Psychosocial Risk Factors Research Articles

Risk factors for suicide reattempt: a systematic review and meta-analysis.

Suicide is one of the main external causes of death worldwide. People who have already attempted suicide are at high risk of new suicidal behavior. However, there is a lack of information on the risk factors that facilitate the appearance of reattempts. The aim of this study was to calculate the risk of suicide reattempt in the presence of suicidal history and psychosocial risk factors and to estimate the effect of each individual risk factor. This systematic review and meta-analysis were conducted following the PRISMA-2020 guidelines. Studies on suicide reattempt that measured risk factors were searched from inception to 2022. The risk factors studied were those directly related to suicide history: history of suicide prior to the index attempt, and those that mediate the transition from suicidal ideation to attempt (alcohol or drug misuse, impulsivity, trauma, and non-suicidal self-injury). The initial search resulted in 11 905 articles. Of these, 34 articles were selected for this meta-analysis, jointly presenting 52 different effect sizes. The pooled effect size across the risk factors was significant (OR 2.16). Reattempt risk may be increased in presence of any of the following risk factors: previous history, active suicidal ideation, trauma, alcohol misuse, and drug misuse. However, impulsivity, and non-suicidal self-injury did not show a significant effect on reattempt. Most of the risk factors traditionally associated with suicide are also relevant when talking about suicide reattempts. Knowing the traits that define reattempters can help develop better preventive and intervention plans.

Psychosocial Risk Factors at Work and Sleep Quality in Healthcare Workers – A Cross-Sectional Study

Abstract Objective To investigate psychosocial factors at work, sleep characteristics, and the correlation between these aspects in healthcare workers. Material and methods A cross-sectional e-survey study was conducted with 125 workers of the Brazilian healthcare system, mostly from the Southeast region, from June 2021 to April 2022. Self-administered questionnaires in Google Forms were used to collect data on personal and occupational characteristics, psychosocial factors (Copenhagen Psychosocial Questionnaire), and sleep quality (Pittsburg Sleep Quality Index). Descriptive statistics and a point biserial correlation test were performed. Results The most reported factors in the risk zone were burnout (86%), stress (81%), emotional demands (75%), work pace (61%), and work-family conflicts (55%). Most participants were classified as poor sleepers (74%), especially nursing technicians/assistants (86%). Burnout (rpb = 0.33) and inadequate predictability (rpb = 0.30) were associated with poor sleep quality. Conclusion Intervention strategies to decrease burnout and increase predictability at work may assist in improving sleep quality among healthcare workers.

Combining the Antenatal Risk Questionnaire and the Edinburgh Postnatal Depression Scale in Early Pregnancy in Danish Antenatal Care-A Qualitative Descriptive Study.

Pregnant women with a history of mental disorders, neglect, or low social support are at increased risk of mental health problems. It is crucial to identify psychosocial risk factors in early pregnancy to reduce the risk of short- and long-term health consequences for mother and child. The Antenatal Risk Questionnaire has been found acceptable as a psychosocial screening tool among pregnant women in Australia, but it has not been tested in a Scandinavian context. The aim of this study was to explore the experiences of pregnant women when using the Antenatal Risk Questionnaire and the Edinburgh Postnatal Depression Scale as part of a model to identify psychosocial vulnerabilities in pregnancy in Denmark. We conducted individual interviews (n = 18) and used thematic analysis. We identified two main themes: (1) Feeling heard and (2) An occasion for self-reflection. Overall, the pregnant women deemed the online ANRQ/EPDS acceptable as a screening tool. The screening model provided a feeling of being heard and provided an occasion for self-reflection about mental health challenges related to pregnancy and motherhood. However, some women expressed that the screening raised concerns and fear of the consequences of answering honestly. A non-judgmental, open, emphatic, and reassuring approach by clinicians may help reduce stigma.

Posttraumatic stress disorder and psychosocial risk factors in first response workers to emergencies mixed method

First responders to emergencies are exposed to various risks, including psychosocial risk factors. Caring for patients in critical situations, experiencing traumatic events, and working under highly complex conditions increase their probability of developing mental disorders, such as posttraumatic stress disorder (PTSD). The objective of the study was to determine the relationship between PTSD and psychosocial risk factors and to understand the experiences of the disorder in this population. An explanatory sequential mixed method research design was used. The quantitative phase was an analytical cross-sectional observational study (n = 193), and the qualitative phase was phenomenological (n = 5). The psychosocial risk factors that best explained the presence of PTSD symptoms were the influence of non-work conditions on work, religion, emotional avoidance, and professional support as individual factors related to coping strategies. Individual factors such as coping strategies were determining factors that explained the symptoms of PTSD, and the influence of non-work conditions on work. It was identified that the demands of the job and the organizational factors, such as leadership style and lack of institutional support, generate anguish in workers and affect their ability to regulate their emotions when exposed to critical incidents.

Physical and psychosocial work-related exposures and the occurrence of disorders of the shoulder: A systematic review update

This review is an update of a previous systematic review and assesses the evidence for the association of work-related physical and psychosocial risk factors and specific disorders of the shoulders. Medline, Embase, Web of Science Core Collection, Cochrane Central and PsycINFO were searched and study eligibility and risk of bias assessment was performed by two independent reviewers. A total of 14 new articles were added with the majority focusing on rotator cuff syndrome (RCS) with seven studies. Nine articles reported psychosocial exposures in addition to physical exposures. The strongest evidence was found for the association between elevation, repetition, force and vibration and the occurrence of SIS and tendinosis/tendonitis. Evidence also suggests that psychosocial exposures are associated with the occurrence of RCS and tendinosis/tendonitis. Other findings were inconsistent which prevents drawing strong conclusions.

Mental Health Concerns During COVID-19: An Observational Study Among a Predominantly Black Community in New York City.

This study examined the prevalence of mental health concerns and its association with COVID-19, selected social determinants of health, and psychosocial risk factors in a predominantly racial/ethnic minoritized neighborhood in New York City. Adult Harlem residents (N = 393) completed an online cross-sectional survey from April to September 2021. The Patient Health Questionnaire (PHQ-4) and the Post-Traumatic Stress Disorder (PC-PTSD) were used to evaluate mental health concerns. Poisson regression with robust variance quantified the associations of interests via prevalence ratios (PR) and 95% confidence intervals (CI). Two-thirds (66.4%) of theresidents reported experiencing mental health concerns, including PTSD (25.7%), depression (41.2%), and anxiety (48.1%). Residents with low-income housing status (PR = 1.16; 95% CI 1.01, 1.34), alcohol misuse (PR = 1.68; 95% CI 1.40, 2.01), food insecurity (PR = 1.23; 95% CI 1.07, 1.42), exposure to interpersonal violence (PR = 1.33; 95% CI 1.08, 2.65), and experience of discrimination (PR = 1.53, 95% CI 1.23-1.92) were more likely to report mental health concerns. Better community perception of the police (PR = 0.97, 95% CI 0.95, 0.99) was associated with fewer mental health concerns. No associations were observed for employment insecurity, housing insecurity, or household COVID-19 positivity with mental health concerns. This study showed a high prevalence of mental health concerns in a low-income racial/ethnic minoritized community, where COVID-19 and social risk factors compounded these concerns. Harlem residents face mental health risks including increased financial precarity, interpersonal violence, and discrimination exposure. Interventions are needed to address these concurrent mental health and psychosocial risk factors, particularly in racial/ethnic minoritized residents.

Association of Psychosocial Risk Factors With Quality of Life and Readmissions 1 Year After LVAD Implantation

BackgroundAmong patients with advanced heart failure (HF), treatment with a left ventricular assist device (LVAD) improves health-related quality of life (HRQOL). We investigated the association between psychosocial risk factors, HRQOL, and outcomes after LVAD implantation. MethodsA retrospective cohort (n=9832) of adults aged ≥ 19 years who received durable LVAD between 2008 – 2017 was identified using the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). Patients were considered to have psychosocial risk factors if ≥1 of the following were present: 1) substance abuse; 2) limited social support; 3) limited cognitive understanding; 4) repeated non-adherence; and 5) major psychiatric disease. Multivariable logistic and linear regression models were used to evaluate the association between psychosocial risk factors and change in Kansas City Cardiomyopathy Questionnaire (KCCQ)-12 scores from baseline to 1-year, persistently poor HRQOL (KCCQ-12 score < 45 at baseline and 1-year), and 1-year rehospitalization. ResultsAmong the final analytic cohort, 2024 (20.6%) patients had ≥1 psychosocial risk factors. Patients with psychosocial risk factors were associated with a smaller improvement in KCCQ-12 scores from baseline to 1-year (Mean ± SD, 29.1 ± 25.9 vs 32.6 ± 26.1, p=0.015) for a difference of -3.51 (95% confidence interval [CI]: -5.88 to -1.13). Psychosocial risk factors were associated with persistently poor HRQOL (adjusted odds ratio [aOR] 1.35, 95% confidence interval [CI] 1.04 – 1.74), and 1-year all-cause readmission (adjusted hazard ratio [aHR] 1.11, 95% CI 1.05 – 1.18). Limited social support, major psychiatric disorder, and repeated non-adherence were associated with persistently poor HRQOL, while major psychiatric disorder was associated with 1-year rehospitalization. ConclusionThe presence of psychosocial risk factors is associated with lower KCCQ-12 scores and higher risk for readmission at 1-year after LVAD. While these associations are statistically significant, further research is needed to determine whether these differences are clinically meaningful.

Psychosocial risk factors for headache in medical students

IntroductionHeadache is often considered as a symptom reflecting mental ill-being of a person. Taking into account heavy academic loads, we should study it in medical students in reference to its connections with various psychosocial risk factorsObjectivesTo establish interrelations between the frequency of headaches in medical students and risk factors of psychosocial natureMethodsWe conducted the research based on the Faculty of Medicine of Ulianov Chuvash State University. It covered 546 students of both genders who had no complains of having mental problems. We surveyed the students by means of Sociocultural Health Questionnaire (E. Nikolaev)ResultsThe research showed that two out of three students complained of headaches of various intensity and frequency. It was present with statistically equal frequency (p&gt;.05) in domestic (68.85%) and foreign (63.90%) medical students. Females experience headache more often (r=.20), and it more often correlates with a high level of stress (r=.25), lesser satisfaction with studying (r=-.14), higher frequency of e-cigarette consumption (r=.15), higher anxiety due to phantom ringing syndrome (r=.15), lower self-esteem of health (r=-.29), confidence (r=-.16), successfulness (r=-.12), happiness (r=-.18), well-being (r=-.11), liveliness (r=-.16), higher frequency of medication consumption (r=.27), higher frequency of visits to a psychotherapist in the childhood (r=.11), higher current need in the help of a psychologist (r=.21), psychiatrist and psychotherapist (r=.21).ConclusionsThese psychosocial risk factors call for attention from mental health professionals, and we should take them into consideration while providing medical care to medical students and developing health programs in universities.Disclosure of InterestNone Declared

Musculoskeletal disorders and psychosocial risks among electricians

IntroductionThere is a growing concern about the link between musculoskeletal disorders (MSD) and psychosocial risk (PSR) among electricians. Both MSD and PSR represent a threat to the electrician’s health, quality of life and productivity.ObjectivesThis study aimed to assess the link between PSR and MSD among electricians.MethodsThe study was conducted in a group from an electricity society. Data were gathered between January-June 2022 using a self-administered questionnaire evaluating socio-professional characteristics, the Nordic musculoskeletal questionnaire during the previous year and the validated French version of the questionnaire KARASEK.ResultsOur study included 68 male electricians. The mean age was 39.2 ± 10.3 years. The average job tenure was 16± 11.4 years. According to the Nordic musculoskeletal questionnaire, 50% of participants experienced pain during the last 12 months.About half of the electricians had high psychological demand (48.5%), 63.2% had a low latitude, and 76.5% had low social support. According to the Karasek model, tense electricians accounted for 26.5% and assets 22.1%. MSDs were associated with high psychological demand at work (p = 0.02).ConclusionsThis study demonstrated that PSR and MSDs are associated among electricians and are highly prevalent. They represent an important concern of the occupational and safety health system. The prevention of MSD should take into account the specific working conditions of electricians to reduce their exposure to psychosocial risk factors in the workplace.Disclosure of InterestNone Declared

Quality of Life and Its Psychosocial Predictors among Patients with Disorders of Gut-Brain Interaction: A Comparison with Age- and Sex-Matched Controls.

The disorders of gut-brain interaction (DGBIs) are a heterogeneous group of chronic conditions that greatly reduce patients' quality of life (QoL). To date, biopsychosocial factors (such as gastrointestinal symptoms, alexithymia, and interpersonal problems) are believed to contribute to the development and maintenance of DGBIs, but their role in affecting patients' QoL is still under investigation. Out of 141 patients seeking treatment for their gastrointestinal symptoms, 71 were diagnosed with a DGBI (47 females, 66.2%; Mage: 41.49 ± 17.23 years) and were age- and sex-matched to 71 healthy controls (47 females, 66.2%; Mage: 40.45 ± 16.38 years) without any current gastrointestinal symptom or diagnosis. Participants completed a sociodemographic and clinical questionnaire and a survey investigating several psychosocial risk factors. We found greater symptom severity and difficulties in identifying feelings among patients compared to controls. Further, multiple linear regression analyses evidenced that, among patients, higher expressive suppression of emotions, difficulties in identifying feelings and interpersonal problems, and a lower cognitive reappraisal of emotions predicted lower QoL. Data suggest that the QoL of patients with DGBIs is affected not only by common risk factors (e.g., interpersonal problems) but also by specific difficulties in processing and regulating emotions. The implications of these findings are discussed.

Review Article] Measurement Tools to Evaluate Psychosocial Factors in a Changing Work Environment: A Rapid Literature Review

This literature review examines the measurement instruments and questionnaires used to assess psychosocial factors in work environments. The focus is on their applicability across diverse professional settings. The review begins with identifying keywords and MeSH/EMTREE terms. Searches were then conducted across multiple databases and grey literature sources. The screening process identified 60 relevant articles. From these, 30 were selected to discuss the validity and reliability of various scales. The Copenhagen Psychosocial Questionnaire (COPSOQ) was found to be the most commonly used instrument, followed by the Job Content Questionnaire (JCQ), the Effort-Reward Imbalance (ERI) model, and the NIOSH General Job Stress Instrument. In Colombia, the evaluation of psychosocial risk factors in organizations is conducted using the _Batería de Instrumentos para la Evaluación de Factores de Riesgo Psicosocial_. This assessment provides a detailed evaluation of both intra-laboral and extra-laboral occupational psychosocial risk factors. Regarding reliability, all instruments identified and reviewed in this article had Cronbach's alpha values ranging from 0.7 to 0.9, indicating acceptable to excellent internal consistency, reliability, and validity for evaluating psychosocial risk factors in a representative work environment sample. Although each instrument is useful, adapting to evolving workplace dynamics is necessary for more comprehensive evaluations. The article emphasizes the impact of the COVID-19 pandemic on work arrangements, specifically remote and hybrid work, and highlights the need to evaluate psychosocial risk factors. The review provides insights into the changing landscape of work and the importance of addressing psychosocial factors to promote employee well-being and organizational effectiveness.

Stress and burnout in the context of workplace psychosocial factors among mental health professionals during the later waves of the COVID-19 pandemic in Hungary.

While literature is abundant on the negative mental health impact of the COVID-19 outbreak, few studies focus on the Central and Eastern European region. We examined stress, burnout, and sleeping troubles among mental health professionals in the context of psychosocial risk factors related to participation in COVID care during the fourth and fifth waves. Mental health professionals (N=268) completed an online cross-sectional survey in Hungary, between November 2021 and April 2022. Of the respondents, 58.2% directly participated in COVID care. The main data collection instrument was the Copenhagen Psychosocial Questionnaire (COPSOQ II), including 20 subscales on work-related psychosocial factors and 3 outcome scales (stress, burnout, and sleeping troubles). We added a question on competence transgression, and items on sociodemographic and professional background. Participation in COVID care was associated with higher work pace (59.08 versus 49.78), more role conflicts (55.21 versus 45.93), lower scores on the influence at work (38.18 versus 51.79), predictability (44.71 versus 57.03), reward (55.82 versus 65.03), role clarity (70.19 versus 75.37), social support from supervisor (59.24 versus 65.55), job satisfaction (54.36 versus 62.84), trust regarding management (55.89 versus 67.86), justice and respect (44.51 versus 54.35) scales. Among those involved in COVID care, only the stress score was higher (47.96 vs. 42.35) in the total sample; however, among psychiatrists, both stress (52.16 vs. 38.60) and burnout scores (58.30 vs. 47.06) were higher. Stepwise multiple regression revealed that work-family conflict, emotional demands and workplace commitment were independent predictors of higher stress and burnout scores; furthermore, competence transgression had a significant effect on stress, and being a psychiatric specialist had a significant effect on burnout. These models explained 40.5% of the variance for stress and 39.8% for burnout. During the fourth and fifth waves, although COVID care was more well-organized, psychiatrists, as specialist physicians responsible for the quality of the care, were still experiencing challenges regarding their competence and influence at work, which may explain their increased levels of stress and burnout.

The COVID-19 lockdown experience suggests that restricting the supply of gambling can reduce gambling problems: An Australian prospective study.

COVID-19 lockdowns limited access to gambling but simultaneously elevated psychosocial stressors. This study assessed the relative effects of these changes on gambling risk status during and after the Australian COVID-19 lockdown from late-March to late-May 2020. The study administered three surveys to people who had gambled within the past year at T1. Wave 1 asked about before (T1, N = 2,125) and during lockdown (T2, N = 2,125). Subsequent surveys focused on one year (T3; N = 649) and two years after lockdown (T4, N = 458). The dependent variable was changes in reporting any problem gambling symptoms (PGSI 0 vs 1+). Bivariate analyses and multinomial logistic regression tested for significant associations with: demographics, psychosocial stressors (perceived stress, psychological distress, loneliness, health anxiety about COVID, financial hardship, stressful life events), gambling participation and gambling frequency. Gambling participation and at-risk gambling decreased between T1 and T2, increased at T3, with little further change at T4. When gambling availability was curtailed, decreased gambling frequency on EGMs, casino games, sports betting or race betting, and lower psychosocial stress, were associated with transitions from at-risk to non-problem gambling. When gambling availability resumed, increased EGM gambling frequency, decreased online gambling frequency, and higher psychosocial stress were associated with transitions from non-problem to at-risk gambling. Gambling availability appears a stronger influence on gambling problems, at the population level, than psychosocial risk factors. Reducing the supply of high-risk gambling products, particularly EGMs, is likely to reduce gambling harm.

Can psychosocial risk factors mediate the association between precarious employment and mental health problems in Sweden? Results from a register-based study.

The aim of this study was to examine the mediating effect of the psychosocial work environment on the association between precarious employment (PE) and increased risk of common mental disorders (CMD), substance use disorders and suicide attempts. This longitudinal register-study was based on the working population of Sweden, aged 25-60 years in 2005 (N=2 552 589). Mediation analyses based on a decomposition of counterfactual effects were used to estimate the indirect effect of psychosocial risk factors (PRF) (mediators, measured in 2005) on the association between PE (exposure, measured in 2005) and the first diagnosis of CMD, substance use disorders, and suicide attempts occurring over 2006-2017. The decomposition of effects showed that the indirect effect of the PRF is practically null for the three outcomes considered, among both sexes. PE increased the odds of being diagnosed with CMD, substance use disorders, and suicide attempts, among both men and women. After adjusting for PE, low job control increased the odds of all three outcomes among both sexes, while high job demands decreased the odds of CMD among women. High job strain increased the odds of CMD and suicide attempts among men, while passive job increased the odds of all three outcomes among women. The results of this study did not provide evidence for the hypothesis that psychosocial risks could be the pathways linking precarious employment with workers` mental health. Future studies in different social contexts and labour markets are needed.

Utilization and Impact of a Radiation Nursing Clinic to Address Acute Care Needs for Patients with Gynecologic Cancers.

The risk factors for acute care utilization in gynecologic oncology patients are poorly understood. This study aimed to evaluate risk factors for the utilization of our centre's acute care radiation nursing clinic (RNC) by gynecologic oncology patients receiving radiotherapy (RT). This was a retrospective cohort study of gynecological cancer patients treated with RT at an academic cancer centre between 1 August 2021 and 31 January 2022. Data on socio-demographics, clinical and treatment characteristics, and RNC visits were collected and summarized by descriptive statistics. The Wilcoxon rank sum test and chi-squared test/Fisher's exact test were used for comparisons of continuous and categorical variables, respectively. RT was delivered to 180 patients, of whom 42 (23%) received concurrent chemoradiation (CCR). Compared to those receiving RT alone, patients receiving CCR had higher rates of RNC utilization (55% vs. 19%, p < 0.001). Within the CCR cohort, patients who presented to the RNC were more likely to be unpartnered (43% vs. 11%, p = 0.04), receive a referral to Psychosocial Oncology (39% vs. 5.3%, p = 0.01), and experience treatment interruptions (52% vs. 16%, p = 0.02). There were no associations between RNC visits and age, disease site, or distance from the cancer centre. The receipt of CCR and specific psychosocial risk factors were associated with increased RNC utilization. Targeted strategies and early intervention to better meet the supportive care and psychosocial needs of this vulnerable population are needed.

Psychosocial job characteristics comparison between work from home and work in the office: a study from the pandemic onwards

IntroductionThe Covid-19 pandemic changed office workers' work situation through the widespread use of the working from home (WFH) model. It also changed the demands for, and the resources allocated to, the same tasks depending on the location of their execution. The aim of this study was to identify potential differences in the level of theoretically established job stressors between WFH and regular office work, especially with respect to working parents with childcare responsibilities.MethodWe tested the relevant working conditions by conducting repeated online surveys with three measurement times between 2020 and 2022 (N = 1,144 in total).ResultsPaired sample t-tests for each measurement time showed significant differences between WFH and work in the office for six out of seven psychosocial risk factors (e.g., social relationships with supervisors and colleagues). Only work intensity did not differ between WFH and work in the office. The specific challenges for WFH parents caring for children were revealed in a decreased work continuity compared to employees without childcare responsibilities. Our results suggest that job stressors are contingent on the place of work.DiscussionIn conclusion, while WFH affords the opportunity to counterbalance job stressors in the long term, it requires the support of social relationships, especially for full-time WFH employees. Parents with childcare responsibilities require assistance in addressing their individual needs amidst the challenges of WFH.

Abstract 64: Risk Factors for Carotid Artery Lipid Deposition Measured by Gray Scale Median of the Intima-Media in Children and Young Adults Over the Life Course

Introduction: Echogenicity of the carotid arterial wall, measured by gray scale median of the intima-media (GSM-IM), is a unitless measure that reflects lipid deposition in the arterial wall, with lower values indicating greater lipid deposition and atherosclerosis. Due to the relative novelty of GSM-IM, its progression and associated risk factors are incompletely understood. This study investigated the GSM profile in childhood and young adulthood using a longitudinal cohort of individuals followed over time, and conducted a priori analysis on the behavioral, psychosocial, and health risk factors for GSM. Methods: Data were collected as part of the Meta-Air2 follow-up study of participants enrolled in the Southern California Children’s Health Study. A total of 240 study participants underwent a carotid artery ultrasound examination in 2008 (mean age±standard deviation [ SD] : 11.2±0.6 years), and again between 2018 and 2023 (24.2±1.6 years) to assess changes in carotid artery health, including GSM-IM, carotid artery intima-media thickness (CIMT), and carotid artery distensibility. Participants self-reported lifestyle behaviors, psychosocial health, and underwent anthropometric and blood pressure measures at both time points. Mixed effects models were used to predict GSM-IM changes with repeated measurements of lifestyle behaviors, perceived stress, BMI, and blood pressure. Results: Means and SDs of GSM-IM were 110.0±27.4 in childhood, and 75.6±15.8 in adulthood, with an annual change rate of -2.6 per year. Individuals of Hispanic ethnicity, and those with lower parental education levels had significantly lower GSM-IM in both childhood and adulthood. GSM-IM was significantly correlated with other measures of carotid artery atherosclerosis, including CIMT (r=0.28; p &lt;0.001) and carotid artery distensibility (r=0.36; p &lt;0.001). Results of mixed effects models adjusting for covariates, indicated that higher BMI (β=-1.35; 95% confidence interval [CI], -1.70, -0.99; p &lt;0.001) and systolic blood pressure (β=-0.32, 95% CI, -0.55, -0.09; p=0.007) were significantly associated with lower GSM-IM. A significant interaction between BMI and age (β difference=0.14; 95% CI, 0.09, 0.20; p &lt;0.001) suggested that a per-unit change in BMI has a greater effect on GSM-IM among adolescents compared to young adults. Health compromising behaviors, including less sleeping time, smoking, drug use, and higher perceived stress were significantly associated with lower GSM-IM in unadjusted models. However, these associations were attenuated after adjustment for covariates. Conclusion: Our study highlights the influence of BMI, particularly during childhood, blood pressure and lifestyle behaviors on adverse changes in GSM-IM, indicative of greater lipid deposition. These risk factors may be key targets for early prevention for atherosclerosis.

Abstract P522: Racial Differences in Sleep Health in Middle-Aged Adults

Introduction: Sleep health is comprised of many dimensions, including duration, quality and sleep disorders. Prior work found that Black adults have worse sleep health than White adults, but the underlying reasons are unknown. Our goal was to examine possible determinants of racial disparities in sleep health. We hypothesized that sleep health would be worse in Black participants, and this would be partly explained by clinical, psychosocial and lifestyle risk factors. Methods: We used cross-sectional data from the sleep ancillary study to the Coronary Artery Risk Development in Young Adults (CARDIA) study. Several objective sleep measures were collected, including 7 days of wrist actigraphy and a home sleep test (Nox T3s). Sleep disordered breathing was classified by oxygen desaturation index (ODI)&gt;=10 or apnea-hypopnea index (AHI) &gt;=15. We used a series of regression models to calculate the percent reduction in the coefficient estimate for race in models for each sleep health metric after adjusting for clinical factors, psychosocial factors or lifestyle factors. Results: There were 565 Black and 741 White adults in this analysis (mean (SD) age 61 (3.6) years). Black adults had significantly worse sleep health based on all measures, including shorter sleep duration, lower sleep percentage, greater sleep fragmentation and higher prevalence of sleep disordered breathing compared to White adults. Clinical factors, psychosocial factors and lifestyle factors all explained a proportion of the racial differences in sleep fragmentation and sleep percentage and explained away the racial differences in sleep disordered breathing (Table). Conclusions: Racial disparities in sleep health may be partly explained by clinical factors, such as blood pressure and BMI, psychosocial factors, such as education and depression, and lifestyle factors, such as smoking, alcohol intake, and physical activity. These findings provide several potential intervention targets to improve sleep health, particularly in Black adults.

Abstract 03: Cardiovascular Disease Risk Factor Control Following Release From Carceral Facilities

Background: Incarceration is a social determinant of cardiovascular disease (CVD) but is rarely addressed in clinical settings or cardiovascular prevention efforts. People who have been incarcerated are more likely to develop CVD at younger ages and have worse cardiovascular outcomes compared with the general population, even after controlling for traditional risk factors. The objective of this study is to identify incarceration-specific factors that are associated with uncontrolled CVD risk factors and identify potential targets for prevention specific to this population. Methods: Using data from Justice-Involved Individuals Cardiovascular Disease Epidemiology (JUSTICE), a prospective cohort study of individuals released from incarceration with CVD risk factors, we examine the association between incarceration-specific and psychosocial factors and CVD risk factor control, including systolic blood pressure (SBP≥140 mmHg, diastolic blood pressure (DBP)≥90, body mass index (BMI)≥40, glycosylated hemoglobin (HbA1c) ≥8%, and low-density lipoprotein cholesterol (LDL-c) ≥160). Incarceration-specific factors include the conditions of confinement (jail vs. prison, time spent in solitary confinement), the carceral health care delivery system (co-payment, medication self-management, discharge planning), and collateral sanctions following release (barriers to housing, food, employment due to criminal record). Psychosocial factors included perceived discrimination and stress, self-efficacy, and lifetime adversity. Results: The mean age of participants (N=417) was 45.2 ±SD 10.7 years and disproportionately men (92%), racially minoritized groups (80%), and poor (66% without an income). Over half (53%) had at least one uncontrolled CVD risk factor. Having been incarcerated in a jail, as compared with prison, was associated with an increased odds of having an uncontrolled CVD risk factor, even after adjusting for age, race and ethnicity, gender, perceived stress, depression symptoms, and life adversity score (AOR 1.79, 95% CI 1.08-2.94). People held in jail, as compared with prison, had higher rates of smoking, uncontrolled hypertension, fewer opportunities to manage one’s own medications while incarcerated, or receive medications prior to release. Discussion: Release from jail is associated with worse CVD risk factor control and requires tailored intervention focused on smoking cessation, hypertension control, and improved discharge planning. These data are especially informative as states design and implement the Centers of Medicare &amp; Medicaid Services new Medicaid Reentry Section 1115 Demonstration Opportunity, which allow Medicaid programs for the first time in history to cover services prior to release from correctional facilities that address chronic health conditions like cardiovascular disease and its risk factors.

Abstract P228: Baseline Characteristics of a Pilot Randomized Controlled Trial of a Self-Management Program for Depressed Black Women at Risk for Hypertension

Introduction: Black women have the highest prevalence of hypertension (HTN) compared to other racial/ethnic groups. Depression impacts women on a 2:1 ratio and increases cardiovascular risk. Black women are less likely to receive evidence-based care for depression and face barriers to engaging in healthy behaviors. In the current descriptive analysis, we examined baseline data from an ongoing pilot randomized controlled trial aimed to assess the efficacy of a group self-management program to decrease depression and HTN risk. Hypotheses: We assessed the hypothesis that a well-characterized sample of 30 depressed Black women would have high levels of physical and psychosocial risk factors for cardiovascular disease, low levels of treatment engagement, and that depression severity would correlate with experience of discrimination, stress, and perceived lack of social support. Methods: Inclusion criteria were Black women between the age of 18-49 with moderate depression (PHQ-9 of ≥10) and at least one risk factor for HTN. Social determinants of health (SDOH), discrimination, stress, and social support were assessed using validated measures. Results: The sample consisted of 30 Black females; mean age=34.27, SD= 8.60, and mean years of education=13.97, SD=1.79. Mean depression=15.10, SD=3.16, 33.33% endorsed thoughts of self-harm, and 36.67% reported currently receiving treatment for depression. Of those, 72.7% were in therapy and 54.5% were taking medication. Forty percent reported a history of physical abuse and 36.7% reported a history of sexual abuse. Salient cardiovascular risk factors included mean BMI=37.47, SD=5.84 (29/30 met BMI&gt;30 criteria), 26.67% smoker, 6% diabetes, 13% high cholesterol, and 46.67% other chronic health conditions. Mean discrimination score was 27.23, SD=10.96 indicating moderate exposure to discrimination and 75% identified race as the main source of discrimination. Additionally, 26.67% scored above the threshold on violence as measured by a SDOH screener and perceived stress averaged in the moderate range. Depression severity was significantly correlated with discrimination ( r =.43, p &lt;.05), stress, ( r =.55, p &lt;.01) and trended with social support ( r =-.39, p =.076). Conclusion: In conclusion, given the high rates of CVD risk factors, multiple psychosocial stressors, and low rates of treatment engagement, to improve cardiovascular health in Black women, we must be aware of and address a more comprehensive set of socio-emotional risk factors. Self-management interventions that simultaneously provide social support, address mental health needs, and are led by peers are likely to increase engagement and improve health outcomes.