Self-reported Characteristics Research Articles

Self-Reported Sleep Duration Is a Useful Tool to Predict Sarcopenia in Chilean Older Adults: Evidence from the ALEXANDROS Longitudinal Study

Age-related sleep disorders share common pathways with sarcopenia. Prospective data from Latin American populations are scarce, and the association between sleep disorders and sarcopenia in Chileans remains unknown. Thus, we aimed to study the longitudinal association between sleep disorders and sarcopenia in a cohort study of 1116 community-dwelling Chilean older people ≥60 years old from the ALEXANDROS cohorts. After the exclusion criteria, 318 subjects were followed. Sociodemographic data, self-reported chronic diseases, sedentarism, sleep characteristics, anthropometric measurements, handgrip strength, and muscle performance were assessed. Results indicated that at baseline, the prevalence of sarcopenia was 24.10% without gender differences, and the prevalence of self-reported sleep problems was 23.3%, higher in women (26.46% versus 17.15% in men). The adjusted Cox regression models for sarcopenia showed an association between sarcopenia, sleep disorders (HR = 2.08, 95% IC 1.14–3.80), and long sleep duration (HR = 2.42, 95% IC 1.20–4.91). After 8.24 years of follow-up, there were 2.2 cases of sarcopenia per 100 person-years. This study demonstrates that sleep disorders are an independent risk factor for sarcopenia in Chilean older people. The identification of sleep disorders through self-reported data provides an opportunity for early identification of risk and cost-effective sarcopenia prevention.

Firearm Access and Socio-Structural Factors Related to Suicidality Among Youth With Diverse Sexual, Gender, and Racial Identities

Objective Elevated rates of suicidal ideation (SI) and suicide attempts (SA) among youth, particularly multiply marginalized youth, are occurring in the context of youths’ access to household firearms. Research examining how perceived access to firearms is related to SI and SA among youth with marginalized identities is limited and often neglects to consider intersectionality. This study explored how intersecting social identities and positions, access to firearms, and socio-structural factors were associated with SI and SA for youth. Method The analytic sample (N = 17,794) included 7-12th grade students who participated in the 2021 Dane County Youth Assessment. Exhaustive CHAID – a decision tree matrix approach – examined all possible combinations of self-reported sociodemographic characteristics (gender identity, sexual identity, racial identity, grade, and firearm access) and socio-structural variables (bias-based bullying, school belongingness, and social pressure) to predict mutually exclusive groups of youth based on past-year SI and SA. Results SI and SA was most prevalent among intersectional groups with multiply marginalized identities and access to firearms. Socio-structural factors, including bias-based bullying victimization, lack of school belongingness, and social pressure, were characteristic of groups with higher prevalence of SI and SA. Conclusions While the marginalized youth in this sample have lower access to firearms, the prevalence of SI and SA was highest among multiply marginalized youth who reported access to firearms in the context of bias-based bullying, social pressure, and a lack of school belongingness. Youth suicide prevention efforts would be strengthened by policies that address firearm access and improve the school environment.

Abstract 2240: An exploratory study of financial toxicity intervention components preferred by cancer survivors

Abstract Background: Despite growing research on financial toxicity (FT) in cancer survivors, few studies have examined cancer survivors’ preferences for FT interventions. Understanding cancer survivors’ preferences for specific intervention components may facilitate the development and implementation of such interventions, potentially reducing the financial burden of cancer treatment. Purpose: The current work is an exploratory study of cancer survivors’ FT intervention component preferences. Methods: Adult survivors (N=105) of colorectal cancer (CRC; n=55) or non-Hodgkin lymphoma (NHL; n=50) from three tertiary care centers self-reported demographic characteristics (gender, race, income, employment status, insurance), clinical characteristics (comorbidities), psychosocial characteristics (PROMIS Global Health scale for mental health, Brief Health Literacy Screen scale, eHealth Literacy Scale), financial impact of cancer (the 11-item comprehensive score for financial toxicity COST scale, and life-altering and care-altering coping strategy scales), and preferences for FT intervention components. Intervention preferences were assessed through survey items on intervention timing and specific content. We employed descriptive statistics to assess overall preferences, and unadjusted linear regression and ANOVAs to identify demographic, clinical, psychosocial and financial predictors of intervention preferences. Results: In terms of timing, 79% of participants favored initiating a FT intervention before treatment compared to during or after treatment. The majority of participants (57%) were interested in at least one FT intervention component. In terms of specific components, participants were most interested in help understanding out-of-pocket costs and insurance (49%), help applying for financial assistance (39%), financial education (32%), and help communicating with the treatment team (32%). Participants were less interested in online tools to manage cancer-related expenses (27%), finance-related stress management (25%), and budgeting (20%). Predictors of overall interest (i.e., number of components endorsed) were: having high FT (B=.413, p=<.001), adopting life-altering coping behaviors (B=.374, p=<.001), using care-altering coping behaviors (B=.241, p=.014), being a non-White survivor (B=.219, p=.024), and having poorer mental health (B=-.280, p=.004). Conclusions: Cancer survivors may prefer FT interventions offered before treatment, and providing guidance on out-of-pocket costs and insurance. FT interventions may be particularly desired by those who experience greater financial toxicity, life and care-altering costs, are a racial/ethnic minority, or have poorer mental health, suggesting potential priority groups and target outcomes for intervention development. Citation Format: Maisha Huq, Claire Conley, Heather Derry-Vick, Amanda Khoudary, Lia Sorgen, Osairys Billini, Thomas Gunning, Conor Luck, Shreya Kaushik, Vanessa Hurley, John Marshall, Benjamin Weinberg, Anteneh Tesfaye, Andrew Ip, Arnold Potosky, Marc D. Schwartz. An exploratory study of financial toxicity intervention components preferred by cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2240.

Use of Digital COVID-19 Exposure Notifications at a Large Gathering: Survey Analysis of Public Health Conference Attendees.

WA Notify was Washington State's smartphone-based COVID-19 digital exposure notification (EN) tool, which was used to help limit the spread of COVID-19 between November 30, 2020, and May 11, 2023. Following the 2022 Washington State Public Health Association Annual Conference, attendees who had WA Notify activated began receiving ENs alerting them to a possible COVID-19 exposure during the conference. A survey was emailed to all conference attendees to measure WA Notify adoption, mechanisms through which attendees received ENs, and self-reported engagement in protective behaviors postexposure. This study aimed to learn more about the experiences of WA Notify adopters and nonadopters who may have been exposed to COVID-19 at a large group gathering. A web-based survey administered through REDCap (Research Electronic Data Capture; Vanderbilt University) was sent to all attendees of the Washington State Public Health Association conference. Self-reported demographic information and characteristics of respondents were summarized. Regression models were used to estimate relative risks to compare WA Notify adoption and testing behaviors between groups. Of the 464 total registered attendees who were sent the survey, 205 (44%) responses were received; 201 eligible attendees were included in this analysis. Of those, 149 (74%) respondents reported having WA Notify activated on their phones at the time of the conference. Among respondents with WA Notify activated, 54% (n=77) reported learning of their potential exposure from a WA Notify EN. Respondents who reported that they did not have WA Notify activated and learned of their potential exposure via the event-wide email from conference organizers were 39% less likely to test for COVID-19 compared to respondents with WA Notify activated who learned of their potential exposure from the email (relative risk 0.61, 95% CI 0.40-0.93; P=.02), and this gap was even larger when compared to respondents who learned of their exposure from a WA Notify EN. The most commonly cited reason for not having WA Notify activated was privacy concerns (n=17, 35%), followed by not wanting to receive ENs (n=6, 12%) and being unaware of WA Notify (n=5, 10%). Digital EN systems are an important tool to directly and anonymously notify close contacts of potential exposures and provide guidance on the next steps in a timely manner. Given the privacy concerns, there is still a need for increasing transparency surrounding EN technology to increase uptake by the public if this technology were to be used in the future to slow the spread of communicable diseases.

On decoding of rapid motor imagery in a diverse population using a high-density NIRS device.

Functional near-infrared spectroscopy (fNIRS) aims to infer cognitive states such as the type of movement imagined by a study participant in a given trial using an optical method that can differentiate between oxygenation states of blood in the brain and thereby indirectly between neuronal activity levels. We present findings from an fNIRS study that aimed to test the applicability of a high-density (>3000 channels) NIRS device for use in short-duration (2 s) left/right hand motor imagery decoding in a diverse, but not explicitly balanced, subject population. A side aim was to assess relationships between data quality, self-reported demographic characteristics, and brain-computer interface (BCI) performance, with no subjects rejected from recruitment or analysis. BCI performance was quantified using several published methods, including subject-specific and subject-independent approaches, along with a high-density fNIRS decoder previously validated in a separate study. We found that decoding of motor imagery on this population proved extremely challenging across all tested methods. Overall accuracy of the best-performing method (the high-density decoder) was 59.1 +/- 6.7% after excluding subjects where almost no optode-scalp contact was made over motor cortex and 54.7 +/- 7.6% when all recorded sessions were included. Deeper investigation revealed that signal quality, hemodynamic responses, and BCI performance were all strongly impacted by the hair phenotypical and demographic factors under investigation, with over half of variance in signal quality explained by demographic factors alone. Our results contribute to the literature reporting on challenges in using current-generation NIRS devices on subjects with long, dense, dark, and less pliable hair types along with the resulting potential for bias. Our findings confirm the need for increased focus on these populations, accurate reporting of data rejection choices across subject intake, curation, and final analysis in general, and signal a need for NIRS optode designs better optimized for the general population to facilitate more robust and inclusive research outcomes.

Association between self-reported pain severity and characteristics of United States adults (age ≥50 years) who used opioids.

The aim of this study was to assess the associations between the characteristics of United States (US) adults (≥50 years) who used opioids and self-reported pain severity using a nationally representative dataset. This retrospective cross-sectional database study used 2019 Medical Expenditure Panel Survey data to identify US adults aged ≥50 years with self-reported pain within the past 4 weeks and ≥1 opioid prescription within the calendar year (n = 1,077). Weighted multivariable logistic regression analysis modeled associations between various characteristics and self-reported pain severity (quite a bit/extreme vs less/moderate pain). The adjusted logistic regression model indicated that greater odds of reporting quite a bit/extreme pain was associated with the following: age 50-64 vs ≥65 (adjusted odds ratio [AOR] = 1.76; 95% confidence interval [CI] = 1.22-2.54), non-Hispanic vs Hispanic (AOR = 2.0; CI = 1.18-3.39), unemployed vs employed (AOR = 2.01; CI = 1.33-3.05), no health insurance vs private insurance (AOR = 6.80; CI = 1.43-32.26), fair/poor vs excellent/very good/good health (AOR = 3.10; CI = 2.19-4.39), fair/poor vs excellent/very good/good mental health (AOR = 2.16; CI = 1.39-3.38), non-smoker vs smoker (AOR = 1.80; CI = 1.19-2.71), and instrumental activity of daily living, yes vs no (AOR = 2.27; CI = 1.30-3.96). Understanding the several characteristics associated with pain severity in US adults ≥50 years who used an opioid may help transform healthcare approaches to prevention, education, and management of pain severity in later life.

Prevalence of complete edentulism among US adults 65 years and older: A Behavioral Risk Factor Surveillance System study from 2012 through 2020

BackgroundThe rapid growth of the older adult population in the United States and their increased risk of edentulism make it essential to analyze trends and factors associated with edentulism. MethodsData were obtained from the Behavioral Risk Factor Surveillance System from 2012 through 2020. US- and state-level trend lines were reported. Multiple logistic regression analyses were used to evaluate the association between self-reported complete edentulism and demographic characteristics, chronic diseases, smoking status, and health insurance status. Multiple imputations were used to address the missing data. ResultsA total of 771,513 (weighted n = 50,410,576) participants were included in the study. There was a significant (P = .021) downward trend in the prevalence of edentulism from 2012 (16.36%) through 2020 (13.54%). Having less than a high school education, being a smoker, being non-Hispanic Black, having an annual household income less than $75,000, and having chronic conditions, including diabetes, myocardial infarction, arthritis, depression, and stroke, were significantly associated with complete edentulism. ConclusionsDespite a decrease in prevalence of edentulism, disparities based on race, income, and education still exist. Edentulism is associated with chronic diseases in older adults. Practical ImplicationsPublic health initiatives should be aimed at reducing the impact of edentulism and improving overall quality of life among older adults. Community health programs allocating resources to improve access to affordable care, reducing precursors to edentulism, expanding dental coverage, and promoting oral and general health awareness are vital components of these efforts.

Early morning sport scheduling is associated with poorer subjective sleep characteristics in British student-athletes.

This study presents the sleep characteristics of British student-athletes and examines the relationships between sport scheduling and time demands on sleep outcomes. Student-athletes (n = 157, 51% male) completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the Sleep Hygiene Index (SHI). Self-reported sleep characteristics on weekdays and weekends, weekly frequencies of early morning and late evening sport sessions, and academic-related and sport-related time demands were also collected. Questionnaires revealed a high prevalence of undesired sleep characteristics including poor sleep quality (global PSQI >5 in 49.0%) and low sleep durations on weekdays (25% reporting <7 h). Paired t-tests revealed significant differences in bedtime, waketime, sleep duration, and sleep onset latency between weekdays and weekends (all p < 0.01). Hierarchical regression analyses indicated that early morning sport frequency was a significant predictor of PSQI (β = 0.30) and SHI (β = 0.24) global scores, weekday waketimes (β = -0.17), and weekday sleep durations (β = -0.25; all p < 0.05) in models adjusted for participant characteristics. Late evening sport frequency, and academic-related and sport-related time demands, were not significant predictors of any sleep outcome. Adjusting sport scheduling to avoid early start times could provide a means to improve sleep outcomes and may improve sporting performance and academic attainment.

Sleep and Risk of Pancreatic Cancer in the UK Biobank.

Light at night, which may cause circadian disruption, is a potential pancreatic cancer risk factor. However, evidence from related exposures such as poor sleep health and shift work remains inconclusive and sparsely investigated. We evaluated associations between self-reported typical sleep duration, chronotype, shift work, insomnia symptoms, snoring, and daytime sleeping and pancreatic ductal adenocarcinomas (PDAC) incidence among 475,286 UK Biobank participants. We used Cox proportional hazards models to estimate HRs and 95% confidence intervals (CI) adjusting for age, sex, body mass index, smoking status, duration, and frequency, alcohol intake, diabetes status, race, and employment/shift work. Over 14 years of follow-up, 1,079 adults were diagnosed with PDAC. There were no associations observed between sleep characteristics, including sleep duration [<7 vs. 7-<9 hours; HR, 1.03; 95% CI, 0.90-1.19; ≥9 hours; HR, 1.00 (0.81-1.24), evening chronotype ("definitely" an evening person vs. "definitely" a morning person; HR, 0.99 (0.77-1.29)], shift work, insomnia symptoms, snoring, or daytime sleep and PDAC risk. Self-reported typical sleep characteristics and shift work were not associated with PDAC risk. Considering the role of light at night and shift work in circadian disruption and cancer risk, it is plausible that poor sleep health among a general population may be related to cancer risk through similar sleep and circadian disrupting processes. This work may suggest that typical sleep characteristics and shift work are not associated with PDAC, although additional work is needed to confirm these findings.

The moderated-mediation role of risk perception and intolerance of uncertainty in the association between residual symptoms and psychological distress: a cross-sectional study after COVID-19 policy lifted in China

BackgroundA considerable number of individuals infected with COVID-19 experience residual symptoms after the acute phase. However, the correlation between residual symptoms and psychological distress and underlying mechanisms are scarcely studied. We aim to explore the association between residual symptoms of COVID-19 and psychological distress, specifically depression, anxiety, and fear of COVID-19, and examine the role of risk perception and intolerance of uncertainty in the association.MethodsA cross-sectional survey was conducted by online questionnaire-based approach in mid-January 2023. Self-reported demographic characteristics, COVID-19-related information, and residual symptoms were collected. Depression, anxiety, fear, risk perception and intolerance of uncertainty were evaluated using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Fear of COVID-19 Scale (FCV-19S), COVID-19 Risk Perception Scale and Intolerance of Uncertainty Scale-12 (IUS-12), respectively. Linear regression analyses were conducted to explore the associations. A moderated mediation model was then constructed to examine the role of risk perception of COVID-19 and intolerance of uncertainty in the association between residual symptoms and psychological distress.Results1735 participants effectively completed the survey. 34.9% of the patients experienced residual symptoms after acute phase of COVID-19. Psychological distress was markedly increased by COVID-19 infection, while residual symptoms had a significant impact on psychological distress (Ps < 0.001), including depression (β = 0.23), anxiety (β = 0.21), and fear of COVID-19 (β = 0.14). Risk perception served as a mediator between residual symptoms and all forms of psychological distress, while intolerance of uncertainty moderated the effect of risk perception on depression and anxiety.ConclusionA considerable proportion of patients experience residual symptoms after acute phase of COVID-19, which have a significant impact on psychological distress. Risk perception and intolerance of uncertainty play a moderated-mediation role in the association between residual symptoms and depression/anxiety. It highly suggests that effective treatment for residual symptoms, maintaining appropriate risk perception and improving intolerance of uncertainty are critical strategies to alleviate COVID-19 infection-associated psychological distress.

Interactions between poor sleep and negative social cognition pose risk for lower maternal sensitivity.

The extent to which mother and infant sleep predict maternal sensitivity as (a) main effects and (b) moderate the association between social cognition about infant crying (i.e., cry processing) and maternal sensitivity was examined in a sample of 299 mother-infant dyads (43% of mothers non-White; 50.5% of infants female). Infant- and mother-oriented cry processing were assessed prenatally using a video recall procedure and mothers self-reported demographics and characteristics reflecting emotional risk. When infants were 2 months old, mothers reported their depressive symptoms and mother and infant sleep. Maternal sensitivity and infant negative mood were observed during free play and the still face. There were no main effects of mother or infant sleep on maternal sensitivity over and above covariates. However, infant total sleep duration across night and day and mother sleep disturbance moderated the effect of mother-oriented cry processing on sensitivity. Specifically, mother-oriented cry processing was associated with lower maternal sensitivity only among mothers whose infants had lower sleep duration and who reported more sleep disturbances. Moderating effects were not apparent for infant night wakings or time awake or mothers' total sleep problems. Constrained opportunities for sleep or respite across the entire day and the totality of mothers' nighttime sleep disturbances, not just those specific to infants' night wakings, undermine maternal sensitivity by exacerbating mothers' preexisting tendency to have self-focused and negative reactions to infant distress. The efficacy of interventions designed to facilitate maternal sensitivity and infant adjustment may be enhanced by adding targeted foci on maternal and infant sleep. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The New Urology Match: How Recent Innovations Including Virtual Interviews and Preference Signaling Have Changed Match Outcomes.

To determine how recent changes in the urology match occurring from 2021 to 2023, including virtual interviews (VIs) and preference signals (PS), affected match outcomes. The American Urological Association (AUA)match data from 2021 to 2023 was compared to the 15 years prior. This was obtained from the AUA website and a previous study of public AUA match data. Self-reported applicant characteristics and outcomes from the Urology Residency Applicant Spreadsheet 2021-2023 were compared to the four years prior. Between 2021 and 2023, residency programs offered 43 interviews each, compared to an average of 35 in the 15 years prior. Programs have been receiving more applications each year, from a low of 225 in 2019 to a peak of 347 in 2022. This resulted in an interview offer rate of 13% between 2021 and 2023, compared to 16% in the five years prior. Applicants applied to a mean of 88 programs in 2023, increasing each year since 40 in 2006. Applicants attended 12 interviews on average between 2021 and 2023, compared to 13 in the two years prior. Self-reported applicant data similarly demonstrated that, compared to the four years prior, applicants between 2021 and 2023 applied to more programs (81 vs. 70), had a lower interview offer rate (22% vs. 32%), and a higher interview acceptance rate (90% vs. 75%). During the years with VIs, programs offered more interviews and applicants attended fewer on average, indicating a larger applicant pool was interviewed. Despite the introduction of PS, applicants applied to more programs in 2022 and 2023 than ever before.

Heterogeneity in response to treatment across tinnitus phenotypes

The clinical heterogeneity of chronic tinnitus poses major challenges to patient management and prompts the identification of distinct patient subgroups (or phenotypes) that respond more predictable to a particular treatment. We model heterogeneity in treatment response among phenotypes of tinnitus patients concerning their change in self-reported health burden, psychological characteristics, and tinnitus characteristics. Before and after a 7-day multimodal treatment, 989 tinnitus patients completed 14 assessment questionnaires, from which 64 variables measured general tinnitus characteristics, quality of life, pain experiences, somatic expressions, affective symptoms, tinnitus-related distress, internal resources, and perceived stress. Our approach encompasses mechanisms for patient phenotyping, visualizations of the phenotypes and their change with treatment in a projected space, and the extraction of patient subgroups based on their change with treatment. On average, all four distinct phenotypes identified at the pre-intervention baseline showed improved values for nearly all the considered variables following the intervention. However, a considerable intra-phenotype heterogeneity was noted. Five clusters of change reflected variations in the observed improvements among individuals. These patterns of treatment effects were identified to be associated with baseline phenotypes. Our exploratory approach establishes a groundwork for future studies incorporating control groups to pinpoint patient subgroups that are more likely to benefit from specific treatments. This strategy not only has the potential to advance personalized medicine but can also be extended to a broader spectrum of patients with various chronic conditions.

Experiences of Interpersonal Violence in Sport and Perceived Coaching Style Among College Athletes

Concern about interpersonal violence (IV) in sport is increasing, yet its implications remain poorly understood, particularly among currently competing college athletes. To document the self-reported prevalence of IV in college sports; identify associated risk factors; examine potential consequences associated with athletes' psychosocial well-being, emotional connection to their sport, and willingness to seek help; and explore the associations between IV reporting and perceived variations in coaching styles. This survey study analyzes results of the 2021 to 2022 National Collegiate Athletic Association (NCAA) myPlaybook survey, which was administered from July to December 2021 to 123 colleges and universities across the US. Participants were NCAA athletes aged 18 to 25 years who were current players on an NCAA-sanctioned team. Self-reported demographic characteristics (eg, athlete gender identity and sexual orientation) and perceived differences in supportive vs abusive coaching styles (eg, athlete autonomy, team culture, and extent of abusive supervision). The primary outcome was self-reported experiences of IV in sport during the college sports career of currently competing college athletes. Types of IV considered were physical abuse, financial abuse, sexual abuse, psychological or emotional abuse, and neglect or abandonment. Outcomes potentially affected by IV were assessed with 4 questionnaires. A total of 4119 athletes (mean [SD] age, 19.3 [1.5] years; 2302 males [55.9%]) completed the survey (response rate, 21.2%). One in 10 athletes (404 of 4119 [9.8%]) reported experiencing at least 1 type of IV during their college sports career, of whom two-thirds (267 [6.5%]) experienced IV within the past 6 weeks. On multivariable analysis, female gender identity (odds ratio [OR], 2.14; 95% CI, 1.46-3.13), nonheterosexual sexual orientation (OR, 1.56; 95% CI, 1.01-2.42), increasing age beyond 18 years (OR, 1.13; 95% CI, 1.01-1.30), increasing year of NCAA eligibility beyond the first year (OR, 1.19; 95% CI, 1.02-1.39), and participation in select sports (eg, volleyball: OR, 2.77 [95% CI, 1.34-5.72]; ice hockey: OR, 2.86 [95% CI, 1.17-6.95]) were independently associated with IV. When exposed to IV, college athletes reported experiencing consistently worse psychosocial outcomes, including increased burnout (mean difference on a 5-point Likert scale, 0.75; 95% CI, 0.63-0.86; P < .001) and an expressed desire to consider quitting their sport (mean difference, 0.81; 95% CI, 0.70-0.92; P < .001). They were not, however, less willing to seek help. Differences in coaching style were associated with differences in IV reporting. In risk-adjusted linear regression models, having a more supportive coach was associated with a 7.4 (95% CI, 6.4-8.4) absolute percentage point decrease in athletes' probability of reporting experiencing IV. In contrast, having a more abusive coach was associated with up to a 15.4 (95% CI, 13.8-17.1) absolute percentage point increase in athletes' probability of reporting experiencing IV. Results of this survey study suggest that IV is associated with marked changes in the psychosocial health and emotional well-being of college athletes, particularly those who identify as female and with nonheterosexual sexual orientations. Variations in coaching style have the potential to alter these associations. Ongoing efforts are needed to leverage the unique position that coaches hold to help reduce IV and create safe places where all college athletes can thrive.

Policies, Practices, and Environmental Characteristics Among Family Child Care Homes in South Carolina.

Background: Child care program requirements have adopted nutrition and physical activity standards to address childhood obesity, but few studies have examined the effects of these standards in family child care homes (FCCHs). Methods: In a cross-sectional study (2017-2019), the Childcare Home Eating and Exercise study examined self-reported provider characteristics and observed policies and practices related to physical activity and nutrition in FCCHs in South Carolina. Two-sample t-tests were used to compare observed nutrition and physical activity policy, practice, and environment scores in child care homes that participated in versus did not participate in the state's ABC Quality program, which is designed to improve child care and includes policies and practices intended to increase physical activity levels and improve diet quality. Results: Environment and Policy Assessment and Observation results for nutrition and physical activity were 7.5 out of 21 and 11.8 out of 30, respectively, indicating much room for improvement in nutrition and physical activity policies, practices, and environment in South Carolina FCCHs. The study found one difference between FCCHs that did and did not participate in the ABC Quality program; non-ABC homes provided more time for physical activity. Conclusions: Future research should develop ways to strengthen the guidelines and improve the implementation of obesity prevention standards in FCCHs.

Patterns of Mentally Active versus Passive Sedentary Behavior in Adults: Post-COVID-19 Insights

Background: Although sedentary behavior (SB) before and during COVID-19 has been studied, mental activity-based SB patterns have been overlooked. This secondary analysis investigated the patterns of mentally active vs. passive SB in adults post-COVID-19 pandemic and examined sex differences. Methods: Adults (n = 1255; 45% males; 50% aged between 20 and 29 years old) self-reported general characteristics, anthropometric and socioeconomic variables, and mentally active and passive SB (weekdays and weekend days) using a structured web-based survey. Adjusted ANCOVA on Ranks tests assessed differences between mentally active and mentally passive SB during the day, on weekdays, and weekend days. Adjusted Quade Nonparametric ANCOVA tests evaluated these differences in males vs. females. Results: Adults significantly spent greater time in mentally active vs. passive SB (5.61 ± 4.57 vs. 2.50 ± 3.25; p &lt; 0.001). Mentally active SB was more prevalent on weekdays than on weekends (6.00 ± 5.00 vs. 5.00 ± 5.00; p &lt; 0.001). No significant difference was observed for mentally passive SB (p &gt; 0.05). Males significantly accumulated more mentally active SB compared to females (p &lt; 0.001 for all). Females significantly spent more time in mentally passive SB on weekdays than males (p &lt; 0.05). Conclusion: Our results highlight the need for individualized SB reduction strategies based on mental activity to obtain the most benefits of SB reduction interventions and promoting overall health post-COVID-19 pandemic.

Integrating Psychosocial Skill and Characteristic Development Into an English Academy Soccer Coaching Program: A Preliminary Investigation

This study aimed to assess the impact of a psychosocial development program on academy soccer players with coaches being central design and delivery. The 8 Pillars program (designed to foster Communication, Control, Commitment, Confidence, Concentration, Resilience, Presence, and Self-awareness) was delivered through player workshops, coaching practice, and coach-led environmental manipulation. A total of 25 academy soccer players (Mage 14.7 ± 0.3) completed the Psychological Characteristics of Development Excellence Questionnaire-2 pre- and postseason, and a self-report scale for each of the eight prescribed psychosocial skills and characteristics at five time points across the season. Significant (p &lt; .05) improvement between pre- and postseason for “Imagery and Active Preparation,” “Seeking and Using Social Support,” and “Active Coping” factors within the Psychological Characteristics of Development Excellence Questionnaire-2 were evident. Significant (p &lt; .05) improvements were shown for “Communication,” “Control,” “Commitment,” “Concentration,” and “Resilience” scales across the season. These findings give initial efficacy that a targeted, multifaceted program, largely delivered by coaches, can improve player self-reported psychosocial skills and characteristics in a U.K. academy soccer setting.

National Attitudes Toward Living Kidney Donation in the United States: Results of a Public Opinion Survey

Understanding national attitudes about living kidney donation will enable us to identify and address existing disincentives to living kidney donation. We performed a national survey to describe living kidney donation perceptions, perceived factors that affect the willingness to donate, and analyzed differences by demographic subgroups. The survey items captured living kidney donation awareness, living kidney donation knowledge, willingness to donate, and barriers and facilitators to living kidney donation. We surveyed 802 US adults (aged 25-65 years) in June 2021, randomly selected from an online platform with diverse representation. We developed summed, scaled indices to assess the association between the living kidney donation knowledge (9 items) and the willingness to donate (8 items) to self-reported demographic characteristics and other variables of interest using analysis of variance. All other associations for categorical questions were calculated using Pearson's χ2 and Fisher exact tests. We inductively evaluated free-text responses to identify additional barriers and facilitators to living kidney donation. Most (86.6%) of the respondents reported that they might or would definitely consider donating a kidney while they were still living. Barriers to living kidney donation included concerns about the risk of the surgery, paying for medical expenses, and potential health effects. Facilitators to living kidney donation included having information on the donation surgery's safety, knowing that the donor would not have to pay for medical expenses related to the donation, and hearing living kidney donation success stories. Awareness of the ability to participate in kidney-paired donation was associated with a higher willingness to donate. Potential for selection bias resulting from the use of survey panels and varied incentive amounts, and measurement error related to respondents' attention level. Most people would consider becoming a living kidney donor. Increased rates of living kidney donation may be possible with investment in culturally competent educational interventions that address risks associated with donating, policies that reduce financial disincentives, and communication campaigns that raise awareness of kidney-paired donation and living kidney donation.

Occupational physical activity as a determinant of daytime activity patterns and pregnancy and infant health.

Though physical activity (PA) is recommended during pregnancy, it remains unclear how occupational physical activity (OPA) and sedentary behavior (SB) contribute to activity patterns and health during pregnancy. The purpose of this secondary analysis was to determine if OPA pattern is a determinant of all-day PA and evaluate associations with pregnancy/infant health outcomes. Data was from two prospective cohorts with study visits each trimester: MoM Health (Pittsburgh, PA; n = 120) and PRAMS (Iowa City, Iowa; n = 20). Using employment status/job hours (self-reported in demographic questionnaires) and OPA from the Pregnancy Physical Activity Questionnaire, latent class analysis identified three groups: sitting (n = 61), part-time mixed (n = 9), and active (n = 29). A fourth group included non-working participants (n = 32). Device-based PA (ActiGraph GT3X), SB (activPAL3 micro), and blood pressure were measured each trimester. Glucose screening test, gestational age, gestational weight gain, adverse pregnancy outcomes (APOs: gestational hypertension, preeclampsia, eclampsia, gestational diabetes, intrauterine growth restriction, and preterm birth), and infant outcomes (length, weight, and sex) were abstracted from medical records. Associations between groups with APOs and pregnancy/infant health were calculated using linear/logistic regression with adjustment for age, pre-pregnancy BMI, education, and race. Self-reported participant characteristics were similar across groups, except education which was higher in the sitting versus other groups. All-day device-based PA differed across groups; for example, the sitting group had the highest SB across trimester (all p<0.01) while the active group had the highest steps per day across trimesters (all p<0.01). Pregnancy/infant health did not differ between groups (all p>0.09). Compared to the non-working group, the risk of any APO was non-significantly higher in the sitting (OR = 2.27, 95%CI = 0.63-8.18) and active groups (OR = 2.40, 95%CI = 0.66-9.75), though not the part-time mixed (OR = 0.86, 95%CI = 0.08-9.1). OPA pattern is a determinant of all-day PA during pregnancy. Future studies with larger samples should examine associations between pregnancy OPA patterns and pregnancy/infant health.

COMPARING THE ASSOCIATION BETWEEN DIABETES AND MORTALITY IN TWO INDEPENDENT BIRTH COHORT OF OLDER ADULTS IN MEXICO

Abstract The prevalence of diabetes among middle-aged and older adults in Mexico has nearly doubled since the year 2000. This increase is primarily due to healthcare reforms that promoted diabetes screening. Insulin use and other treatments have also increased during the same period. Early diagnosis and treatment can reduce diabetes mortality risk. However, it is unclear if the increased diagnosis and treatment of diabetes in Mexico have reduced the mortality risk associated with diabetes in older adults. We used the Mexican Health and Aging Study to compare the association between diabetes and 5-year mortality in two independent cohorts of adults aged 60-69 in 2001 (1932-1941) and 2012 (1943-1952). The final sample included 3,694 participants in 2001 and 4,769 in 2012. Demographic variables included age, gender, education, living in an urban community, and having health insurance coverage. Self-reported health conditions included diabetes, hypertension, stroke, and respiratory disease. We used cox-proportional hazard regression models that included an interaction term for diabetes by cohort and adjusted for demographic and self-reported health characteristics. Overall, diabetes was associated with 2.56 times higher mortality (95% CI=2.18-3.00). The 2012 cohort did not have significantly different mortality risk compared to the 2001 cohort (HR=0.91, 95% CI=0.77-1.07). The association between diabetes and mortality for participants in the 2001 cohort (HR=2.52, 95% CI=1.95-3.26) was not significantly different from the 2012 cohort (HR=2.58, 95% CI=2.09-3.17). Our results indicate that diabetes continues to be a major risk factor for mortality in Mexico despite the increase in screening and treatment.