Preventive Care Research Articles

Predicting adverse long-term neurocognitive outcomes after pediatric intensive care unit admission

Background and objectiveCritically ill children may suffer from impaired neurocognitive functions years after ICU (intensive care unit) discharge. To assess neurocognitive functions, these children are subjected to a fixed sequence of tests. Undergoing all tests is, however, arduous for former pediatric ICU patients, resulting in interrupted evaluations where several neurocognitive deficiencies remain undetected. As a solution, we propose using machine learning to predict the optimal order of tests for each child, reducing the number of tests required to identify the most severe neurocognitive deficiencies. MethodsWe have compared the current clinical approach against several machine learning methods, mainly multi-target regression and label ranking methods. We have also proposed a new method that builds several multi-target predictive models and combines the outputs into a ranking that prioritizes the worse neurocognitive outcomes. We used data available at discharge, from children who participated in the PEPaNIC-RCT trial (ClinicalTrials.gov-NCT01536275), as well as data from a 2-year follow-up study. The institutional review boards at each participating site have also approved this follow-up study (ML8052; NL49708.078; Pro00038098). ResultsOur proposed method managed to outperform other machine learning methods and also the current clinical practice. Precisely, our method reaches approximately 80% precision when considering top-4 outcomes, in comparison to 65% and 78% obtained by the current clinical practice and the state-of-the-art method in label ranking, respectively. ConclusionsOur experiments demonstrated that machine learning can be competitive or even superior to the current testing order employed in clinical practice, suggesting that our model can be used to severely reduce the number of tests necessary for each child. Moreover, the results indicate that possible long-term adverse outcomes are already predictable as early as at ICU discharge. Thus, our work can be seen as the first step to allow more personalized follow-up after ICU discharge leading to preventive care rather than curative.

LEADERSHIP IN GLOBAL HEALTH: NAVIGATING CHALLENGES AND OPPORTUNITIES FOR IMPACTFUL OUTCOMES IN AFRICA AND SRI LANKA

Effective leadership is paramount in addressing the complex challenges and harnessing the opportunities in global health, particularly in regions such as Africa and Sri Lanka. This review explores the multifaceted dimensions of leadership within the context of global health, highlighting the unique challenges and opportunities faced by these regions. In Africa, leadership in global health is confronted with a myriad of challenges including limited resources, political instability, and infrastructural deficiencies. The burden of infectious diseases, inadequate healthcare access, and socio-economic disparities further exacerbate the complexities. However, amidst these challenges lie opportunities for transformative leadership. Visionary leaders can leverage partnerships, innovative technologies, and community engagement to strengthen health systems, promote preventive healthcare, and address the root causes of health inequities. Similarly, in Sri Lanka, leadership in global health faces its own set of challenges and opportunities. Despite notable achievements in healthcare infrastructure and disease control, the country grapples with emerging health threats, non-communicable diseases, and disparities in healthcare access. Effective leadership is essential in mobilizing resources, fostering intersectoral collaboration, and implementing evidence-based interventions to ensure equitable health outcomes for all segments of the population. In both regions, transformative leadership in global health necessitates a multidisciplinary approach that integrates political commitment, scientific innovation, and community participation. Leaders must possess strong communication skills, cultural competence, and a deep understanding of local contexts to navigate the intricate socio-political landscapes. Furthermore, fostering leadership capacity at all levels of the healthcare system is crucial for sustainability and resilience in the face of evolving health challenges. By examining the challenges and opportunities for leadership in global health within the contexts of Africa and Sri Lanka, this review underscores the importance of visionary leadership in driving impactful outcomes. Empowering leaders to navigate complexities, foster collaboration, and innovate solutions is essential for advancing the global health agenda and achieving health equity on a global scale.
 Keywords: Leadership, Global Health, Africa, Sri Lanka, Healthcare, Review

Protein quality control systems in the endoplasmic reticulum and the cytosol coordinately prevent alachlor-induced proteotoxic stress in Saccharomyces cerevisiae

Alachlor, a widely used chloroacetanilide herbicide for controlling annual grasses in crops, has been reported to rapidly trigger protein denaturation and aggregation in the eukaryotic model organism Saccharomyces cerevisiae. Therefore, this study aimed to uncover cellular mechanisms involved in preventing alachlor-induced proteotoxicity. The findings reveal that the ubiquitin-proteasome system (UPS) plays a crucial role in eliminating alachlor-denatured proteins by tagging them with polyubiquitin for subsequent proteasomal degradation. Exposure to alachlor rapidly induced an inhibition of proteasome activity by 90 % within 30 min. The molecular docking analysis suggests that this inhibition likely results from the binding of alachlor to β subunits within the catalytic core of the proteasome. Notably, our data suggest that nascent proteins in the endoplasmic reticulum (ER) are the primary targets of alachlor. Consequently, the unfolded protein response (UPR), responsible for coping with aberrant proteins in the ER, becomes activated within 1 h of alachlor treatment, leading to the splicing of HAC1 mRNA into the active transcription activator Hac1p and the upregulation of UPR gene expression. These findings underscore the critical roles of the protein quality control systems UPS and UPR in mitigating alachlor-induced proteotoxicity by degrading alachlor-denatured proteins and enhancing the protein folding capacity of the ER.

Psychosocial factors contributing to value creation in value-based healthcare: a scoping review.

Healthcare systems constantly evolve to improve care quality and resource utilization. One way is implementing Value-Based Healthcare (VBHC) an economic approach. This scoping review aims to identify and describe the literature on VBHC, particularly its psychosocial aspects, to uncover research gaps. The review followed the PRISMA guidelines for Scoping Reviews. We took the following 14 steps: (a) defining the research question; (b) identifying relevant studies; (c) selecting studies; (d) 15 mapping data; (e) collecting, synthesizing and reporting results. A detailed Boolean search was conducted from January 2021 to August 31, 2021, across APA PsycINFO and PubMed databases using keywords such as "Value-Based Healthcare" and "psychosocial perspective." Initially, three reviewers screened 70 e-records independently, assessing titles, abstracts, and full-text against the inclusion criteria. Discrepancies regarding the evaluation of the articles were resolved through consensus sessions between the reviewers. The final review included 14 relevant e-records in English from peer-reviewed sources, focusing on quantitative and qualitative research. From the analysis, four areas emerged: (1) Value chains in Healthcare; (2) Styles, activities, and practices of value co-creation in Healthcare; (3) Value co-creation in the encounter process; (4) Value co-creation in preventive health services. The scoping review findings suggest several potential key aspects, including the interdependence between patients and healthcare organizations, organizational culture in healthcare, and the role of patient-centered approaches that focus on relationships, communication, and social support in healthcare. This can be achieved through patient engagement, patient-centered care and communication, health literacy, psychosocial support services, comprehensive psychosocial assessments, care coordination, and continuity of care. Integrating psychosocial elements in VHBC enhances quality and optimizes resource use. Findings highlight the need to develop practical guidance on how to implement a culture of value in care that takes into account the psychosocial aspects that have emerged, but not fully addressed. The pandemic teaches that the workforce poorly receives sudden and unsystematic changes. This review could provide an initial basis for the redesign of value in healthcare and a paradigm shift that has already begun with patient-centered medicine and patient engagement.

Maryland School Health partners' Perspectives on the Impact of COVID-19 on School Health Services for Grades K-12.

The COVID-19 pandemic disrupted routine school operations, including school health programs. This study aims to describe the pandemic's impact on school health service delivery from the perspective of Maryland school health partners. We conducted semi-structured interviews with health service representatives from public schools (K-12) between July and December 2021. Interviews were recorded, transcribed, and coded through an iterative process to develop analytic themes. Twenty school health partners from 15 Maryland school districts participated. Participants identified key impacts of COVID-19 on school health: (1) COVID-19 disrupted delivery of services such as dental, mental health, and preventative care, (2) COVID-19 necessitated changes in service delivery platforms, (3) COVID-19 affected school health staff through increased responsibilities and staffing shortages, and (4) COVID-19 prompted schools to become hubs for community outreach and health education. Consideration of school health service disruptions and the increased demands on service providers may inform future priorities for school administrators, health departments, and policymakers. COVID-19 impacted the timing and method of service delivery as well as the roles of school health staff and schools themselves in public health and education.

Feasibility of Using Blood-based Biomarkers to Evaluate the Effectiveness of Individualized Neurodegenerative Disease Preventive Care (P4-9.002)

Feasibility of Using Blood-based Biomarkers to Evaluate the Effectiveness of Individualized Neurodegenerative Disease Preventive Care (P4-9.002)

Evaluating the WISE (Women in the South-East) Telehealth Network: A Model of Healthcare and Health Promotion at Rural Libraries.

The purpose of this study was to evaluate the effectiveness of the WISE (Women in the South-East) Telehealth Network. A follow-up survey design was used to determine the impact of the program on access to healthcare. WISE provided preventive care to women and gender expansive people at local libraries and the Mobile Library in the rural South Carolina Lowcountry. In 1year (February 2021-2022), WISE reached 523 individuals with 151 agreeing to participate in the study. Most participants identified as white (66%) or Black (22%). A Community Health Worker provided health education, connection to telehealth services, referrals, and connected individuals with community and social services. The Telehealth Usability Questionnaire (TUQ), changes in knowledge, satisfaction with WISE, Acceptability of Intervention measure (AIM), and sociodemographic characteristics. Participants with a high telehealth usability score were significantly more likely to be under the age of 35 (OR 4.60 [95% CI 1.21-17.52]), married (OR 10.00 [95% CI 2.19-45.64]), or white (OR 4.00 [95% CI 1.06-15.08]). The intervention earned a high acceptability score 4.46 (± .61)/5.0 by helping participants obtain necessary medical care and resources, as well as meeting their educational needs. This study offers practical suggestions to expand the use of telehealth initiatives to improve health outcomes by engaging libraries in rural communities.

Temporal Trends in Quality of Acute Stroke and Secondary Stroke Prevention Care in Patients with Pre-stroke Disability in the Safe Implementation of Treatment in Stroke (SITS) Registry (P1-5.002)

Temporal Trends in Quality of Acute Stroke and Secondary Stroke Prevention Care in Patients with Pre-stroke Disability in the Safe Implementation of Treatment in Stroke (SITS) Registry (P1-5.002)

Primary Cerebrovascular Preventive Care in Women: Primary Stroke Prevention by Obstetrician/Gynecologists (P1-5.007)

Primary Cerebrovascular Preventive Care in Women: Primary Stroke Prevention by Obstetrician/Gynecologists (P1-5.007)

The world's experience of introducing prophylactic programs in dentistry

Relevance. The oral health of the global population is fundamentally influenced by the incidence and severity of dental caries and periodontal diseases. To combat these issues, developed nations devise and execute preventive programs, tailoring their efforts to address the DEF (Decayed, Extracted, and Filled teeth) index across various age demographics. This approach signifies a paradigm shift, with governments now prioritizing the support of oral health through the introduction of comprehensive preventive strategies aimed at combating prevalent oral diseases. The efficacy of these programs, however, hinges on the occurrence of dental caries and, by extension, the availability of oral health professionals. This availability, in turn, shapes the landscape of health facilities—whether public or private—determining their ability to cater to community needs for oral health services. Consequently, the capacity to implement preventive measures is gauged against these dynamics. Furthermore, the nature and scope of preventive actions within these programs vary from one country to another, influenced primarily by the allocation of healthcare budgets by respective governments.Materials and methods. Analysis of scientific articles and original research from the PubMed, ResearchGate, ScienceDirect for the last 10 years. The search was carried out by keywords: dental prevention programs in the world, prevention of dental health, organization of preventive care in the world. An examination of research articles and original papers was conducted, drawing from databases such as PubMed, ResearchGate, and ScienceDirect over the last decade. The search employed specific key phrases, including "dental prevention programs worldwide", "dental health prevention", and "global organization of preventive dental care".Results. The initial advancement towards the creation and implementation of fluoride prophylaxis programs occurred following the discovery of fluoride's presence in water. A pivotal moment occurred in 1949 at Indiana State University when J.C. Muhler introduced the idea of fluoride toothpaste (specifically sodium fluoride) as a means to combat dental caries in children. Subsequent innovations included the use of silver fluoride for argentation. European countries took a holistic approach, emphasizing oral hygiene, fluoride toothpaste usage, and balanced nutrition. Meanwhile, the US and EU shifted towards a preventive approach within health insurance frameworks. A critical factor influencing the effectiveness of these preventive care programs is the availability of oral health professionals per 10,000 people in the population, alongside social workers advocating for healthy living and oral health. The engagement of more oral health professionals in preventive efforts correlates with a reduction in the incidence and severity of common oral diseases.Conclusion. The six stages of preventive care development and transformation highlight the evolving trends in global dentistry, which are crucial for ensuring the quality of oral health care across different countries. The effectiveness of these programs in individual nations is contingent upon the specific preventive care.

In vitro study of the bactericidal activity for new derivatives of quaternary ammonium salts based on pyridoxine against gram-positive/gram-negative bacteria

Background: preventive care and successful treatment of infectious diseases (including hospital-acquired infections) are among the most important tasks of modern healthcare. There are not many effective antiseptics and disinfectants to solve this problem. Quaternary ammonium salts are currently one of the promising classes of disinfectants but their use is limited by the ability of microorganisms to develop resistance to these compounds. Modification of QAS with substituents of various natures is a possible way to solve this problem.
 Aims: in this work a bactericidal activity comparative analysis for two original quaternary ammonium compounds based on pyridoxine was carried out in comparison with benzalkonium chloride.
 Materials and methods: the bactericidal activity of 0.1% and 0.2% aqueous solutions of original QACs based on pyridoxine were studied against two widespread pathogens: S. aureus and E. coli. Antibacterial activity data were obtained using a standard in vitro test (bactericidal activity test on a metal surface, exposure time 1, 5 and 15 minutes). In addition to standard conditions, antibacterial efficacy was also studied under protein loading conditions (adding BSA solution to the surface).
 Results: for the studied compounds the RF (reduction factor - reduction lgCFU of microorganisms) was on average ≥ 3. Complicating the model conditions in the form of protein load led to a decrease in efficiency by 1-3 orders. We have also observed an interesting effect of exposure time-dependent specificity reversal to the S. aureus and E. coli.
 Conclusions: The obtained results showed high activity of the studied compounds (corresponding to the effectiveness criterion RF≥3 for commercial compounds used in this field).

The Bitemporal Lens Model-toward a holistic approach to chronic disease prevention with digital biomarkers.

We introduce the Bitemporal Lens Model, a comprehensive methodology for chronic disease prevention using digital biomarkers. The Bitemporal Lens Model integrates the change-point model, focusing on critical disease-specific parameters, and the recurrent-pattern model, emphasizing lifestyle and behavioral patterns, for early risk identification. By incorporating both the change-point and recurrent-pattern models, the Bitemporal Lens Model offers a comprehensive approach to preventive healthcare, enabling a more nuanced understanding of individual health trajectories, demonstrated through its application in cardiovascular disease prevention. We explore the benefits of the Bitemporal Lens Model, highlighting its capacity for personalized risk assessment through the integration of two distinct lenses. We also acknowledge challenges associated with handling intricate data across dual temporal dimensions, maintaining data integrity, and addressing ethical concerns pertaining to privacy and data protection. The Bitemporal Lens Model presents a novel approach to enhancing preventive healthcare effectiveness.

Exploring machine learning for untargeted metabolomics using molecular fingerprints

BackgroundMetabolomics, the study of substrates and products of cellular metabolism, offers valuable insights into an organism's state under specific conditions and has the potential to revolutionise preventive healthcare and pharmaceutical research. However, analysing large metabolomics datasets remains challenging, with available methods relying on limited and incompletely annotated metabolic pathways. MethodsThis study, inspired by well-established methods in drug discovery, employs machine learning on metabolite fingerprints to explore the relationship of their structure with responses in experimental conditions beyond known pathways, shedding light on metabolic processes. It evaluates fingerprinting effectiveness in representing metabolites, addressing challenges like class imbalance, data sparsity, high dimensionality, duplicate structural encoding, and interpretable features. Feature importance analysis is then applied to reveal key chemical configurations affecting classification, identifying related metabolite groups. ResultsThe approach is tested on two datasets: one on Ataxia Telangiectasia and another on endothelial cells under low oxygen. Machine learning on molecular fingerprints predicts metabolite responses effectively, and feature importance analysis aligns with known metabolic pathways, unveiling new affected metabolite groups for further study. ConclusionIn conclusion, the presented approach leverages the strengths of drug discovery to address critical issues in metabolomics research and aims to bridge the gap between these two disciplines. This work lays the foundation for future research in this direction, possibly exploring alternative structural encodings and machine learning models.

The Metabolic Insight into Autism Spectrum Disorder: Evaluating Adiponectin's Impact on Severity and Therapy

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition with a complex interplay of genetic and environmental factors. Recent research has suggested a significant link between metabolic alterations and ASD pathology, particularly focusing on adiponectin, a hormone related to glucose regulation and fatty acid breakdown. Anomalies in adiponectin levels have been associated with cognitive impairment and the severity of ASD. Objective: This study aims to evaluate the potential of the ADIPOQ gene as a biomarker for dementia in individuals with ASD, exploring its correlation with cognitive decline and metabolic dysregulation. Methods: A total of 108 EDTA blood samples from ASD patients and 32 from healthy controls were collected after obtaining written informed consent. The inclusion criteria included individuals aged over 40 with Type II Diabetes Mellitus and confirmed cases of diabetes and dementia. Exclusion criteria comprised the absence of clinical history, refusal of consent, and secondary autism. Adiponectin levels were quantified using ELISA, and cognitive function was assessed via MMSE scores over a six-month follow-up period. Data analysis was conducted using GraphPad Prism 9.0 with ANOVA for statistical significance. Results: The study found a significant decrease in adiponectin levels among ASD patients (5.17±1.04 µg/mL) compared to healthy controls (11.37±4.14 µg/mL, p=0.014). MMSE scores were notably lower in the ASD group (10.26±2.56) than in controls (23.1±3.12, p=0.006). A marked underexpression of ADIPOQ gene (fold change of 4.9) was observed in patients with dementia. Conclusion: The ADIPOQ gene shows potential as a biomarker for the early detection of dementia in ASD, offering avenues for personalized medical interventions and preventative healthcare measures. Recognizing its role could lead to improved therapeutic strategies and a reduction in the healthcare burden due to neurodegenerative diseases associated with ASD.

Population Health Management: Leveraging it for Better Patient Outcome’s

Purpose: The primary aim is to investigate how IT integration within PHM frameworks significantly improves patient care by enabling proactive health interventions and fostering a comprehensive understanding of population health trends.
 Methodology: Utilizing a mixed-method approach, the study evaluates various IT tools and technologies ranging from EHRs to AI-driven analytics within PHM contexts. The research methodology includes data analysis through Python’s scikit-learn and pandas libraries, emphasizing model training, evaluation, and application areas in real healthcare settings.
 Findings: Results indicate that IT advancements, particularly EHRs, telehealth, and AI predictive analytics, markedly enhance the effectiveness of PHM. Key outcomes include improved chronic disease management, more effective preventive healthcare measures, and heightened patient engagement. Moreover, IT facilitates optimal resource allocation and operational efficiency within healthcare systems.
 Unique Contribution to Theory, Policy, and Practice: This study contributes to healthcare literature by providing empirical evidence on the transformative role of IT in PHM. It offers a theoretical framework for integrating IT solutions in healthcare strategies, informing policy by highlighting the necessity for interoperability standards, and suggesting practical guidelines for healthcare practitioners to implement technology-driven PHM effectively.

"It's My Secret": Shame as a Barrier to Care in Individuals With Opioid Use Disorder.

Substance use disorder (SUD) is a chronic illness impacting more than 59 million Americans last year. Opioid use disorder (OUD) is a subset of SUD. The literature supports that healthcare providers frequently stigmatize patients with OUD. Individuals with OUD often feel shame associated with their disorder. Shame has been associated with maladaptive and avoidant behaviors. The aim of this qualitative descriptive study was to examine and describe the experiences of shame and health-seeking behaviors in individuals with OUD. A qualitative exploratory design using focus groups with individuals in treatment for OUD was used to identify the issue of shame and its relationship to health-seeking behaviors. A systematic content analysis of discussions with 11 participants in four focus groups revealed four major themes and associated subthemes: Avoidance of Preventive Care (belief providers are judgmental); the Hidden Disorder (keeping secrets); Constraints of Shame (justification for the continuation of drug usage); and Trust in MOUD (Medication for Opioid Use Disorder) Providers. The feeling of shame leads to a reluctance to engage in health-promoting actions, such as scheduling appointments with primary care providers and dentists. Healthcare practitioners must prioritize providing a safe, nonstigmatizing environment for patients with SUD/OUD. This includes establishing trust and rapport, providing education, collaboration with psychiatric mental health specialists and other healthcare providers, and the offering support and resources to help patients manage their condition to achieve optimal health outcomes.

Factors associated with meningitis vaccine awareness and engagement among Latino men who have sex with men in South Florida.

Awareness and uptake of the meningitis vaccine remains low among marginalized groups, such as Latino men who have sex with men (LMSM), potentially due to structural and psychosocial barriers in accessing preventative healthcare. The current study explored awareness and uptake of meningitis vaccines among a group of LMSM (N = 99) living in South Florida. A three-pronged variable selection approach was utilized prior to conducting regression models (linear and logistic). Overall, 48.5% of the participants reported little to no knowledge about meningitis vaccines, and 20.2% reported being vaccinated. Living with HIV (OR = 10.48) and time since outbreak (OR = 1.03) were significant predictors of meningitis vaccine uptake. No significant correlates of meningitis vaccine awareness were identified. More research is needed to identify other important factors associated with meningitis vaccine awareness and uptake among LMSM, a multiple marginalized group.

Development and psychometric evaluation of uncertainty about disease and treatment scale in hemodialysis patients: a sequential-exploratory mixed-method study

Background and objectiveThe need for long-term treatment and frequent visits to treatment centers for hemodialysis can lead to psychological problems such as Uncertainty about Disease and Treatment (UC about D&T) in patients with chronic kidney failure. In order to understand uncertainty about disease and treatment and to plan for preventive measures and care interventions in various dimensions, there is a need for reliable and valid tools. The present study was conducted to design and psychometrically evaluate the Uncertainty about Disease and Treatment Scale (UC about D&TS) in patients undergoing hemodialysis.MethodsThis study is of a methodological type and conducted in two stages. The first stage included a deductive (literature review) and an inductive approach (face-to-face interviews). In the second stage, psychometric indices of the UC about D&TS, including face validity (qualitative-quantitative), content validity (qualitative-quantitative), construct validity (exploratory factor analysis), and reliability (using Cronbach's alpha and McDonald's omega) were examined.ResultsIn the literature review stage, 66 items were extracted, and in the qualitative stage, 48 items were extracted. After merging similar items, 29 items were entered into the psychometric process. No items were removed in the face and content validity stages. In the construct validity stage, five factors were extracted, including self-uncertainty, uncertain situation, uncertain future, uncertainty of treatment outcomes, and information uncertainty, which constituted a total of 82.16% of the total variance. In this stage, five items were removed from the study due to a corrected item-total correlation below 0.32, and four items were removed due to cross-loading. The α and Ω were calculated as 0.828 and 0.818, respectively. The measurement stability and standard error of measurement were estimated at 0.977 and 2.019, respectively.ConclusionThe results showed that the UC about D&TS is a valid and reliable measure for patients undergoing hemodialysis. This scale is specifically designed to measure UC about D&T in hemodialysis patients, and it is recommended that healthcare providers (Hcps) use this scale in follow-up visits.

Abstract LB372: Examining medical mistrust and access to cancer preventive care in a diverse sample

Abstract Background: Medical mistrust has been linked to lower health care utilization, satisfaction and preventive actions among underserved populations. Further exploration of medical mistrust within these groups is needed to inform research and clinical approaches to improve trust and health equity. This study examined the relationship between medical mistrust and access to cancer preventive care among Black, American Indian (AI) and White participants in Virginia. Methods: A convenience sample (N=1,288) designed to oversample underrepresented communities in Virginia completed surveys assessing medical mistrust, access to medical care and colorectal cancer screening. Measures included the medical mistrust index, visiting a doctor in the last year (yes/no), ever having a colonoscopy (yes/no), perceived health status, race, age, sex, education, marital status, insurance coverage and rurality. Bivariate tests evaluated significant (p<.05) associations between outcomes of having a doctor visit in the last year and colonoscopy screening with medical mistrust, health status, and sociodemographics; significant findings were included in logistic regression models. Differences among endorsements of individual mistrust scale items by race was also assessed. Results: Sample was μ age=45 (SD=18), 47% female, 40% Black, 36% White, 14% AI, 45% had ≤ high school diploma/GED, 63% married, majority resided in metro areas (91%) and were medically insured (85%). Among the sample 80% had visited doctor in the last year and 63% of those eligible had a colonoscopy. Medical mistrust was significantly higher among Black and AI participants compared to White. In overall and stratified logistic regression models medical mistrust was not associated with visiting a doctor in the last year or obtaining a colonoscopy. 5 of 7 items of the medical mistrust index were endorsed more often among Black and AI participants compared to White. These included feeling that medical institutions deceive people (Black: r=0.07, p<0.01; AI: r=0.07, p=0.01; White: r=-0.11, p<0.01), cover-up mistakes (Black: r=0.11, p<0.01; AI: r=0.96, p=0.04; White: r=-0.13, p<0.01), conduct harmful experiments (Black: r=0.07, p<0.02; White: r=-0.10, p<0.01), lack competency (AI: r=0.07, p=0.01; White: r=-0.08, p<0.01), and make mistakes often (AI: r=0.10, p<0.01; White: r=-0.09, p<0.01). Conclusions: Medical mistrust was significantly higher among Black and AI participants compared to White but this was not associated with accessing medical care. Given differential endorsement of items dealing with medical errors and their concealment, these results suggest a need to investigate patient experiences after care is initiated to understand what factors may contribute to medical mistrust and care outcomes long term. Citation Format: Jackie Knigh Wilt, Maria D. Thomson. Examining medical mistrust and access to cancer preventive care in a diverse sample [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB372.

Abstract SY15-02: Health insurance and outcome disparities in adolescents and young adults with cancer

Abstract SY15-02: Health insurance and outcome disparities in adolescents and young adults with cancer