammography=90%). During the program, 46% participants measured and recorded their weights at least one day per week (MAC=17%; Project CHURCH=60%; HRBC=80%; Mammography=50%); 65% wore the Fitbit at least 2 days per week (MAC=44%; Project CHURCH=90%; HRBC=80%; Mammography=60%); 77% responded to text messages 15 out of 30 times (MAC=61%; Project CHURCH=90%; HRBC=90%; Mammography=80%); and 92% were satisfied with the program (MAC=100%; Project CHURCH=100%; HRBC=78%; Mammography=89%). After the program, we observed about 2% weight loss in average (self- report: p=0.009; scale measured: p=0.010). There were significant improvements in weight- related eating behaviors (routine restraint: +0.55, p=0.001; compensatory restraint: +0.49, p=0.001; susceptibility to external cues: -0.41, p=0.026; and emotional eating: -0.57, p=0.001). Stage of change for weight control showed significant shifts from action to maintenance stage (p=0.012). Furthermore, dietary habits significantly changed after the intervention with decreased 30% of total energy intake (p&amp;lt;0.001), increased 14% protein intake (p=0.044), and decreased 56% added-sugar intake (p&amp;lt;0.001). Conclusions: This digital weight loss program was determined as feasible and effective for weight loss and improving eating behaviors and dietary intake among minority and medically underserved individuals with obesity. The MAC showed a higher drop-out rate and less engaged in the program compared to other cohort, and therefore, this cohort may need adapted and more support that a low touch digital weight loss program can provide to improve the feasibility. Citation Format: Che Young Lee, Thuan Le, Carrie R Daniel, Larkin L. Strong, Scherezade K Mama, Lorna H McNeill, Abenaa Brewster, Samir Hanash, Karen Basen-Engquist. A pilot study of a digital weight loss program for cancer prevention among obese individuals from four diverse cohorts [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 B053.