American Participants Research Articles

Ambient Air Pollution and COPD: The Multiethnic Cohort Study.

Globally, in 2019, chronic obstructive pulmonary disease (COPD) was the third leading cause of death. While tobacco smoking is the predominant risk factor, the role of long-term air pollution exposure in increasing risk of COPD remains unclear. Moreover, there are few studies that have been conducted in racial and ethnic minoritized and socioeconomically diverse populations, while accounting for smoking history and other known risk factors. To evaluate the association for ambient air pollution and COPD in a multiethnic population in California. Among 38,654 African American, Japanese American, Latino and White California participants in the Multiethnic Cohort study enrolled in the fee-for-service component of Medicare, we used Cox proportional hazards regression to estimate the association of time-varying ambient air pollutants: particulate matter with diameter ≤2.5 μm or 10 μm (PM2.5, PM10), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3), benzene and ultrafine particles (UFP) with COPD risk (n=10,915 cases; 8.8 years of follow-up). Subgroup analyses were conducted by race and ethnicity, sex, smoking status at MEC baseline questionnaire, and neighborhood socioeconomic status (nSES). We observed positive associations for NOx (per 50 ppb) with risk of COPD (hazards ratios (HR)=1.45; 95% CI: 1.35-1.55). The associations for NO2 (per 20 ppb), PM2.5 (10ug/m3), PM10 (10ug/m3), CO (1000 ppb), and UFP (IQR=5241.7 particles/cm3) with risk of COPD were in similar directions as these air pollutants are highly correlated with NOx. These associations were found in African American, Latino, and Japanese American participants, but not in whites (p-heterogeneity across race and ethnicity<0.04). These associations also differed by nSES with effects being stronger in racial and ethnic minoritized populations and residents of low SES neighborhoods. Long-term ambient air pollutant exposure is associated with COPD risk in a multiethnic, older adult (>65 years of age), population.

Potential Therapeutic drug Targets for Hypertension Identified using Proteomics and Mendelian Randomization.

Hypertension (HT) is the most prevalent risk factor for cardiovascular disease (CVD) worldwide. Despite being a highly heritable trait, the underlying mechanisms of HT remain elusive due to its complex genetic architecture. Discovering disease-associated proteins with causal genetic evidence offers a potential strategy for identifying therapeutic targets for HT. We analyzed the plasma proteome of 4,657 plasma proteins from 7,213 European American (EA) participants in the ARIC study. Genome-wide association study (GWAS) data for HT were sourced from FinnGen R10, which includes 102,864 cases and 289,117 controls. Cis-Mendelian randomization (MR) was conducted to assess the causal effect of circulating proteins on the risk of HT. A multiverse sensitivity analysis was performed to evaluate the robustness of these causal relationships. Colocalization analysis was conducted to determine whether these features share the same associated single nucleotide polymorphisms (SNPs). The causal effects of HT-associated proteins were then validated using cis-protein quantitative trait loci (Cis-pQTL) genetic instruments from the deCODE database. Among 1,788 proteins, genetically predicted levels of 18 plasma proteins were associated with HT in the discovery stage. Seven of these proteins showed strong support for colocalization. After replication, only ERAP1 and ACVRL1 were validated as therapeutic candidates for HT, demonstrating a negative correlation with the risk of HT. By combining cis-MR analysis with colocalization analysis, we identified ERAP1 and ACVRL1 as potential targets for interventions in the primary prevention of HT, with ERAP1 emerging as a particularly promising drug target after further validation.

COVID-19 vaccination attitudes and acceptance among people with serious mental illness

ObjectiveThis study examines attitudes towards COVID-19 vaccination among a diverse cohort of adults with serious mental illness (SMI), participant characteristics that are associated with vaccine acceptance, and barriers to COVID-19 vaccination among this population.MethodsA 28-item questionnaire was administered to 185 adults with SMI receiving care at a university-based outpatient psychiatric clinic. Variables included demographics, health behaviors, and vaccination status. Chi-square tests were used for categorical demographic comparisons on binary COVID-19 vaccine status.ResultsFemale participants were more likely to have received COVID-19 vaccination (77.6%) than male (55.7%) participants. White (73.3%) and Hispanic/Latino (81.8%) participants were more likely to have received vaccination than Black/African American (54.9%) participants. Participants who reported having seen a primary care provider (PCP) within the past two years were more likely to be vaccinated (72.1%) than those who had not (41.7%). Participants who reported having received an influenza vaccine in the past two years were more likely to be vaccinated (80.2%) than those who had not (41.8%). Participants who had not been vaccinated were more likely to report greater concerns about all potential barriers to vaccination, including concerns about side effects, cost, health effects, and distrust of clinicians and governments.ConclusionsThe overall vaccination rate of study participants with SMI was similar to that of the general population. Efforts to enhance engagement in primary care may help improve preventative health behaviors in people with SMI.

On the Perception of Moral Standing to Blame.

Is everyone equally justified in blaming another's moral transgression? Across five studies (four pre-registered; total N = 1,316 American participants), we investigated the perception of moral standing to blame-the appropriateness and legitimacy for someone to blame a moral wrongdoing. We propose and provide evidence for a moral commitment hypothesis-a blamer is perceived to have low moral standing to blame a moral transgressor if the blamer demonstrates weak commitment to that moral rule. As hypothesized, we found that when blamers did not have the chance or relevant experience to demonstrate good commitment to a moral rule, participants generally believed that they had high moral standing to blame. However, when a blamer demonstrated bad commitment to a moral rule in their past behaviors, participants consistently granted the blamer low moral standing to blame. Low moral standing to blame was generally associated with perceiving the blame to be less effective and less likely to be accepted. Moreover, indirectly demonstrating moral commitment, such as acknowledging one's past wrongdoing and feeling/expressing guilt, modestly restored moral standing to blame. Our studies demonstrate moral commitment as a key mechanism for determining moral standing to blame and emphasize the importance of considering a blamer's moral standing as a crucial factor in fully understanding the psychology of blame.

African American pharmacists in professional pharmacy associations.

The early participation of African Americans in professional pharmacy associations between the 1870s and the 1970s is explored. The early participation African American pharmacists in the national pharmacy organizations was limited to the American Pharmaceuticals Association (APhA), a small number of the APhA state and local affiliates, and the pharmaceutical section of the national and state Black medical associations. Little to no participation of African American pharmacists as members in other national organizations (e.g., National Association of Retail Druggists (NARD), National Wholesale Druggists Association (NWDA), or the American College of the Apothecaries) occurred before the 1960s. Few African American pharmacists played a leadership role as officers before the 1960s except in the Black professional pharmacy organizations. (This is the first of three papers dealing with key points of black professional pharmacy association).

Performance of the pooled cohort equations and D:A:D risk scores among individuals with HIV in a global cardiovascular disease prevention trial: a cohort study leveraging data from REPRIEVE.

Risk estimation is an essential component of cardiovascular disease prevention among people with HIV. We aimed to characterise how well atherosclerotic cardiovascular disease (ASCVD) risk scores used in clinical guidelines perform among people with HIV globally. In this prospective cohort study leveraging REPRIEVE data, we included participants aged 40-75 years, with low-to-moderate traditional cardiovascular risk, not taking statin therapy. REPRIEVE participants were enrolled from sites in 12 countries across Global Burden of Disease Study (GBD) regions. We assessed the performance of the pooled cohort equations (PCE) risk score for ASCVD and the data-collection on adverse effects of anti-HIV drugs (D:A:D) risk score. We calculated C statistics, observed-to-expected (OE) event ratios, and Greenwood-Nam-D'Agostino goodness-of-fit (GND) statistics, overall and in subgroups by race, sex, and GBD regions (clustering low-income and middle-income countries and high-income countries). We did a recalibration for PCE risk score among people with HIV in high-income countries. REPRIEVE was registered with ClinicalTrials.gov, NCT02344290. We included 3893 participants, recruited between March 26, 2015, and July 31, 2019. The median age was 50 years (IQR 45-55), with 2684 (69%) male and 1209 (31%) female participants. 1643 (42%) were Black or African American, 1346 (35%) participants were White, 566 (15%) were Asian, and 338 (9%) were recorded as other race. Overall, discrimination of the PCE risk score was moderate (C statistic 0·72 [95% CI 0·68-0·76]) and calibration was good (OE event ratio 1·11; GND p=0·87). However, calibration suggested overprediction of risk in low-income and middle-income countries and corresponding underprediction in high-income countries. When restricted to high-income countries, we found underprediction (OE event ratio >1·0) among women (2·39) and Black or African American participants (1·64). Findings were similar for the D:A:D risk score (C statistic 0·71 [0·65-0·77]; OE event ratio 0·89; p=0·68). Improved calibration of the PCE risk score in high-income countries was achieved by multiplying the original score by 2·8 in Black or African American women, 2·6 in women who were not Black or African American, and 1·25 in Black or African American men. Among the global cohort of people with HIV in REPRIEVE, the PCE risk score underpredicted cardiovascular events in women and Black or African American men in high-income countries and overpredicted cardiovascular events in low-income and middle-income countries. Underprediction in subgroups should be considered when using the PCE risk score to guide statin prescribing for cardiovascular prevention among people with HIV in high-income countries. Additional research is needed to develop risk scores accurate in predicting ASCVD among people with HIV in low-income and middle-income countries. US National Institutes of Health, Kowa Pharmaceuticals America, Gilead Sciences, and ViiV Healthcare.

Face consciousness: the impact of gift packaging shape on consumer perception

PurposeThis study aims to shed new light on the effect of gift packaging shape, specifically the distinction between horizontal and vertical orientations, on the face consciousness of both gift givers and recipients. The underlying mechanism of the main effect is examined, focusing on the perception of social status symbols. In addition, downstream outcome variables were included in the study to explore the effects of gift package shape on willingness to buy (WTB) and word-of-mouth (WOM) in the giver and receiver contexts, respectively. Furthermore, these effects were repeatedly verified in both China and the USA, revealing the significance of cultural differences. The study also investigated the moderating effects of an individual’s power state (low or high power) on the giver’s face consciousness.Design/methodology/approachSix studies were conducted to address the research objectives. Study 1 compared the gift givers’ face consciousness of a gift when presented with vertical package shapes versus horizontal. Subsequently, Study 2 investigated whether consumers’ perception of social status symbols mediates the effect of gift package shape on gift givers’ face consciousness. Study 3a expanded the conceptual model to include the downstream outcome variable of WTB in the context of gift-giving. Study 3b was validated with American participants, revealing the influence of cultural background differences on face consciousness. Study 4 introduced a gift-receiving context to investigate the chain-mediated effects of gift package shapes on consumer WOM. Lastly, Study 5 critically examined the boundary effect of personal power states on the interaction between the gift givers’ face consciousness and WTB.FindingsThe results indicate that gift givers and recipients attribute higher face consciousness to gifts with vertical package shapes compared to horizontal ones. In addition, consumers’ perception of gifts as status symbols was the underlying mechanism driving the impact of gift packaging shape on face consciousness. Furthermore, the face consciousness for gift packages of vertical shape was enhanced when people were in lower-power states as opposed to higher-power states, subsequently leading to an increase in the WTB.Research limitations/implicationsThe research is limited to an online virtual brand study; future field studies could be conducted to enhance the authenticity of the participants’ gift-giving experience and the overall external validity of the studies. In addition, gender-based stereotypes and the relationship between the giver and the receiver (transactional or intimate) may also influence the relationship between gift package shapes and face consciousness.Practical implicationsThe practical implications of this research focus on three points. First, gift brand managers should strategically employ vertical package shapes to signal high-end attributes and evoke face consciousness among consumers, aligning with the psychology of both givers and recipients. Second, managers must consider consumers’ power states in gift-giving scenarios, tailoring packaging recommendations to the dynamics between givers and recipients to maximize market share. Last, cultural differences in face consciousness, particularly between Asian and Western cultures, necessitate that managers adapt packaging designs to respect and enhance the social status of both givers and recipients in culturally sensitive ways. These findings underscore the importance of understanding and integrating consumer psychology, power dynamics, and cultural nuances into gift packaging strategies to boost market share.Originality/valueThe research contributes to understanding the impact of gift packaging shape on the perception of face consciousness among both gift givers and recipients. It highlights the mediating role of social status symbols and extends its scope by examining downstream effects such as WTB and WOM. It explores individual power states as a moderating factor, revealing how personal dynamics influence perceptions of face-saving consciousness. Also, the cross-cultural validation of these effects in China and the USA underscores the importance of considering cultural differences.

Lifespan cardiometabolic exposures are associated with midlife white matter microstructure: The Bogalusa Heart Study.

Compartment model analysis of diffusion MRI data provides unique information on the microstructural properties of white matter. However, studies relating compartment model microstructural measures to longitudinal cardiometabolic health data are rare. 130 cognitively healthy participants in the Bogalusa Heart Study completed diffusion MRI scans. Compartment model analysis was performed, and summary metrics were measured in organized and diffuse white matter. Multiple linear regression models were used to relate the white matter microstructure metrics to demographics and cardiometabolic risk factors. In both organized and diffuse white matter, age was associated with worse diffusion metrics, women had better diffusion metrics than men, and African American participants had worse diffusion metrics compared to White participants. Greater blood pressure in pre-adulthood was associated with worse diffusion metrics in midlife. Summary metrics from compartment model analyses of diffusion MRI data were associated cardiometabolic risk factors from youth to midlife as well as demographic factors.

The parent-child relationship and child shame and guilt: A meta-analytic systematic review.

Empirical findings on the associations of positive and dysfunctional parent-child relationship (PPCR/DPCR) characteristics with child shame, adaptive guilt, and maladaptive guilt were synthesized in six meta-analyses. The 65 included samples yielded 633 effect sizes (Ntotal = 19,144; Mage = 15.24 years; 59.0% female; 67.7% U.S. samples, n = 12,036 with 65% White, 12.3% Hispanic and Latinx, 10.8% Black, 6.3% mixed race, 5.6% Asian American, 0.3% Native American participants). Small positive correlations were found between DPCR and shame (r = .17), DPCR and maladaptive guilt (r = .15), and PPCR and adaptive guilt (r = .14). A small negative correlation was found between PPCR and shame (r = -.12). Sample and study moderators and sources of bias are investigated and discussed.

Happy to co­create: the influence of product co­creation over consumer hedonic adaptation

PurposeResearchers have been exploring the consequences of the hedonic adaptation process at length. This phenomenon is characterized by the reduction of pleasure with consumption experiences over time. Meanwhile, co-creation initiatives seem to be gaining traction in brand strategies. However, little is known about how individuals experience the co-creation effects in consumption. The purpose of this study is to analyse the impact of consumer co-creation experiences on predicting hedonic adaptation. Also, it aims to provide insights into the emotional aspects of consumption.Design/methodology/approachThree mixed-design experimental studies were conducted to explore the effects of co-creation on consumer hedonic adaptation, affective forecasting and emotional responses. Study 1 and Study 2 were conducted online with American participants. Study 3 was conducted in a laboratory setting in Brazil.FindingsThe research demonstrated that individuals predict that the path to consumption adaptation will be longer when co-creating their products co-create. However, this effect varies depending on the type of product. As for the emotional aspect, consumers attribute more positive emotions than negative ones in the context of co-creation.Research limitations/implicationsThis study manipulated different conditions considering specific product types. Future research should apply this framework to other products and services to confirm the generalization of the study’s findings. Also, the authors encourage future studies that explore emotions in different co-creation scenarios.Practical implicationsElucidating how co-creation impacts consumers’ hedonic adaptation empowers companies to leverage co-creation to cultivate positive consumer attitudes and brand loyalty. Marketing campaigns can highlight the emotional benefits of ownership and personalization. It also provides a sustainable perspective for companies, which seeks consumers who remain present over time and trust the company. Furthermore, co-creation can be used strategically for innovation management. By co-creating limited-edition trial products, companies can involve new customers, foster a sense of ownership and potentially mitigate hedonic adaptation, while gathering valuable insights for new product development.Originality/valueThis research advances the limited literature on co-creation and customer hedonic adaptation, which lies at the interface between consumer behaviour and product development. It explores how product co-creation affects consumers’ predictions and shopping experiences concerning pleasure decrease, including product value and company feedback. Additionally, it examines the role of emotions in co-creation and hedonic adaptation. This research contributes by demonstrating the impact of co-creation on adaptation, affective forecasting and emotional responses during consumption.

Valence-based biases in collective temporal thought: The role of question framing, culture, and age.

Collective temporal thought includes individuals' memories of group experiences and expectations about the group's collective future. Prior studies have found inconsistent valence biases (e.g., positivity) in North American collective memory and consistently negative biases in collective future thought. Discrepancies in collective memory valence biases may be due to different question framing across studies. Moreover, a limited number of studies extend collective temporal thought research beyond Western nations and few studies examine potential age-related differences in this area. Therefore, the present study investigates valence-based biases in collective temporal thought from the perspective of question framing, culture, and participant age. Participants (N = 1,548) included younger (20-39 years) and older (60+ years) adults from the USA and mainland China. Whereas Americans' collective memory biases varied across question framings, Chinese participants consistently displayed positivity biases. The American bias patterns were specific to collective memory and did not carry over to collective future thought ratings. Chinese participants showed higher dialectical thinking than American participants and dialectical thinking positively correlated with the proportion of positive events reported. Older adults generated significantly more positive events than younger adults, more so in collective memory than in collective future thought. Overall, collective temporal thinking is influenced by question framing, cultural context, and participant age.

Dementia Diagnosis Unawareness and Caregiver Burden in a Multi-ethnic Cohort.

Previous reports suggest patient and caregiver lack of awareness of dementia. Little is known about how this varies by ethnicity and how informal (family) caregiver burden is associated with knowing a dementia diagnosis. To investigate whether participants with probable dementia were aware of a diagnosis provided by a physician and how this differed among Mexican American and non-Hispanic White participants; whether having a primary care physician was associated with dementia diagnosis unawareness; and the association of dementia diagnosis unawareness with caregiver burden. This was a population-based cohort study in Nueces County, Texas. Participants who scored less than 20 on the Montreal Cognitive Assessment (MoCA) were classified as having probable dementia. Diagnosis unawareness was defined as participants with probable dementia who had not been told that diagnosis by a healthcare provider. Logistic regression models examined the association of ethnicity and dementia diagnosis unawareness. A negative binomial regression was used to assess the association of dementia diagnosis unawareness and caregiver burden. Eighty-one percent of eligible participants were not aware of a dementia diagnosis. Mexican American participants (MAP) were more likely to be unaware of a diagnosis (85%, 95% CI 81-89%) than non-Hispanic white participants (NHWP) (68%, 95% CI 58-75%). Only 6.6% of the participants with probable dementia had no primary care provider, with no observed association between diagnosis unawareness and lack of primary care. Diagnosis unawareness was not associated with caregiver burden (IRR = 0.93, 95% CI 0.77-1.14) but was associated with lower MoCA score (IRR = 0.98, 95% CI 0.96-1.00) and greater physical impairment (IRR = 1.06, 95% CI 1.03-1.10). Dementia diagnosis unawareness was very high in this community. MAPs are more likely to be unaware of a diagnosis than NHWPs. Lack of access to primary care and caregiver burden were not associated with dementia diagnosis unawareness. Study registered at clinicaltrials.gov NCT03403257.

Neighborhood environment associations with cognitive function and structural brain measures in older African Americans

BackgroundSince older adults spend significant time in their neighborhood environment, environmental factors such as neighborhood socioeconomic disadvantage, high racial segregation, low healthy food availability, low access to recreation, and minimal social engagement may have adverse effects on cognitive function and increase susceptibility to dementia. DNA methylation, which is associated with neighborhood characteristics as well as cognitive function and white matter hyperintensity (WMH), may act as a mediator between neighborhood characteristics and neurocognitive outcomes.MethodsIn this study, we examined whether DNA methylation in peripheral blood leukocytes mediates the relationship between neighborhood characteristics and cognitive function (N = 542) or WMH (N = 466) in older African American (AA) participants without preliminary evidence of dementia from the Genetic Epidemiology Network of Arteriopathy (GENOA).ResultsFor a 1-mile buffer around a participant’s residence, each additional fast food destination or unfavorable food store with alcohol per square mile was nominally associated with a 0.05 (95%CI: 0.01, 0.09) and a 0.04 (0.00, 0.08) second improvement in visual conceptual tracking score, respectively. Also, each additional alcohol drinking place per square mile was nominally associated with a 0.62 (0.05, 1.19) word increase in delayed recall score, indicating better memory function (all p < 0.05). Neighborhood characteristics were not associated with WMH. We did not find evidence that DNA methylation mediates the observed associations between neighborhood characteristics and cognitive function.ConclusionsThe presence of fast food destinations and unfavorable food stores with alcohol was associated cognitive measures, possibly due to greater social interaction provided in these venues. However, replication of these findings is necessary. Further examination of the potential pathways between the neighborhood environment and cognitive function/WMH may allow the development of potential behavioral, infrastructural, and pharmaceutical interventions to facilitate aging in place and healthy brain aging in older adults, especially in marginal populations that are most at risk.

The role of culture in shaping food-related attitudes and behaviors: A qualitative study of African American and Afro Caribbean immigrant women

ABSTRACT Obesity-related messages and interventions tend to target Black women within the United States as a homogeneous group, thus ignoring the cultural differences that exist within the population’s various subgroups. As a first step toward understanding some of the cultural differences that exist among some of these subgroups, we conducted in-depth interviews with 13 African American women and 12 recently immigrated Afro Caribbean women living in Atlanta, Georgia, to compare their food-related attitudes and behaviors. The findings showed that more cultural differences than similarities existed between these two groups. The Afro Caribbean participants were more homogeneous, grew up with health-conscious role models, and therefore, were themselves health-conscious and deliberate in maintaining healthy food-related attitudes and behaviors. The African American participants’ attitudes and behaviors were influenced by role models who were focused on the historical significance of their food choices as part of their identity and culture. These findings indicated important cultural differences with implications for differentiating the strategies that are used to address obesity among women within Black US-subgroups.

Social Determinants of Health and Cross-Sectional Cognitive Intra-Individual Variability in Adults from the Deep South Living with HIV.

Cognitive intra-individual variability (IIV) is a sensitive marker of neuropathology and is increased in people with HIV (PWH). In a sample of PWH from the United States Deep South, we examined the relationship of cognitive IIV with cognitive impairment and social determinants of health (SDoH). This secondary analysis included 131 PWH from a larger cognitive training protocol. Our primary outcome measure was the coefficient of variation (CoV). We also included the individual standard deviation (iSD), with both calculated from demographically adjusted T-scores and unadjusted sample-based scores. Mixed-effects models investigated the relationship between IIV and cognitive impairment severity (i.e., Global Rating Score), SDoH, and clinical variables. Bivariate correlations were used to further explore these relationships. Greater cognitive IIV was associated with greater cognitive impairment in PWH, when accounting for demographic factors. When IIV is calculated from the sample, then IIV is no longer associated with cognitive impairment, but is associated with race (>IIV in Black and African American participants). Demographically adjusted IIV is associated with global cognition, Wide Range Achievement Test-Fourth Edition reading score, and viral load (iSD only). No correlations were significant when using the unadjusted sample-based IIV metrics. In PWH from the Deep South, greater cognitive variability is seen in those with greater cognitive impairment, in Black participants, and in those with lower reading scores. Further research on the psychometric properties of IIV in HIV and other populations is needed, as results varied depending on the normative adjustments.

Examining psychological correlates of vaccine hesitancy: a comparative study between the US and Israel.

It is important to identify psychological correlates of vaccine hesitancy, including among people not from the United States (U.S.). College students were recruited between March-June 2023 in the US (n = 330, M age = 20.21, 79.5% female) and in Israel (n = 204, M age = 23.45, 92.6% female) to complete a cross-sectional survey on vaccine attitudes, emotions, and behavior. A 2 (Nation: US, Israel) × 2 (Vaccine Status: Vaccinated, Unvaccinated) factorial design was used. Individual ANCOVAS controlling for sociodemographic factors were conducted to test main effects of nation and vaccine status, and their interaction, across various psychological correlates of health behavior. Consistent with hypotheses, unvaccinated (vs. vaccinated) individuals reported higher perceived ambiguity, reactance, and anger as well as perceived lower susceptibility, severity, worry, positive emotion, and intentions to vaccinate. Contrary to hypotheses, unvaccinated individuals reported greater fear. Israeli (vs. American) participants reported higher perceived ambiguity, worry, fear, and anger, as well as lower perceived susceptibility. Vaccinated Americans reported higher intentions to vaccinate again in the future (M = 2.89, SE = 0.08) compared to vaccinated Israelis (M = 2.36, SE = 0.08). However, unvaccinated Americans reported lower intentions to vaccinate (M = 1.80, SE = 0.15) than unvaccinated Israelis (M = 1.95, SE = 0.21). Findings provide insight into correlates to target for vaccine promotion and emphasize the need for cultural tailoring.

Systematic Review and Meta-analysis of Individual Participant Data: Randomized, Placebo-Controlled Trials of Selective Serotonin Reuptake Inhibitors for Pediatric Obsessive-Compulsive Disorder.

Selective serotonin reuptake inhibitors (SSRIs) are the first choice in pharmacotherapy for children and adolescents with obsessive-compulsive disorder (OCD). SSRI trials for pediatric OCD have not been investigated using individual participant data (IPD), which is crucial for detecting patient-level effect modifiers. This study performed an IPD meta-analysis of efficacy of SSRIs compared with placebo and a meta-regression on baseline patient characteristics that might modify efficacy. Crude participant data from short-term, randomized, placebo-controlled SSRI trials for pediatric OCD were obtained from the registry of the Dutch regulatory authority. A systematic literature search was also performed, and authors were approached to provide IPD. A 1- and 2-stage analysis was conducted, with change on Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) as the primary outcome. Odds ratio (OR) with≥35% CY-BOCS reduction was used as the responder outcome measure. Modifying effect of age, sex, weight, duration of illness, family history, and baseline symptom severity was examined. The Cochrane RoB 2.0 tool was used to examine methodological rigor, and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to examine certainty of evidence. Data were obtained from 4 studies comprising 614 patients. The sample represented 86% of all participants ever included in double-blind placebo-controlled SSRI trials for pediatric OCD. Meta-analysis showed reduction of 3.0 CY-BOCS points compared with placebo (95% CI 2.5-3.5), corresponding to a small effect size (0.38 Hedges' g). Analysis of response showed an odds ratio of 1.89 (95% CI 1.45-2.45). Of all possible modifiers, severity was correlated negatively with odds ratio for response (β=-0.92, p= .0074). Risk of bias was generally low. All studies were performed in North America with an overrepresentation of White participants. Findings were limited by inability to include data on additional variables such as socioeconomic status and comorbidities. This IPD meta-analysis showed a small effect size of SSRIs in pediatric OCD, with baseline severity as a negative modifier of response. Generalizability of findings might be limited by selective inclusion of White, North American participants. Patient Characteristics and Efficacy of SSRI Treatment in Children and Adolescents With Obsessive Compulsive Disorder: An Individual Participant Data Meta-analysis of Randomized, Placebo-Controlled Trials; https://www.crd.york.ac.uk; CRD42023486079.

Association Between Sleep Duration and Cardiovascular Disease Among Asian Americans.

Cardiovascular disease (CVD) prevalence varies widely among Asian American adults. The American Heart Association added healthy sleep to its metrics to define ideal cardiovascular health. Little is known about the association between sleep and CVD prevalence among Asian subgroups. We aim to examine the association between suboptimal sleep duration and CVD risk prevalence among Asian American subgroups. We used 2012 to 2018 National Health Interview Survey data to examine the association between suboptimal sleep duration and CVD prevalence. We included 6868 self-identifying Asian adults age >40 years (Asian Indian [n=1053], Chinese [n=1415], Filipino [n=1734], and Other Asian [n=2666] adults). Suboptimal sleep was defined as <7 or >9 hours per night. CVD was defined as self-reported stroke, heart attack, coronary artery disease, or angina. Logistic regression was used to calculate odds ratios and 95% CI to estimate the association between suboptimal sleep duration and CVD prevalence. Filipino and Other Asian participants with suboptimal sleep had the highest prevalence of CVD. Aggregated Asian American participants with suboptimal sleep duration had a higher prevalence of CVD (odds ratio [95% CI, 1.35 [1.09-1.68]) compared with those with optimal sleep duration. After stratification by race or ethnicity or both, a significant association persisted for Other Asian participants (1.77 [95% CI, 1.27-2.46]) but not among all other Asian American subgroups. Our study highlights the heterogeneity of CVD prevalence associated with suboptimal sleep duration among Asian American adults. Future studies should consider how different measures of sleep duration and quality affect CVD outcomes among disaggregated Asian American subgroups.

Mental Illness Stigma in Black, Latina/o, and Asian Americans.

Mental illness stigma has significant psychiatric consequences and can impede mental health treatment seeking, especially among racial minority groups; who are understudied in stigma research and experience striking treatment disparities. Guided by a novel empirical model of racial minority stigma and treatment seeking, this study investigated stigma and its effects on treatment seeking in Black, Latina/o, and Asian American adults. Data were collected via national panel survey from 613 Black, Latina/o, and Asian American adults. Perceptions of mental illness including seriousness, treatability, causal attributions, desired social distancing, and perceived dangerousness were assessed. Data were analyzed and compared with a nationally representative sample of the U.S. public from the 2018 General Social Survey. Minority participants exhibited stronger mental illness stigma than the U.S. public, with Black, Latina/o, and Asian American participants largely perceiving mental illness as less serious, less treatable, and desiring greater social distance from individuals with major depression, who were perceived as potentially dangerous. Notably, different stigma components significantly associated with willingness to seek treatment differently across Black, Latina/o, and Asian American participants. Overall, study findings indicate that mental illness stigma is strong and associates with treatment seeking in Black, Latina/o, and Asian Americans, suggesting a need to develop culturally tailored interventions to reduce stigma and associated treatment utilization disparities in these underserved minority groups.

Facilitators and Barriers to Health Research Knowledge and Participation Among Arab/Middle Eastern and North African (MENA) Patients in the US.

Research examining Arab and Middle Eastern and North African (MENA) health disparities faces several research limitations. These obstacles include unrepresentative national data due to the absence of a MENA identifier on the US Census, and a lack of Arab/MENA American participant trust in surveying bodies. This research hesitancy prompts the need for targeted investigation of the barriers preventing Arab/MENA Americans from participating in health research. Using community- and patient-centered methods, we created and disseminated a patient-facing survey to identify barriers to Arab/MENA American research participation. Through regular meetings and collaboration with stakeholders on research instrument development and participant recruitment, a novel quantitative survey was created (April-May 2023) to identify barriers affecting Arab/MENA American participation in health research and to explore their experiences and opportunities for improvement in the healthcare sector. The survey instruments assessed interest in research, as well as the motivators and barriers to clinical research participation. The data were analyzed quantitatively using descriptive statistics and logistic regression models. A total of 149 respondents had non-missing values on both outcomes. The study sample was largely college educated and foreign-born. Over three quarters of respondents (77.5%) felt they knew what health research was while slightly less than three quarter of respondents (72.5%) would accept to participate in a health research study in the future. Those who were foreign-born, in lower income levels (< $65k), or had low English proficiency or acculturation were less likely to report knowing what health research was. Facilitators to participating in research included a belief that participation would improve health, the idea of contributing to science, if monetary compensation was available, and if participation could be withdrawn at any time. These data further enhance our knowledge of Arab/MENA American comfortability with health research participation and can help inform future interventions. Immigration and sociodemographic factors are related to knowledge and willingness to participate as are several ideals including a desire to improve community health.