Hispanic Men Research Articles

Racial/ethnic/gender-Based Differences in Health Trajectories Among American Older Adults: 10-Year Longitudinal Evidence from the Health and Retirement Study

ABSTRACT Health disparity by race/ethnicity or gender has been well-documented. However, few researchers have examined health outcomes based on the intersection of individuals’ race, ethnicity, and gender or investigated various health dimensions. Guided by an intersectionality framework, this study explores racial/ethnic/gender-based differences in trajectories of multiple health outcomes over a ten-year period among American older adults. Longitudinal data from the Health and Retirement Study (2004–2014) were used (N = 16,654). Older adults (65+) were stratified into six mutually-exclusive groups based on their race, ethnicity, and gender: Non-Hispanic (NH) White Men, NH White Women, NH Black Men, NH Black Women, Hispanic Men, and Hispanic Women. Growth curve models examined the trajectories of three health measures, including cognitive function, physical function limitations (i.e. activities of daily living and instrumental activities of daily living), and depressive symptoms. NH White men and women reported significantly better outcomes in cognition and physical function trajectories than racial/ethnic minority groups. Women in all racial/ethnic groups had more depressive symptoms but better cognition than men. Hispanic women reported the most depressive symptoms. Hispanic women and NH Black women had the worst physical function limitations. NH Black men/women were the most disadvantaged in cognition. Racial/ethnic/gender-based differences were stable over time in all health trajectories. Study findings highlight the utility of an intersectional framework in understanding how multiple social identities intersect to generate protective and/or risk effects on cognitive, mental, and physical health. Multilevel intervention strategies are warranted to reduce the persistent health inequity gap.

Ethnic and Gender Differences in Sun-Related Cognitions Among College Students: Implications for Intervention.

Skin cancer incidence and prognosis vary by ethnicity and gender, and previous studies demonstrate ethnic and gender differences in sun-related cognitions and behaviors that contribute to this disease. The current study sought to inform skin cancer interventions tailored to specific demographic groups of college students. The study applied the prototype willingness model (PWM) to examine how unique combinations of ethnic and gender identities influence sun-related cognitions. Using data from a survey of 262 college students, the study tested whether self-reported sun-related cognitions were different for White women, Hispanic women, White men, and Hispanic men. Path modeling was also used to identify which PWM cognitions (e.g., prototypes, norms) were the strongest predictors of risk and protection intentions and willingness in each demographic group. Several differences in sun-related cognitions and PWM pathways emerged across groups, emphasizing the need for tailored skin cancer education and interventions. Results suggest that, for White women, interventions should primarily focus on creating less favorable attitudes toward being tan. Interventions for Hispanic women may instead benefit from manipulating perceived similarity to sun-related prototypes, encouraging closer personal identification with images of women who protect their skin and encouraging less identification with images of women who tan. For White men, skin cancer interventions may focus on creating more favorable images of men who protect their skin from the sun. Lastly, interventions for Hispanic men should increase perceived vulnerability for skin cancer.

(119) Impact of Ethnicity on Clinical Outcomes of Intralesional CCH in Peyronie's Disease Patients Across Kaiser Permanente Southern California Database

Abstract Introduction Intralesional CCH injection is an effective treatment for Peyronie’s disease (PD) that utilizes collagenolytic enzymes to break down collagen plaque, thus reducing the penile deformity. The IMPRESS I and II clinical trials demonstrated efficacy of CCH in a predominant Caucasian population of men (95.8%). Little is known about treatment efficacy in the non-Caucasian population. Objective Using Kaiser Permanente’s ethnically diverse database, we sought to study the impact of race on CCH treatment outcomes. Methods This study examined the efficacy of intralesional CCH injection in a large healthcare system over 15 years. We defined treatment efficacy as percent change in penile curvature abnormality from baseline after a maximum of 4 treatment cycles. Impact of comorbidities on CCH efficacy was also examined. Patients with ventral curvature or initial curvature <30 ̊ or >90 ̊ were excluded from analysis. Standard statistical analysis was performed. Results 112 patients underwent CCH therapy and were included in this analysis. 46.4% of men completed all 4 cycles. Among men who received CCH, 66.1% were Caucasian, 22.3% Hispanic, and 9.8% African American. For co-morbidities, 87.5.% of men were not diabetic, while 22.3% of men had erectile dysfunction. The mean baseline pre-injection penile curvature was 51.63 degrees (range was 32-87 degrees). Caucasian men had the largest treatment response to CCH (45.6% decrease in penile curvature) compared to African American men (43.7%) and Hispanic men (40.5%), p = 0.9554. Non-diabetic men had a larger treatment response to CCH (44.9% decrease in curvature versus 39.3% in diabetics, p = 0.4726). Younger Men (age 18-44) also experienced a greater treatment response compared to other age groups (57.9% reduction in curvature, p = 0.171). There was a significant difference in number of cycles completed across different ethnicities (p = 0.0220). Hispanic men were significantly less likely to complete all 4 cycles of CCH compared to Caucasian and African American men (p=0.0004). Only 28.2% of Hispanic men completed all 4 treatment cycles. 48% of Hispanic patients report the need of language interpretation services during health appointments. Conclusions This is the largest post-market analysis of CCH treatment outcomes in a racially diverse PD population. Caucasian men had a greater treatment response after CCH injection possibly due to higher rate of completing all 4 treatment cycles. Nondiabetic men and younger men (aged 18 to 44) also had a greater treatment response after CCH injection. Hispanic men were significantly less likely to complete 4 cycles of injection therapy; possible explanations include language barriers. Future study is needed to determine if patient resources prepared in Spanish can improve treatment outcomes in Hispanic men with PD, and reduce these health care disparities observed in our study. Disclosure No.

(092) Racial/ethnic Differences in Semen Parameters and Male Reproductive Hormones in the United States: A Systematic Review and Meta-Analysis

Abstract Introduction Semen quality and reproductive hormones are key indicators of male fertility potential, but studies have reported inconsistent results on racial/ethnic differences in these factors in the United States. Objective To perform a meta-analysis evaluating pooled differences in semen analysis parameters and male reproductive hormones across racial/ethnic groups in the United States through a systematic literature search. Methods PubMed, Scopus, and Web of Science were systematically searched up to December 17, 2022, with no language limitation. All studies on racial/ethnic variations in semen parameters and male reproductive hormones among the general population of the United States were included in this meta-analysis. Standardized mean difference (SMD) and its 95% confidence interval (95%CI) between races/ethnicities were pooled using the random-effects model. Newcastle–Ottawa Quality Assessment Scale (NOS) was used for risk of bias assessment. Heterogeneity was assessed by the I2 index. Results Our search yielded 731 articles. After screening, 9 studies were included. These studies had a low risk of bias (NOS ≥ 7) and involved a total of 7,641 participants. The pooled analysis showed no significant differences between White and Black men in the percent of total motility (p-value=0.513; I2=99.76%), total testosterone (p-value=0.272; I2=99.79%), free testosterone (p-value=0.220; I2=99.78%), and estradiol (p-value=0.876; I2=96.90%). However, higher sperm concentration (SMD=3.64; 95%CI: 0.18, 7.09; p-value=0.039; I2=99.53%) and total sperm count (SMD=6.04; 95%CI: 0.09, 11.99; p-value=0.046, I2=99.68%) were estimated for White men compared to Black men. Additionally, higher sperm concentration (SMD=1.39; 95%CI: 0.56, 2.23; p-value=0.001, I2=92.06%) and total motility (SMD=3.06; 95%CI: 0.09, 6.02; p-value=0.043, I2=99.14%) were estimated for Hispanic men compared to non-Hispanic men, with no differences in total sperm count (p-value=0.579, I2=97.79%) or total testosterone (p-value=0.078, I2=95.95%) (Figure 1). Conclusions This meta-analysis demonstrated reductions in semen analysis parameters, especially sperm concentration, for Black and non-Hispanic men relative to White and Hispanic men in the United States. Disclosure No.

(082) Integrated Urology and Primary Care Model Improves Outcomes for Men with Testosterone Deficiency

Abstract Introduction Testosterone deficiency affects approximately 4-5 million men in the United States. The bidirectional association between testosterone deficiency and metabolic syndrome has been well-established. The diagnosis of testosterone deficiency should serve as a trigger for medical evaluation of other comorbidities. Furthermore, male sex is an independent predictor of decreased routine health maintenance; men are 40% less likely to have a primary care provider (PCP) compared to women in the United States. Thus, many patients who present to the urologist for symptomatic testosterone deficiency might have undiagnosed or poorly managed comorbidities coupled with a lack of a PCP. Objective We sought to investigate the impact of offering primary care access within an integrated Men’s Health Center to men presenting for initial evaluation of symptomatic testosterone deficiency. Methods This is a retrospective single institution study. All new patients presenting with testosterone deficiency between October 2019 and October 2022 were offered evaluation by a PCP within a university-based Men’s Health Center. Patients who were seen by the PCP underwent standard health screening and blood work including a lipid profile, liver function testing, and diabetes screening with hemoglobin (Hgb) A1c. All data were collected from the electronic medical record and deidentified. Institutional review board (IRB) exemption was obtained. Variables collected for analysis included age, race, body mass index (BMI), testosterone level on presentation, prior access to a pre-existing PCP, and number of visits attended with our PCP. Outcomes measured include new diagnoses made by the PCP and referral patterns to other specialties. All statistical analysis was conducted utilizing SPSS version 28. Results 81 men were evaluated over the 3-year study period. Median age was 49.0 (range: 21.2-93.7 years). 48 men (59%) established continuity of care and were seen by our PCP for more than 1 visit. 33 men (41%) did not have a pre-existing PCP. Older men were significantly more likely to have a pre-existing PCP (OR 1.06 [95% CI: 1.02-1.10], p<0.001). Hispanic men were significantly less likely to have an existing PCP (OR 0.16 [95% CI: 0.03-0.84], p=0.01). Newly diagnosed comorbidities included hypertension (41%), obesity (37%), hyperlipidemia (27%), obstructive sleep apnea (OSA; 25%), depression (23%), and diabetes (14%). 41 patients (51%) were prescribed a new medication. 21 patients (26%) were referred to nutrition, with mean BMI decrease of 1.75. 26 patients (32%) underwent sleep medicine evaluation for OSA. 27 (33%) and 37 patients (46%) received a flu vaccination and immunization updates. 11 patients (14%) were referred for screening colonoscopy. Patients who established continuity of care were significantly more likely to be treated for a new diagnosis (p<0.001) and receive a flu vaccination (p=0.007; Table 1). Conclusions This is the first report of integrated primary care and urology evaluation for testosterone deficiency. This comprehensive model results in improved outcomes including increased access to subspecialty referrals, objective weight loss, treatment of new diagnoses, updated immunizations, and cancer screening. Further studies are needed to assess reproducibility across other institutions, cost-effectiveness of this model, and patient satisfaction. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific, Endo Pharmaceuticals.

Men's Depression and Anxiety: Contributing Factors and Barriers to Intervention.

Urban, ethnically/racially diverse, impoverished men are predisposed to experience unaddressed depression and anxiety. The overlap of these factors creates significant mental health inequity. This study sought to capture men's impressions of the factors that contributed to their experience of depression and anxiety as well as barriers that they experienced in pursuing intervention. Using community-based participatory research, in the context of long-term partnerships between a department of nursing and three urban, racially/ethnically diverse, and impoverished neighborhoods, the researchers recruited 50 men ages 23-83 years. Data were collected via six homogeneous, Zoom-based focus groups composed of Black, Hispanic, and White men, respectively. The men identified multiple themes pertaining to modifiable and non-modifiable contributing factors that played a role in their development of depression and anxiety as well as barriers related to stigma, resource issues, and a lack of knowledge of mental illness that they faced when seeking intervention. Understanding men's perspectives on the contributing factors and barriers to mental health intervention can provide an evidence base with which to address mental health inequity via tailored care, policy, and research agendas.

Health Care Engagement in Disease Prevention and Management: Factors Influencing Chronic Disease Program Referral Adherence Among Non-Hispanic Black and Hispanic Men With Chronic Conditions.

This study aimed to identify factors associated with being referred to an evidence-based disease prevention and management program by a health care provider and adherence to such referrals by non-Hispanic Black and Hispanic men. Utilizing a cross-sectional design, data were collected via an internet-based questionnaire from a national sample of 1,679 non-Hispanic Black and Hispanic men ages 40 years and older with one or more chronic diseases. A 105-item survey assessed program referral and attendance, chronic conditions and medications, disease symptoms, support, communication during physician visit, health care frustrations, disease self-management efficacy, barriers to self-care, helpfulness of learning from others for self-care, and sociodemographics. Binary logistic regression models were fitted to assess factors associated with referrals to a disease prevention and management program and attendance. Results indicated that approximately 23% of participants were referred to a program, and 19.2% reported attendance. Factors associated with being referred to and attending a program included being younger, having more chronic conditions, taking more medications daily, having higher pain scores, reporting more health care frustrations, and reporting better communication with physicians during visits. Men referred to attend a chronic disease program by a health care provider were 16.86 times more likely to attend a chronic disease program (p < .001). These findings suggest the importance of health care engagement for non-clinical disease prevention and management programs, particularly among non-Hispanic Black and Hispanic men with complex disease profiles.

Capturing men's perspectives on prevalence, existing resources, and solutions to depression and anxiety using community-based participatory research and focus groups.

Men are predisposed to suffer from unaddressed depression and anxiety. The purpose of this study was to capture the perceptions of men in three urban, racially/ethnically diverse, under-resourced, and impoverished neighborhoods around this health issue. The results were used to design a resident-driven solution to this health disparity. Design This study utilized a focus group method within the ideological perspective of community-based participatory research (CBPR). Sample The researchers recruited 50 Black, Hispanic, and White men aged 23-83 years to participate in this study during the summer of 2021. Measurements Data were collected via six homogeneous, Zoom-based focus groups. Five of the focus groups were offered in English and the sixth in Spanish. The men identified themes and subthemes pertaining to the perception of widespread depression and anxiety in their neighborhoods, existing typical and atypical community resources, and suggested solutions to this health disparity. These results were translated into a solution involving the training of five male, lay mental health ambassadors. Policies and solutions to issues of mental health disparity must be informed by the communities that they intend to serve. CBPR is a robust vehicle for empowering communities to address the healthcare issues facing them.

Comparison of Childless and Partnerless Vasectomy Rates Before and After Dobbs v. Jackson Women's Health Organization.

The Supreme Court ruling Dobbs v. Jackson Women's Health Organization (June 2022) overturned federal protection of abortion rights, resulting in significant impact on both male and female reproductive rights and health care delivery. We conducted a retrospective review of all patients who underwent vasectomy at a single academic institution between June 2021 and June 2023. Our objective was to compare the rates of childless and partnerless vasectomies 1 year before and after this ruling, as these men may be more susceptible to postprocedural regret. Of total, 631 men (median age = 39 years, range = 20-70) underwent vasectomy consultation. Total vasectomies pre- and post-Dobbs were 304 (48%) versus 327 (52%). Total childless and partnerless vasectomies pre- and post-Dobbs were 44 (42%) versus 61 (58%) and 43 (46%) versus 50 (54%). Vasectomy completion rate was slightly increased post-Dobbs (90% vs. 88%; p = .240). The post-Dobbs cohort had significantly less children (1.8 vs. 2.0; p = .031). Men in the post-Dobbs era were significantly more likely to be commercially insured (72% vs. 64%) and less likely to be uninsured (1% vs. 6%; p = .002). Men who underwent childless vasectomy were significantly more likely to be younger (36.4 vs. 39.8 years; p < .001). There was a significantly greater proportion of Hispanic and Black men in the partnerless cohort compared to the cohort with partners (24% vs. 19% and 9% vs. 2%; p = .002). In conclusion, patients should be counseled on the permanent nature of this procedure, underscoring need for effective and reversible male contraception.

Racial and ethnic differences in the receipt of metabolic syndrome risk factor screening and treatment among individuals with prostate cancer treated with androgen deprivation therapy.

29 Background: Racial and ethnic health disparities in prostate cancer screening, and treatment constitute the largest of all cancer disparities. Androgen deprivation therapy (ADT) is widely used in the treatment of localized or metastatic prostate cancer. However, ADT is associated with toxic cardiovascular and metabolic adverse events that may occur as early as 6 months of therapy initiation. This study aimed to assess racial/ethnic differences and longitudinal changes in metabolic syndrome risk factor (MSRF) screening/treatment among patients with prostate cancer treated with ADT at a university-affiliated comprehensive cancer center in the southwestern U.S. between 2010-2021. We also aimed to identify patient and healthcare provider factors that influence MSRF screening among study sample. Methods: A retrospective observational cohort study of 803 patients treated with ADT for at least six months at the cancer center was conducted. Patients were followed three months pre- to 12 months post-ADT initiation to evaluate MSRF screening/treatment. Determination of MSRF screening was based on primary care provider referral for MSRF screening/treatment or receipt of blood glucose, lipid profile, and blood pressure screening within six months post-treatment with ADT. Patients were considered treated for MSRF if they were started or continued therapy (within six months of ADT initiation) with science advisory guideline recommended treatments. Results: Guideline-concordant MSRF screening rate approached 23.5%; MSRF treatment rate was 76.9%. A higher treatment rate in MSRF treatment was found for NHW compared to Hispanic men ( p=0.02). We found a significant difference in the proportion of patients receiving MSRF screening across all racial/ethnic groups ( p=0.03). MSRF screening rates from 13.9% to 35.6% were observed over the 10-year data collection period. Patients with dyslipidemia at baseline had higher odds of having MSRF screening than patients without dyslipidemia ( p&lt;0.0001). Oncologists with &gt;20 years of experience had higher odds of providing MSRF screening compared with &lt;10 years of experience ( p=0.006). Conclusions: Minority populations had significantly lower odds of having MSRF screening than NHW patients after adjusting for clinical and socio-economic variables. Closer clinical attention and education, as well as the development and implementation of innovative practice tools and interventions to optimize MSRF screening and treatment are warranted to mitigate the harmful adverse effects of ADT in patients with prostate cancer.

Variation in patterns of second primary malignancies across U.S. race and ethnicity groups: a Surveillance, Epidemiology, and End Results (SEER) analysis.

One in six incident cancers in the U.S. is a second primary cancer (SPC). Although primary cancers vary considerably by race and ethnicity, little is known about the population-based occurrence of SPC across these groups. Using Surveillance, Epidemiology, and End Results (SEER) 12 data and relative to the general population, we calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for SPC among 2,457,756 Hispanics, non-Hispanic Asian American/Pacific Islanders (NHAAPI), non-Hispanic black (NHB), and non-Hispanic whites (NHW) cancer survivors aged 45years or older when diagnosed with a first primary cancer (FPC) from 1992 to 2015. The risk of second primary bladder cancer after first primary prostate cancer was higher than expected in Hispanic (SIR = 1.18, 95% CI: 1.01-1.38) and NHAAPI (SIR = 1.41, 95% CI: 1.20-1.65) men than NHB and NHW men. Among women with a primary breast cancer, Hispanic, NHAAPI, and NHB women had a nearly 1.5-fold higher risk of a second primary breast cancer, while NHW women had a 6% lower risk. Among men with prostate cancer whose SPC was diagnosed 2 to <12months, NHB men were at higher risk for colorectal cancer and Hispanic and NHW men for non-Hodgkin's lymphoma. In the same time frame for breast cancer survivors, Hispanic and NHAAPI women were significantly more likely than NHB and NHW women to be diagnosed with a second primary lung cancer. Future studies of SPC should investigate the role of shared etiologies, stage of diagnosis, treatment, and lifestyle factors after cancer survival across different racial and ethnic populations.

Disparities by Sex, Race, and Ethnicity in Use of Left Ventricular Assist Devices and Heart Transplants Among Patients With Heart Failure With Reduced Ejection Fraction.

The extent to which sex, racial, and ethnic groups receive advanced heart therapies equitably is unclear. We estimated the population rate of left ventricular assist device (LVAD) and heart transplant (HT) use among (non-Hispanic) White, Hispanic, and (non-Hispanic) Black men and women who have heart failure with reduced ejection fraction (HFrEF). We used a retrospective cohort design combining counts of LVAD and HT procedures from 19 state inpatient discharge databases from 2010 to 2018 with counts of adults with HFrEF. Our primary outcome measures were the number of LVAD and HT procedures per 1000 adults with HFrEF. The main exposures were sex, race, ethnicity, and age. We used Poisson regression models to estimate procedure rates adjusted for differences in age, sex, race, and ethnicity. In 2018, the estimated population of adults aged 35 to 84 years with HFrEF was 69 736, of whom 44% were women. Among men, the LVAD rate was 45.6, and the HT rate was 26.9. Relative to men, LVAD and HT rates were 72% and 62% lower among women (P<0.001). Relative to White men, LVAD and HT rates were 25% and 46% lower (P<0.001) among Black men. Among Hispanic men and women and Black women, LVAD and HT rates were similar (P>0.05) or higher (P<0.01) than among their White counterparts. Among adults with HFrEF, the use of LVAD and HT is lower among women and Black men. Health systems and policymakers should identify and ameliorate sources of sex and racial inequities.

Lessons Learned From a Community-Based Men's Health Fair.

Strategies are needed to promote the uptake of preventive health services among Black, Hispanic, and rural men because these men underutilize health services. Previous research indicates that men prefer community-based health promotion programming, such as health fairs; however, specific guidance on how to tailor health fairs for Black, Hispanic, and rural men are lacking. The present seeks to study provides that guidance. A multisectoral team developed, implemented, and evaluated a men's health fair in a county of South Carolina with a sizeable Black, Hispanic, and rural-dwelling population. Although the health fair was open to all men in the county, specific outreach campaigns were implemented to attract Black and Hispanic men. The health fair occurred on Father's Day weekend in 2023 and consisted of health screenings, health information, and other resources (eg, condoms, research studies). Participants who attended the health fair were asked to complete a check-in survey (N = 103) that assessed demographic information and how they heard about the health fair, followed by a survey (N = 58) that assessed facilitators/barriers to participation in a men's health fair. Results were stratified by the gender of respondent. The results highlight the facilitators/barriers experienced by men to attending health fairs and also highlight important differences in facilitators/barriers for men to attend a health fair as perceived by men and women. These findings have implications for the design and implementation of future men's health fairs to promote preventive health service use among Black, Hispanic, and rural men.

INCIDENT AND RECURRENT FALLS AMONG NON-HISPANIC BLACK AND HISPANIC MEN WITH CHRONIC CONDITIONS

Abstract While much is known about the complexities of fall-related risks among older adults, less is known about the risk for falls among men, and especially older non-Hispanic Black and Hispanic men with chronic conditions. This study examined factors associated with incident falls (1 fall) and recurrent falling (2+ falls) among non-Hispanic Black and Hispanic men ages ≥60 years with ≥1 chronic condition. Collected with a web-delivered questionnaire, data were analyzed from a national sample of 779 non-Hispanic Black (58.8%) and Hispanic (41.2%) men. To assess incident and recurrent falls, the number of self-reported falls in the past year was trichotomized (0 falls vs. 1 fall vs. 2+ falls) and used as the dependent variable. A multinomial logistic regression was fitted to assess factors associated with incident and recurrent falls. The model adjusted for sociodemographics, disease characteristics, health status, and social support. On average, participants were age 66.8 (±5.4) years and reported 3.8 (±2.7) chronic conditions. Seventy-three percent of men reported 0 falls, 12.6% reported 1 fall, and 14.4% reported 2+ falls in the past year. Relative to men reporting 0 falls, Hispanic men (P&amp;lt; 0.05), men with worse general health status (P&amp;lt; 0.05), and those with clinical depression (P&amp;lt; 0.05) were more likely to report incident and recurrent falls, respectively. Men with more comorbidities (P&amp;lt; 0.05) and those with less help/support to manage health problems (P&amp;lt; 0.05) were more likely to report recurrent falling. Findings highlight the importance of multi-component interventions to prevent falls by strengthening disease self-management, addressing mental health, and introducing social supports.

BARRIERS TO DISEASE SELF-CARE AMONG OLDER NON-HISPANIC BLACK AND HISPANIC MEN WITH CHRONIC CONDITIONS

Abstract Disease self-care is multi-faceted and influenced by physical, mental, social, and environmental factors. Because males traditionally underutilize preventive healthcare services, self-care is increasingly important to manage disease symptomatology and slow disease progression. This study examines factors associated with barriers to disease self-care among Hispanic and non-Hispanic Black men ages ≥65 years with ≥1 chronic condition. Data were analyzed from a national sample of 470 Hispanic (43.2%) and non-Hispanic Black (56.8%) men and collected with an internet-delivered questionnaire. The 5-item Barriers to Self-Care Scale served as the dependent variable (range=5-20). A least squares regression model was fitted to identify factors associated with barriers to disease self-care. The model adjusted for sociodemographics, disease characteristics, health status, and social engagement and support. On average, participants were age 70.1 (±4.5) years and reported 3.9 (±2.6) chronic conditions. Men with higher body mass index (β=0.13, P=0.001), more depressive symptomatology (β=0.09, P=0.046), and lower self-rated quality of life (β=-0.23, P&amp;lt; 0.001) reported higher barriers to disease self-care. Further, men with poorer access to healthcare (β=-0.17, P&amp;lt; 0.001) and higher healthcare frustrations (β=0.17, P&amp;lt; 0.001) reported higher barriers to disease self-care. Barriers to self-care were positively associated with being more socially disconnected (β=0.09, P=0.049) and higher reliance on others to manage health problems (β=0.14, P&amp;lt; 0.001). Findings reinforce the importance of mental health, healthcare access, and social support for disease self-management among Hispanic and non-Hispanic Black men. Efforts are needed in clinical and community-based settings to reduce self-care barriers through culturally appropriate self-management education, interventions, and services.

GENDER DIFFERENCES IN COGNITIVE IMPAIRMENT OF AFRICAN AMERICAN AND HISPANIC SEXUAL AND GENDER MINORITY OLDER ADULTS

Abstract Cognitive health of sexual and gender minority (SGM) older adults with intersecting racial/ethnic minority identities is an under-researched topic. This research utilizes data from Aging with Pride: National Health Sexuality/Gender study to examine differences in health-promoting and risk factors for cognitive impairment among African American and Hispanic SGM older adults. Informed by the Health Equity Promotion Model, bivariate statistics and linear regression models were applied to better understand subgroup differences in cognitive impairment and risk and protective factors. Daily discrimination and identity stigma were positively associated with cognitive impairment for African American and Hispanic groups. Outdoor leisure was negatively associated with cognitive impairment for African Americans whereas social support was negatively associated with cognitive impairment for Hispanics. Analysis of gender differences revealed that African American men experienced significantly higher rates of identity stigma than African American women; however, the effect of identity stigma on cognitive impairment was stronger for African American women. Among Hispanics, women compared to men were significantly more vulnerable to the effects of daily discrimination and identity stigma on cognitive impairment. Regarding cognitive impairment, engaging in physical activity and outdoor leisure were significantly protective for African American men but not for women, whereas social support was significantly protective for both Hispanic men and women. These findings address a void in SGM aging research by examining racial/ethnic and gender differences in cognitive health. They highlight the need for intersectionality and subgroup differences in research to develop tailored interventions to improve cognitive health among racially/ethnically diverse SGM older adults.

Perceived disrespectful treatment in low-income healthcare settings through the lens of intersectionality

Race and gender differences in the quality of one’s health care encounters are widely documented, but few studies explore the multiplicative impacts of race and gender. Drawing on intersectionality frameworks, we contrast white, Black, Hispanic, Asian, and Native American men’s and women’s perceptions of disrespectful treatment from health care providers and staff (e.g., receptionists, clerks) in low-income health settings. Data are from the 2014 Health Center Patient Survey (N = 5385), a nationally representative survey of community-dwelling patients receiving care at health centers funded through Section 330 of the Public Health Service Act. Our results show race and sex differences in the study outcomes, yet weak support for intersectional effects. Asian and Native American patients report more disrespectful treatment from providers, relative to other ethnic groups. Women are more likely than men to report disrespectful treatment from staff. Asians also report disrespectful treatment from staff. Health care providers and staff may require training focused on the distinctive needs of Asian patients, for whom “saving face” may be a salient goal. Structural changes to reduce wait times and employ medical interpreters to ensure clear communication, and staff training focused on verbal and nonverbal communication may mitigate against actions perceived as disrespectful in low-income health settings.

Preconception health indicators among adult US men: Race/ethnicity variations and temporal trends.

Preconception health is important for men as it is for women. However, optimizing preconception health is understudied among men. To examine the time trends and temporal shifts in preconception health risk indicators among 20-44-year-old adult US men in need of preconception care and their racial/ethnic variations. Data from the 2011-2019 National Survey of Family Growth male file was used to estimate the prevalence of nine preconception health indicators among men (20-44 years) intending to have a future pregnancy (n=6813), stratifying by race/ethnicity, and assessing temporal changes across the study period. Binary logit and linear regression models estimated temporal trends from 2011-2013 to 2017-2019. Absolute and relative changes were estimated to detect temporal shifts in men's preconception health comparing 2011-2013 to 2017-2019. Men in all groups exhibited substantial preconception health needs, with unique trends across race/ethnicity groups. Between 2011 and 2019, the prevalence of marijuana use (28.6%-39.4%, p=0.001), overweight/obese status (60.7%-65.1%, p≤0.001), and the mean number of preconception health indicators (M=2.69-2.84, p=0.018) increased. Among non-Hispanic White men, the prevalence of marijuana use (30.1%-41.4%, p=0.028), overweight/obese status (60.6%-63.7%, p=0.002), and mean number of preconception health risk indicators (M=2.74-2.90, p=0.033) increased. Among Hispanic men, the prevalence of inconsistent/no condom use (68.9%-81.4%, p=0.022), marijuana use (18.9%-40.4%, p=0.001), and the mean number preconception health risk indicators (M=2.50-2.96, p=0.014) increased. Among non-Hispanic Black men, sexually transmitted infections declined (5.4%-3.6%, p=0.002). Significant temporal shifts, which varied by race/ethnicity, were also observed. Our study, which provides initial insight into men's preconception health development in the last decade, highlights a tremendous need for preconception health care among men. Their increasing preconception health needs, and their racial/ethnic variations, suggest additional contributors to racial/ethnic differences in men's reproductive outcomes and their long-term health.

Association of serum testosterone with chronic obstructive pulmonary disease (COPD) in a nationally representative sample of White, Black, and Hispanic men.

The association between total testosterone (T) and chronic obstructive pulmonary disease (COPD), remains poorly understood. We aim to investigate this association and how it varies by smoking status, body fatness, and race/ethnicity in a nationally representative sample of American men. Data included a full sample (NHANES 1988-1991, 1999-2004, 2011-2012) and subset sample (excluding 2011-2012, no estradiol and SHBG levels available) of 2748 and 906 men (≥20 years), respectively. COPD was measured by self-report or spirometry test. Total T (ng/mL) was measured among men who participated in a morning examination session. Weighted multivariable-adjusted logistic regression models were conducted. Low T was positively associated with self-reported COPD in the full sample (OR = 2.10, 95% CI = 1.18-3.74, Ptrend = 0.010), and when stratified by current smokers and body fatness. When examined across race and ethnicity strata, this association persisted among White men (OR = 2.50, 95% CI = 1.30-4.79, Ptrend = 0.002) but not among Hispanic or Black men. In the subset sample, low T was positively associated with self-reported COPD (OR = 1.42, 95% CI, 0.57,3.55, Ptrend = 0.04), including among smokers and White men, but not body fatness. No significant associations were observed with COPD defined with spirometry plus self-report. Low levels of T were associated with an increased prevalence of self-reported COPD in the full and subset samples. Similar associations were observed after stratifying by smoking status, body fatness, and race/ethnicity in the full sample and subset sample. Prospective studies are warranted to confirm these significant associations among understudied and underserved populations.

Abstract A043: Trusted sources of human papillomavirus (HPV) vaccine information in Mexican American parents: A cross-sectional study

Abstract Human papillomavirus (HPV) infection is associated with many types of cancers that disproportionately impact Hispanics. Mortality is 20% higher in Hispanic women than non-Hispanic white women who have cervical cancer. Hispanic men are 4x times more likely to have HPV-associated oropharyngeal cancer than women (9,100 cases vs. 2,000 cases, respectively) and Hispanic males have higher rates of HPV-associated penile cancer than non-Hispanics. An HPV vaccine exists that can prevent 90% of HPV-associated cancers; however, HPV vaccination rates have declined by approximately 75% in adolescents during the pandemic. The purpose of this study was to identify trusted sources of HPV vaccine information in Hispanics of Mexican American origin. A cross-sectional study design with an online survey was used to collect data from Mexican American parents of children 11-17 years of age. Two hundred and twenty-five parents (M age = 38.30, SD = 7.30) who identified predominately as female (83.1%) were included in the study. Over a third (39.1%, n = 88) of the participants reported to have three or more children and most of the sample (68%; n =153) reported to have vaccinated at least one of their children with the HPV vaccine. When participants were asked who they trust to provide information about the HPV vaccine, the top five trusted sources of HPV vaccine information were medical doctors (94.7%), registered nurses (52%), the Centers for Disease Control and Prevention (47.1%), the World Health Organization (43.1%), and pharmacists (25.3%). The least trusted sources of HPV vaccine information were the president of the U.S. (7.6%) and religious leaders (2.7%). Linear regression models revealed that HPV vaccine acceptance was associated with trusting registered nurses (p &amp;lt; .001) and the Centers for Disease and Control (p = .014) for recommending the HPV vaccine. Lastly, we examined the association between family-held beliefs about vaccines and personal beliefs about vaccines. Correlations ranged from -.28 to .72. The strongest correlation was between having a family with negative feelings about vaccines while growing up and believing that vaccines can cause serious illness (r = 0.72; p &amp;lt; .001). Importantly, the family-held belief that vaccines cause autism was strongly correlated with personal beliefs that vaccines cause autism (r = 0.56; p &amp;lt; .001). Several important findings emerged in the current study highlighting the importance of having trusted sources of HPV vaccine information to promote the HPV vaccine. Our findings have implications for designing health communications and interventions that incorporate trusted sources of HPV vaccine information to promote the HPV vaccine in Mexican American families. Citation Format: Gabriel A. Frietze, Alyssa A. Martinez, Surendranath S. Shastri. Trusted sources of human papillomavirus (HPV) vaccine information in Mexican American parents: A cross-sectional study [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A043.