Hispanic Participants Research Articles

Intersecting Identities Among Hispanic Sexual Minority Youth and Their Relationship With Substance Use and Depressive Symptoms.

Intersecting Identities Among Hispanic Sexual Minority Youth and Their Relationship With Substance Use and Depressive Symptoms.

Emergency Department Surveillance of Self-Reported Covid-19.

Emergency Department Surveillance of Self-Reported Covid-19.

Genome-wide association study of angiotensinogen levels and key single nucleotide polymorphism associations with blood pressure.

The renin angiotensin aldosterone system plays a key role in circulatory homeostasis. We sought to identify genetic determinants of measured plasma angiotensinogen levels and subsequently evaluate the association of these single nucleotide polymorphisms (SNPs) with blood pressure (BP) and hypertension in a multiethnic population. Genome-wide association study (GWAS) of plasma angiotensinogen levels, measured using an enzyme-linked immunoassay, was conducted in 4899 Multi-Ethnic Study of Atherosclerosis (MESA) participants (self-identified as White, n = 1865; Hispanic, n = 1113; Black, n = 1224; and Chinese, n = 629). Linear and logistic models examined the association between SNPs with angiotensinogen and hypertension, respectively. Mediation analysis evaluated the effect of angiotensinogen on BP/hypertension through the top SNPs identified by GWAS. In the analysis utilizing all participants, 115 SNPs were associated with angiotensinogen (P < 5 × 10-8), including lead SNP rs4762(G>A) in exon 2 (P = 1.51E-100) and rs5050(T>G) in the promoter region (P = 2.26E-69) of the AGT gene. Race/ethnic-specific analyses identified rs4762(G>A) as the lead SNP for White and Hispanic participants, whereas Black and Chinese participants had rs5050(T>G) and rs16852311(G>C), respectively. Both rs4762(G>A) and rs5050(T>G) indirectly increased systolic BP, diastolic BP, and the odds of hypertension through its effect of increasing angiotensinogen. Our findings demonstrate racial/ethnic differences in genetic effects on angiotensinogen levels across multiple SNPs. AGT rs4762(G>A) and rs5050(T>G) impact BP and hypertension through a mediated effect via angiotensinogen, though opposing direct effects may mask the overall association.

1893-LB: Improving Diabetes Care in Underserved Communities—An RCT Evaluating an mHealth-Driven Feedback Loop with Community Health Workers and Clinicians

Introduction and Objective: Barriers to accessibility and communication hinder diabetes care in underserved communities. Integrating mobile health (mHealth) and community health workers (CHWs) into care models offers significant potential to address these challenges but requires thorough evaluation. We assessed the effectiveness of an mHealth-driven feedback loop connecting participants, CHWs, and clinicians across multiple health systems Methods: A total of 258 uninsured Hispanic participants with type 2 diabetes were randomly assigned to either standard care at their community clinic (control) or a 12-month comprehensive diabetes education program. This program included group education, YouTube video highlights, and a weekly mHealth-driven Participant-CHW-Clinician feedback loop to identify participant concerns. Outcomes measured included (1) HbA1c (primary) from baseline to 12 months, (2) adherence to pre-defined ADA preventive care measures, and (3) the execution of feedback loops to identify and resolve participant issues. Results: *Compared to the control arm, intervention participants showed a significant improvement in HbA1c (intervention:−1.0% vs. control:−0.1%, p = 0.002) and demonstrated better adherence to preventive care for diabetes foot exams (p&amp;lt;0.01) and statin therapy (p=0.04). CHWs identified 815 issues (average=6.5 per participant) and resolved 90% of them through the feedback loop model. The majority of issues were related to supplies (25%), physical health (20%), and medication access (20%). *final data will be completed by April 30, 2025 Conclusion: An mHealth-based feedback loop connecting participants, CHWs, and clinicians was associated with improved HbA1c levels, better adherence to ADA guidelines, and the identification and resolution of participant issues. Future research is needed to identify implementation strategies that can enhance the sustainability of the program. Disclosure E.M. Vaughan: None. C. Johnston: None. A. Amspoker: None. A. Balasubramanyam: None. S. Virani: None. C.M. Ballantyne: Research Support; Abbott Diagnostics. Consultant; Abbott Diagnostics, 89bio, Inc. Research Support; Akcea Thearpeutics, Inc, Amgen Inc. Consultant; Amarin Corporation, Amgen Inc. Research Support; Arrowhead Pharmaceuticals, Inc. Consultant; Arrowhead Pharmaceuticals, Inc, AstraZeneca, Denka Seiken, ESPERION Therapeutics, Inc., Genentech, Inc, Illumina. Research Support; Ionis Pharmaceuticals. Consultant; Ionis Pharmaceuticals, Eli Lilly and Company. Research Support; Merck &amp; Co., Inc. Consultant; Merck &amp; Co., Inc. Research Support; NewAmsterdam Pharma. Consultant; NewAmsterdam Pharma. Research Support; Novartis Pharmaceuticals Corporation. Consultant; Novartis Pharmaceuticals Corporation. Research Support; Novo Nordisk. Consultant; Novo Nordisk. Research Support; Roche Diagnostics. Consultant; Roche Diagnostics. L.R. Porterfield: None. Funding NIH/NIDDK (R01 DK129474)

Variations in weight loss and glycemic outcomes after sleeve gastrectomy by race and ethnicity.

This study examined racial and ethnic differences in percent total weight loss (%TWL) and glycemic improvement following sleeve gastrectomy (SG) and explored the role of socioeconomic and psychosocial factors in postsurgical outcomes. This longitudinal study included patients who underwent SG between 2017 and 2020, with follow-up visits over 24 months. Non-Hispanic Black (NHB) participants had lower %TWL at 3, 12, and 24 months compared with Hispanic (H) and non-Hispanic White (NHW) participants. Fat mass index was initially lower in NHB, with smaller reductions over time and significant group differences persisting at 24 months. NHB participants had higher baseline fat-free mass index values; by 24 months, fat-free mass index values were lower in H participants. Hemoglobin A1c decreased across all groups but remained consistently higher in NHB and H compared with NHW at 24 months. NHB participants reported higher perceived discrimination, sleep disturbance, and perceived stress than H and NHW participants at all time points. Employment status predicted %TWL at 12 months. There was a significant interaction between race and ethnicity and employment status observed at 12 and 24 months, suggesting that employment-related disparities could impact surgical outcomes. NHB participants experienced less favorable outcomes following SG, emphasizing the need for tailored interventions addressing socioeconomic and psychosocial disparities.

Whole genome sequence association analysis of brain structural volume measures in the NHLBI TOPMed Program highlights novel loci in diverse participants

Brain structural volumes are highly heritable and are linked to multiple neuropsychological outcomes, including Alzheimer’s disease (AD). Genome-wide association studies have successfully identified genetic variants associated with intracranial volume (ICV), total brain volume (TBV), hippocampal volume (HV), and lateral ventricular volume (LVV). However, these studies mostly focused on common genetic variants with minor allele frequencies (MAF) > 1%, and individuals included in most of these studies were of predominantly European ancestry. Here, we performed whole-genome sequence (WGS) association studies of MRI brain volumes in 7,674 individuals of diverse race and ethnicity from the Trans-Omics for Precision Medicine (TOPMed) program. We identified novel genetic loci on chromosomes 13 and 16 near LINC00598 and CACNG3 associated with HV and TBV, respectively (lead variants rs115674829, P-value = 1.7×10−9 in pooled analysis and rs150440001, P-value = 6.6×10−9 in black participants). Both lead variant minor A alleles are rarer in white participants (MAF = 0.14% and 0.03%) and in Hispanic participants (MAF = 1.5% and 0.17%) but more common in black participants (MAF = 13% and 1.5%). Rare variant aggregated analyses identified RIPK1, a gene encoding a kinase involved in neuroinflammation and promising target for AD treatment, suggestively associated with LVV (P-value=5×10−6). This study provides new insights into the genetic correlates of brain structural volumes and illustrates the importance of leveraging WGS data and cohorts of diverse race and ethnicity to better characterize the genetic architecture of complex polygenic traits.

Racial and ethnic diversity in ophthalmology: a meta-analysis of industry-sponsored phase 3 clinical trials from a single company

BackgroundThere is a lack of representation of most racial and ethnic populations in clinical trials in ophthalmology. In 2017, Roche/Genentech began to introduce a range of initiatives to improve the diversity of trial participants.ObjectiveTo assess whether company initiatives improved the racial/ethnic representation of participants in Roche/Genentech-sponsored phase 3 trials for the indications of neovascular age-related macular degeneration (nAMD)/geographic atrophy (GA), retinal vein occlusion (RVO), and diabetic retinopathy (DR)/diabetic macular oedema (DMO).MethodsProportions for each group were calculated and a Chi-Square test with continuity correction used to determine the statistical significance of difference between pre-2017 (2003–2017) and post-2017 (2018–2021) proportions (based on first-patient-in dates). Analyses were conducted for United States (US) sites only and for all global sites (including US).ResultsThe noted significant improvements in enrolment were: in the global population, the proportion of Asians/Native Hawaiians/Pacific Islanders included in the trials for each indication increased significantly from pre-2017 to post-2017 (for nAMD/GA by eight-fold, for RVO by seven-fold, for DR/DMO by two-fold); for nAMD/GA trials, both the US and global populations had a significant (about four-fold) increase in the proportion of Black/African American participants from pre-2017 to post-2017, although the proportion was still very low (0.8%); for RVO trials, the proportion of Hispanic participants increased from pre-2017 to post-2017 both in the US and globally.ConclusionsCompany initiatives have improved the racial/ethnic diversity of participants in Roche/Genentech-sponsored phase 3 trials for ophthalmology. Roche/Genentech will continue efforts to enhance the representation of underserved populations in clinical trials.

Sociodemographic factors associated with access to preventative care for children

Since the beginning of the 21st century, there has been an ongoing decline in children’s physicals, delayed immunizations, and well visits. This study investigates sociodemographic factors including poverty levels (PDL), employment status, adequacy of insurance, and race on the accessibility of preventative care check ups. The research from this study has been derived from the 2022 National Survey of Children's Health survey that sampled 53,621 participants from diverse socioeconomic and racial backgrounds. This study uses Binary regression analysis and Pearson's chi-squared tests to examine and test the association between key factors and access of care. For example, participants in the lowest poverty level (0-99%) experienced poorer health outcomes (27.2%) compared to those in 400%+ income level (12.4%). Furthermore, when compared to the unemployed or unpaid class of participants, the participants who work full-time are associated with better health outcomes (OR=1.219, 95% CI = 1.100, 1.352). Racial minorities, including Hispanic (OR=0.763), Black (OR=0.801), and Asian (OR=0.553) participants, showed lower odds of positive outcomes compared to participants of White descent. This research seeks to encourage the creation of targeted interventions strategies focusing on poverty reduction, stable income, and equitable, universal access to preventative measures for children across diverse populations. Keywords: preventative care, children, sociodemographic factors, United States

Socio-Ecological Determinants of Food Pantry Use Among Food Insecure Racial and Ethnic Diverse College Students.

College students are disproportionately more food insecure as compared to the general U.S. population with racial and ethnic minority students at greater risk. The purpose of this study is to explore socio-ecological characteristics of food pantry utilization among food insecure Black/African American non-Hispanic and Hispanic college students employing secondary data analyses of a larger cross-sectional study of food insecurity among college students. The current study sample (n = 460) was comprised of 174 self-identified Black/African American non-Hispanic, 26 Black/African American & Hispanic, and 260 Hispanic participants. Food pantry use served as the dependent variable. Multi-level independent variables included Individual, Interpersonal, and Community Level factors. A multivariate logistic regression model analyzed the relationship between food pantry use and independent variables found to be significant in earlier independent sample t-tests and chi-square analyses. Statistical significance was set at P < .05 and a confidence interval (CI) of 95%. "Saving" coping mechanisms (OR = 1.15, 95% CI [1.082-1.231] and discrimination experiences of day-to-day unfair treatment (OR = 1.04, 95% CI [.1.000-1.077]) were predictive of food pantry utilization. This study suggests food pantry use among food insecure racial and ethnic minority college students may be influenced by socio-cultural influences at both interpersonal and community levels. Implications include interventions developed with a health equity framework.

Provision of COVID-19 Self-Test Kits to Patients for Distribution to Social Contacts

Widespread and equitable access to testing remains critical to controlling the COVID-19 pandemic, which has disproportionately affected medically underserved communities. To determine whether secondary distribution of COVID-19 self-test (ST) kits, in which an individual distributes ST kits to contacts in their social networks, increases COVID-19 testing. The COVID-19 Self-Testing Through Rapid Network Distribution study was a randomized clinical trial conducted between May 2021 and September 2023 at 4 federally qualified health centers serving medically underserved populations in Philadelphia, Pennsylvania. Participants were adults aged 18 years or older presenting to federally qualified health centers without SARS-CoV-2 infection in the past 90 days. Participants were randomized 1:1 to receive 5 COVID-19 ST kits or 5 clinic test referral cards to distribute to contacts in their social network, and testing among their social network contacts was measured. Investigators were masked to study group assignment. Data were analyzed from December 11, 2023, to August 23, 2024. Participants in the intervention group received 5 COVID-19 ST kits; control participants received 5 clinic test referral cards. The primary outcome was confirmed testing among at least 2 network contacts 8 weeks after randomization. Secondary outcomes included the proportion of participants with at least 1 network contact tested and total number of network contacts reached. A total of 776 participants (median [IQR] age, 44 [32-57] years; 428 [55.2%] cisgender female) were included in the study, of whom 388 participants were randomized to the ST intervention group and 388 participants were randomized to the control group. There were 112 Hispanic or Latine participants (14.4%), 459 non-Hispanic Black participants (59.1%), and 120 non-Hispanic White participants (15.5%). There was no difference between study groups in the primary outcome, with 5 participants (1.3%) in the ST group vs 2 participants (0.5%) in the control group having at least 2 contacts confirmed tested at the 8-week follow-up (risk difference, 0.0077; 95% CI -0.0056 to 0.0210; P = .45). This randomized clinical trial found that secondary distribution of COVID-19 ST kits had no effect on confirmed testing rates among network contacts, which were low in both study groups. Despite these null findings, the study provides insight that may be useful when designing and implementing ST trials. ClinicalTrials.gov Identifier: NCT04797858.

Ethnic disparities in clinical trials for FDA-approved drugs in breast cancer: A post-COVID era analysis (2020-2024).

e13759 Background: Despite advances in cancer treatment, racial and ethnic minorities remain significantly underrepresented in cancer research, particularly in clinical trials. This underrepresentation raises concerns about the transferability of findings to diverse patient populations as well as equitable treatment outcomes. This study evaluates racial representation in breast cancer clinical trials supporting FDA-approved treatments since 2020. Methods: We analyzed racial representation in breast cancer clinical trials by examining data from 9 industry-sponsored trials, encompassing 9,688 patients. Racial distribution data were obtained from these trials, and SEER incidence rates were used to determine expected participation proportions. A chi-square goodness-of-fit test was performed to examine disparities between observed and expected representation among White, Black, Asian, and Hispanic populations. P-values were calculated to assess the statistical significance of these differences. Results: Out of a total of 16 industry trials reviewed, 6 (37.5%) did not present any race data, 1 trial presented white vs non-white, and none presented data on Hispanic participants. Among the nine trials reporting race, White participants were overrepresented (70.7%, p &lt; 0.0001), Black participants were significantly underrepresented (2.35%, p &lt; 0.0001), and Asian participants were also overrepresented but to a lesser extent ( p &lt; 0.0001). Some of the trials were international and domestic. Conclusions: Our findings highlight persistent racial disparities in breast cancer clinical trials, with significant underrepresentation of Black participants and a complete lack of Hispanic-specific data. Lack of diversity in clinical trials threatens the applicability of these treatments across different populations, as well as raises concerns about equitable access to the latest advancements in cancer care. Enhancing recruitment strategies, standardizing race and ethnicity reporting, and establishing policy-driven diversity targets are key steps toward ensuring clinical trials more accurately represent the populations they aim to serve.

Evolving trends in Latin American oncology clinical trial sites.

e23155 Background: The globalization of oncology trials has created opportunities for emerging regions to play larger roles in clinical research. This study evaluated trends in the establishment of new trial sites in Latin America (LATAM) compared to other regions and assessed participant representation. Methods: We analyzed phase 3 oncology trials posted on ClinicalTrials.gov from January 2013 to December 2022. Trials with at least one newly initiated LATAM site, defined by the date of first participant enrollment, were included. Data on site distribution, cancer types, interventions, control types, and demographics were collected, with regions classified by World Bank criteria. Site proportions were calculated using descriptive statistics, and growth trends were assessed with the Mann-Kendall test. Results: The year 2022 was excluded from the trend analysis due to limited data. A total of 172 trials (29,718 sites, 120,582 participants) were analyzed. LATAM contributed 2,609 sites (8.8%) across 10 countries, led by Brazil (n = 1,194, 4%), Argentina (n = 485, 1.6%), and Mexico (n = 339, 1.1%). Hispanic participants were reported in 99 trials (57.6%). Over the 9-year period, new LATAM sites showed a significant upward trend (p = 0.04), while North America declined (p &lt; 0.01) and Asia increased (p &lt; 0.01). Regionally, new sites in Brazil decreased over time (p = 0.03), with no sustained trends in other LATAM countries. The most frequently studied cancers were breast (n = 623, 23.9% of LATAM sites), lung (n = 611, 23.4%), and prostate (n = 472, 18.1%). Immunotherapy accounted for most new LATAM sites (n = 922, 35.5%), followed by targeted therapies (n = 565, 21.7%), biologic therapies (n = 277, 10.6%), hormone therapies (n = 262, 10%), PARP inhibitors (n = 144, 5.5%), and antibody-drug conjugates (n = 67, 2.5%). Other therapies contributed 9.7% (n = 254) of new sites. Trials primarily used double-arm active comparators (n = 1,395, 54%), followed by placebo-controlled designs (n = 1,006, 38%), and multi-arm designs (n = 208, 8%). Conclusions: Nearly half of LATAM trials lacked Hispanic participant data, suggesting underreporting or limited standardization in reporting. The growth of new trial sites across the region was not concentrated in a single country, suggesting increasing contributions from smaller nations. Brazil accounted for the majority of trial sites, likely due to its stronger economic environment, more developed healthcare infrastructure, and larger population, which facilitate trial initiation and participant recruitment. Further research is needed to analyze global trends and factors driving these shifts. New LATAM trial sites per year. 2013 2014 2015 2016 2017 2018 2019 2020 2021 Argentina 48 74 60 19 54 61 123 37 9 Brazil 166 128 215 93 206 152 127 94 13 Chile 15 25 41 18 22 33 51 24 1 Colombia 9 16 32 - 10 18 41 13 - Costa Rica - 1 2 - 5 7 1 - - El Salvador 1 1 - - - - - - - Guatemala 3 4 1 - 5 9 - - 5 Mexico 30 65 66 16 48 65 32 16 1 Panama 3 2 1 - - 1 - - - Peru 18 31 23 8 13 43 19 9 7

Racial and ethnic disparities in US neuroendocrine tumor clinical trial enrollment over the past quarter century.

e16353 Background: Neuroendocrine tumors (NETs) are a heterogeneous group of neoplasms originating from neuroendocrine cells, with considerable variation in behavior and clinical presentation. The rising incidence of NETs has driven advancements in drug development; however, it remains unclear whether all demographic groups have equal access to novel therapeutic trials. Previous oncologic epidemiological studies have identified race-specific disparities in overall and disease-specific survival. This study aimed to assess whether similar racial and ethnic disparities exist in the enrollment of patients in NET clinical trials. Methods: We collected data from all completed NET clinical trials involving adult patients conducted in the United States over the past 25 years (1/1/2000 to 1/1/2025) as reported on clinicaltrials.gov. Therapeutic interventional trials were included while observational, non-interventional or non-therapeutic trials were excluded. Key study variables included race, ethnicity, sex, tumor type, and year of study. To assess enrollment patterns, we calculated the enrollment ratio for each racial and ethnic group, defined as the percentage of enrollees from each group divided by their proportion among the overall NET patient population. Results: We analyzed 64 NET trials, comprising 5,020 participants total. The gender distribution was similar, with 2,455 women and 2,565 men. Racial demographic data were reported in 60.9% (39/64) of the trials, while ethnicity data were provided in 42.2% (27/64). The reporting of race increased markedly, rising from 16.7% during 2008–2011 to 78.3% in 2020–2024. The comparison of enrollment ratios revealed that Black participants were significantly underrepresented compared to White participants (0.292, p &lt; 0.001 ), and Hispanic participants were significantly underrepresented compared to Non-Hispanic participants (0.536, p &lt; 0.001 ). Conclusions: Black and Hispanic Americans are significantly underrepresented in NET clinical trials. Clinical trials are critical for developing effective treatments and understanding how interventions perform across populations. The lack of representation hinders our ability to evaluate how NET therapies affect different racial and ethnic groups, potentially worsening existing health disparities. Enhancing the inclusion of underrepresented minorities in NET clinical trials is vital to promoting equitable care and improving health outcomes for all patients. Demographic representation and enrollment ratios in NETs clinical trials. Black White Hispanic Non-Hispanic NETs Patient Demographics 16.1% 74.0% 10.4% 89.6% NETs Clinical Trial Enrollee Demographics 5.33% 83.5% 5.69% 91.3% Enrollment Ratio 0.331 1.13 0.546 1.02 Relative Enrollment Compared with White 0.292 (p&lt;0.001) 1.00 - - Relative Enrollment Compared with Non-Hispanic - - 0.536 (p&lt;0.001) 1.00

Patient-reported outcomes, race, and ethnicity in high-impact lung cancer clinical trials.

e23015 Background: Lung cancer clinical trials enroll disproportionately low numbers of Black and Hispanic patients. Patient-reported outcomes (PRO) accurately assess adverse events and are also widely advocated for by patient groups but are not uniformly included in clinical trials. This study reports updated race/ethnicity enrollment and rate of PRO reporting in the highest-impact lung cancer trials. Methods: New England Journal of Medicine (NEJM), Journal of Clinical Oncology (JCO), and Lancet Oncology (LO) were systematically searched to identify clinical trials including patients with lung cancer published between 2020-2024. In the event of multiple publications, each study was included once, and the index publication date recorded. Chi-square tests were used to calculate statistical significance between groups and for trend, with p &lt; .05 cutoff for significance. Results: 128 lung cancer trials were published in NEJM, JCO, and LO between 2020 and 2024. Across all trials, a total of 440 Black patients and 65 Hispanic patients were enrolled. 53% of studies specified the race of patients. 89% NEJM, 41% LO, and 47% JCO publications reported the race of participants (p &lt; .05). Among trials that reported race, 1.8% of patients were Black and 61% were white. 10% of trials specified enrolling patients of Hispanic ethnicity; amongst these trials, Hispanic patients comprised 2.2% of participants. Reporting of race increased with advancing publication year (p &lt; .05). The proportion reporting enrollment of least one Black or Hispanic patient also increased with advancing year, though this did not reach significance (p = .29 and p = .38, respectively). 63% included PRO collection in their protocol and 47% published a PRO. 74% of trials that collected PRO published the outcomes. 38% of PRO were published in the index publication and 62% in a secondary publication, 65% of which were peer-reviewed papers. 52% of trials investigating therapies that were for non-curative or palliative intent reported PRO; 29% of trials for curative-intent treatment reported PRO (p &lt; .05). There was no increase in PRO reporting over time (p = .27). Conclusions: Race is under-reported, and Black patients are under-enrolled in high-impact lung cancer publications. Only 10% of trials specified Hispanic ethnicity, though this group of trials enrolled a proportion of Hispanic patients that approximated the relatively lower incidence of NSCLC in Hispanic patients. The minority of trials published PRO. Structured efforts should continue to encourage aligning trials with demographics and values of patients. PRO and reported race in NSCLC trials by publication year. Publication date n Published PRO (%) Reported race (%) % enrolling &gt;/= 1 Black patient % enrolling &gt;/= 1 Hispanic patient Black + Hispanic participants (%) &lt;2020 14 79 35 22 0 1.2 2020 23 48 47 33 4 0.7 2021 15 53 43 30 0 0.6 2022 23 26 70 52 9 0.6 2023 27 37 73 42 11 1.8 2024 26 54 36 29 15 1.2

Ethnic disparities in clinical trials for FDA-approved drugs in lung cancer: A post-COVID era analysis (2020-2024).

e13819 Background: In the post- COVID era, disparities in healthcare have become more apparent, highlighting the urgent need to address inequities in cancer research. Although lung cancer treatments have advanced, racial minorities are still underrepresented in clinical trials, raising concerns about fair access to new therapies. The pandemic further exacerbated challenges, specially access to health care and increased socioeconomical barriers, affecting disproportionately minority communities. This study evaluates racial representation in lung cancer clinical trials that lead to FDA approval in the post Covid Era compared to SEER incidence rates to identify gaps and address barriers to equitable participation. Methods: We analyzed racial demographics from twenty-two industry-sponsored lung cancer trials, from which only fifteen (68.18 %; NCT03703297, NCT03800134, NCT03456076, B7461006, NCT04025879, NCT03600883, NCT05060016, NCT04035486, NCT02409342, NCT03425643, NCT03785249, NCT03157128, NCT04487080, NCT04538664) included racial and ethnic data comprising 6694 participants. The observed racial distribution was compared against SEER incidence data for lung cancer. Expected counts were derived by normalizing SEER incidence rates to the total trial enrollment. A chi-square test was performed to assess statistical significance. Results: Among trial participants, 56.9% were White, 1.0 % were Black, 38.6 % were Asian and 0.04 % were Hispanic. In contrast, SEER data suggests and expected distribution of 24.45 % White, 23.19 % Black, 13.79 % Asian, and 11.83 % Hispanic. Chi-square analysis confirmed significant disparities across all racial groups (p &lt; 0.001), with White (χ² = 44.82, p &lt; 0.001), and Asian (χ² = 48.12, p &lt; 0.001) participants overrepresented, while Black (χ² = 21.65, p &lt; 0.001), and Hispanic (χ² = 12.18, p &lt; 0.001) participants were underrepresented. These findings highlight the need to address inequities in lung cancer clinical trial participation. Some of the trials were international and domestic. Conclusions: Our findings demonstrate persistent racial and ethnic disparities in lung cancer clinical trials, with White and Asian participants significantly overrepresented while Black and Hispanic population remain underrepresented. This underrepresentation raises significant concerns about the applicability of trial results and the fair development of new lung cancer treatments. Moreover, inconsistencies in reporting race and ethnicity in trials highlight the urgent need to prioritize diversity in clinical research. Tackling these disparities requires immediate action, such as implementing targeted recruitment strategies and standardized reporting practices, to ensure clinical trials represent the diverse populations most impacted by lung cancer and provide equitable treatment outcomes for everyone.

Black and Hispanic Women's Views on LUTS Treatment and a Home-Based Intervention.

This study aimed to examine facilitators and barriers to treatment for lower urinary tract symptoms among care-seeking Black and Hispanic women and to explore perspectives on "SUPPORT," a self-directed, 8-week, home-based intervention combining education, bladder retraining, pelvic floor muscle training, and cognitive behavior therapy. This was a qualitative observational study. We recruited a convenience sample of care-seeking women with lower urinary tract symptoms who self-identified as Black race or Hispanic ethnicity and were English or Spanish speaking. We conducted focus groups in the participants' primary language. Two authors analyzed the focus group transcripts using modified grounded theory techniques. We enrolled 27 participants and conducted 7 focus groups. There were 13 non-Hispanic Black and 14 Hispanic participants. The mean ± SD age of the cohort was 49 ± 14 years. Barriers reported by both Black and Hispanic participants included (1) unfamiliarity with treatment options and negative perceptions of procedural treatments, (2) unsatisfactory interactions with the health care team, (3) travel distance for treatment, and (4) resources. Barriers distinct to Spanish-speaking and Black participants were inadequate interpreter services and feeling blocked from accessing care by clinic staff, respectively. Facilitators of treatment included (1) patient-centered clinical environments, (2) streamlined financial assistance services, and (3) shared treatment decision making. Most participants found the SUPPORT intervention concept promising for reducing psychosocial stress related to lower urinary tract symptoms and potentially overcoming various barriers to treatment. Participants reported multilevel barriers to lower urinary tract treatments. The concept of the SUPPORT intervention was acceptable to participants and may overcome barriers to treatment.

Perceived Balance Predicts Falls in Community-Dwelling Older Adults: A Longitudinal Study Using the National Health and Aging Trend Study (NHATS) Data

Abstract Background and Objectives Falls are an increasing problem among older adults. Older adults’ self-report of falls is the primary method of fall risk identification. However, up to 72% of Medicare beneficiaries who have fallen do not report falls and fall-related injuries to their healthcare providers. Research suggest that older adults prefer the term “balance problems” instead of “fall risk.” The purpose of this study was to examine if perceived balance problem is a predictor of self-reported falls after controlling for known predictors of falls among older adults. Research Design and Methods The Health Belief Model served as the theoretical framework. A longitudinal secondary analysis was conducted using data from a subsample of independently living participants (N = 5446) from the National Health and Aging Trends Study. Baseline data was from year 2015, and the outcome was self-reported falls in 2016. Results Complex samples multiple logistic regression analyses revealed that the single item perceived balance problem question (OR = 1.69, p &amp;lt; .001) predicted falls in 2016, whereas, the balance performance measure, Short Physical Performance Battery, did not (OR = 0.98, p = .06). Non-Hispanic White participants were more likely to report falling compared to non-Hispanic Black and Hispanic participants, as were females compared to males. A hospital stay in 2015, co-morbidities, fear of falling, and a fall in 2015 were also predictive of falls. Discussion and Implications Assessing older adults’ perceived balance is important in primary care to identify fall risk and recommend appropriate home modifications, assistive devices, and/or interventions.

The Interaction Between Race/Ethnicity and Sex on Societal Participation Among Individuals With Traumatic Brain Injury: A NIDILRR Model Systems Study.

To examine the interaction of race/ethnicity and sex on societal participation (productivity and overall participation) among individuals with traumatic brain injury (TBI). Community. A total of 8861 individuals aged ≥16 who identified as non-Hispanic White (1750 females, 4270 males), non-Hispanic Black (315 females, 1147 males), or Hispanic (314 females, 1065 males), and who completed a 1-year postinjury follow-up interview in the TBI Model Systems National Database. Secondary analysis of a longitudinal cohort study at 1-year postinjury. The Participation Assessment with Recombined Tools-Objective-17 (PART-O-17) Productivity items (ie, school, employment, and homemaking) and subscale, and total Summary scores were the primary outcomes used to assess societal participation. The covariates were age, years of education, and total score on the Functional Independence Measure (FIM). A significant sex× race/ethnicity interaction with homemaking was identified (P =.047). Compared with Non-Hispanic White males, odds of not endorsing homemaking were 1.55 times greater for Non-Hispanic Black males and 1.71 times greater for Hispanic males. No significant sex × race/ethnicity interactions were found with employment (P =.221) or school items (P =.967). After adjusting for age, education, and FIM Total, a significant sex × race/ethnicity interaction on Productivity scores was found, F(28852)=10.3, P<.001, such that sex differences were observed for only Non-Hispanic Black and Hispanic participants compared to Non-Hispanic White participants. No significant interaction regarding sex differences across racial/ethnic groups was identified using the PART-O-17 Summary score. Compared with non-Hispanic White males, non-Hispanic Black and Hispanic males were less likely to report engaging in homemaking activities, resulting in greater sex differences among Non-Hispanic Black and Hispanic males and females on the Productivity subscale than were observed on this scale among non-Hispanic White individuals. Current community participation measures may not accurately capture the experiences of diverse populations with TBI.

Ingroup Favoritism Surrounding COVID-19 Vaccinations in the Hispanic Communities: Experimental Study

BackgroundHispanic communities have been disproportionately affected by the COVID-19 pandemic. In addition to elevated health risks and burdens, these populations have faced persistent barriers to accessing accurate, timely information regarding the pandemic’s trajectory, including vaccine-related updates. To address these challenges, it is crucial to examine the conditions under which Hispanics are most likely to seek information about COVID-19 vaccinations.ObjectiveGrounded in social identity theory and self-categorization theory, the primary goal of this study is to investigate how ethnic and linguistic cues influence information-seeking preferences related to COVID-19 vaccinations among Hispanic individuals. The first aim is to compare Hispanic and non-Hispanic participants in terms of their preferences for COVID-19 vaccine-related social media pages, in which the ethnicity of individuals shown in the images (Hispanic vs non-Hispanic) and the language in the text (Spanish vs English) vary. The second aim is to identify which combination of ethnic imagery and language in the text is most preferred among Hispanic participants when seeking COVID-19 vaccination information.MethodsA total of 936 participants (Hispanic: n=448; non-Hispanic: n=488) were included in the study. We created experimental social media group pages modeled after Facebook groups, in which the ethnicity of individuals shown in the imagery and the language used in the text were manipulated. A total of 4 conditions were developed: (1) Hispanic imagery with Spanish text, (2) non-Hispanic imagery with Spanish text, (3) Hispanic imagery with English text, and (4) non-Hispanic imagery with English text. Participants were asked to indicate the extent to which they would be willing to seek help from each social media group page, under the assumption that they were looking for information or assistance related to the COVID-19 vaccine, regardless of their actual vaccination status. A between-subjects ANOVA and a one-way repeated-measures ANOVA were conducted to analyze the data.ResultsThe findings indicated that Hispanic participants significantly preferred social media pages featuring Hispanic imagery and Spanish text compared to non-Hispanic participants. Moreover, a page with non-Hispanic imagery and English text was less preferred by Hispanic than by non-Hispanic individuals. Among Hispanic participants, the condition featuring Hispanic imagery and Spanish text emerged as the most favored, particularly when compared to conditions featuring non-Hispanic imagery paired with either Spanish or English text. Notably, there was no significant difference between the preference for the condition with Hispanic imagery and Spanish text and the condition with Hispanic imagery and English text, suggesting that imagery may have a stronger influence than language in shaping preferences.ConclusionsThese results suggest that incorporating ethnic and language cues that reflect the target audience’s identity can enhance the effectiveness of public health messaging, particularly in efforts to improve information engagement among Hispanic populations.

Spine Disease Clinical Trial Representation: An Analysis of Racial, Ethnic, and Gender Diversity.

Spine diseases significantly burden individuals' health and quality of life, affecting millions worldwide. Ensuring diverse representation in spine disease-related clinical trials, particularly concerning race, ethnicity, and gender, is essential for developing effective and safe therapies for all populations. The objective of this study was to analyze whether spine disease clinical trials have adequate representation. Detailed trial records from all US clinical trials (up to January 1, 2024) registered in ClinicalTrials.gov relating to spine disease that were completed, had results, and included participants aged older than 18 years were analyzed. Data for race, ethnicity, and gender were collected and compared with state Census demographic estimates. Trends in demographic reporting and representation of trials over time, how trial factors are correlated with these trends, and the type of trial interventions were analyzed. One hundred and ninty-three clinical trials met our inclusion criteria. From this cohort, we found that only 48.19% of trials reported race and 30.05% reported ethnicity. Most participants were White (median: 93.43%), which exceeded the state Census estimate of White representation (median: 76.58%, Asymp. Sig. P < .001). Asian, Native Hawaiian, Pacific Islander, Black, and Hispanic participants were significantly under-represented (Asymp. Sig. P < .001). For gender, men were significantly under-represented between 2008 and 2016 (Asymp. Sig. P = .027) and over-represented between 2018 and 2022 (P = .036). These results indicate that racial and ethnic minorities in spine disease-related clinical trials remain under-represented relative to the US population even after the Revitalization Act of 1993, the Food and Drug Administration Amendments Act of 2007, Section 801, and the Final Rule policy. Furthermore, gender representation fluctuated after the enactment of the policies. For this reason, clinical trials should be more aware of having adequate representation during enrollment and more transparent in reporting race, ethnicity, and gender.