Primary Language Research Articles

EMERGENCY DEPARTMENT USE AMONG OLDER ADULTS RECEIVING MEDICAID HOME- AND COMMUNITY-BASED SERVICES

Abstract Medicaid-funded home and community-based services (HCBS) for older adults aim to prolong independent living despite physical and cognitive disabilities. Medicaid-eligible HCBS populations are racially and ethnically heterogeneous, with multiple chronic conditions. Clinical threats to continued independent living among older adult HCBS recipients include acute illnesses, injuries, and exacerbations of chronic conditions, which could trigger a pathway of emergency department (ED) visits, hospitalization, and long-term nursing home admission. Despite its importance in the pathway from independent living, little is known about the rate of, or risk factors for, ED use in this target population. Accordingly, we determined predictors of ED use in a statewide cohort (N=5,651) in Connecticut’s Medicaid HCBS program for adults age >65, who were clinically assessed using a uniform tool between April 2020-March 2021. ED use, (0 vs 1+ visits), was ascertained over 12 months following clinical assessment using Medicare and Medicaid claims data. Predictor variables were racial and ethnic group, primary language, age, sex, educational attainment level, dementia diagnosis or moderate-severe cognitive impairment, depressive symptom severity, and Charlson comorbidity index. Cohort members were 76% female, 30% Hispanic, 15% non-Hispanic Black, 4% non-Hispanic Asian, 33% age >85. Forty-one percent had 1+ ED visits. Multivariate logistic regression analyses revealed that ED use was associated with (adjusted odds ratios p<0.05): high school education, more severe depressive symptoms, and more chronic conditions. Non-Hispanic Asian individuals had lowest ED visit likelihood. ED use among older adults receiving Medicaid HCBS might be reduced if depressive symptoms and multiple chronic conditions are optimally managed.

Engaging primary care physicians is critical in the screening and diagnosis of colorectal cancer at safety-net hospital systems

BackgroundPrimary care physicians (PCP) play a key role in offering colorectal cancer (CRC) screenings, particularly amongst underserved populations. Given potential delays in or omission of CRC screening in the absence of a PCP, we aimed to determine stage of CRC at diagnosis in an underserved population. MethodsA retrospective chart review was conducted at two Los Angeles County safety-net hospitals. Inclusion criteria were a CRC diagnosis between 2018 and 2021 and age between 50 and 75 years at diagnosis time. The primary outcome was the cancer stage at diagnosis. ResultsA total of 373 patients were included, of those, 52.5 % had a PCP. Compared to others, PCP was similar in age, racial composition, and primary spoken language (Table 1). Of patients with a PCP, 52.0% were diagnosed by screening. After screening, the most common indication for colonoscopy were blood per rectum (24.9 %) and imaging findings (18.0 %). Patients with a PCP had a significantly lower rate of late stage CRC than those without a PCP (42.4 % vs. 68.0 %, p < 0.001). After adjustment, having a PCP was associated with significantly reduced odds of late stage CRC (Adjusted Odds Ratio 0.83, 95 % Confidence Interval [0.68–1.04]). Having a PCP was not associated with any adjusted increase in number of adenomas or tumor size. ConclusionsPatients with a PCP, irrespective of undergoing screening, were diagnosed at earlier CRC stages. This underlines the crucial role of PCPs in CRC and diagnosis, reinforcing the need for their active involvement in these processes.

Learner Strategies and the Perception of Cross-Linguistic Interaction in Young L3 Learners

Founded on psycholinguistic insights into the interaction between the language systems of multilinguals and the key role that language learning awareness carries in the development of L3 students’ multilingual systems, the paper deals with the use of learner strategies and the perception of cross-linguistic interaction. The results of the empirical research carried out on an extensive sample of primary school students whose L1 is Croatian, while L2 and L3 are English or German, show that primary school L3 learners apply both examined components of language learning awareness in learning and using languages. However, the findings also suggest that their multilingual potential is neither used nor developed sufficiently in primary school language teaching.

ASSOCIATIONS BETWEEN CLINICAL FUNCTIONING AND AD BIOMARKERS AMONG HISPANIC AND WHITE NON-HISPANIC OLDER ADULTS

Abstract Objectives Hispanics are 1.5x more likely to develop Alzheimer’s disease (AD) when compared to White non-Hispanics (WNHs). There is also evidence to support that cognitive performance disproportionately reflects neuropathology among Hispanics and that functional decline is concurrent with the accumulation of AD biomarkers. The current study aimed to examine relationships between AD biomarkers and a functional measure among Hispanic and WNH older adults. It was hypothesized that the functional measure would be strongly related to AD biomarkers among Hispanics. Methods The modified clinical dementia rating scale (mCDR) was administered in the participants primary language (English or Spanish) to WNH (n=203) and Hispanic (n=258) older adults who were cognitive normal or diagnosed with Mild Cognitive Impairment (MCI) or dementia. Invariance SEM models were used to compare the pattern of relationships between the mCDR and neurocognitive test performance, MRI volumes, and amyloid load adjusting for age, education, ApoE4 status, and intracranial volume. Results Model fit was good and not significantly worsened by imposing strict structural invariance. Nested model comparisons indicated that regression weights and correlations among measures differed by group, suggestive of moderation by Hispanic status. Among Hispanic participants, sex (♌=-0.17, p&amp;lt;.05) and Amyloid load (♌=0.25, p&amp;lt;.001) significantly predicted mCDR scores. MRI volumes significantly predicted MCDR scores among both Hispanic (♌=-0.51, p&amp;lt;.001) and WNH participants (♌= -0.42, p&amp;lt;.001). Conclusions Functional measures like the mCDR may better correlate with Amyloid load among Hispanic older adults than among WNHs, while the correlation with MRI volumes may be comparable in both groups.

Social Transformation in English First Additional Language Teaching and Learning Classrooms: Multilingual Pedagogy

Appreciating indigenous knowledge systems and the rich history and tradition of South Africa as essential factors in fostering the principles outlined in the Constitution, is one of the aims of the South African Language in Education Policy. The main objective of this paper was to propose a multilingual pedagogy in English First Additional Language classrooms that will cater for all learners in order that they benefit in the learning environment. This study was underpinned by the Indigenous Standpoint Theory, which advocates for a renewed look at how various institutions interpret and analyse indigenous knowledge systems. A qualitative approach, entrenched in an intepretivist paradigm, was utilised to gather data from 12 conveniently sampled grade 10 English First Additional Language educators from the Eastern Cape rural schools in the Eastern Cape Province of South Africa through semi-structured interviews, and observations. The results of this inquiry indicated that social transformation could be achieved through the use of the learners’ primary languages through codeswitching, translation, and translanguaging as alternative instructional strategies. Social transformation has emerged as an emancipatory factor in EFAL teaching and learning as learners participate actively when their primary languages, in which they are most proficient, are recognised in the classrooms. Thus, a multilingual pedagogy will benefit all types of learners. The author recommends that the Language in Education Policy should have a transformed look at the recognition of indigenous languages, and further recommends multilingual education to have equal educational opportunities. Keywords: English First Additional Language, Indigenous Languages, Multilingualism, Social Transformation.

Öğretmenlerin İşitme Engelli Öğrencilerin Yabancı Dil Olarak İngilizce Eğitimine Erişimine İlişkin Görüşleri

In Türkiye, K-12 Deaf students often do not learn English as hearing students learn. This paper applies a qualitative approach and uses semi-structured interviews as the data source to analyze the perspectives of nine teachers of Deaf students on Deaf students' access to English as a foreign language education in Türkiye. In analysis, the study applies content analysis and considers Bourdieu's forms of capital, the theory of figured world, and social model of disability as the theoretical framework. The findings show that teachers of Deaf students in Türkiye have an ideology of Deafness as a culture, view Turkish Sign Language as the primary language of Deaf individuals, and support using sign language as a medium in Deaf education. However, teachers of Deaf students prefer postponing English as a foreign language education for Deaf students until Turkish Sign Language is fully acquired. The findings of the study suggest integrating Turkish Sign Language in K-12 Deaf education as a medium and designing education programs to teach English as a foreign language to Deaf students simultaneously without postponing learning any languages.

Sudden Shift to Telehealth in COVID-19: A Retrospective Cohort Study of Disparities in Use of Telehealth for Prenatal Care in a Large Midwifery Service.

The coronavirus disease 2019 (COVID-19) pandemic created disruption in health care delivery, including a sudden transition to telehealth use in mid-March 2020. The purpose of this study was to examine changes in the mode of prenatal care visits and predictors of telehealth use (provider-patient messaging, telephone visits, and video visits) during the COVID-19 pandemic among those receiving care in a large, academic nurse-midwifery service. We conducted a retrospective cohort study of those enrolled for prenatal care in 2 nurse-midwifery clinics between 2019 and 2021 (n = 3172). Use outcomes included number and type of encounter: in-person and telehealth (primary outcome). Comparisons were made in frequency and types of encounters before and during COVID-19. A negative binomial regression was fit on the outcome of telehealth encounter count, with race/ethnicity, age, language, parity, hypertension, diabetes, and depression as predictors. When comparing pre-COVID-19 (before March 2020) with during COVID-19 (after March 2020), overall encounters increased from 15.9 to 19.5 mean number of encounters per person (P < .001). The increase was driven by telehealth encounters; there were no significant differences for in-person prenatal visit counts before and during the pandemic period. Direct patient-provider messaging was the most common type of telehealth encounter. Predictors of telehealth encounters included English as primary language and diagnoses of diabetes or depression. No differences in the frequency of in-person prenatal care visits suggests that telehealth encounters led to more contact with midwives and did not replace in-person encounters. Spanish-speaking patients were least likely to use telehealth-delivered prenatal care during the pandemic; a small, but significant, proportion of patients had no or few telehealth encounters, and a significant proportion had high use of telehealth. Integration of telehealth in future delivery of prenatal care should consider questions of equity, patient and provider satisfaction, access, redundancies, and provider workload.

Insights Into L1 and L2 Vocabulary Size Association: A Perspective From Elementary Pashto-English Sequential Bilinguals

Vocabulary is a crucial predictive factor in the linguistic advancement of children whether monolingual or bilingual. The increasing number of bilingual individuals underscores the significance of accurately assessing vocabulary development among bilinguals at school. However, assessing the vocabulary of bilingual children is intricate due to their acquisition of words across two languages. Determining the most suitable metric for comprehensively measuring their vocabulary, especially in comparison to monolingual counterparts, remains an ongoing endeavor. This correlational descriptive study aims to examine the vocabulary knowledge of sequential bilingual children and evaluate the effectiveness of a conceptual scoring approach that incorporates the terms known in both their first and second languages. The sample consisted of bilingual(n=200) and monolingual (n=95) elementary school learners from Mardan district, Khyber Pakhtunkhwa, recruited through purposive and random sampling to ensure a balanced and unbiased outcome. The assessment procedure involved gauging each participant's passive and active vocabulary in English and Pashto, achieved through the utilization of tools such as X-Lex and the Category Generation Task. Data analysis carried out using SPSS version 25, revealed a substantial correlation between the vocabulary sizes of bilingual individuals across both their primary (L1) and secondary (L2) languages. The findings of the study may have far-reaching effects, providing significant novel perspectives on instructional practices and stimulating further investigation.

Theoretical and Practical Aspects of Modern Methods of Teaching English at the Ganja State University

The purpose of the research is to identify the key components of the modern methodology of teaching English in the example of Ganja State University in Azerbaijan. Research is significant due to the global importance of English as the primary international language and its role in modernizing education systems worldwide. The main question of the research is to find out the impact of the key components of the modern methodology of teaching English on the formation of the necessary competencies in young specialists. For this purpose, the main tasks were solved: the key requirements for modern methods of teaching English were analyzed, the current state of education in Azerbaijan as a whole was characterized, and the methods for improving the modern educational process were proposed. The main directions of research are predetermined by the lack of theoretical and methodological development of this issue as well as its increasing practical significance. The leading method of studying this issue is the analysis of the most popular and effective methods of teaching English in modern conditions, determining the need for their synthesis in the formation of competent young professionals. Also, ways of further development of the most effective methods were modeled. The study examined foreign experts’ materials to comprehensively assess the significance of learning foreign languages in contemporary settings. It identified vital English teaching methods based on current trends and expert research. These findings hold practical value for improving English instruction at Ganja State University in Azerbaijan.

Association between adherence to posttreatment National Comprehensive Cancer Network (NCCN) surveillance guidelines and detection of recurrent uterine cancer

ObjectiveTo identify correlations between disease recurrence and adherence to NCCN posttreatment surveillance guidelines in patients who develop recurrent uterine cancer. MethodsRetrospective analysis identified patients (n = 60) with recurrent uterine cancer and at least one surveillance visit with a gynecologic oncologist between 2011 and 2020. Adherence to NCCN guidelines and details of recurrence were recorded. ResultsRecurrent uterine cancer was identified in 60 patients with an average time to recurrence (TTR) of 25 months. Of those, 39 (65%) were adherent to NCCN surveillance guidelines and 36 (60%) were symptomatic at the time of recurrence diagnosis. Asymptomatic recurrence was diagnosed by imaging in 11 (46%), physical exam in 7 (29%), and blood work in 6 (25%) patients. Patients who were adherent to NCCN guidelines were diagnosed with recurrence on average 11 months earlier (p = 0.0336). Adherence was an independent predictor of TTR for all patients regardless of symptoms. There was no significant effect of age, race, primary language, or stage of disease on adherence. ConclusionAdherence to NCCN posttreatment surveillance guidelines for uterine cancer is independently associated with an earlier diagnosis of recurrence.

Level of Negative Emotional States among Parents of Speech and Language Delay

Background: The prevalence and impact of delayed speech and language disorders in children have increasingly become a concern, particularly regarding the psychological well-being of their parents. Prior research has explored various factors influencing parental stress in families with children suffering from different developmental disorders, including Down, Williams, Fragile X, and Prader-Willi syndromes. However, there is a need to understand specifically how delayed speech and language disorders in children affect the emotional states of their parents. Objective: This study aimed to evaluate the levels of stress, anxiety, and depression among parents of children with primary and secondary speech and language delays. It sought to identify the predominant emotional states in these parents and understand the relationship between the child's developmental status and the parent's emotional well-being. Methods: A cross-sectional study was conducted in Multan, involving parents of 70 children with delayed speech and language disorders. Using the Depression Anxiety Stress Scales (DASS) Inventory, parents were assessed for levels of stress, anxiety, and depression. The study employed a non-probability convenient sampling technique, and the data were analyzed using the Statistical Package for the Social Sciences (SPSS), Version 23. Results: The analysis showed significant correlations between depression, anxiety, and stress. Depression had a mean score of 6.986, anxiety had a mean score of 5.529, and stress showed the highest mean score at 7.971. These results indicate that stress is the most prevalent emotional issue among these parents, exceeding the levels of depression and anxiety. Conclusion: The study concludes that parents of children with delayed speech and language disorders in Multan experience high levels of stress, overshadowing other negative emotional states like depression and anxiety. These findings highlight the need for targeted support and interventions for these families, focusing not only on the child's development but also on the mental health and well-being of the caregivers.

TEACHING ENGLISH LANGUAGE CHALLENGES AMONG BEGINNER ENGLISH TEACHERS AT SECONDARY SCHOOLS IN JORDAN

This study investigates the difficulties faced by novice English teachers in Jordanian secondary schools, focusing on the impact of errors made by new teachers on the academic performance of (EFL ) students. The research used interviews and observation to gather data, with purposive sampling strategies employed. The results showed that novice EFL teachers needed to focus more on lesson overviews, presenting topics in a logical order, explaining major and minor points clearly, providing explanations for complex or challenging topics, and providing definitions of terms and concepts. The primary language challenges faced by novice teachers were pronunciation, listening comprehension, and grammar. 40% of teachers did not connect lessons together, and 45% needed to deliver lesson themes in a logical order. Only 30% of inexperienced teachers focused on emphasizing the lesson's essential elements, while 60% needed to. 65% of new teachers needed to clearly articulate important and small ideas, while 30% needed more attention on offering definitions of terms, concepts, and principles. 60% of new teachers needed to provide clear examples to illustrate lessons and put steps into practice while solving homework difficulties. The study suggests that the native tongue of EFL beginning teachers, irregularities in sound, diverse grammar forms, tenses, and vocabulary size account for most of these challenges. Socio-psycho variables, such as attitude, anxiety, and self-confidence, also impact these teachers. To address these challenges, it is crucial to set uniform standards for all schools and conduct further research on the root causes of these challenges.

Disparities in Lung Cancer Clinical Trial Discussion and Enrollment at a Safety Net Hospital

Background In the United States, less than 5% of all adult cancer patients enroll in clinical trials. Few studies explore participation in cancer clinical trials at safety net hospitals, which disproportionately care for minoritized, low-income, uninsured, and underinsured populations. Our study aims to investigate disparities in clinical trial discussions and enrollment among lung cancer patients at Boston Medical Center, the largest safety net hospital in New England. Methods We included 1121 patients diagnosed with lung cancer between January 2015 and December 2020. Electronic Medical Records (EMR) were queried, and patients were categorized into three groups: (1) clinical trial discussed and the patient enrolled, (2) clinical trial discussed but the patient not enrolled, and (3) clinical trial not discussed. Sociodemographic variables such as age, gender, race, ethnicity, city, primary language, median household income, medical insurance type, and education level were also collected. Chi-squared, t test, and multivariate regression analysis was done using SPSS version 26.0. Results Of the 1121 patients, clinical trials were discussed in 141 patients (12.6%), of which 22 (15.6%) were enrolled. Clinical trial discussions were conducted more with younger patients (68.19 vs 71.37, p = .001), but on multivariate analysis there was no significant difference (OR = 1.023; 95% CI 0.998-1.048; p = .068). There was no significant difference in clinical trial discussion or enrollment between the other sociodemographic factors. Conclusion Additional study of barriers to cancer clinical trial discussion and enrollment at safety net institutions can serve as a prerequisite to ameliorating racial disparities observed on a national scale.

The economic returns to language in Belize: evidence from the 2000 census

English is the official language of Belize used in the conduct of official government business and as the standard in public education. However, English is not the primary language spoken in Belizean households nor in the conduct of local business transactions. Belize is a polyglot nation inclusive of European-based languages, native languages, and creole languages. In this paper, we demonstrate the economic returns to language acquisition and usage in Belize using census 2000 data.&#x0D; &#x0D; Our results indicate that Belize primarily rewards the ability to communicate in English and Spanish. Other language skills are also important, such as the ability to speak German, to speak Maya and English or Spanish, and the ability to speak in combination Creole-Spanish-English. There is a severe wage penalty associated with the speaking of Maya and Garifuna. Other non-language endogenous and exogenous variables are also explored.

Trends in Risk Factors for Peripartum Depression in Socio-economically Disadvantaged Childbearing Community

Introduction: Perinatal depression is defined as a depressive episode(s) during the pregnancy and/or postpartum period up to one year. Studies have shown that childbearing people in urban settings experience a higher burden of social factors, such as low socioeconomic status, which may influence the likelihood of developing perinatal depression. Of note, episodes of perinatal depression have been shown to negatively impact child development. Our study has identified population trends in Center for Epidemiological Studies Depression Scale (CES-D) scores &gt;10 during perinatal periods alongside significant social risk factors for people served by LSA Family Health Service providing skilled home-based nursing visits to reduce adverse outcomes. Methods: A retrospective chart review of nursing notes from 2009-2017 was conducted for this cross-sectional study. Outcome measures included antepartum (AP) and postpartum (PP) Center for Epidemiological Studies Depression Scale (CES-D) scores, with a score of &gt; 10, suggesting a positive risk for developing depression. Data were grouped and analyzed using Microsoft Excel and SPSS software (SPSS version 23). Data have been presented as yearly population percentages scoring &gt;10 on their CES-D screen. Results: The maternal outreach program (MOP) enrolled 1,183 birthing individuals from 2009-2017. The mean parental age was 27 years. 70% were Latinx (n=829) and 20.88% (n=247) were Black. Spanish was the primary language for 43.62% (n=516) of participants. Among CES-D screens completed in the antepartum period, 4.5% to 24.6% of the population met criteria over the 9-year study period for risk of developing depression. Positive CES-D screens completed postpartum ranging from 11.9% to 27.2% during the study period. Significant risk factors for positive postpartum CES-D screens were postpartum risk assessment score (p=0.03), increased gestational age (p=0.05), low income (p=0.03), teen/inexperienced parents (p=0.003), and low education levels (p=0.04). Conclusion: Trends of positive antepartum and postpartum depression screens in this population have fluctuated over the study period; however, we have identified significant risk factors for positive postpartum screens. Screening for postpartum depression risk factors is important to identify birthing parents who may most benefit from mental health interventions.

Gender Representation in Children’s EFL Textbooks: A Comparison between Private Primary Schools and Language Centers in Fes

It is commonly assumed that the social and cultural values of societies are always ingrained in their educational systems, particularly in teaching and learning materials. Textbooks are one of the materials in which gender stereotypes have been documented worldwide. In the Moroccan context, children's EFL (English as a foreign language) textbooks used in primary schools may transmit typical patterns and discriminatory images about gender, which perpetuate more gender disparities. To this end, this research aims to determine the way gender is depicted in four EFL textbooks for the 4th grade published between 2012 and 2020 in Morocco. It also tends to exhibit the major differences between EFL textbooks used at language centers (Super Minds 4 and Let’s Go 4) and private primary schools (English Pass Pack 4 and Passport to English 4). The research is conducted both qualitatively and quantitatively. The results of this study show that there are equal gender representations in EFL textbooks used at language centers compared to textbooks used at primary schools in terms of nouns and proper names, pronouns, non-human character representations, and roles associated with males and females.

A community-based volunteer service to reduce COVID-19 vaccination inequities in New York City.

We describe our experiences and challenges as community volunteers in assisting individuals in scheduling initial COVID-19 vaccine appointments and highlight disparities and barriers in vaccine access in New York City (NYC). Priority for assistance was given to individuals who were eligible for vaccination in NYC and New York State with the following barriers: technological, language, medical, physical and undocumented immigrants. Volunteers in NYC performed outreach and created program to assist in scheduling appointments. In sum, 2101 requests were received to schedule COVID-19 vaccine appointments from 28 February to 30 April 2021. Vaccinations were successfully scheduled for 1935 (92%) individuals. Challenges in this project included limited community outreach, language barriers, transportation difficulties and safety concerns travelling to vaccination sites. Spanish (40.5%) and Chinese (35.6%) were the primary languages spoken by appointment requesters. Most requests came from residents of Queens (40%) and Brooklyn (27.2%). The older population, public-facing workers, non-English speakers, undocumented immigrants and the medically complicated population experienced challenges in vaccine appointment access. In-person services and early website access in languages in addition to English may have reduced barriers in appointment navigation. While volunteers faced numerous obstacles when assisting individuals in scheduling vaccine appointments, most found the work fulfilling and rewarding.

Abstract PR020: Predictors of cancer screening in federally qualified health centers in the United States: A cross sectional study

Abstract Background: Patients from medically underserved populations are less likely to have access to cancer screening. Federally Qualified Health Centers (FQHCs) provide primary care services for medically under-served communities on a sliding-fee scale and are well-positioned to increase equity in cancer screening access. However, there is limited data about predictors and patterns of cancer screening among FQHC patients. The purpose of our study was to evaluate predictors and patterns of breast, colorectal, and cervical cancer screening in FQHCs across the United States. Methods: Data on the FQHCs was obtained from publicly available data sets from the Health Resources and Services Administration and included locations across the United States. Primary outcomes included breast, colorectal, and cervical cancer screening percentages. Primary exposures included the number of patients; percentages of patients by race/ethnicity, primary language, poverty threshold, and insurance status. Descriptive statistics (median and IQR) were obtained for all continuous variables. Spearman’s correlation coefficients were estimated to evaluate the association between cancer screening percentages and primary exposures. Results: We analyzed data from 1,375 FQHCs. The median population size served was 12,404 (IQR 6,084-24,757) patients, with 12% (IQR 2-38) Black/African American, 18% (IQR 5-48) Hispanic/Latino, 1% (IQR 1-3) Asian, and 1% (IQR 0-2) American Indian/Alaska Native patients. The median percentage of patients below the 100% poverty line was 66% (IQR 52-78), the percentage of uninsured patients was 19% (IQR 11-31), and the percentage of patients with Medicaid was 42% (IQR 28-57). 13% of patients preferred receiving care in a language other than English (IQR 3-32). Median percentage of mammography screening was 44% (IQR 31-56). Percentage of uninsured patients was negatively correlated with mammography screening percentages (r = -0.23, p &amp;lt; 0.001). Median percentage of colorectal cancer screening was 39% (IQR 27-51). Percentage of uninsured patients (r = -0.29, p &amp;lt; 0.001) and percentage of patients below 100% of the poverty line (r = -0.24, p &amp;lt; 0.001) were negatively correlated with colorectal cancer screening percentages. Median percentage of cervical cancer screening 48% (IQR 37-59). Percentage of Hispanic patients (r = +0.22, p &amp;lt; 0.001) and percentage of patients for whom English is not their first language (r = +0.29, p &amp;lt; 0.001) were positively correlated with cervical cancer screening percentages. Conclusions: Compared with national averages, patients who are served by FQHCs are less likely to receive recommended breast, colorectal, and cervical cancer screening tests, likely driven by social determinants of health. FQHCs represent trusted healthcare providers who serve high proportions of uninsured, Medicaid, low-income, diverse patients. Health care researchers and practitioners interested in reducing cancer disparities should consider working with FQHCs to conduct targeted outreach initiatives. Citation Format: Ashley M. Stuckwisch, Anand K. Narayan. Predictors of cancer screening in federally qualified health centers in the United States: A cross sectional study [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 PR020.

More research needed on Music programs in Nursing Homes and Senior Living Centers

AbstractBackgroundIn the United States, most dementia care is provided in senior living centers/nursing homes. For various reasons, the response to residents’ behavioral problems is often medications which can have various side effects.MethodWe conducted a literature review in Google Scholar and Pubmed on music programs in nursing homes and senior living centers in order to explore the utility of non‐pharmacological programs.ResultSeveral studies indicate that non‐pharmacological interventions such as music programs improve patient behaviors and can lead to a decrease in negative behaviors like agitation. One study found that individualized music programs are associated with reductions in behavioral and psychological symptoms of dementia and medication use. In another study of 4107 residents, Music and Memory program researchers found decreases in medication use and better behaviors. Music also improves memory in Alzheimer’s patients. Group music therapy can reduce depression among patients with dementia. A review of 25 Randomized Controlled Trials or Clinical Controlled Trials found most studies supported the argument that music programs improve mood, quality of life, and neuromotor performances. In particular, music can be customized to better suit the needs of the individual, as studies have shown the importance of selecting music connected to one’s social and national identity. Music programs in groups are also a great opportunity to facilitate social interaction.ConclusionThe literature supports the need for the arts for seniors however there is a need for larger, more systematic data. Further, there appears to be a research gap on how the lack of funding and reimbursement for music in nursing homes impacts access. For example, do residents have the same access depending on their location (e.g. urban/rural), primary language(s), and/or number of Medicaid beds? Do artists have the training on how to respond if residents become agitated or confused? People with dementia and their caregivers could benefit greatly from more equity in arts access as well as training for artists who want to better support seniors.

Abstract A083: Initiation and persistence of hormone therapy in endocrine positive breast cancer at an urban safety-net hospital

Abstract Background: Evidence demonstrates inequities in receipt and persistence of hormone therapy among breast cancer patient populations based on race, ethnicity, insurance, and language. Institutions where patients seek cancer care may have an impact on receipt of treatment. It is unknown whether safety net hospitals, servicing a vulnerable patient population, exhibit inequities in receipt of hormone therapy for breast cancer. Study Design: We performed a retrospective study of patients diagnosed with all stages of hormone positive (ER+ and/or PR +) breast cancer treated at a safety net institution over the five year period from January 1, 2009 to December 31, 2013. The initiation of and persistence of hormone therapy were assessed by race, ethnicity, insurance status, and primary language. Persistence of therapy was defined as defined as at least 3 prescriptions (90 day supply) or more than 1 visit after start of treatment documenting taking treatment. Results: A total of 599 women were identified. The median age was 59 years, 58% were non-White, 32% were non-English-speaking, and 35% had Medicaid or no insurance. A total of 506 (84%) were started on hormone therapy. In multivariate regression analysis, the rate of endocrine therapy initiation was associated with higher stage at diagnosis, post-menopausal status, and HER2 negative status. Non-white race, Hispanic/Latino ethnicity, non-English-language, and Medicaid/no insurance were not significantly associated with or without initiation of hormone therapy. 93% of patients started on hormone therapy had evidence of continued treatment, 91% had evidence of continued treatment at 1 year, 75% finished their recommended course of hormone therapy. Conclusion: At an urban safety-net hospital, we do not observe inequities in the initiation of endocrine therapy for breast cancer by race, ethnicity, insurance, or language. Persistence of therapy was similar to nationally reported data. Additional research by hospital type, and granular reasons for non-adherence are warranted. Citation Format: Quinn S. Solfisburg, Brendin R. Beaulieu-Jones, Michael R. Cassidy, Naomi Y. Ko. Initiation and persistence of hormone therapy in endocrine positive breast cancer at an urban safety-net hospital [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 A083.