non-Hispanic Black Respondents Research Articles

Abstract A016: Understanding the Impact of Numerous Cancer Prevention Guidelines on Public Adherence

Abstract Background: Organizations like the American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF) have developed comprehensive cancer prevention guidelines focusing on nutrition, physical activity, cancer screening, and vaccination with a goal of reducing cancer incidence and improving cancer health outcomes. However, the abundance and complexity of these guidelines can lead to public confusion and potentially hinder adherence. This study investigates public perception of the multitude of cancer prevention guidelines and their potential impact on compliance. Methods: Data were derived from the 2020 Health Information National Trends Survey (HINTS 5, Cycle 4, 2020), conducted via a mail survey from February to June 2020. We examined public perception about cancer prevention recommendations and if the number of recommendations made it more difficult to determine which ones to follow. Multivariable Logistic regression was used to examine the factors that are associated with agreement with the statement: “there are so many different recommendations about preventing cancer, it's hard to know which ones to follow.” Results: Survey respondents consisted of 3,747 U.S. adults. Approximately 74.1% of respondents agreed with the statement, "There are so many different recommendations about preventing cancer, it's hard to know which ones to follow." Non-Hispanic Black respondents had the highest proportion of agreement (80.6%) Level of education was statistically significantly associated with agreement with the statement "there are so many different recommendations about preventing cancer, it's hard to know which ones to follow." As education level increased, the odds of agreeing with the statement decreased. Specifically, college graduates (aOR 0.58; 95% CI: 0.36-0.94), and those with postgraduate education had an aOR of 0.38 (95% CI: 0.22-0.67). Conclusion: The study highlights significant public perception challenges regarding the abundance of cancer prevention guidelines. These findings suggest a need for streamlined communication and education strategies to enhance guideline adherence and optimize cancer prevention efforts. Citation Format: Tochukwu Nzeako, Onyema Chido-Amajuoyi. Understanding the Impact of Numerous Cancer Prevention Guidelines on Public Adherence [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A016.

Religious Involvement and Cognitive Function Among White, Black, and Hispanic Older Adults.

We examined whether religious involvement was associated with cognitive function among older adults in the 2006-2020 waves of the Health and Retirement Study. Using growth curve analysis, we found the association between religious involvement and cognition varied by facet of religious involvement and race and Hispanic ethnicity. Attending religious services with friends was associated with higher initial levels of cognitive function (b = 0.22, p < .05). For Hispanic older adults, frequent attendance at religious services was associated with a slower rate of cognitive decline (b = 0.16, p < .01). Stratified models by race and Hispanic ethnicity demonstrated that religious salience was associated with lower initial levels of cognitive function among non-Hispanic White adults (b = -0.19, p < .01). We found no association between religious involvement and cognitive function among non-Hispanic Black respondents. In sum, elements of religious involvement are positively or negatively related to cognitive function in later life and vary by race and ethnicity.

Disparities in Exposure to Tobacco on Television or Streaming Platforms

With the rise in popularity of streaming platforms concerns about exposure to tobacco advertising and promotion have emerged. While tobacco marketing and promotion through traditional television (TV) media channels has been extensively studied, less is known about exposure to tobacco through TV or streaming platforms and its associated factors. To examine the prevalence and factors associated with exposure to tobacco products advertised, marketed, or promoted on TV or streaming platforms among US adults. This cross-sectional study used data from the National Cancer Institute's Health Information National Trends Survey (HINTS 6), conducted from March 7 to November 8, 2022. The nationally representative survey included noninstitutionalized civilian US adults. The primary outcome was self-reported exposure to tobacco advertisements, marketing, or promotion on TV or streaming platforms in the past 3 months. Factors associated with exposure were explored using multivariable survey logistic regression. The study included 5775 participants (3415 females [weighted percentage, 50.5%], 970 Hispanic individuals [weighted percentage, 16.9%], 872 non-Hispanic Black or African American individuals [11.1%], 3144 non-White individuals [61.5%], and 632 individuals who currently smoke [12.0%]). The estimated exposure to tobacco advertisements, marketing, or promotion on television or streaming platforms was 12.4% (95% CI, 10.8%-14.2%). Multivariable logistic regression analysis revealed that exposure odds were higher among those who had a level of education of high school or less (adjusted odds ratio [aOR], 1.60; 95% CI, 1.08-2.37), individuals who currently smoke (aOR, 1.85; 95% CI, 1.06-3.25), non-Hispanic Black or African American respondents (aOR, 2.20; 95% CI, 1.40-3.45) and Hispanic respondents (aOR, 1.58; 95% CI, 1.04-2.42). In this study of the prevalence of exposure to tobacco advertisements on TV or streaming platforms among US adults, disparities in exposure by race or ethnicity, education level, and smoking status were identified. These findings underscore the need for targeted public health interventions and regulation to address these disparities and reduce the impact of tobacco advertisements on vulnerable populations.

Socializing Policy Feedback: The Long-Term Effects of Adolescent Program Participation on Adult Party Identification

Despite the expectation that welfare participation—because of its direct monetary payments—fosters strong attachments to the Democratic Party, the evidence to date suggests that welfare is unrelated to party identification. The majority of this research, however, focuses on adults, when partisan development is over. We argue that adolescent welfare participation may serve as a class-based signal that reinforces identification with the Democratic Party. Our inferences are generally consistent with this line of reasoning, but we also find important differences across race and ethnicity. Depending on the model, the likelihood of identifying with the Democratic Party in adulthood for white respondents is anywhere from 9 to 16% points higher for respondents who grew up in families that received welfare compared to those who did not have adolescent welfare participation. Other results, however, suggest a negative association between adolescent welfare use and identification with the Democratic Party for non-Hispanic black respondents. We conclude that despite the fact that adult welfare experiences lead to political disengagement, adolescent program participation can be sites of partisan learning.

Tobacco and Nicotine Product Use Transitions by Race and Ethnicity: Results from a Latent Transition Analysis Using Data from the Truth Longitudinal Cohort (2020–2022)

Objective To examine use and frequency patterns across e-cigarettes, cigarettes, and little cigars, cigars, and cigarillos (LCCs) over time and determine whether patterns differ by race and ethnicity. Methods Data was obtained from the Truth Longitudinal Cohort of youth and young adults between September 2020 and June 2022. Latent class and transition analyses were used to classify participants (N = 4448) into subgroups, based on frequency of tobacco product use in the past 30 days, and to estimate the probability of use pattern transitions by race and ethnicity, adjusted for the effects of gender, financial situation, parental education, household tobacco use, and sensation seeking. Results Four latent classes were identified: former/noncurrent users, predominantly frequent to daily (FTD) e-cigarette users, predominantly FTD e-cigarette and LCC users, and predominantly FTD cigarette with polytobacco users. Use trajectories differed by race and ethnicity. A lower proportion of those who identified as non-Hispanic Black (60.0%) remained e-cigarette and LCC users, relative to those who identified as non-Hispanic White (86.0%), Hispanic or Latino (86.0%), and another race and ethnicity (79.0%). A lower proportion of those who identified as Hispanic or Latino (54.0%) and another race and ethnicity (59.9%) remained cigarette with polytobacco users, relative to those who identified as non-Hispanic White (76.0%) and non-Hispanic Black (72.0%). A greater proportion of non-Hispanic Black respondents transitioned from e-cigarette and LCC user to former/noncurrent user (40.0%) and polytobacco user to e-cigarette and LCC user (11.0%), relative to other racial/ethnic groups. Conclusion More research is needed to determine why tobacco use trajectories differ by race and ethnicity. Such research will be important in informing comprehensive approaches that promote evidence-based prevention policies and programs.

Coverage and Access Changes During Medicaid Unwinding

States resumed Medicaid eligibility redeterminations, which had been paused during the COVID-19 public health emergency, in 2023. This unwinding of the pandemic continuous coverage provision raised concerns about the extent to which beneficiaries would lose Medicaid coverage and how that would affect access to care. To assess early changes in insurance and access to care during Medicaid unwinding among individuals with low incomes in 4 Southern states. This multimodal survey was conducted in Arkansas, Kentucky, Louisiana, and Texas from September to November 2023, used random-digit dialing and probabilistic address-based sampling, and included US citizens aged 19 to 64 years reporting 2022 incomes at or less than 138% of the federal poverty level. Medicaid enrollment at any point since March 2020, when continuous coverage began. Self-reported disenrollment from Medicaid, insurance at the time of interview, and self-reported access to care. Using multivariate logistic regression, factors associated with Medicaid loss were evaluated. Access and affordability of care among respondents who exited Medicaid vs those who remained enrolled were compared, after multivariate adjustment. The sample contained 2210 adults (1282 women [58.0%]; 505 Black non-Hispanic individuals [22.9%], 393 Hispanic individuals [17.8%], and 1133 White non-Hispanic individuals [51.3%]) with 2022 household incomes less than 138% of the federal poverty line. On a survey-weighted basis, 1564 (70.8%) reported that they and/or a dependent child of theirs had Medicaid at some point since March 2020. Among adult respondents who had Medicaid, 179 (12.5%) were no longer enrolled in Medicaid at the time of the survey, with state estimates ranging from 7.0% (n = 19) in Kentucky to 16.2% (n = 82) in Arkansas. Fewer children who had Medicaid lost coverage (42 [5.4%]). Among adult respondents who left Medicaid since 2020 and reported coverage status at time of interview, 47.8% (n = 80) were uninsured, 27.0% (n = 45) had employer-sponsored insurance, and the remainder had other coverage as of fall 2023. Disenrollment was higher among younger adults, employed individuals, and rural residents but lower among non-Hispanic Black respondents (compared with non-Hispanic White respondents) and among those receiving Supplemental Nutrition Assistance Program benefits. Losing Medicaid was significantly associated with delaying care due to cost and worsening affordability of care. The results of this survey study indicated that 6 months into unwinding, 1 in 8 Medicaid beneficiaries reported exiting the program, with wide state variation. Roughly half who lost Medicaid coverage became uninsured. Among those moving to new coverage, many experienced coverage gaps. Adults exiting Medicaid reported more challenges accessing care than respondents who remained enrolled.

Mental-somatic multimorbidity in trajectories of cognitive function for middle-aged and older adults.

Multimorbidity may confer higher risk for cognitive decline than any single constituent disease. This study aims to identify distinct trajectories of cognitive impairment probability among middle-aged and older adults, and to assess the effect of changes in mental-somatic multimorbidity on these distinct trajectories. Data from the Health and Retirement Study (1998-2016) were employed to estimate group-based trajectory models identifying distinct trajectories of cognitive impairment probability. Four time-varying mental-somatic multimorbidity combinations (somatic, stroke, depressive, stroke and depressive) were examined for their association with observed trajectories of cognitive impairment probability with age. Multinomial logistic regression analysis was conducted to quantify the association of sociodemographic and health-related factors with trajectory group membership. Respondents (N = 20,070) had a mean age of 61.0 years (SD = 8.7) at baseline. Three distinct cognitive trajectories were identified using group-based trajectory modelling: (1) Low risk with late-life increase (62.6%), (2) Low initial risk with rapid increase (25.7%), and (3) High risk (11.7%). For adults following along Low risk with late-life increase, the odds of cognitive impairment for stroke and depressive multimorbidity (OR:3.92, 95%CI:2.91,5.28) were nearly two times higher than either stroke multimorbidity (OR:2.06, 95%CI:1.75,2.43) or depressive multimorbidity (OR:2.03, 95%CI:1.71,2.41). The odds of cognitive impairment for stroke and depressive multimorbidity in Low initial risk with rapid increase or High risk (OR:4.31, 95%CI:3.50,5.31; OR:3.43, 95%CI:2.07,5.66, respectively) were moderately higher than stroke multimorbidity (OR:2.71, 95%CI:2.35, 3.13; OR: 3.23, 95%CI:2.16, 4.81, respectively). In the multinomial logistic regression model, non-Hispanic Black and Hispanic respondents had higher odds of being in Low initial risk with rapid increase and High risk relative to non-Hispanic White adults. These findings show that depressive and stroke multimorbidity combinations have the greatest association with rapid cognitive declines and their prevention may postpone these declines, especially in socially disadvantaged and minoritized groups.

Predictors of U.S. Adults' Opinion Toward an R-Rating Policy for Movies With Cigarette Smoking.

Recently, multiple health organizations and advocacy groups have pushed for giving an R-rating for movies depicting tobacco imagery. This study examined several predictors of U.S. adults' opinion toward an R-rating policy for movies depicting cigarette smoking. We used data from the Health Information National Trends Survey (2020 cycle), for a nationally representative sample of 3,865 US adults (aged ≥ 18). The outcome variable was opinion toward an R-rating policy (support, neutral, and oppose) for movies depicting cigarette smoking. A weighted adjusted multinomial logistic regression analysis with comparisons of support versus oppose, support versus neutral, and neutral versus oppose was performed. About 48.2% of respondents were supportive of, 31.1% were neutral toward, and 20.7% were opposed to an R-rating policy. Adults aged 50 to 64 years (adjusted odds ratio [aOR] = 2.28, p = .008) and ≥65 years (aOR = 4.54, p <.001) (vs. 18-34 years) were more likely to support the R-rating policy than oppose it. Non-Hispanic Black respondents (vs. non-Hispanic Whites) were 1.74 times more likely to support than oppose the policy (aOR = 1.74, p = .04), whereas adults with a household annual income of US$75,000 or more (vs. <$20,000) and those with moderate (vs. liberal) political viewpoints were more likely to be neutral than oppose the policy. Former and current e-cigarette users (vs. never users) were less likely to support than oppose the policy. Tailored messaging addressing the rationale behind R-rating policy should be directed towards communities based on age, race/ethnicity, household income, e-cigarette usage, and political ideologies.

Abstract 814: Bridging the gap: Informal caregivers' access to information on genetic testing for cancer risk

Abstract Introduction: Cancer risk genetic testing (referred to as genetic testing thereafter) benefits patients by allowing them to make informed behavioral and medical decisions to reduce cancer risk and by facilitating surveillance and earlier detection. Informal caregivers, who often serve as primary advocates for those at risk, play a pivotal role in supporting behavioral and medical decisions based on genetic testing information. Assessing caregivers’ knowledge of genetic testing can guide future interventions supporting informed decision-making to ensure that all groups benefit equally from advances in genetic testing. We examined the association between caregiving and knowledge of genetic testing as well as other individual and socioeconomic factors. Methods: Secondary data analysis was conducted using the 2020 Health Information National Trends Survey (HINTS 5 Cycle 4). HINTS is a nationally representative survey of adults in the civilian non-institutionalized US population. Exposure variable was caregiving (yes/no) assessed with the question “Are you currently caring for or making health care decisions for someone with a medical, behavioral, disability, or other condition?”. The outcome variable was genetic testing knowledge (yes/no) assessed with the question “have you heard of high-risk cancer genetic testing - e.g., BRCA 1/2". Weighted, multivariable logistic regression was used to estimate the association between caregiving and genetic testing knowledge adjusting for age, gender, race/ethnicity, marital status, education level, having a regular provider, rural-urban residence, and self-reported general health status. Results: A total of 3,136 participants aged ≥18 were included in the study, of whom 16.4% were caregivers and 35.9% had heard of genetic testing. In the adjusted analysis, there was no statistically significant difference between caregivers and non-caregivers in relation to genetic testing knowledge (P=0.7881). However, respondents who were ≥65 years old (aOR=0.54, 95% CI: 0.40-0.72) were less likely to have heard about genetic testing compared to those aged 18-49, as were respondents who had no regular provider (aOR=0.71, 95% CI: 0.53-0.95) compared to those with a regular provider. Compared to non-Hispanic White respondents, non-Hispanic Black (aOR=0.45, 95% CI: 0.31-0.66) or Hispanic respondents (aOR=0.44, 95% CI: 0.29-0.68) were less likely to have heard about genetic testing. Female respondents (aOR=2.02, 95% CI: 1.55-2.61) were twice as likely to have heard about genetic testing than their male counterparts. Conclusions: We found that about a third of Americans had heard about genetic testing; patients who were younger, female, White, and those who had access to a regular provider were more likely to be aware of testing. Interventions targeting under-resourced caregivers are urgently needed to promote equity in genetic testing and its benefits. Citation Format: Eric Adjei Boakye, Pranali G. Patel, Chaitali S. Dagli, Sarah Wagoner, Mrudula Nair, Nosayaba Osazuwa-Peters, Veronica Bernacchi, Samantha H. Tam. Bridging the gap: Informal caregivers' access to information on genetic testing for cancer risk [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 814.

Public support for and concerns regarding pediatric dose optimization for seizures in emergency medical services: An exception from informed consent (EFIC) trial.

Federal regulations allow exception from informed consent (EFIC) to study emergent conditions when obtaining prospective consent is not feasible. Little is known about public views on including children in EFIC studies. The Pediatric Dose Optimization for Seizures in EMS (PediDOSE) trial implements age-based, standardized midazolam dosing for pediatric seizures. The primary objective of this study was to determine public support for and concerns about the PediDOSE EFIC trial. The secondary objective was to assess how support for PediDOSE varied by demographics. We conducted a mixed-methods study in 20 U.S. communities. Participants reviewed information about PediDOSE before completing an online survey. Descriptive data were generated. Univariable and multivariable logistic regression analysis identified factors associated with support for PediDOSE. Reviewers identified themes from free-text response data regarding participant concerns. Of 2450 respondents, 79% were parents/guardians, and 20% had a child with previous seizures. A total of 96% of respondents supported PediDOSE being conducted, and 70% approved of children being enrolled without prior consent. Non-Hispanic Black respondents were less likely than non-Hispanic White respondents to support PediDOSE with an adjusted odds ratio (aOR) of 0.57 (95% CI 0.42-0.75). Health care providers were more likely to support PediDOSE, with strongest support among prehospital emergency medicine clinicians (aOR 5.82, 95% CI 3.19-10.62). Age, gender, parental status, and level of education were not associated with support of PediDOSE. Common concerns about PediDOSE included adverse effects, legal and ethical concerns about enrolling without consent, and potential racial bias. In communities where this study will occur, most respondents supported PediDOSE being conducted with EFIC and most approved of children being enrolled without prior consent. Support was lowest among non-Hispanic Black respondents and highest among health care providers. Further research is needed to determine optimal ways to address the concerns of specific racial and ethnic groups when conducting EFIC trials.

Measurement of cigarette relighting: A common but understudied behavior

ObjectiveRelighting, i.e., extinguishing, saving, and later relighting and smoking unfinished cigarettes, appears prevalent, may be associated with nicotine dependence and negative health outcomes, yet is poorly understood. We estimate the prevalence, frequency, correlates of, and reasons for, cigarette relighting. MethodsSurvey respondents (n=676) were 18–45-year-old US-based Amazon Mechanical Turk (MTurk) participants who smoked cigarettes every/some days. Items assessed frequency of and reasons for relighting. Reported smoking sessions per day were compared to calculations based on reported cigarettes per day (CPD) and relighting frequency. ResultsSeventy-two percent of those who smoked reported relighting cigarettes. Reasons included not having time to finish (77%), not feeling like finishing (75%), saving money or avoiding wasting (70%), and making cigarettes last longer (59%). Nearly half (44%) relight to cut down and 34% to reduce harm. Hispanic (OR=1.73, CI:1.03–2.91) and non-Hispanic Black respondents (OR= 2.23, CI:1.20–4.10) had higher odds of relighting than others, as did those who smoke within 30minutes of waking (OR=2.45, CI:1.33–4.52) or wake up at night to smoke (OR=2.40, CI:1.68–3.44) (all ps <0.05). Respondents demonstrated low consistency in reporting the number of times they smoke (first-lit and relit) compared to calculations based on CPD and relighting frequency. ConclusionsRelighting is associated with race, ethnicity, nicotine dependence, and is often done to save money, cut down smoking, and reduce harm. Among those who relight, “smoking session” frequency seemed to be underestimated. Single item smoking frequency measures may not be ideal for individuals who smoke and relight.

Differences in Time to Reported First Arrest by Race, National Origin, and Immigrant Generation: A Test of Assimilation Theories

This study examines immigrant assimilation theories by focusing on arrest during adolescence and adult life using the National Longitudinal Survey of Youth 1997, a nationally representative panel study that follows children from adolescence through adulthood. The analysis compares outcomes for the first and second-generation of Mexican origin and other parts of Latin America to third- and fourth-plus generation (1) non-Hispanic white, (2) non-Hispanic black, and (3) Hispanic respondents. This investigation employs survival analyses to account for the timing of arrest and other events (e.g., graduation, childbirth, and employment). Results indicate the first generation, both of Mexican and Other Hispanic origin, are less likely to experience arrest than their higher-generation counterparts, regardless of race/ethnicity of the comparison group.

BEREAVED PARENTS OF THE HEALTH AND RETIREMENT STUDY

Abstract The loss of a child—no matter their age—is often regarded as one the most tragic forms of loss. Here, we sought to identify sociodemographic, psychosocial, and health profiles of older adults who have experienced offspring death in the Health and Retirement Study (HRS). Our sample was composed of 2,035 respondents from the 2018 wave of HRS who experienced (n =381) or did not experience (n = 1,654) the loss of a child at any point in their lifetime. In an adjusted logistic regression, we found that both women (OR=1.53, [1.13, 2.09]) and non-Hispanic Black respondents (OR = 1.85; [1.31, 2.61]) had significantly higher odds of experiencing the death of a child. Education was also significantly associated with offspring death: relative to individuals with less than a high school education, high school and college-educated respondents had a 34% and 64% lower likelihood of reporting offspring death, respectively (OR=0.66, [.47, .91]; OR=0.36, [.25, .51]). Lastly, every one unit increase in cognition was associated with a 3% lower likelihood of experiencing the offspring death (OR=0.97, [.94, .99]). Interestingly, bereaved parents were no more likely to experience depression nor report multimorbidity than individuals who had not grieved the loss of a child. These findings highlight a grim picture of premature and untimely death among Black Americans, the power of education, and potential psychological and physiological resilience among this older sub-population of bereaved parents.

Abstract A082: Factors associated with willingness to participate in future clinical trials

Abstract Background: Biannually, Sidney Kimmel Cancer Center at Jefferson in Philadelphia, PA their catchment area to identify and describe the population. Since less than 6.3% of cancer patients nationally are involved in clinical trials, the most recent survey included questions related to willingness to participate in clinical trials (CTs) and reasons for or against participation. Methods: A cross-sectional study was conducted among adult residents in Philadelphia, Delaware, Bucks, and Montgomery Counties in Pennsylvania as well as Camden, Burlington, and Gloucester Counties in New Jersey from July to August 2022 and included 2,744 respondents. Survey questions included reasons for or against willingness to participate in CTs, lifestyle behaviors, cancer screening frequencies, cancer attitudes or beliefs, health literacy, and numeracy. Frequency counts were weighted against population totals from the American Community Survey. The survey was fielded in English, Spanish, and Chinese. The univariate associations of covariates with the outcome were evaluated with a ꭓ2 test. Logistic regression using weighted survey procedures were used to calculate the odds ratios (ORs), 95% confidence intervals (CIs), and p-values of trial participation controlling for covariates. Results: The weighted sample represented the 3,889,048 residents of the catchment area. Survey respondents completed the survey in English (80.1%), Spanish (13.2%), and Chinese (6.7%) and self-identified as Hispanic (9.3%), non-Hispanic (NH) White (57.8%), NH Black (19.0%), and NH Other (14.0%). The catchment population was willing to participate in CTs (69.8%). Respondents answering in Chinese were 40% less likely than those answering in English to indicate future CT participation (OR 0.60, p=0.04). Both Hispanic and NH Black respondents were over 30% less likely to participate compared to NH Whites (OR 0.67, p=0.03 and 0.68 p=0.02, respectively). While some respondents view CTs as “experiments” (17.0%), the most common reason given not to participate in a CT was side effects (25.6%). Respondents reporting a high level of discrimination were 48% more likely to participate in a CT than low discrimination respondents (p=0.02). The population reporting the highest level of discrimination also reported wanting to participate to “learn more about their health and medical condition” (66.3%) and a desire to “help my community” (54.5%). Conclusions: Clinical trials offer a segment of the population access to care not normally available and a way to serve their community. However, fear of experimentation remains a strong reason not to participate. The findings highlight the importance of catchment assessment when designing recruitment methods and future endeavors involving education on the trial safety of trials may improve participation. While education may assuage fears, it will not dispel mistrust. Proactively engaging the community in study design may help repair the relationship between science and the people it serves. Citation Format: Amy L. Shaver, Nikita Nikita, Joshua Banks, Christiane El Khoury, Rebecca J. Melillo, Yawei Song, Grace Lu-Yao, Amy E. Leader. Factors associated with willingness to participate in future clinical trials [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 A082.

Social Determinants and Perinatal Hardships During the COVID-19 Pandemic.

Background: This study examined perinatal experiences of pandemic-related hardships and disparities by race/ethnicity, income, insurance type at childbirth, and urban/rural residency. Materials and Methods: We used cross-sectional survey data from the 2020 Pregnancy Risk Assessment Monitoring System COVID-19 supplement in 26 states, the District of Columbia, and New York City to explore: (1) job loss or cut work hours/pay, (2) having to move/relocate or becoming homeless, (3) problems paying the rent, mortgage, or bills, or (4) worries that food would run out. We estimated the prevalence of outcomes overall and by race/ethnicity, income, insurance, and urban/rural residency. We used weighted multivariable logistic regression models to calculate adjusted predicted probabilities. Results: Due to the COVID-19 pandemic, 31.9% of respondents reported losing their job or having a cut in work hours or pay, 11.2% of respondents had to move/relocate or became homeless, 21.8% had problems paying the rent, mortgage, or bills, and 16.86% reported worries that food would run out. Compared to overall, rates of all hardships were higher among respondents who were non-Hispanic Black, Hispanic, uninsured, or Medicaid insured. The adjusted predicted probability of employment instability, financial hardships, and food insecurity was significantly higher among non-Hispanic Black respondents and respondents who were uninsured. The adjusted predicted probability of all hardships was significantly higher among respondents with Medicaid. Conclusions: Black, Medicaid-insured, and uninsured respondents were particularly vulnerable to perinatal hardships during COVID-19. Our results suggest a need to alleviate the overall and disparate consequences of hardships for individuals who gave birth during the COVID-19 pandemic.

Racial and ethnic disparities in influenza vaccination coverage among pregnant women in the United States: The contribution of vaccine-related attitudes

ObjectiveRacial and ethnic disparities in influenza vaccination coverage among pregnant women in the United States have been documented. This study assessed the contribution of vaccine-related attitudes to coverage disparities. MethodsSurveys were conducted following the 2019–2020 and 2020–2021 influenza seasons in a US research network. Using electronic health record data to identify pregnant women, random samples were selected for surveying; non-Hispanic Black women and influenza-unvaccinated women were oversampled. Regression-based decomposition analyses were used to assess the contribution of vaccine-related attitudes to racial and ethnic differences in influenza vaccination. Data were combined across survey years, and analyses were weighted and accounted for survey design. ResultsSurvey response rate was 41.2% (721 of 1748) for 2019–2020 and 39.3% (706 of 1798) for 2020–2021. Self-reported influenza vaccination was higher among non-Hispanic White respondents (79.4% coverage, 95% CI 73.1%–85.7%) than Hispanic (66.2% coverage, 95% CI 52.5%–79.9%) and non-Hispanic Black (55.8% coverage, 95% CI 50.2%–61.4%) respondents. For all racial and ethnic groups, a high proportion (generally >80%) reported being seen for care, recommended for influenza vaccination, and offered vaccination. In decomposition analyses, vaccine-related attitudes (e.g., worry about vaccination causing influenza; concern about vaccine safety and effectiveness) explained a statistically significant portion of the observed racial and ethnic disparities in vaccination. Maternal age, education, and health status were not significant contributors after controlling for vaccine-related attitudes. ConclusionsIn a setting with relatively high influenza vaccination coverage among pregnant women, racial and ethnic disparities in coverage were identified. Vaccine-related attitudes were associated with the disparities observed.

Socioeconomic Characteristics Associated With Development of Chronic Pain After Pain Interference Experienced in Early Adulthood.

Predictors of pain persistence have been identified among patients undergoing treatment for chronic pain or related conditions, but correlates of pain persistence in the general population remain underexplored. We identify socioeconomic variables associated with pain onset or persistence over a 6-10 year period in a nationally representative cohort. Using panel data from the National Longitudinal Survey of Youth-1997, we examined the presence of pain interference at age 29 and chronic pain at ages 35-39. Persistent pain was defined as pain present at both interview timepoints; new onset pain was defined as pain not reported at age 29, but present at ages 35-39; and transient pain was defined as experiencing pain interference at age 29 with no report of chronic pain at ages 35-39. Based on a sample of 6,188 participants, we estimated that 4% experienced persistent pain, 11% experienced transient pain, and 7% experienced new-onset pain. Pain persistence was less likely among non-Hispanic Black respondents but more likely among formerly married respondents and those with poor health, health-related work limitation, or greater pain interference at the age 29 baseline. New onset pain was most likely among female respondents, respondents with some college education, and respondents with poor self-rated health or obesity at baseline. Development of chronic pain by mid-late 30s was common among young adults experiencing pain interference at age 29. Race/ethnicity, gender, and educational attainment exhibited different associations with persistence as compared to new onset of pain problems.

Prevalence and predictors of perceived COVID-19 stigma within a population-based sample of adults with COVID-19

BackgroundGrowing evidence suggests that individuals with COVID-19 face stigmatization, which is associated with poor health outcomes and behaviors. However, very few population-based studies have examined risk factors for experiencing COVID-19 stigma. This study examined prevalence and predictors of perceived COVID-19 stigma using a population-based probability sample of adults with COVID-19.MethodsWe included adults with polymerase chain reaction-confirmed SARS-CoV-2 in Michigan between January 1, 2020 and July 31, 2021. Perceived COVID-19 stigma was considered present if a respondent answered affirmatively to any of the following items due to people thinking they might have COVID-19: “you were treated badly,” “people acted as if they were scared of you,” and “you were threatened or harassed.” We conducted modified Poisson regression with robust standard errors to estimate associations between perceived COVID-19 stigma and potential predictors, including sex, age, race and ethnicity, household income, education, employment, smoking status, body mass index, preexisting diagnosed physical or mental comorbidities, and COVID-19 illness severity.ResultsPerceived COVID-19 stigma was commonly reported among our respondents (38.8%, n = 2,759). Compared to those over 65 years, respondents who were 18 − 34 (adjusted prevalence ratio (aPR): 1.41, 95% confidence intervals (CI): 1.12 − 1.77) and 35 − 44 years old (aPR: 1.66, 95% CI: 1.31 − 2.09) reported higher perceived stigma. Female respondents had 1.23 times higher prevalence of perceived COVID-19 stigma (95% CI: 1.10 − 1.37) than male respondents and non-Hispanic Black respondents had 1.22 times higher prevalence of perceived COVID-19 stigma (95% CI: 1.04 − 1.44) than non-Hispanic White respondents. Moreover, respondents with pre-existing diagnosed psychological or psychiatric comorbidities were more likely to report perceived COVID-19 stigma (aPR: 1.29, 95% CI: 1.13 − 1.48) compared to those without diagnosed comorbidities. Respondents with very severe COVID-19 symptoms were also more likely to report perceived COVID-19 stigma (aPR: 1.47, 95% CI: 1.23 − 1.75) than those with asymptomatic or mild symptoms.ConclusionsWe found that populations who are marginalized in United States, such as females, non-Hispanic Black adults, or individuals with chronic conditions, are more likely to report perceived COVID-19 stigma. Continuing to monitor COVID-19 stigma, especially in vulnerable populations, may provide useful insights for anti-stigma campaigns and future pandemics.

Dried blood spot based biomarkers in the Health and Retirement Study: 2006 to 2016.

The Health and Retirement Study (HRS) has collected biomarker data over multiple waves. Such data can help improve our understanding of health changes in individuals and the causal pathways related to health. There are, however, technical challenges to using the HRS dried blood spots (DBS) biomarker data due to changes over time in assay protocols, platforms, and laboratories. We provide technical and summary information on biological indicators collected as part of the HRS from 2006 to 2016 that should be helpful to users of the data. We describe the opportunities and challenges provided by the HRS DBS data as well as insights provided by the data. The HRS collected DBS from its nationally representative sample of respondents 51 years of age or older from 2006 to 2016. DBS-based biomarkers were collected from half the sample in 2006, 2010, and 2014, and from the other half of the sample in 2008, 2012, and 2016. These DBS specimens were used to assay total and HDL cholesterol, glycosylated hemoglobin, C-reactive protein, and cystatin C from 2006 to 2016, and Interleukin 6 was added in 2014/2016. Samples included approximately 6000 individuals at each wave, and completion rates ranged from 81% to 90%. HRS transformed DBS values into venous blood equivalents to make them more comparable to those of the whole blood-based assays collected in most other studies and to facilitate longitudinal analysis. Distribution of changes over time by age shows that total cholesterol levels decreased for each age, while HbA1c levels increased. Cystatin C shows a clear age gradient, but a number of other markers do not. Non-Hispanic Black persons and Hispanic respondents have a higher incidence of risk levels of each biomarker except for CRP among non-Hispanic Black older persons. These public-use DBS data provide analysis opportunities that can be used to improve our understanding of health change with age in both populations and among individuals.

Racial and Ethnic Differences in Openness to Communication From Local Faith-Based Congregations During Public Health Emergencies.

During public health emergencies, people at risk of exposure or illness will likely be presented with extensive information about an unfamiliar topic and be asked to make decisions quickly. In difficult situations, people often turn to trusted leaders, including from their local faith-based congregation (FBC). We examined how people receive, interpret, and respond to health communication information from clergy and lay leaders from their local FBC during public health emergencies. We analyzed responses to 10 questions from a 2021 nationally representative US survey. Porter Novelli designed the survey and administered it to 4510 US adults aged ≥18 years, of whom 3553 people completed the survey. We examined sociodemographic characteristics, trust of health information from clergy and lay leaders, and willingness to engage in health behaviors recommended by their FBC and receive health services through their local FBC. All estimates were weighted. We conducted bivariate analysis with contrast t tests for proportions at α = .05. More than half of adults (55.4%), including 65.8% of non-Hispanic Black and 58.8% of Hispanic or Latino adults, were members of an FBC. Among FBC members, a higher percentage of Hispanic or Latino (29.1%) and non-Hispanic Black (36.3%) adults than non-Hispanic White adults (20.4%) reported trust in their FBC for health information (P < .05). This trust translated into greater intent to engage in health behaviors promoted by the local FBC among non-Hispanic Black respondents (31.4%) compared with non-Hispanic White respondents (22.5%) (P < .05). Public health officials can consider ways to better understand how the cultures and practices of populations being served influence people's health perceptions and behaviors. Collaboration between federal, state, and local public health officials and FBCs can promote health equity during public health emergencies.