Prevalence Of Behavioral Risk Factors Research Articles

Prevalence of hypertension, diabetes mellitus, and their risk factors in an informal settlement in Freetown, Sierra Leone: a cross-sectional study

BackgroundNoncommunicable diseases (NCDs), especially hypertension and diabetes mellitus are on the increase in sub-Saharan Africa (SSA). Informal settlement dwellers exhibit a high prevalence of behavioural risk factors and are highly vulnerable to hypertension and diabetes. However, no study has assessed the prevalence of hypertension, diabetes, and NCDrisk factors among informal settlement dwellers in Sierra Leone. We conducted a study in June 2019 to determine the prevalence of hypertension, diabetes, and NCD risk factors among adults living in the largest Sierra Leonean informal settlement (KrooBay).Methods and materialsWe conducted a community-based cross-sectional survey among adults aged ≥ 35 years in the KrooBay community. Trained healthcare workers collected data on socio-demographic characteristics and self-reported health behaviours using the World Health Organization STEPwise surveillance questionnaire for chronic disease risk factors. Anthropometric, blood glucose, and blood pressure measurements were performed following standard procedures. Logistics regression was used for analysis and adjusted odd ratios with 95% confidence intervals were calculated to identify risk factors associated with hypertension.ResultsOf the 418 participants, 242 (57%) were females and those below the age of 45 years accounted for over half (55.3%) of the participants. The prevalence of smoking was 18.2%, alcohol consumption was 18.8%, overweight was 28.2%, obesity was 17.9%, physical inactivity was 81.5%, and inadequate consumption of fruits and vegetables was 99%. The overall prevalence of hypertension was 45.7% (95% CI 41.0-50.5%), systolic hypertension was 34.2% (95% CI 29.6–38.8%), diastolic blood pressure was 39.9% (95% CI 35.2–44.6), and participants with diabetes were 2.2% (95% CI 0.7–3.6%). Being aged ≥ 55 years (AOR = 7.35, 95% CI 1.49–36.39) and > 60 years (AOR 8.05; 95% CI 2.22–29.12), separated (AOR = 1.34; 95% 1.02–7.00), cohabitating (AOR = 6.68; 95% CL1.03-14.35), vocational (AOR = 3.65; 95% CI 1.81–7.39 ) and having a university education (AOR = 4.62; 95% CI 3.09–6.91) were found to be independently associated with hypertension.ConclusionThe prevalence of hypertension,and NCD risk factors was high among the residents of the Kroobay informal settlement. We also noted a low prevalence of diabetes. There is an urgent need for the implementation of health education, promotion, and screening initiatives to reduce health risks so that these conditions will not overwhelm health services.

Sex differentials in the prevalence of behavioral risk factors and non-communicable diseases in adult populations of West Kazakhstan.

The prevalence of non-communicable diseases (NCDs) is increasing worldwide. Several modifiable risk factors, such as smoking, alcohol drinking, physical inactivity, and obesity, have been linked to the development of NCDs in both genders. Understanding the prevalence of these risk factors and their associated factors is crucial for effective intervention planning in adult populations. This study aimed to provide an overview of the prevalence and associated factors of these risk behaviors among different genders of adults in West Kazakhstan. A cross-sectional study was conducted in four regions of West Kazakhstan. A stratified multistage sampling technique was utilized to obtain a representative sample size of 4,800 participants aged 18 -69 years. Trained researchers administered face-to-face interviews using validated questionnaires to gather information pertaining to sociodemographic characteristics, smoking habits, alcohol drinking, dietary patterns, physical activity levels, body mass index (BMI), and prevalent diseases. This study, which included 4,800 participants from West Kazakhstan, revealed some striking numerical findings. The overall prevalence rates of behavioral risk factors and metabolic conditions were as follows: smoking was 13.6% (95%CI: 3.2-24.0%), alcohol drinking was 47.0% (27.7-66.3%), current obesity was 22.3% (9.0-35.6%), and physical inactivity was 80.7% (55.4-106.0%). In addition, the overall prevalence rates of metabolic conditions were 25.6% (11.3-39.9%) for hypertension, 7.5% (0.2-15.2%) for diabetes, 11.8% (2.1-21.5%) for high cholesterol, and 13.0% (2.8-23.2%) for cardiovascular diseases. Additionally, a higher prevalence of high cholesterol was observed in men, and a greater prevalence of heart disease was identified in women. Multinomial logistic regression revealed that physical inactivity was associated with hypertension, diabetes, and heart disease, while obesity was linked to hypertension, high cholesterol, and heart disease. This study in West Kazakhstan identified variations in the prevalence of behavioral risk factors and NCDs, highlighting gender, age, and regional disparities. Notably, men showed higher rates of smoking and alcohol drinking, while women exhibited a greater prevalence of physical inactivity and obesity. Gender and regional differences were evident, with the West Kazakhstan region standing out for distinct patterns. Tailored interventions are crucial to address these disparities and enhance public health in the region.

Socio-demographic characteristics and behavioral risk factors of the Vladimir region population

Aim. To analyze socio-demographic characteristics and the prevalence of behavioral risk factors in the adult population of the Vladimir region, taking into account sex characteristics.Material and methods. This cross-sectional population-based study was organized in 5 cities of the Vladimir region (Vladimir, Kovrov, Murom, Yuryev-Polsky and Vyazniki) from May 2018 to March 2020. The study included 1350 men and women aged 30-69 years. The response rate was 87%. A total of 1174 people completed the study, of whom 424 (36.1%) were men and 750 (63.9%) were women. A total of 1174 people completed the study. Of these, 424 (36,1%) were men and 750 (63,9%) women. Respondents were surveyed using a standard questionnaire prepared by the National Medical Research Center for Therapy and Preventive Medicine, which included socio-demographic characteristics, behavioral risk factors, data on somatic diseases and medications taken.Results. Smoking prevalence among men was 38,4%, which was 4 times higher than in women (p=0,001). Walking <30 min/day, as a sign of a sedentary lifestyle, was detected in 41,3% of men, and among women in every third (33,2%, p=0,007). Every second man and woman during the survey reported insufficient consumption of vegetables and fruits. Adding salt to food was detected in 34,4% of men and 21,7% of women (p=0,001). Alcohol abuse rate among men was 12,5, while among women it was 2 times lower and amounted to 5,6% (p=0,001). The variability of these disorders was noted in different Vladimir region cities.Conclusion. In the analyzed random sample of adults from the Vladimir region, every second man and woman does not consume enough vegetables and fruits, while every third person leads a sedentary lifestyle. At the same time, there are 4 times more male smokers and 2 times more male alcohol abusers than females.

Associations of health and physical activity selfassessment among the population of a mediumurbanized city of Western Siberia (gender aspect)

Substantiation of research. Health self-assessment is recognized as a lifestyle indicator that establishes the interpretation of behavioral risk factors and the interest of the population in preventive measures at the population level. The validity of using health self-assessment as a significant indicator of its association with the prevalence of behavioral risk factors for cardiovascular diseases, and particular, with physical activity, is shown both in domestic and foreign scientific literature.Aim. To determine the associations of parameters of health self-assessment and physical activity of the population of a medium-sized city of Western Siberia in terms of gender differences.Methods. The analysis is based on the results of studies obtained by extrapolating data from representative samples of the working-age population to the model of the city of Tyumen. The results are based on the analysis of the questionnaire conducted in the framework of cardiological screenings.Results. It is shown that in a moderately urbanized city of Western Siberia, negative self-assessment of health and complaints about it prevails among women. About 10% of the population of both sexes state sufficient concern for their health. The attitude to physical activity among the working-age population of a medium-urbanized city of Western Siberia is manifested by its low self-esteem with priority among men, and among women by a greater share of lack of leisure in the gender aspect. In the gender aspect, among people who consider themselves healthy, the most negative attitude towards physical activity in terms of positions of a negative attitude towards physical exercise, unsuccessful attempts to do physical exercises, minimal active leisure, low self-esteem of physical activity, as well as its decline over the last year,was established in men. Among people with high self-esteem of health, the prevailing number of men relative to women with a pronounced negative assessment of their physical activity in comparison with other people of their age. Among men, relative to women with low self-esteem of health, the most negative attitude to physical activity was determined in terms of negative attitude to physical exercise, as well as the realization of readiness to perform physical exercises.Conclusion. Thus, the associative patterns established in the Tyumen population for conventional and non-conventional cardiovascular diseases risk factors represent a scientific basis for some important aspects of regional prevention programs. Such programs should be aimed at the in-depth development of the information block, taking into account medical, social, behavioral and gender differences.

Abstract A001: Racial differences in cigarettes and marijuana use among acute pancreatitis patients

Abstract Background/Objectives: Smoking increases the risk of pancreatitis and pancreatic cancer, while the effects of marijuana on pancreatic disorders are unknown. Black and White patients with chronic pancreatitis differ in the prevalence of behavioral risk factors, contributing to subsequent racial differences in pancreatic cancer risk, but the behavior pattern has been unexplored in patients with acute pancreatitis (AP). Our objectives were to: 1) estimate the prevalence of current and lifetime cigarettes and marijuana use among AP patients who identify as Black, White, and other races, and examine racial differences in their usage patterns, and 2) describe the type and frequency of marijuana or other cannabis products used among the different racial groups. Methods: We utilized data from an on-going case-crossover study of patients diagnosed with alcohol-associated AP who are recruited from five medical sites in the United States. Hospitalized patients who meet the Revised Atlanta Classification of AP and have an AUDIT-C score of 3 or higher are enrolled in the study. Chi-squared tests were used to assess for racial differences in co-substance use and the type of substance used; while Fisher’s exact test was used to examine racial differences in the frequency of marijuana and other cannabis products used. To account for multiple testing, post-hoc pairwise comparisons were conducted using Holm procedure. Other races included American Indian/Alaska Native, Asian, Brazilian, Mexican, Indian, and people who did not know or could not provide their race. Results: In this analysis, a total of 143 participants were included, among whom 71 identified as White, 46 as Black, and 20 as belonging to other racial backgrounds. Males comprised 69% of patients and the median age was 39 years. Current cigarette smoking and use of marijuana was reported by 51% and 48% patients, respectively. Concurrent cigarette smoking and marijuana use at enrollment was reported in 19%, while 51.8% reported ever use of both substances. Joints/cigars/blunts (JCB) was the most common form of cannabis product used followed by edibles. Majority of the marijuana users used it regularly: daily (36.2%) or 1-6 days a week (38%). While current co-use was not statistically different between races (24% in White, 17% in Black, and 10% in Other), we found that White (62%) and Black (54%) patients were more likely to report ever use of both cigarette and marijuana than other races (20%) (p= 0.013). The differences were also noted for the use of JCB: 38% in White, 52% in Black, and 10% in other races (p=0.006). Conclusions: We identified racial differences in the usage of cigarettes and marijuana, the use of JCB, and the number of marijuana or other cannabis products. Our findings underscore the importance of considering race when addressing multiple substance use in AP patients. Citation Format: Esther A. Adeniran, Dhiraj Yadav, Sungjin Kim, Georgios I. Papachristou, James L. Buxbaum, Joseph R. Pisegna, Stephen J. Pandol, Christie Y. Jeon. Racial differences in cigarettes and marijuana use among acute pancreatitis patients [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 A001.

Development and validation of a questionnaire for assessment of happiness with reference to behavioral determinants of health. The Indian happiness rating scale III

Background: Recent surveys indicate that the prevalence of happiness is more common in developed countries compared to developing countries, which is considered due to better availability of affordable medical care, more satisfaction in life and economic development. It is possible that chronic anxiety, aggression and depression may be associated with lack of happiness which may predispose poor social, and physical health, leading to unhappiness. This study aims to develop and validate questionnaire for assessment of happiness with greater accuracy, in the behavioral risk factors, so that the same can be used as a tool in the population studies. Subjects and methods: This cross-sectional survey was conducted at Halberg Hospital and Research Institute, Moradabad, India. All subjects; 980 urban (495 men and 485 women), 900 rural (510 men and 390 women) above 25 years of age were randomly selected and recruited from urban and rural populations. Clinical data as well as risk factors were recorded with the help of case record form using the validated questionnaires. Assessment of happiness was made by a new more detailed modified questionnaire involving happiness of mind by including questions related to social, emotional and psychological health behaviours with reference to behavioural risk factors. Results: The prevalence of happiness was 62.2% (n=612) among urban and 63.2% (n=569) among rural subjects. The prevalence of very happy and satisfied (20.2 vs 22.2 %), moderately happy and satisfied (23.7 vs 22.9 %) and the modestly happy and satisfied (18.4 vs 17.9 %) were not significantly different among urban and rural subjects. It seems that the accuracy of the Indian Happiness Rating Scale III is good enough to assess happiness in other populations. The prevalence of behavioral risk factors; alcoholism, alcohol intake in moderation, sedentary behavior, western type diet intake, sleep disorders, emotional stress disorders, breakfast missing, late night dinner, night shift work, were significantly greater among urban subjects compared with rural subjects. However, among subjects with happiness, the frequency of moderate alcohol intake was significantly greater compared to subjects with no happiness among urbans. There were no gender differences in happiness. Conclusions: It is possible that this modified questionnaire with 16 attributes, may accurately assess the status of happiness and successfully used for assessment of happiness rates in urban and rural populations. The questionnaire allowed us to identify approximately two third subjects with happiness, among both urban and rural populations. Similar prevalence of happiness among urban and rural subjects, despite more behavioral risk factors among urbans, indicate that economic development may not be necessary for happiness. Further studies are necessary to find out the role of happiness in relations to health and behavioral risk factors.

Selected outcomes from the study The Youth and Parents Risk Factor Behavior Survey in Bratislava

Abstract Background The cross-sectional study of behavioural risk factors in adolescents and adults in Slovakia comes from a bilateral American-Slovak project aimed to evaluate the impact of selected behavioural, psychological, and socioeconomic factors on the health of adolescents/young adults and their parents/caregivers. Methods The questionnaires for students and parents were developed according to the studies designed by CDC and adapted to national specificities. A total of 2,384 questionnaires were distributed to a sample of students aged 15-19 years from eight secondary schools and to their caregivers (798 + 1,586). The survey was anonymous and voluntary, approved by the Ethical Committee of the Faculty of Medicine Comenius University and University Hospital in Bratislava. Results The study found a high prevalence of behavioural risk factors among adolescents, including smoking (19.9 %), alcohol consumption (39.7 %), substance abuse (27.3%), and suicidal thoughts (41%), particularly at a younger age. The excessive use of IT was also found, mainly over the weekend. The study revealed a significantly lower age of first alcohol consumption and first sexual intercourse among adolescents than among their parents. Additionally, the study confirmed a significant relationship between maternal and child smoking (p = 0.043; OR = 1.84 95% CI 1.02-3.34), while the proportion of children who drank at least once in the last month increased significantly with the intensity of the father's drinking (p = 0.013). Similarly, statistically significant relationship was found between children's and mothers’ drug use (p = 0.008; OR = 2.77 95% CI 1.28-5.99). Conclusions The study identified various forms of risky behaviour among adolescents and highlighted the significant influence of parents’ risky behaviour on their children. Parents/caregivers serve as primary role models for their children, and their behaviour significantly impacts adolescent development. Supported by KEGA 015UK-4/2022 Key messages • The study assessed behavioural risk factors in adolescents, revealing high prevalence of smoking, substance abuse, suicidal thoughts. • Parental/caregiver behaviour was found to significantly impact adolescent development.

Behavioral risk factors for the health of machine tool operators as the basis of the company’s social policy

To form a competent social policy of the enterprise, aimed at reducing the risk of chronic non-infectious diseases, early loss of ability to work, information is needed not only about working conditions, but also about the priority behavioral health risk factors for workers. In order to identify the priority behavioral health risk factors for the workers of the machine-building enterprise the characteristics of the lifestyle, information on the awareness and perception of behavioral and occupational health risk factors (by active interviewing method) were obtained. The observation groups consisted of machine-tool workers of the machine-building enterprise with different work experience (Group 1 — ≤5 years; Group 2 — > 5 years). Numerous violations of lifestyle characteristics of machine operators were revealed, priority health risk factors were established: bad habits, low physical activity, violation of quality nutrition, low medical activity. The absence of self-preserving behavior in everyday life and in the workplace was shown. The increase in the prevalence of behavioral risk factors in the dynamics of length of service, and pronounced differences in the understanding of the significance of behavioral and occupational risk factors depending on age have been established. The results justified the need for a differentiated approach to the development of preventive programs to preserve health and longevity of the contingent of workers, taking into account the length of service, age and nature of work.

Assessment of the Prevalence of Behavioral Risk Factors and Their Impact on the Health of the Adult Population in the Russian Federation

The objective of this study is to substantiate the system of indicators for assessing behavioral risk factors (tobacco use, alcohol consumption, detrimental diet patterns, lack of physical activity) and their impact on public health in the Russian Federation based on the authors’ methodology for assessing the impact of behavioral risk factors on the health of the adult population using the materials of the statistical survey of the health status of the population (conducted by Rosstat in 2021). For each risk factor, two main indicators were calculated: the prevalence of the risk factor and its impact on public health according to demographic characteristics. The scale of such a risk factor as smoking was assessed in terms of consumption of various types of tobacco and nicotine-containing products and the prevalence of nicotine addiction of varying severity. Alcohol consumption as a behavioral risk factor was assessed in the context of the relationship between the amount of consumption of various alcoholic products and the degree of health risk. The impact of a detrimental diet was estimated by the body mass index for overweight and obesity, with the account to the physical activity of Russian citizens. According to the authors, the proposed set of indicators and specific calculation results can be used to organize continuous monitoring of the prevalence of behavioral risk factors and their impact on the health of the population of the Russian Federation. As a result, a more effective response of the healthcare system and strengthening of interagency cooperation to reduce non-communicable diseases is possible.

Prevalence of behavioral risk factors and their association with dementia in the urban population of North India

Background: Dementia has become a public health problems due to its association with behavioural risk factors; smoking, alcoholism, sedentary behaviour, western type diet, obesity, diabetes, and hypercholesterolemia. Most of these behavioural risk factors appear to be associated with dementia as well as with risk of cardiovascular diseases (CVDs) and diabetes. This study aims to find out the prevalence of behavioural risk factors and their association with cognitive deficit and dementia. Study design and setting: Cross-sectional survey in a hospital. Subjects and methods: After written informed consent and approval from hospital ethic committee, all subjects (n=2002) above 25 years of age (1016 males and 986 females) were randomly selected and recruited from urban population of Moradabad, North India. Clinical data and risk factors were recorded with the help of case record form and validated questionnaires. Assessment of cognitive decline and dementia was made by a new memory function rating scale and behavioural risk factors by validated questionnaires. The association of behavioral risk factors with dementia was calculated by multivariate logistic regression analysis after adjustment of age and sex, obesity, diabetes and CVDs. Results: Low cognitive activity, low education, sedentary behavior, sleep duration, tobacco intake, alcoholism and western diet, were highly prevalent independent risk factors of dementia. Low education was not associated with risk. Logistic regression analysis revealed that regardless of age and body mass index, sedentary behavior, odds ratio and confidence intervals: (men 0.74 (0.69 - 0.79), women, 0.71 (0.63 - 0.74) and tobacco intake (men 0.88 (0.79 - 0.94), women 0.90 (0.84 - 0.97) and sleep disruption (men 0.80 (0.71 - 0.89), women 0.85 (0.79 - 0.91) were strongly (p<001) and significantly (p<0.001) associated with dementia in both sexes, respectively. Alcoholism (men 0.71 (0.65 - 0.78) was also strongly and significantly (P<001) associated with dementia in men but not in women. Low cognitive activity, (men 0.83 (0.75 - 0.92), (women 0.89 (0.84 - 0.99), and western diet (men 0.88(0.80-0.95), (women 0.89 (0.81 - 0.99) were weakly but significantly (p=0.05) associated with dementia in both sexes. Meditation and prayer was inversely associated with dementia among (men 0.92 (0.85 - 0.99) and (women 0.90 (0.85 - 0.97). Conclusions: It is possible that increased physical activity, no tobacco and alcoholism, optimal sleep, intake of healthy foods, meditation and prayer, high cognitive activity, and good sleep for 6-8 hours, can protect against dementia.

Abstract P641: Gaming the Way to Cardiovascular Health in Nepal: A Digital Approach in Adolescents

High prevalence of behavioral risk factors for cardiovascular disease (CVD) warrants a life course approach for efficient prevention. Our previous HARDIC trial in semi-urban Nepal shows conventional CVD educational interventions for mothers improved knowledge, attitude, and practice (KAP). Digital cardiovascular health promotion provides opportunities to efficiently reach adolescents. Our aim was therefore to develop such digital health promotion through a serious game that is educational and entertaining, as an innovative way to reach adolescents. We conducted a mixed-method study to assess adolescents’ KAP and perception regarding CVD, explored opportunities for digital cardiovascular health promotion, and developed a concept for a serious game prototype. In total, 649 adolescents grades 8-10 in two government and seven private schools in a semi-urban community of Nepal were surveyed cross-sectionally following parental consent. A self-administered questionnaire assessed KAP of CVD, mobile phone use, internet availability at home and gaming behaviors. For deeper understanding of adolescents’ perception on CVD, we conducted eight focus group discussions (FGDs) separately among boys and girls (n=76). The health belief model and the technology acceptance model guided FGD development and analysis. Eighty percent of adolescents were aged 13-15 years, 49% were girls and 40.4% studied in government schools. The median (IQR) percent scores for KAP were 70.6 (10.59), 78.5 (8.46) and 69.5 (11.59), respectively. Good KAP (median percent scores >75%) was found in 27.7%, 69% and 27.8% adolescents, respectively. Knowledge ( p <0.001), attitude ( p =0.025) and practice ( p <0.001) was higher among adolescents in private than government schools. Girls had better attitude than boys (<0.001). Furthermore, 98% adolescents had smartphone access and 91.6% had internet access.Preliminary FGD analyses show that adolescents mentioned physical, nutritional, mental, environmental, and hereditary causes for CVD. Financial and work-related burdens, as well as psychological, mental and family-related issues were perceived to influence CVD severity. Temptations for junk food and physical inactivity were barriers to follow heart-healthy behavior. Adolescents perceived serious games as beneficial and easy to use for creating CVD awareness. The game should offer challenge and exhibit increased levels of difficulty to remain stimulating throughout its intended use.We conclude that the existing gaps in knowledge and practice, with good attitude and excellent mobile and internet prerequisites, provide great opportunity for serious games in Nepal. The prototype of “Happy Heart” is being pilot-tested among adolescents, suggesting a promising way forward for digital cardiovascular health promotion.

Informal caregivers in Germany - who are they and which risks and resources do they have?

The aim of this study is to describe the social characteristics, the health and living situation and the prevalence of behavioral risk factors of adult informal caregivers compared to non-caregivers in Germany. We used data from the German Health Update (GEDA 2019/2020-EHIS survey) which is a cross-sectional population-based health interview survey conducted between 04/2019 and 09/2020. The sample comprised 22,646 adults living in private households. Three mutually exclusive groups of providing informal care or assistance were differentiated: intense caregivers (informal care ≥10 h/week), less-intense caregivers (informal care<10 h/week) and non-caregivers. For the three groups weighted prevalences of social characteristics, health status (self-perceived health, health-related activity limitations, chronic diseases, low back disorder or other chronic back defect, depressive symptoms), behavioral risk factors (at-risk drinking, current smoking, insufficient physical activity, non-daily fruit and vegetable consumption, obesity) and social risk factors (single household, low social support) were calculated and stratified by gender. Separate regression analyses adjusted for age-group were conducted to identify significant differences between intense and less-intense caregivers vs. non-caregivers, respectively. Overall, 6.5% were intense caregivers, 15.2% less-intense caregivers and 78.3% non-caregivers. Women provided care more often (23.9%) than men (19.3%). Informal care was most frequently provided in the age group of 45 to 64 years. Intense caregivers reported worse health status, were more often current smokers, physical inactive, obese and lived less often alone than non-caregivers. However, in age-group adjusted regression analyses only few significant differences were seen: Female and male intense caregivers had more often a low back disorder and lived less often alone compared to non-caregivers. In addition, male intense care-givers reported more often worse self-perceived health, health-related activity limitation, and the presence of chronic diseases. In contrast, less-intense caregivers and non-caregivers differed in favor of the less-intense caregivers. A substantial proportion of the adult German population provides informal care regularly, especially women. Intense caregivers are a vulnerable group for negative health outcomes, especially men. In particular measures to prevent low back disorder should be provided. As the necessity of providing informal care will probably increase in the future, this will be important for the society and public health.

Knowledge on behavioural risk factors of lifestyle diseases and its prevalence

The present study was aimed to assess knowledge and practice on behavioural risk factors of lifestyle diseases among people attending outpatient departments (OPD’s) in selected health centers at Kottayam district. A quantitative non experimental research approach was used for the study. The study was theoretically supported by Betty Neuman’s System Model. People came to OPD’s were selected until 350 subjects obtained. The tools used for data collection were socio personal data sheet, structured knowledge questionnaire to assess the knowledge, behavioural risk assessment scale to assess behavioural risk factors, clinical data sheet to obtain data regarding lifestyle diseases and rating scale to assess practice. Result of the study revealed that majority of people had good knowledge and practice on behavioural risk factors of lifestyle diseases. There was significant association between knowledge and practice regarding behavioural risk factors of lifestyle diseases with age, gender, education, economic status and source of information. The prevalence of behavioural risk factors among the people based on behavioural risk assessment revealed that majority of people attending OPD of health centres were leading unhealthy lifestyle.

PS-P11-8: GESTATIONAL DIABETES MELLITUS AS A PREDICTOR OF TYPE 2 DIABETES MELLITUS: CARDIOVASCULAR RISK FACTORS AND BIOLOGICAL MARKERS IN KAZAKH WOMEN

Aim: To study the prevalence of gestational diabetes mellitus in the regions of the Republic of Kazakhstan, cardiovascular risk factors and biological markers in women of the Kazakh population Design and method: Analysis of the prevalence of gestational diabetes mellitus was carried out according to the data of the medical information systems “Diabetes mellitus” and “Register of pregnant women and women of childbearing age”. Results: Analysis of the primary incidence of DM2 among adults, within 5 years there has been a steady increase, while women with type 2 diabetes are much more - 65.5%. The increase in cases of type 2 diabetes was 140 thousand cases (46%), and among women over this period - 85 thousand cases (41%). At the same time, an analysis of the prevalence of type 1 diabetes indicates that there is no gender difference in this type of diabetes mellitus, the number of women left 47.3%. The increase since 2016 was 34.2%, among women 29.5%. The increase DM2 among women of childbearing age is 58.3%, which is significantly higher than in women of all age groups (41%). DM1 increase was 37.4%. Analysis of the prevalence of GDM according to the statistical data of the “Register of pregnant women and women of childbearing age” showed differences in frequency across the regions of Kazakhstan (from 4.0% to 11.0%). At the same time, in 2021 alone, the growth in GDM amounted to about 50% compared to 2020. Abdominal obesity was found in more than 50% of patients with GDM (the highest rate in the Almaty region, the lowest in Aktobe). The prevalence of hypertension among women with GDM is also lower in Aktobe region. An analysis of the prevalence of behavioral risk factors for CVD showed that the largest number of smokers was in Almaty and Almaty region. To study gene polymorphism, GWAS-associated SNPs polymorphisms with the development of GDM were selected: genes for impaired insulin synthesis and those associated with insulin signal transmission; genes for impaired insulin secretion; genes that regulate carbohydrate and lipid metabolism. Conclusion: The results of the analysis demonstrate high prevalence rates of GDM and DM 2. among women in the studied regions, including women of childbearing age, and high variability between regions.There is a need to standardize approaches to screening for GDM. Abdominal obesity and hypertension are the leading risk factors for the development of GDM.

A Key Comprehensive System for Biobehavioral Surveillance of Populations Disproportionately Affected by HIV (National HIV Behavioral Surveillance): Cross-sectional Survey Study.

The National HIV Behavioral Surveillance (NHBS) is a comprehensive system for biobehavioral surveillance conducted since 2003 in 3 populations disproportionately affected by HIV: gay, bisexual, and other men who have sex with men (MSM); people who inject drugs; and heterosexually active persons at increased risk for HIV infection (HET). This ongoing and systematic collection and analysis of data is needed to identify baseline prevalence of behavioral risk factors and prevention service use, as well as to measure progress toward meeting HIV prevention goals among key populations disproportionately affected by HIV. This manuscript provides an overview of NHBS from 2003 to 2019. NHBS is conducted in rotating, annual cycles; these 3 annual cycles are considered a round. Venue-based, time-space sampling is used for the MSM population. Respondent-driven sampling is used for people who inject drugs and HET populations. A standardized, anonymous questionnaire collects information on HIV-related behavioral risk factors, HIV testing, and use of prevention services. In each cycle, approximately 500 eligible persons from each participating area are interviewed and offered anonymous HIV testing. From 2003 to 2019, 168,600 persons were interviewed and 143,570 agreed to HIV testing across 17 to 25 cities in the United States. In the fifth round (2017 to 2019), over 10,000 (10,760-12,284) persons were interviewed each of the 3 population cycles in 23 cities. Of those, most (92%-99%) agreed to HIV testing. Several cities also conducted sexually transmitted infection or hepatitis C testing. NHBS is critical for monitoring the impact of the Ending the HIV Epidemic in the United States initiative. Data collected from NHBS are key to describe trends in key populations and tailor new prevention activities to ensure high prevention impact. NHBS data provide valuable information for monitoring and evaluating national HIV prevention goals and guiding national and local HIV prevention efforts. Furthermore, NHBS data can be used by public health officials and researchers to identify HIV prevention needs, allocate prevention resources, and develop and improve prevention programs directed to the populations of interest and their communities.

Abstract 3665: Clear cell renal cell carcinoma molecular characteristics in Hispanic Americans compared to European Americans

Abstract Background: Hispanic Americans (HAs) have higher incidence and mortality rates of renal cell carcinoma (RCC) than European Americans (EAs). Despite the disparate burden of RCC, tumor molecular characteristics among HAs are unknown. This study explored clear cell RCC (ccRCC) molecular difference between HAs and EAs. Methods: Paraffin embedded surgical specimens of ccRCC patients who underwent nephrectomy for a treatment of RCC were obtained. Three exons of VHL gene were screened for somatic mutations in a total of 150 patients. 96 patients were included for TempO-Seq analysis. A centroid-based approach with 34 gene set was used to assign molecular subtype (ccA or ccB). DESeq2 was used for differential gene expressional analysis. Results: HAs were younger (mean age of 55.7 vs. 61.2) and had slightly higher mean Body Mass Index (BMI, 32.1 vs. 30.3). More HAs reported that they never smoked (71%) compared to EAs (46%). 73 somatic mutations in coding regions of VHL were found in 56 patients (37.3%), and 11 patients had more than 2 somatic mutations in coding regions. Mutations in coding regions were more common in EAs (41.5%) than HAs (35.5%), but the difference was not statistically significant (p=0.49). When we focused on moderate or high impact mutations, EAs had mutations at higher frequency than HAs (40.2 vs. 27.4%; p=0.07 after adjusting for age and sex). Frequency of somatic mutations was also higher for former (30.3%) and current smokers (40.0%) compared to non-smokers (24.3%). After including smoking history in the regression model, HA ethnicity was not associated with presence of high/moderate impact somatic mutations. HAs had a higher frequency of ccA subtype than EAs (61.9% vs 45.8%). ccA subtype was also more common in patients with BMI&amp;gt;35 (65.2%) than patients with BMI&amp;lt;25 (45.0%). In the adjusted model, HAs had significantly increased odds of having ccA (OR 3.34, 95%CI: 1.17-9.52). Haptoglobin (HP) gene was most significantly over-expressed in high-grade compared to low-grade ccRCC in an analysis including all samples (log2 fold change 4.0, adjusted-p=1.7x10-12). HP was highly over-expressed in high-grade compared to low-grade ccRCC in EAs (log2 fold change 5.2, adjusted-p=4.9x10-9), but not in HA tumors (log2 fold change 2.5, adjusted-p=0.06). Conclusion: HA and EA tumors have different molecular characteristics potentially due to differences in prevalence of behavioral risk factors. Impact: Different molecular characteristics in racial/ethnic groups may impact clinical treatment in diverse patient populations. Citation Format: Ken Batai, Yuliang Chen, Brenna Rheinheimer, Ron Heimark, Nathan Ellis, Benjamin R. Lee. Clear cell renal cell carcinoma molecular characteristics in Hispanic Americans compared to European Americans [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3665.

Cohort profile: Bandar Kong prospective study of chronic non-communicable diseases.

Chronic non-communicable diseases (NCDs), are the leading causes of death among adults worldwide. It is projected that half of the NCDs could be avoided by preventing measures. Under the prospective epidemiological research studies in Iran (PERSIAN), we established a prospective population-based cohort study in southern Iran. The present study was designed to observe changing pattern of lifestyle transition over time and investigate the incidence and prevalence of regional modifiable risk factors as well as their associations with major NCDs. At baseline, 4063 participants aged 35-70 years were recruited on Oct, 2016and planned to get re-evaluated every 5 years along with annual follow-up. Data using validated electronic questionnaire comprising 55 questions and 482 items including general, medical and nutrition queries was collected. Blood, hair, nails, urine specimens and anthropometric measurements were taken. The response rate was 99%. In the results; male and female participants were 42.5% and 57.5%, respectively. Of note, 30.4% of women and 16.1% of men were obese. The prevalence of hypertension in men and women was 14.6% and 21%; however, diabetic men and women were 17.4% and 12.4%, respectively. Living in rural areas increased the odds of having hypertension by 1.33 (AOR = 1.33, 95% CI:1-09, 1.61). Noteworthy, logistic regression displayed that aging could predispose individuals to be more overweight, hypertensive and diabetic. The prevalence of multimorbidity of 3 or more NCDs were 8% (No. 326) and 6% (No.240), respectively. Intake of fruits, vegetables and dairy was less than two servings per day in 9.2%, 13% and 58.3% of the participants. Lower cardiovascular diseases and serum level of FBS and higher HDL level in sailors/fishermen compared to other job groups were significant (p-value <0.001). The second annual follow-up was completed and now at the end of the third wave. Findings of the present study signified the high prevalence of behavioral risk factors and their associations with respective NCDs. Subsequently, it is essential to keep track lifestyle variations, the modifiable risk factors and NCDs trends by prospective population-based cohort studies.

Using latent class analysis to inform the design of an EHR-based national chronic disease surveillance model.

The Multi-state EHR-based Network for Disease Surveillance (MENDS) developed a pilot electronic health record (EHR) surveillance system capable of providing national chronic disease estimates. To strategically engage partner sites, MENDS conducted a latent class analysis (LCA) and grouped states by similarities in socioeconomics, demographics, chronic disease and behavioral risk factor prevalence, health outcomes, and health insurance coverage. Three latent classes of states were identified, which inform the recruitment of additional partner sites in conjunction with additional factors (e.g. partner site capacity and data availability, information technology infrastructure). This methodology can be used to inform other public health surveillance modernization efforts that leverage timely EHR data to address gaps, use existing technology, and advance surveillance.

Health and health behaviors in China: Anomalies in the SES-health gradient?

ObjectivesFundamental Cause Theory (FCT) predicts that higher socioeconomic status (SES) leads to better health outcomes, through mechanisms including health-promoting behaviors. Most studies supporting FCT use data from Western countries. However, limited empirical studies from China, as well as theoretical considerations suggested by China's unique history and culture, raise questions about the generalizability of FCT to the Chinese context. This study explores whether the associations between SES, health behaviors, and health status in Western countries are also observed in China, and to what extent behavioral risk factors explain socioeconomic disparities in Chinese health. Data and methodUsing data on adults age 45+ from the nationally-representative 2015 China Health and Retirement Longitudinal Study (CHARLS; n = 14,420), we conduct regressions of multiple health outcomes (self-rated health, disease count, and several common chronic conditions) on demographic characteristics, SES (measured via education and wealth), and behavioral risk factors (smoking, high-frequency drinking, and overweight). To assess whether behavioral risk factors mediate the SES-health association, we use the Karlson, Holm and Breen (KHB) mediation analysis method. ResultsSupporting FCT, both education and wealth predict higher self-rated health and lower risk of arthritis. However, inconsistent with FCT, neither education nor wealth predict disease count, diabetes, or hypertension; education shows some positive association with cardiovascular disease; and higher SES is strongly associated with higher risk of dyslipidemia. Prevalence of smoking and high-frequency drinking are flat by wealth and inversely U-shaped by education, while overweight is somewhat concentrated in the highest SES groups. Results of mediation analyses show both suppression and mediation effects. ConclusionHigh prevalence of behavioral risk factors across SES groups appears to damage health in much of the Chinese population, and thus attenuates social gradients in health. A broader range of cultural, historical, and political factors should be incorporated into FCT's theoretical framework, particularly in non-Western contexts.

Incorporating Participatory Approaches and Implementation Science Toward an Integrated Research Paradigm to Promote Equity in Cancer Prevention and Control Research for Sexual and Gender Diverse Populations

Multiple, complex factors contribute to cancer disparities for sexual and gender diverse (SGD) individuals, including a high prevalence of behavioral risk factors (e.g., smoking, alcohol consumption, and obesity), higher exposure to sexually transmitted infectious agents (e.g., human immunodeficiency and human papilloma viruses), and low utilization of preventive services including vaccination and cancer screening. While ongoing research focuses on documenting these disparities, few studies have produced interventions to address these disparities and promote equity. Moreover, existing research does not always translate to real-world clinical and/or community practice to achieve meaningful and sustainable improvements in cancer-related health outcomes for SGD populations. In this paper, we propose an integrated research paradigm that incorporates Community Based Participatory Research (CBPR) approaches and Implementation Science (IS) to ensure that we develop interventions that truly benefit SGD communities along the cancer care continuum. Using two ongoing research programs as examples, we demonstrate how participatory approaches and existing implementation frameworks are particularly appropriate for working with medically underserved SGD populations. We discuss ways in which such a research paradigm could lead to informed, actionable, and achievable outcomes for researchers, practitioners, and SGD communities. Combined with resources and training opportunities highlighted in this paper, we call on investigators to employ CBPR approaches and IS to make a shift from research that operates in silos and simply focuses on identifying disparities to one that synergistically promotes and sustains health equity by engaging stakeholders across the research to practice and cancer care continuums.