Low Socioeconomic Environments Research Articles

The interplay of maternal and paternal postpartum depressive symptoms with children's internalizing and externalizing symptoms from childhood to adolescence: does socioeconomic status matter? Alongitudinal cohort study.

Maternal postpartum depression is an important risk factor for internalizing and externalizing problems in children. The role of concurrent paternal depression remains unclear, especially by socioeconomic status. This study examined independent and interactive associations of postpartum maternal and paternal depression with children's internalizing/externalizing symptoms throughout childhood and adolescence (ages 3.5-17 years). We used data from the Québec Longitudinal Study of Child Development, a representative birth cohort (1997-1998) in Canada. Data included self-reported maternal and paternal depressive symptoms at 5 months' postpartum using the Center for Epidemiologic Studies Depression Scale. Internalizing and externalizing symptoms in children were reported by parents, teachers and children/adolescents using the Social Behaviour Questionnaire (ages 3.5-13 years) and the Mental Health and Social Inadaptation Assessment for Adolescents (ages 15-17 years). We used three-level mixed effects modelling to test associations after adjusting for confounding factors. With 168 single-parent families excluded, our sample consisted of 1,700 families with useable data. Of these, 275 (16.2%) families reported maternal depression (clinically elevated symptoms), 135 (7.9%) paternal depression and 39 (2.3%) both. In families with high socioeconomic status, maternal depression was associated with greater child internalizing (β = .34; p < .001) and externalizing symptoms (β = .22; p = .002), regardless of the presence/absence of paternal depression. In families with low socioeconomic status, associations with symptoms were stronger with concurrent paternal depression (internalizing, β = .84, p < .001; externalizing, β = .71, p = .003) than without (internalizing, β = .30, p < .001; externalizing, β = .24, p = .002). Maternal depression increases the risk for children's internalizing/externalizing problems in all socioeconomic contexts. In families with low socioeconomic status, risks were exacerbated by concurrent paternal depression. Postpartum depression, especially in low socioeconomic environments, should be a primary focus to optimize mental health across generations.

Mindfulness-Based Education: Exploring Cultural and Age-Related Perspectives Through Course Design

This study delves into the complexities of designing and implementing mindfulness education tailored to children and adolescents. Using basic theories of cognitive development such as Piaget's stages and Vygotsky's socio-cultural theories, the mindfulness classroom was designed to accommodate age-specific cognitive abilities and resulted in a curriculum design model that can be flexibly utilized to develop self-regulation skills and relate to activities that are critical in childhood, with the theory of mindfulness, present-focused activities, meditation activities, and perceptual activities that can be utilized as habits in real life. Through a combination of theoretical present-focused activities, meditation-related activities, perception-related activities, and activities that can be utilized in real life as habits, students develop self-regulation skills that are consistent with the cognitive flexibility that is essential in development. Sensory-related activities reinforce the integration of mindfulness into daily life. Working together to ensure accessibility in low socioeconomic status environments promotes inclusivity classroom, the study took place in a collective Chinese culture, but consideration of individualistic culture is also essential, and curricula tailored to the socio-emotional challenges of different ages need to be continually refined. Future research should explore cultural adaptation and expand the diversity of participants for a more inclusive understanding. In conclusion, this study advocates for mindfulness curricula to be synchronized with cognitive development, emphasizing that curricula should be designed with age-appropriate content, meditative practices, and real-life connections and adapted to different cultural backgrounds, socioeconomic backgrounds, and student populations with special needs.

Breastfeeding duration and brain-body development in 9-10-year-olds: modulating effect of socioeconomic levels.

To investigate relationships of breastfeeding duration with brain structure and adiposity markers in youth and how these relationships are modified by neighborhood socioeconomic environments (SEEs). This was a cross-sectional study of youth enrolled in the Adolescent Brain and Cognitive Development (ABCD) Study® (n = 7511). Mixed effects models examined associations of breastfeeding duration with global brain measures and adiposity markers, adjusting for sociodemographic, pre- and post-natal covariates. Stratified analysis was performed by area deprivation index (ADI) tertiles. Total cortical surface area (SA) (False Discovery Rate - FDR corrected P < 0.001), cortical (FDR corrected P < 0.001) and subcortical gray matter (GM) volume (FDR corrected P < 0.001) increased with increased breastfeeding duration. Body mass index (BMI) z-scores (FDR corrected P = 0.001), waist circumference (FDR corrected P = 0.002) and waist-to-height ratio (WHtR) (FDR corrected P = 0.001) decreased with increased breastfeeding duration. Breastfeeding duration was inversely associated with adiposity in youth from high- and medium- ADI neighborhoods, but positively associated with SA across ADI tertiles. In this cross-sectional study, longer breastfeeding duration was associated with lower adiposity indices, particularly in youth from lower SEEs and greater SA across SEE levels. Longer breastfeeding duration showed long-term associations with brain and body development for offspring. Building on previous findings that longer breastfeeding duration is associated with healthier weight gain, lower obesity risk, and brain white matter development in infancy, our results find longer breastfeeding duration to be associated with lower adiposity indices and greater cortical and subcortical gray matter volume, and cortical surface area during peri-adolescence. Children from lower socioeconomic environments (SEEs) demonstrated stronger negative associations of breastfeeding duration and adiposity indices, and children across SEEs showed positive relationships between breastfeeding duration and cortical surface area. Promoting breastfeeding, particularly among women from lower SEEs would confer long-term benefits to offspring.

Cognitive stimulation as a mechanism linking socioeconomic status and neural function supporting working memory: a longitudinal fMRI study.

Childhood experiences of low socioeconomic status are associated with alterations in neural function in the frontoparietal network and ventral visual stream, which may drive differences in working memory. However, the specific features of low socioeconomic status environments that contribute to these disparities remain poorly understood. Here, we examined experiences of cognitive deprivation (i.e. decreased variety and complexity of experience), as opposed to experiences of threat (i.e. violence exposure), as a potential mechanism through which family income contributes to alterations in neural activation during working memory. As part of a longitudinal study, 148 youth between aged 10 and 13years completed a visuospatial working memory fMRI task. Early childhood low income, chronicity of low income in early childhood, and current income-to-needs were associated with task-related activation in the ventral visual stream and frontoparietal network. The association of family income with decreased activation in the lateral occipital cortex and intraparietal sulcus during working memory was mediated by experiences of cognitive deprivation. Surprisingly, however, family income and deprivation were not significantly related to working memory performance, and only deprivation was associated with academic achievement in this sample. Taken together, these findings suggest that early life low income and associated cognitive deprivation are important factors in neural function supporting working memory.

Abstract A054: Leveraging the power of Hope Leaders for enhancing diversity in clinical trials via a bi-directional cancer health information model

Abstract Introduction: Despite increasing recognition of the need for diversity in clinical trials, participation from racial and ethnic minorities, particularly from low socioeconomic communities, remains dismally low. This underrepresentation hinders the generalizability of trial results and perpetuates health disparities. Low socioeconomic environments, characterized by economic instability, restricted healthcare access, food scarcity, and deficient educational resources, exacerbate these challenges. Residents of such communities often lean on "Hope Leaders" - trusted community figures - as a strategy to navigate through these adversities. Recognizing the pivotal role of these Hope Leaders, we advocate for a community-centered bi-directional cancer health information flow model, which positions these Leaders at the core of community engagement endeavors. This model fosters a bi-directional health information exchange that synergizes Hope Leaders with the scientific community, thereby promoting improved health equity within clinical intervention research. The implementation of this model commences with a pre-engagement phase, a respectful approach where we familiarize ourselves with the community and its dynamics, without imposing any specific demands or expectations. Approach: The University of Illinois Cancer Center has had 6 community engagement specialists that have engaged with community members through numerous pre-engagement events that encompass activities ranging from mental health, cancer prevention, survivorship events, education, health fairs and community meetings. Based on these insights, we established a dedicated working group to identify hope leaders and to create targeted engagement strategies for specific areas of our catchment region through the bi-directional cancer health information flow model. These strategies are tailored to address the unique challenges and barriers these communities face regarding enrollment in cancer clinical trials. Additionally, the community-driven health communication model was implemented to identify Hope Leaders and engage them with cancer researchers as a part of our phase I activities for this model. Conclusion: This innovative approach aims to leverage the unique position of Hope Leaders in underserved communities to amplify community voices, improve engagement, and ultimately, increase minority representation in cancer clinical trials. The model provides a promising strategy to address the persistent disparity in clinical trial participation, facilitating more equitable and inclusive research outcomes. Citation Format: Joseph Dufraine, Yamile Molina, Jeanette Gonzalez, Maria Olivero, Theresa Mobley, Saria Lofton, Dedra Reis. Leveraging the power of Hope Leaders for enhancing diversity in clinical trials via a bi-directional cancer health information model [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 A054.

Humanising Online Teaching and Learning in the BEd. Foundation Phase Programme: Moving Beyond Covid-19

Covid-19 brought unforeseen and unpredicted challenges to higher education institutions (HEIs). In this paper, we recount the authors' experiences of exploring a humanising pedagogy as a way of practising social justice during online learning. Our Bachelor of Education, Foundation Phase (FP) classes consist of students from predominantly rural and urban low socioeconomic environments. The primary focus of this study was to explore the experiences of lecturers who teach a humanising pedagogy-embedded programme in the FP at an HEI through online learning in a highly under-resourced context. The study further focuses on technological strategies and pedagogies used in HEIs, issues related to lecturers' inclination and adaptation to technology, the digital divide, and barriers to online learning. This study resides within a critical transformative paradigm, and uses humanising pedagogy principles as a lens. We draw on our lived experiences and engage in dialogue to make sense of the process of online learning. In this qualitative research, we engage in narrative freewriting to gather data. Thematic analysis was used to reduce the data and to identify common themes. The two themes that emerged, and are discussed in this paper, are mutual vulnerability and lecturer resilience and collaboration. The findings of the study encouraged lecturers to critically reflect on the challenges and opportunities that Covid-19 presented, and to incorporate some of the practices that enabled better delivery of teaching in a humanising way.

Myocardial infarction care in low and high socioeconomic environments: claims data analysis.

To date, claims data have not been used to study outcome differences between low and high socioeconomic status (SES) patients surviving ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) in the Netherlands. To evaluate STEMI and NSTEMI care among patients with low and high SES in the referral area of three Dutch percutaneous coronary intervention (PCI) centres, using claims data as asource. STEMI and NSTEMI patients treated in 2015-2017 were included. Patients' SES scores were collected based on their postal code via an open access government database. In patients with low (SES1) and high (SES4) status, revascularisation strategies and secondary prevention medication were compared. Atotal of 2065 SES1 patients (age 68 ± 13years, 58% NSTEMI) and 1639 SES4 patients (age 68 ± 13years, 63% NSTEMI) were included. PCI use was lower in SES1 compared to SES4 in both STEMI (80% vs 84%, p < 0.012) and NSTEMI (42% vs 48%, p < 0.002) patients. Coronary artery bypass grafting was performed more often in SES1 than in SES4 in both STEMI (7% vs 4%, p = NS) and NSTEMI (11% vs 7%, p < 0.001) patients. Optimal medical therapy use in STEMI patients was higher in SES1 compared to SES4 (52% vs 46%, p = 0.01) but comparable among NSTEMI patients (39% vs 40%, p = NS). One-year mortality was comparable in SES1 and SES4 patients following STEMI (14% vs 16%, p = NS) and NSTEMI (10% vs 11%, p = NS). Combined analysis of claims data and area-specific socioeconomic statistics can provide unique insight into how to improve myocardial infarction care for low and high SES patients.

Nilai Kebersamaan dalam Keluarga

This study aims to explore parents' perceptions of the importance of togetherness in the family and to examine the types of physical activities carried out by the family, including frequency, nature, and constraints. Methods Semi-structured telephone interviews were conducted with 35 parents of children aged 10 to 12 who attended schools in low, middle, and high socioeconomic status environments. Interviews were transcribed using verbatim, anonymized, and analyzed. The results showed that most parents valued family involvement in physical activity as necessary. The benefits of joint activities can increase parent-child interaction and communication, take advantage of the time together, improve mental health and physical fitness, and control weight. However, it was found that families rarely did physical activities together as a family unit, and any activities done together were usually sedentary. Schedule complexity hinders the implementation of activities with the family, in addition to busy lifestyles, differences in ages and interests of children and adults, lousy weather, and lack of access to facilities, transportation, and activity costs. In conclusion, family-based interventions must be prioritized for implementation in accommodating complex family demands and needs by taking into account the affordability and capabilities of the family.&#x0D; Keywords: Physical Activity, Family Interaction, Togetherness Values, Mental Health.

Balancing evolutionary impulses: Effects of mindfulness on virtue food preference

AbstractMindfulness is emerging as a contemplative tool that may positively influence consumers' preference for virtue food, thus supporting health and well‐being. However, it remains unclear which consumer groups may benefit the most from mindfulness. Previous research has demonstrated that consumers who experienced unpredictable environments in low socioeconomic households as children exhibit the likelihood of an adaptive chronic preference for vice food. Against this backdrop, the current research explores how mindfulness can support consumers who experienced low socioeconomic environments as children and further sheds light on the psychological mechanism, reduced impulsivity, for increased virtue food choice. This effect is tested across different manipulations of mindfulness and virtue food contexts. The research also introduces the unique mindfulness intervention of object visualization for helping stabilize the present‐moment for consumers. Overall, the findings show that mindfulness may be a potential solution to impulsivity and increase preference for virtue food, supporting consumers in health and well‐being.

The impact of child poverty on brain development: does money matter?

The development of the human nervous system makes up a series of fundamental and interdependent events involving birth, growth, and neuronal maturation, in addition to the positive or negative selection of synapses of these neurons that will participate in the composition of neural circuits essential to the activity of the nervous system. In this context, where environment and social relationships seem to be relevant markers for neurodevelopment, advanced neuroimaging techniques and behavioral assessment tools have demonstrated alterations in brain regions and cognitive functions among children developing in low or high socioeconomic status environments. Considering the aspects mentioned, this review aimed to identify the importance of socioeconomic status in children's brain development, seeking to identify what are the impacts of these factors on the morphological and physiological formation of the nervous system, allowing a greater understanding of the importance of environmental factors in neurodevelopmental processes.

"It's Kind of Like Code-Switching": Black Older Adults' Experiences with a Voice Assistant for Health Information Seeking.

Black older adults from lower socioeconomic environments are often neglected in health technology interventions. Voice assistants have a potential to make healthcare more accessible to older adults, yet, little is known about their experiences with this type of health information seeking, especially Black older adults. Through a three-phase exploratory study, we explored health information seeking with 30 Black older adults in lower-income environments to understand how they ask health-related questions, and their perceptions of the Google Home being used for that purpose. Through our analysis, we identified the health information needs and common search topics, and discussed the communication breakdowns and types of repair performed. We contribute an understanding of cultural code-switching that has to be done by these older adults when interacting with voice assistants, and the importance of such phenomenon when designing for historically excluded groups.

Multi‐disciplinary collaborative consensus guidance statement on the assessment and treatment of breathing discomfort and respiratory sequelae in patients with post‐acute sequelae of SARS‐CoV‐2 infection (PASC)

<scp>Multi‐disciplinary</scp> collaborative consensus guidance statement on the assessment and treatment of breathing discomfort and respiratory sequelae in patients with <scp>post‐acute</scp> sequelae of <scp>SARS‐CoV</scp>‐2 infection (<scp>PASC</scp>)

The experiences of early childhood development care centre staff in providing care and learning support in a low socioeconomic community in South Africa

ABSTRACT The aim of this study was to explore the experiences of early childhood development (ECD) centre staff in providing care and learning support to children living in a high-risk, low socioeconomic community. We interviewed 14 staff from an ECD centre. Interviews were audio-recorded, transcribed verbatim and analysed thematically. We derived four over-arching themes which demonstrated contextual-, parent-, child- and staff-related factors that influenced ECD staff’s daily work experiences. Challenges relating to poverty, violence, trauma, and substance exposure cut across each theme. Providing a safe and nurturing learning place for children was essential to staff and allowed them an opportunity to deal with some challenges. Characteristics of staff such as passion, resourcefulness, and commitment, went a long way in providing motivation to overcome challenges. Finding ways to support ECD staff working in low socioeconomic environments are important avenues for further research to prevent staff burnout, and to promote optimal child development.

176 Linear and Nonlinear Associations Between Sleep and Academic Achievement in Middle Childhood: The Role of Early Life SES

Abstract Introduction Elementary-aged children in low socioeconomic environments are more likely to experience poor sleep, which can negatively impact academic performance. However, it is unknown whether early-life socioeconomic status (SES) influences associations between sleep and academic achievement later in childhood. Using a demographically diverse sample of children followed longitudinally from 1 to 8 years, we tested linear and nonlinear associations between actigraphy-based sleep duration, midpoint time, sleep duration variability, and parent-reported sleep problems with academic achievement. In addition, we examined whether these associations varied by early SES. Methods The sample comprised 707 twins (52% female; Mage=8.44 years; 28.7% Hispanic/Latinx; 29.7% at or below the poverty line). SES was ascertained at 1 and 8 years, and children wore actigraph watches to assess sleep for 7 nights (Mnights=6.79) and completed the Applied Math, Picture Vocabulary, and Passage Comprehension subtests of the Woodcock-Johnson IV Tests of Achievement. Primary caregivers also reported on their children’s sleep and academic performance (Children’s Sleep Habits Questionnaire and Health and Behavior Questionnaire, respectively). Results Sleep was not linearly related to academic achievement, but there was a significant quadratic association between sleep midpoint with Picture Vocabulary (b=0.28, p&amp;lt;.01) and Passage Comprehension (b=0.17, p&amp;lt;.05). More parent-reported sleep problems were negatively related to Applied Problems performance for lower (b=-1.16, p&amp;lt;.001) and positively associated for higher early SES (b = 1.00, p &amp;lt; .01). More parent-reported sleep problems predicted lower Passage Comprehension for lower (b = -0.59, p &amp;lt; .05), but not higher early SES. Longer sleep duration predicted higher parent-reported academic achievement for lower early SES (b=0.14, p&amp;lt;.01) and lower achievement for higher early SES (b=-0.23, p&amp;lt;.001). Conclusion Our findings illustrate the complex, sometimes nonlinear associations between children’s sleep and academic performance. Many associations varied by early-life SES, suggesting that early childhood environments have long-lasting implications for child functioning, over and above the effect of concurrent SES. Increasing the quantity and quality of children’s sleep could improve academic outcomes, particularly for children who have experienced socioeconomic disadvantage. Support (if any) This research was supported by grants from NICHD (R01HD079520 and R01HD086085) and ASU T. Denny Sanford School of Social and Family Dynamics.

The ability of teachers to identify Grade 1 learners in low socio-economic environments with possible developmental coordination disorder

Background: Early identification of learners in low socio-economic environments with possible developmental coordination disorder (DCD) is important. Although various screening tools are available, it is unclear whether teachers can use the movement assessment battery for children - second edition checklist (MABC-2 checklist) to identify learners with possible DCD. Aim: To establish teachers’ ability to identify Grade 1 learners in low socio-economic environments with possible DCD. Setting: The study was conducted in the Mangaung Metro, Motheo District of the Free State Province, South Africa. Grade 1 learners aged 6–8 years ( n = 200) from a low socio-economic environment attending quintile one to three schools were randomly selected for assessment. Twenty-nine teachers participated in the study. Methods: Kinderkineticists identified learners with possible DCD (displaying motor skills far below the child’s age) by means of the MABC-2 performance test. The teachers used the MABC-2 checklist to identify possible DCD. The convergent validity of the MABC-2 performance test and checklist was compared. Results: The convergent validity between the MABC-2 performance test and the MABC-2 checklist indicated a kappa (k) coefficient of 0.17, indicating a slight agreement between the performance test and the checklist. Overall, the specificity was 58% (105/180), and the sensitivity was 85% (17/20). Conclusion: Teachers could effectively identify learners with possible DCD. However, they demonstrated a low ability to identify learners without possible DCD when using the MABC-2 checklist. It is therefore recommended that the performance test should be used in conjunction with the checklist to obtain the most reliable results.

Temperament moderates the effects of early deprivation on infant attention.

Institutional care has been shown to increase the risk of attention problems in children, but some children are more sensitive to their environment, both for better and for worse. With this in mind, the current study examined the moderating role of temperament (falling reactivity) between early adversity and attention skills. Six- to 15-month-old infants residing in institutions (n=63) and infants reared by their biological families from low socioeconomic environments (n=59) were recruited. The infants' attention skills were measured by calculating the length of time they spent looking at toys. The infants' temperaments were measured by a subscale of the Infant Behavior Questionnaire (falling reactivity/rate of recovery from distress). The findings were in line with the differential susceptibility theory. Compared to infants with high levels of falling reactivity, infants with lower levels of falling reactivity had better attention skills if they were in a family group, but they had lower attention skills if they were residing in institutions. The attention skills of the infants who had higher scores for falling reactivity did not appear to be affected by the adverse environment.

Food havens not swamps: a strength-based approach to sustainable food environments

The current paper provides a critical review of food environments' literature, with a focus on the metaphoric typology that has been developed over recent decades. This has tended to focus understandably on harmful food environments using well-known metaphors: that of food deserts, food swamps and food mirages. The purpose of the review was to consider the current typology in relation to what constitutes healthy food environments, and the implications for population groups in low socioeconomic environments who are often disadvantaged by current food systems and unhealthy food environments. The paper posits a new term, alongside the notion of the food oasis, that of food havens. Oasis indicates a small place of plenty in a setting of scarcity. Haven extends the boundaries of plenty in society by positing places and settings of refuge and safety, even sanctuary from which health and well-being can be attained and supported. We argue for focusing on creating such sustainable food environments so as to proliferate and promote examples of what needs to be done urgently in the fight to transform global food environments for the health of people particularly those that are vulnerable and the planet. Elements of the food haven as proposed in this paper have been drawn from indigenous perspectives-these include Māori and Pacific worldviews. Future research should consider what food environments might look like in different contexts and how we might move away from food swamps and deserts to food oases and havens; and utilize these positive motifs to go further in creating whole sustainable food environments encompassing all of society.

Prevalence of possible developmental coordination disorder among Grade 1 learners in low socio-economic environments in Mangaung, South Africa

Background: Developmental coordination disorder (DCD) affects motor skills and consequently has an impact on the performance in daily living activities of learners with this impairment.Aim: The aim of this study was to determine the prevalence of possible DCD in Grade 1 (Gr. 1) learners in a low socio-economic environment in Mangaung, South Africa.Setting: The study was conducted in the Mangaung Metro, Motheo District, Free State Province. Gr. 1 learners, 6–8 years old (n = 242), from a low socio-economic environment attending Quintile 1–3 schools were randomly selected for assessment.Methods: The Movement Assessment Battery for Children-2nd edition (MABC-2) was used to identify learners with possible DCD. Furthermore, results were compared with regard to gender.Results: Of the 242 learners, 9.9% were identified with possible DCD. With regard to gender, 10.5% of boys and 9.3% of girls showed signs of possible DCD. No significant difference (p = 0.9439) has been found between boys and girls.Conclusion: The prevalence of possible DCD among Gr. 1 learners in this setting was higher than that in previously reported studies in other low and high socio-economic environments of South Africa. Further research is required to establish the full extent of possible DCD within learners living in low socio-economic environments.

Effectiveness and promising behavior change techniques of interventions targeting energy balance related behaviors in children from lower socioeconomic environments: A systematic review.

This systematic review aims to summarize the evidence regarding the effectiveness of interventions targeting energy balance-related behaviors in children from lower socioeconomic environments and the applied behavior change techniques. The literature search was conducted in Cochrane, Embase, Psycinfo and Pubmed. Articles had to be published between January 2000 and September 2019. Studies were included that i) targeted dietary behavior, physical activity and/or sedentary behavior; ii) had a controlled trial design; iii) included children aged 9-12 years old; iv) focused on lower socioeconomic environments; and v) took place in upper-middle or high income countries. Two independent researchers extracted data, identified behavior change techniques using the Behavior Change Technique Taxonomy v1, and performed a methodological quality assessment using the quality assessment tool of the Effective Public Health Practice Project. We included 24 studies, of which one received a high and three a moderate quality rating. Demonstration, practice and providing instructions on how to perform a behavior were the most commonly applied behavior change techniques. Seven studies reported significant beneficial intervention effects: five on physical activity, one on physical activity and sedentary behavior and one on dietary behavior. When comparing effective versus non-effective interventions, and comparing our review to previous reviews focusing on children from the general population, similar behavior change techniques were applied. More high quality research is needed to evaluate the effectiveness of interventions and their behavior change techniques targeting children of low socioeconomic environments. PROSPERO registration number: CRD42016052599.

Abstract IA21: Social factors and prostate cancer disparities in African American men

Abstract African-American (AA) men experience the highest prostate cancer (PCa) incidence and mortality rates of all U.S. racial/ethnic groups. They are also known to present with more aggressive high-risk disease, especially of higher Gleason score and PSA levels. Factors contributing to the high burden of PCa among AA men are not known. AAs are exposed to considerably higher levels of social stressors such as institutional and interpersonal discrimination, early life adversity, crime, low socioeconomic status, social isolation, and resource-poor environments. These social stressors exist at multiple levels, from individual to neighborhood to institutional, and across the lifecourse, leading to chronic stress. These social stressors experienced among AA men may thus be a contributor to the development of aggressive PCa and high mortality. This presentation will explore the conceptual multilevel frameworks that emphasize the consideration and evaluation of exposures from “cells to society” to understand how “stress gets under the skin” to cause biologic vulnerability, specifically the high burden of PCa among AA men. Within the infrastructure of the new RESPOND (Research on Prostate Cancer in Men of African Ancestry: Defining the Roles of Genetics, Immunity and Social Stress) Study, a nationwide cohort of 10,000 AA men with incident PCa, our project aims to: 1) Examine the associations between exposures to neighborhood social stressors and risk of aggressive PCa and mortality among AA and non-Hispanic White (NHW) men. Among population-based samples of all AA (N=149,000) and NHW (N=668,000) men diagnosed with PCa in the RESPOND catchment areas, we will link geospatial neighborhood data on segregation, racial composition, socioeconomic deprivation, and other social and built environment attributes to cancer registry data and examine the associations between these neighborhood factors and aggressive PCa and risk of mortality. 2) Examine the associations between exposures to multilevel social stressors across the lifecourse and risk of aggressive PCa among 10,000 AA men in RESPOND. 3) Examine the associations between exposures to multilevel social stressors across the lifecourse and genetic factors, as well as their combined effects in association with aggressive PCa. Covering 6 states and 1 metropolitan region and representing 38% of all AA men with PCa in the US, RESPOND will represent the single largest coordinated research effort to study aggressive PCa in AA men, with an innovative focus on social stressor exposures that are most relevant to this population. This project has the potential of identifying modifiable risk factors for aggressive prostate cancer to inform targeted prevention on a broad public health scale, such as targeting community support resources to neighborhoods with high stressors; the lifecourse approach will also provide the opportunity to identify critical time windows of disease susceptibility. The short-term impact of this research will be our expanded understanding of contextual- and individual-level stressors that are associated with aggressive disease among African American men, and the long-term impact, with future follow-up, is the determination of the effect of these social factors on disease progression and mortality. Citation Format: Scarlett Lin Gomez, Iona Cheng, Salma Shariff-Marco, Mindy C. DeRouen, Ann S. Hamilton, Daphne Y. Lichtensztajn, Pushkar Inamdar, Debby Oh, Laura Allen, Kirsten Beyer, Yuhong Zhou, Joseph Gibbons, Richard Pinder, David J. Press, David Conti, Christopher Haiman. Social factors and prostate cancer disparities in African American men [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr IA21.