non-Hispanic African American Research Articles

Investigating sex, race, and geographic disparities in bronchus and lung cancer mortality in the United States: a comprehensive longitudinal study (1999-2020) utilizing CDC WONDER data.

Lung and bronchus cancer has become the leading cause of cancer-related mortality in the United States. Understanding the patterns of mortality is an absolute requirement. This study analyzed Lung and Bronchus cancer-associated mortality rates from 1999 to 2020 using death certificate data from the Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research (CDC WONDER). Age-adjusted mortality rates (AAMRs), per 100000 people, and annual percentage change (APCs) were also calculated. 3599577 lung and bronchus cancer-related deaths occurred in patients aged younger than 1-85+ years between 1999 and 2020. Overall AAMRs declined from 59.1 in 1999 to 58.9 in 2001 (APC: -0.1364) then to 55.9 in 2005 (APC: -1.4388*) 50.5 by 2010 (APC: -2.0574*) 44.7 by 2014 (APC: -2.9497*) and 35.1 by 2020 (APC: -4.1040*). Men had higher AAMRs than women (overall AAMR men: 61.7 vs. women: 38.3). AAMRs were highest among non-Hispanic (NH) Black or African American (52.7) patients followed by NH White (51.8), NH American Indian or Alaska Native (38.6), NH Asian or Pacific Islander (24.7) and Hispanic or Latino race (20.2). AAMRs varied in region (overall AAMR; South: 52.4; Midwest: 52.3; Northeast: 46.3; West: 39.1). Non-metropolitan areas had a higher AAMR (55.9) as compared to metropolitan areas (46.7). The top 90th percentile states of Lung and Bronchus cancer AAMR were Arkansas, Kentucky, Mississippi, Tennessee, and West Virginia. An overall decreasing trend in AAMRs for lung and bronchus cancer was seen. Public health measures to regulate risk factors and precipitating events are needed.

Race-Ethnicity, Rurality, and Age in Prospective Preferences and Concerns Regarding Closed-Loop Implanted Neural Devices.

Responsive and human-centered neurotechnology development requires attention to public perceptions, particularly among groups underserved by existing treatments. The authors conducted a preregistered nationally representative survey (https://osf.io/ej9h2) using the NORC at the University of Chicago AmeriSpeak panel. One vignette compared an implanted neural device with surgical resection in a scenario involving epilepsy, and another compared an implanted neural device with medications in a scenario involving mood disorders. The survey also contained questions about respondents' confidence that a device would be available if needed and confidence that enough research has been conducted among people like themselves. Responses were entered into nested survey-weighted logistic regression models, including a base demographic model (to test the overall effect of demographic factors) and an adjusted model that also included socioeconomic, religious and political, and health care access predictors. A total of 1,047 adults responded to the survey, which oversampled Black non-Hispanic (N=214), Hispanic (N=210), and rural (N=219) Americans. In the base demographic model, older Americans were more likely to prefer an implanted device in the two scenarios, and non-Hispanic Black Americans were less likely than non-Hispanic White Americans to prefer a device; rural Americans were less confident than urban or suburban Americans in having access, and non-Hispanic Black and rural Americans were less confident that enough research has been conducted among people like themselves. In adjusted models, income was a key mediator, partially explaining the effect of age and the contrast between Black and White non-Hispanic respondents on preferences for a device in the epilepsy scenario and fully explaining the effect of rurality on confidence in access. Demographic differences in prospective preferences and concerns highlight the importance of including members of underserved communities in neurotechnology development.

Measuring Relationship Influences on Romantic Couples' Cancer-Related Behaviors During the COVID-19 Pandemic: Protocol for a Longitudinal Online Study of Dyads and Cancer Survivors.

Research has established the effects of romantic relationships on individuals' morbidity and mortality. However, the interplay between relationship functioning, affective processes, and health behaviors has been relatively understudied. During the COVID-19 pandemic, relational processes may influence novel health behaviors such as social distancing and masking. We describe the design, recruitment, and methods of the relationships, risk perceptions, and cancer-related behaviors during the COVID-19 pandemic study. This study was developed to understand how relational and affective processes influence romantic partners' engagement in cancer prevention behaviors as well as health behaviors introduced or exacerbated by the COVID-19 pandemic. The relationships, risk perceptions, and cancer-related behaviors during the COVID-19 pandemic study used online survey methods to recruit and enroll 2 cohorts of individuals involved in cohabiting romantic relationships, including 1 cohort of dyads (n=223) and 1 cohort of cancer survivors (n=443). Survey assessments were completed over 2 time points that were 5.57 (SD 3.14) weeks apart on average. Health behaviors assessed included COVID-19 vaccination and social distancing, physical activity, diet, sleep, alcohol use, and smoking behavior. We also examined relationship factors, psychological distress, and household chaos. Data collection occurred between October 2021 and August 2022. During that time, a total of 926 participants were enrolled, of which about two-thirds were from the United Kingdom (n=622, 67.8%) and one-third were from the United States (n=296, 32.2%); about two-thirds were married (n=608, 66.2%) and one-third were members of unmarried couples (n=294, 32%). In cohorts 1 and 2, the mean age was about 34 and 50, respectively. Out of 478 participants in cohort 1, 19 (4%) identified as Hispanic or Latino/a, 79 (17%) as non-Hispanic Asian, 40 (9%) as non-Hispanic Black or African American, and 306 (64%) as non-Hispanic White; 62 (13%) participants identified their sexual orientation as bisexual or pansexual, 359 (75.1%) as heterosexual or straight, and 53 (11%) as gay or lesbian. In cohort 2, out of 440 participants, 13 (3%) identified as Hispanic or Latino/a, 8 (2%) as non-Hispanic Asian, 5 (1%) as non-Hispanic Black or African American, and 398 (90.5%) as non-Hispanic White; 41 (9%) participants identified their sexual orientation as bisexual or pansexual, 384 (87.3%) as heterosexual or straight, and 13 (3%) as gay or lesbian. The overall enrollment rate for individuals was 66.14% and the overall completion rate was 80.08%. We discuss best practices for collecting online survey data for studies examining relationships and health, challenges related to the COVID-19 pandemic, recruitment of underrepresented populations, and enrollment of dyads. Recommendations include conducting pilot studies, allowing for extra time in the data collection timeline for marginalized or underserved populations, surplus screening to account for expected attrition within dyads, as well as planning dyad-specific data quality checks. DERR1-10.2196/48516.

Ethnic bias, economic achievement and trust between large ethnic groups: A study in Germany and the U.S

Evidence for ingroup bias is extensive, yet the distinct patterns of discrimination among dominant ethnic groups in the diverse societies of modern industrial nations such as the United States and Germany remain largely unexplored. Incentivized trust games in nationally-representative samples from both countries reveal biases of roughly equal size by non-Hispanic White Americans, Hispanic Americans, and African Americans against each outgroup. In Germany, the majority demonstrates twice as much bias against Turkish minorities compared to Eastern Europeans. Interestingly, both minority groups send similar amounts to ethnic Germans and members of their own groups. We examine the notion that outgroup discrimination by majority group members stems from stereotypes of minorities as economically unsuccessful, employing trust games with high-income counterparts. We find that majority senders’ bias against minority receivers declines when receivers are known to have high incomes, in line with that idea. Interestingly, some minority groups, especially Turkish descendants, display a negative propensity to transfer to rich members of their ingroup in comparison with outgroup members, relative to baseline. While we focus on differences in sending by ethnic pairing, we note that all participants send less to second movers identified as high income, and discuss possible explanations. We estimate that four-fifths of the observed ingroup bias is taste-based rather than due to expected trustworthiness differences. This estimation is robust to identifying the purely altruistic component of trust game sending toward each ethnic group, including one's own.

Lay down your sword? Christian nationalism, race, and opposition to requiring gun permits

ABSTRACT Christian nationalism and race are both important predictors of firearm policy preferences in the United States, and a growing body of research argues that ideas about gun control tend to be racially coded. Building on these findings, we use data from the 2021 General Social Survey to examine how race and ethnicity moderate the association between Christian nationalism and firearm policy preferences – specifically requiring a police permit to purchase a gun. Analyses show strong, racially divergent associations between Christian nationalism and opposition to requiring gun permits. Christian nationalism is associated with higher opposition to requiring gun permits for non-Hispanic White Americans, but lower opposition for non-Hispanic Black Americans. Moreover, accounting for biblical literalism attenuates the association for White Americans but amplifies the association for Black Americans. These findings support the conceptualization of Christian nationalism as a racialized ideology, i.e. one which has different meanings and effects across ethno-racial identities.

Investigating the Rates of Cesarean and Vaginal Deliveries Across Different Races and Ethnicities at Ascension St. Vincent Indianapolis

Background: Cesarean section remains one of the most common surgical procedures for women in the United States. Previous studies have shown higher rates in African-American and Asian women and lower rates among White and Hispanic women. The objective of this study is to investigate the rates of cesarean and vaginal deliveries across different races and ethnicities as well as languages spoken at our institution. Methods: A retrospective chart review was completed of nulliparous women with term, singleton, and vertex deliveries between 2015-2020. Factors increasing risk for cesarean or contraindications for vaginal delivery were excluded. Binomial logistic regression analysis was used to evaluate mode and delivery indications among racial and ethnic groups as well as among primary languages spoken. Results: White was the largest race reported (66.4%), followed by Black or African American (27.6%), then Asian (3.6%). “Other” or rather, “Non-Hispanic”, was the largest ethnicity reported (85.2%). Cross-tabulating race and ethnicities, the largest group was non-Hispanic White (54%), followed by Non-Hispanic Black or African American (26.5%), then Hispanic or Latino (10.8%). Primary languages were English (91.0%), followed by Spanish (5.7%), then Other (3.3%). Preliminary results showed statistically significant differences in age, BMI, insufficient prenatal care, and specific labor dystocia indications among different races and ethnicities. There were also differences among English vs Spanish vs “Other” languages but not in rates of vaginal and cesarean deliveries. The binomial logistic regression analysis showed that BMI and most labor dystocia positively correlated with cesarean delivery, whereas race/ethnicity, language, age, insufficient prenatal care, and induction status did not change the outcome. Conclusions: Racial and ethnic differences in mode of delivery have been previously documented in previous studies; although we did not find this at our institution. Our findings, however, show a positive relationship between Body Mass Index (BMI) and cesarean delivery, as has previously been documented.

Associations between urine glyphosate levels and metabolic health risks: insights from a large cross-sectional population-based study

BackgroundThe prevalence of metabolic syndrome (MetS) in American adults increased from 37.6% in the 2011–12 period to 41.8% in 2017–2018. Environmental exposure, particularly to common compounds such as glyphosate, has drawn increasing attention as a potential risk factor.MethodsWe employed three cycles of data (2013–2018) from the National Health and Nutrition Examination Survey (NHANES) in a cross-sectional study to examine potential associations between urine glyphosate measurements and MetS incidence. We first created a MetS score using exploratory factor analysis (EFA) of the International Diabetes Federation (IDF) criteria for MetS, with data drawn from the 2013–2018 NHANES cycles, and validated this score independently on an additional associated metric, the albumin-to-creatinine (ACR) ratio. The score was validated via a machine learning approach in predicting the ACR score via binary classification and then used in multivariable regression to test the association between quartile-categorized glyphosate exposure and the MetS score.ResultsIn adjusted multivariable regressions, regressions between quartile-categorized glyphosate exposure and MetS score showed a significant inverted U-shaped or saturating dose‒response profile, often with the largest effect for exposures in quartile 3. Exploration of potential effect modification by sex, race, and age category revealed significant differences by race and age, with older people (aged > 65 years) and non-Hispanic African American participants showing larger effect sizes for all exposure quartiles.ConclusionsWe found that urinary glyphosate concentration is significantly associated with a statistical score designed to predict MetS status and that dose–response coefficient is nonlinear, with advanced age and non-Hispanic African American, Mexican American and other Hispanic participants exhibiting greater effect sizes.

Treatment for Opioid Use Disorder: Population Estimates - United States, 2022.

In 2022, 81,806 opioid-involved overdose deaths were reported in the United States, more than in any previous year. Medications for opioid use disorder (OUD), particularly buprenorphine and methadone, substantially reduce overdose-related and overall mortality. However, only a small proportion of persons with OUD receive these medications. Data from the 2022 National Survey on Drug Use and Health were applied to a cascade of care framework to estimate and characterize U.S. adult populations who need OUD treatment, receive any OUD treatment, and receive medications for OUD. In 2022, 3.7% of U.S. adults aged ≥18 years needed OUD treatment. Among these, only 25.1% received medications for OUD. Most adults who needed OUD treatment either did not perceive that they needed it (42.7%) or received OUD treatment without medications for OUD (30.0%). Compared with non-Hispanic Black or African American and Hispanic or Latino adults, higher percentages of non-Hispanic White adults received any OUD treatment. Higher percentages of men and adults aged 35-49 years received medications for OUD than did women and younger or older adults. Expanded communication about the effectiveness of medications for OUD is needed. Increased efforts to engage persons with OUD in treatment that includes medications are essential. Clinicians and other treatment providers should offer or arrange evidence-based treatment, including medications, for patients with OUD. Pharmacists and payors can work to make these medications available without delays.

Rising Mortality among Non-Hispanics due to Pancreatic Cancer in the United States. A CDC Database analysis.

To examine mortality trends among non-Hispanic (NH) adults with pancreatic cancer. CDC-WONDER database was used to extract death certificate data on pancreatic cancer-related mortality in NH adults aged ≥ 45 from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent changes (APCs) were calculated and stratified by year, age, sex, race, and region. From 1999 to 2020, 783,772 deaths occurred among middle-aged (45-64) and older (65-85 +) NH adults. Overall AAMR increased from 31.7 in 1999 to 33.8 in 2020 (APC: 0.35; 95% CI:0.28-0.41). NH older adults had higher AAMRs (67.9) than NH middle-aged adults (12.5). Men consistently had higher AAMRs (37.7) than women (28.4). NH African Americans had the highest AAMRs (40.8) compared to NH Whites (32.1), NH American Indians (23.9), and NH Asians (22.4). Metropolitan areas had a higher AAMR (32.7) than non-metropolitan areas (32.2). The Northeast region had the highest AAMR (34.0) followed by Midwest (33.2), South (32.2), and West (30.1). Delaware, District of Columbia, Louisiana, Michigan, and Mississippi had the highest AAMRs among states. Pancreatic cancer-related mortality among NH adults has increased from 1999 to 2020. Highest AAMRs were reported in older men, NH African Americans, the Northeastern and metropolitan areas.

Mpox Surveillance Based on Rash Characteristics - 13 Emergency Departments, United States, June-December 2023.

In 2022, a global mpox outbreak occurred, primarily affecting gay and bisexual men who have sex with men (GBMSM). To screen for mpox's reemergence and investigate potentially unsuspected cases among non-GBMSM, prospective surveillance of patients aged ≥3 months with an mpox-compatible rash (vesicular, pustular, ulcerated, or crusted) was conducted at 13 U.S. emergency departments (EDs) during June-December 2023. Demographic, historical, and illness characteristics were collected using questionnaires and electronic health records. Lesions were tested for monkeypox virus using polymerase chain reaction. Among 196 enrolled persons, the median age was 37.5 years (IQR=21.0-53.5 years); 39 (19.9%) were aged <16 years, and 108 (55.1%) were male. Among all enrollees, 13 (6.6%) were GBMSM. Overall, approximately one half (46.4%) and one quarter (23.5%) of enrolled persons were non-Hispanic White and non-Hispanic Black or African American, respectively, and 38.8% reported Hispanic or Latino (Hispanic) ethnicity. Unstable housing was reported by 21 (10.7%) enrollees, and 24 (12.2%) lacked health insurance. The prevalence of mpox among ED patients evaluated for an mpox-compatible rash was 1.5% (95% CI=0.3%-4.4%); all persons with a confirmed mpox diagnosis identified as GBMSM and reported being HIV-negative, not being vaccinated against mpox, and having engaged in sex with one or more partners met through smartphone dating applications. No cases were identified among women, children, or unhoused persons. Clinicians should remain vigilant for mpox and educate persons at risk for mpox about modifying behaviors that increase risk and the importance of receiving 2 appropriately spaced doses of JYNNEOS vaccine to prevent mpox.

Novel early-onset Alzheimer-associated genes influence risk through dysregulation of glutamate, immune activation, and intracell signaling pathways.

Alzheimer Disease (AD) is a highly polygenic disease that presents with relatively earlier onset (≤70yo; EOAD) in about 5% of cases. Around 90% of these EOAD cases remain unexplained by pathogenic mutations. Using data from EOAD cases and controls, we performed a genome-wide association study (GWAS) and trans-ancestry meta-analysis on non-Hispanic Whites (NHW, NCase=6,282, NControl=13,386), African Americans (AA NCase=782, NControl=3,663) and East Asians (NCase=375, NControl=838 CO). We identified eight novel significant loci: six in the ancestry-specific analyses and two in the trans-ancestry analysis. By integrating gene-based analysis, eQTL, pQTL and functional annotations, we nominate four novel genes that are involved in microglia activation, glutamate production, and signaling pathways. These results indicate that EOAD, although sharing many genes with LOAD, harbors unique genes and pathways that could be used to create better prediction models or target identification for this type of AD.

Navigating disparities: Insights from a colorectal cancer screening program in federally qualified community healthcare centers.

1537 Background: Colorectal cancer (CRC) is the second leading cause of cancer deaths in Georgia. Despite evidence for the effectiveness of CRC screening, disparities in access are prevalent in underserved populations. Georgia’s Federally Qualified Health Centers (FQHCs) struggle with low screening rates (42.8%), partly due to Georgia’s lack of Medicaid expansion, poor access to health services in rural areas, and deficiencies in coordinated strategies. The Georgia Colorectal Cancer Control Program (GCRCCP) was funded by the Centers for Disease Control and Prevention to implement evidence-based interventions (EBIs) in qualifying FQHCs across South Georgia. Here, we assess the program's impact on clinic-level screening rates (SR). Methods: Fourteen clinics with 12,159 CRC-eligible patients (ages 50-75) were enrolled from East Georgia Healthcare Center (EGHC) and Albany Area Primary Health Center (AAPHC). FQHC clinics had to have a SR below 60% to participate in the program. In addition to the EBIs (provider assessment and feedback, provider reminders, patient reminders, reducing structural barriers), the GCRCCP integrated provider education using the ECHO Model and navigation through a nationally recognized, evidence-based patient navigation program. We compared baseline (2020 and 2021) and follow-up data (2022) to determine the average change in SR over time, overall, and by demographic sub-groups. Results: The overall change in SR for the 14 clinics was +6.7%, from a baseline average of 45.3% to 52% in 2022. The average change in SR for EGHC clinics (n=9) was +11.5% (from 32.2 to 43.7%). Women had a higher SR (44.9%) than men (41.8%), but both realized an increase in SR, +10.5% and +9.1%. Non-Hispanic Black Americans (NHBA) experienced a higher increase in SR, +13.7% (from 37.2 to 50.9%) than their Non-Hispanic White (NHW) counterparts (+7.5% (from 29.8 to 37.3%)). The uninsured vs. insured followed a similar pattern (+15.3% (from 17.8 to 33.1%)) vs. +2.1 (from 45.9 to 48%). The average change in SR for AAPHC clinics (n=5) was +1.8% (from 58.4 to 60.2%). There was a decline in SR for men, -8.6% (from 64 to 55.4%), and an increase for women, +3.8% (from 58.2 to 62%). NHBA had a decrease in SR, -0.8% (from 61.2 to 61%), while NHW Americans had an increase in SR, +0.2% (from 53.8 to 54.2%). The uninsured and insured groups realized minimal increases of +0.6% (from 46 to 46.6%) and +0.8% (from 62 to 62.8%), respectively. Conclusions: The implementation of EBIs and patient navigation show varied potential to reduce disparities in accessing CRC screening in underserved populations. FQHC clinics that sustain implementation activities and workflow processes can benefit communities long-term and improve health equity.

Prevalence of Stroke - Behavioral Risk Factor Surveillance System, United States, 2011-2022.

Stroke was the fifth leading cause of death in the United States in 2021, and cost U.S. residents approximately $56.2 billion during 2019-2020. During 2006-2010, self-reported stroke prevalence among noninstitutionalized adults had a relative decrease of 3.7%. Data from the Behavioral Risk Factor Surveillance System were used to analyze age-standardized stroke prevalence during 2011-2022 among adults aged ≥18 years. From 2011-2013 to 2020-2022, overall self-reported stroke prevalence increased by 7.8% nationwide. Increases occurred among adults aged 18-64 years; females and males; non-Hispanic Black or African American (Black), non-Hispanic White (White), and Hispanic or Latino (Hispanic) persons; and adults with less than a college degree. Stroke prevalence was higher among adults aged ≥65 years than among younger adults; among non-Hispanic American Indian or Alaska Native, non-Hispanic Native Hawaiian or Pacific Islander, and Black adults than among White adults; and among adults with less than a high school education than among those with higher levels of education. Stroke prevalence decreased in the District of Columbia and increased in 10 states. Initiatives to promote knowledge of the signs and symptoms of stroke, and the identification of disparities in stroke prevalence, might help to focus clinical and programmatic interventions, such as the Million Hearts 2027 initiative or the Paul Coverdell National Acute Stroke Program, to improve prevention and treatment of stroke.

Abstract PO2-09-06: Interaction of racial disparities on outcomes and toxicities associated with treatment of HER2+Breast Cancer- a TrinetX Database study

Abstract Objective: Investigate the interaction of racial disparities on outcomes and toxicities associated with treatment of HER2+BrCa (Breast Cancer)- a TrinetX Database study Background: HER2+BrCa is an aggressive subtype accounting for about 1/3rd of all BrCa, for which Trastuzumab based therapy remains the mainstay of treatment. While we are starting to understand the breadth of racial disparities in BrCa , the knowledge about outcomes and toxicities in relation to treatment of HER2+ BrCa is still limited. Design/Methods: In this propensity score-matched cohort study we used the TriNetX Research Network, a multi-health care organization de-identified electronic health record (EHR) database, to compare the 1-, 3-, and 5-year mortality of HER2+BrCa non-Hispanic African American (NHAA) women to a corresponding non-Hispanic White cohort (NHW). Qualification into the two race based HER2+BrCa cohorts required the presence of a C50 ICD-10-CM diagnosis code and at least one proxy for HER2 positivity such as Trastuzumab administration (index event). Cohorts were matched for age, BMI, comorbidities (HTN, DM ), and lab values using 1:1 matching with a greedy nearest neighbor search. Toxicity outcomes of interest such as cardiomyopathy, neuropathy, diarrhea, rashes, leg swelling/edema, and fatigue as well as the frequency of emergency room visits were also compared between the cohorts. The associations of observed outcome frequencies in the two cohorts were tested for significance using the chi-square test. The odds ratios and p-values, corrected for multiple hypothesis testing using the Benjamini-Hochberg procedure, are reported as an effect size and significance estimation. Results: 15983 patients met the inclusion criteria for HER2+BrCa (13611-NHW and 2372-NHAA). The mean age at the index event was 55.6 ± 12.6 years for NHAA and 57.2 ± 13.3 years for NHW. After matching the two sub-cohorts, 2303 patients remained in each. NHAA women were found to have significantly increased odds of neuropathy and cardiomyopathy for 1, 3, and 5-year time intervals after the HER2+BrCa index date, as compared to the reference NHW women (abbreviated results given in Table 1). In addition, the odds of an emergency room visit (for any reason) was found to be increased by as much as 79% in NHAA women as compared to the NHW women. The odds of experiencing fatigue/malaise, diarrhea/nausea, and rash, were reduced for NHAA women across all time intervals investigated. Odds ratios for mortality and leg swelling did not meet the significance threshold (p-value &amp;lt; 0.05). Conclusion: This study, which examined racial disparities in outcomes and toxicities associated with HER2+BrCa, revealed significant findings. NHAA women with HER2+BrCa treated with Trastuzumab based therapy demonstrated increased odds of experiencing neuropathy and cardiomyopathy compared to their NHW counterparts. Additionally, NHAA women had a higher likelihood of emergency room visits for any reason. Conversely, NHAA women exhibited decreased odds of fatigue/malaise, diarrhea/nausea, and rash. These findings underscore the importance of considering the impact of race on HER2+BrCa outcomes and treatment toxicities and suggest the need for further research and targeted interventions to address disparities and thus enhance treatment outcomes in diverse populations. Table 1: Representative significant Odds ratios and corrected p-values for outcomes comparing the NHAA and NHW cohorts. Citation Format: Monali Vasekar, Justin Petucci, Avnish Katoch, Vasant Honavar. Interaction of racial disparities on outcomes and toxicities associated with treatment of HER2+Breast Cancer- a TrinetX Database study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-09-06.

Prevalence of Positive Childhood Experiences Among Adults - Behavioral Risk Factor Surveillance System, Four States, 2015-2021.

Positive childhood experiences (PCEs) promote optimal health and mitigate the effects of adverse childhood experiences, but PCE prevalence in the United States is not well-known. Using Behavioral Risk Factor Surveillance System data, this study describes the prevalence of individual and cumulative PCEs among adults residing in four states: Kansas (2020), Montana (2019), South Carolina (2020), and Wisconsin (2015). Cumulative PCE scores were calculated by summing affirmative responses to seven questions. Subscores were created for family-related (three questions) and community-related (four questions) PCEs. The prevalence of individual PCEs varied from 59.5% (enjoyed participating in community traditions) to 90.5% (adult in respondents' household made them feel safe), and differed significantly by race and ethnicity, age, and sexual orientation. Fewer non-Hispanic Black or African American (49.2%), non-Hispanic Alaska Native or American Indian (37.7%), and Hispanic or Latino respondents (38.9%) reported 6-7 PCEs than did non-Hispanic White respondents (55.2%). Gay or lesbian, and bisexual respondents were less likely than were straight respondents to report 6-7 PCEs (38.1% and 27.4% versus 54.7%, respectively). A PCE score of 6-7 was more frequent among persons with higher income and education. Improved understanding of the relationship of PCEs to adult health and well-being and variation among population subgroups might help reduce health inequities.

Abstract PO5-10-06: A Pilot Study for Clinical Research Nurse Navigation at an Urban NCI-Designated Comprehensive Cancer Center

Abstract Background: Breast cancer is now the leading cause of cancer death for non-Hispanic Black women in Georgia with non-Hispanic Black women 40% more likely to die of breast cancer compared to White women. Inadequate representation of patients in clinical trials may contribute to health care inequity, though prior work has also shown disparate outcomes on similar clinical trials at Emory, suggesting differences in tumor biology may also be contributing to the disparity. Improving diversity in trial participation is imperative to better understand these differences, particularly with newer molecularly targeted therapies. We aimed to utilize Clinical Trials Nurse Navigation to increase clinical trial enrollment at an urban NCI-designated comprehensive care center in Atlanta, Georgia. Methods: A prospective pilot study was conducted investigating the role of a Clinical Research Nurse as a dedicated Clinical Trials Nurse Navigator to identify, pre-screen, and refer potential patients to both breast and next generation sequencing (NGS)-driven basket clinical trials at the Winship Cancer Institute at Emory University. The role also included centralizing all molecular data from patients with stage IV breast cancer into a database as a tool to refer patients to NGS-driven clinical trials. This role expands upon the Institute’s current research nursing scope to better meet the needs of our diverse patient population. Our catchment area is 35% non-Hispanic Black or African American. The nurse prescreened patients with stage IV breast cancer from breast oncology clinic templates and the breast NGS database to match them with clinical trials, with a particular emphasis on patients with stage IV triple negative breast cancer. The study began in January 2022 and is currently ongoing. Results: Since study initiation in January 2022, there has been a 27% increase in breast cancer clinical trial enrollment over a 12-month period. Over the last 6 months from January 2023, this has increased even further with 57 patients enrolled onto breast cancer clinical trials compared to a total enrollment of 70 patients onto breast cancer clinical trials in 2022 (Table 1). Of these patients, 11% enrolled in NGS-driven clinical trials in 2022 to present compared to 0% in 2021. Twenty-two (31.4%) non-Hispanic Black women enrolled onto breast cancer clinical trials in 2022 with another 21 (36.8%) non-Hispanic Black women enrolled thus far in 2023 (Table 1). Conclusion: Disparities in clinical trial enrollment may contribute to racial inequities in breast cancer outcomes. Implementation of clinical research nurse navigation has successfully improved clinical trial enrollment and diversity in clinical trial enrollment at our urban cancer center. Through increasing clinical trial prescreening, centralizing an NGS database, and dedicated nurse support to allow patients to navigate onto clinical trials, we achieved a 21% improvement in clinical trial enrollment from 2021 to 2022 and are on track to increase enrollment by 200% by the end of 2023. Clinical trials nurse navigators serve as an essential link between clinical trial patients and their providers, and should strongly be considered a key component of all clinical trials programs. Table 1 Breast Working Group Patient Enrollment by Race and Ethnicity, 2019-2023 Citation Format: Lizzie Huckaby, Maisey Ratcliffe, Madison Canning, Demetria Smith-Graziani, Kevin Kalinsky, Manali Bhave. A Pilot Study for Clinical Research Nurse Navigation at an Urban NCI-Designated Comprehensive Cancer Center [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-10-06.

Prevalence of Diabetes Mellitus among Haitian Americans: A Hidden Epidemic

Abstract: The prevalence of diabetes mellitus in the Haitian American population remains an important question. A recent study revealed an alarming prevalence of 39.9%. To corroborate these data, between November 2021 and September 2023 a representative sample was collected among 401 Haitian Americans in Florida, Maryland, New Jersey, and New York. Results revealed a crude prevalence rate of 36.6% (95% CI 31.85, 41.55%). The age-adjusted prevalence was 29.7% (CI 19.71%, 39.63%). This study's prevalence is nearly double the 16.8% (Z=10.48, p&lt;.0001) rate in non-Hispanic African Americans and nearly two and a half times the 12.0% (Z=14.99, p&lt;.0001) rate in all Americans. The crude prevalence for undiagnosed diabetes mellitus was 13.38% (CI 10.19%, 17.14%), with 17.11% age-adjusted prevalence (CI 7.53%, 26.70%). The scope of the diabetes burden, especially the high rate of undiagnosed cases, indicates a need for better strategies for the prevention, screening, treatment, and management of diabetes among Haitian Americans.

Trends in volumes and survival after hematopoietic cell transplantation in racial/ethnic minorities

AbstractThere has been an increase in volume as well as an improvement in overall survival (OS) after hematopoietic cell transplantation (HCT) for hematologic disorders. It is unknown if these changes have affected racial/ethnic minorities equally. In this observational study from the Center for International Blood and Marrow Transplant Research of 79 904 autologous (auto) and 65 662 allogeneic (allo) HCTs, we examined the volume and rates of change of autoHCT and alloHCT over time and trends in OS in 4 racial/ethnic groups: non-Hispanic Whites (NHWs), non-Hispanic African Americans (NHAAs), and Hispanics across 5 2-year cohorts from 2009 to 2018. Rates of change were compared using Poisson model. Adjusted and unadjusted Cox proportional hazards models examined trends in mortality in the 4 racial/ethnic groups over 5 study time periods. The rates of increase in volume were significantly higher for Hispanics and NHAAs vs NHW for both autoHCT and alloHCT. Adjusted overall mortality after autoHCT was comparable across all racial/ethnic groups. NHAA adults (hazard ratio [HR] 1.13; 95% confidence interval [CI] 1.04-1.22; P = .004) and pediatric patients (HR 1.62; 95% CI 1.3-2.03; P < .001) had a higher risk of mortality after alloHCT than NHWs. Improvement in OS over time was seen in all 4 groups after both autoHCT and alloHCT. Our study shows the rate of change for the use of autoHCT and alloHCT is higher in NHAAs and Hispanics than in NHWs. Survival after autoHCT and alloHCT improved over time; however, NHAAs have worse OS after alloHCT, which has persisted. Continued efforts are needed to mitigate disparities for patients requiring alloHCT.

Federal Retail Pharmacy Program Contributions to Bivalent mRNA COVID-19 Vaccinations Across Sociodemographic Characteristics - United States, September 1, 2022-September 30, 2023.

The Federal Retail Pharmacy Program (FRPP) facilitated integration of pharmacies as partners in national efforts to scale up vaccination capacity during the COVID-19 pandemic emergency response. To evaluate FRPP's contribution to vaccination efforts across various sociodemographic groups, data on COVID-19 bivalent mRNA vaccine doses administered during September 1, 2022-September 30, 2023, were evaluated from two sources: 1) FRPP data reported directly to CDC and 2) jurisdictional immunization information systems data reported to CDC from all 50 states, the District of Columbia, U.S. territories, and freely associated states. Among 59.8 million COVID-19 bivalent vaccine doses administered in the United States during this period, 40.5 million (67.7%) were administered by FRPP partners. The proportion of COVID-19 bivalent doses administered by FRPP partners ranged from 5.9% among children aged 6 months-4 years to 70.6% among adults aged 18-49 years. Among some racial and ethnic minority groups (e.g., Hispanic or Latino, non-Hispanic Black or African American, non-Hispanic Native Hawaiian or other Pacific Islander, and non-Hispanic Asian persons), ≥45% of COVID-19 bivalent vaccine doses were administered by FRPP partners. Further, in urban and rural areas, FRPP partners administered 81.6% and 60.0% of bivalent vaccine doses, respectively. The FRPP partnership administered approximately two thirds of all bivalent COVID-19 vaccine doses in the United States and provided vaccine access for persons across a wide range of sociodemographic groups, demonstrating that this program could serve as a model to address vaccination services needs for routine vaccines and to provide health services in other public health emergencies.

Years of Potential Life Lost and Mean Age of Adults Experiencing Nontraumatic, Out-of-Hospital Cardiac Arrests - Chicago, 2014-2021.

Approximately 1,000 out-of-hospital cardiac arrests (OHCAs) are assessed by emergency medical services in the United States every day, and approximately 90% of patients do not survive, leading to substantial years of potential life lost (YPLL). Chicago emergency medical services data were used to assess changes in mean age and YPLL from nontraumatic OHCA in adults in biennial cycles during 2014-2021. Among 21,070 reported nontraumatic OHCAs during 2014-2021, approximately 60% occurred among men and 57% among non-Hispanic Black or African American (Black) persons. YPLL increased from 52,044 during 2014-2015 to 88,788 during 2020-2021 (p = 0.002) and mean age decreased from 64.7 years during 2014-2015, to 62.7 years during 2020-2021. Decrease in mean age occurred among both men (p<0.001) and women (p = 0.002) and was largest among Black men. Mean age decreased among patients without presumed cardiac etiology from 56.3 to 52.5 years (p<0.001) and among patients with nonshockable rhythm from 65.5 to 62.7 years (p<0.001). Further study is needed to assess whether similar trends are occurring elsewhere, and to understand the mechanisms that underlie these trends in Chicago because these mechanisms could help guide prevention efforts. Increased public awareness of the risk of cardiac arrest and knowledge of how to intervene as a bystander could help decrease associated mortality.