South Texas Research Articles

Abstract 6: Financial Concerns Are Common Among Family Members of Severe Stroke Patients: A Mixed Methods Study

Background: Stroke has a large aggregate financial impact, however the prevalence and predictors of cost concerns among family members of severe stroke patients are unknown. Methods: Family surrogate decision makers of severe stroke patients were recruited from the BASIC and OASIS projects in a South Texas community. Clinical information was obtained from medical charts. Patient and family member sociodemographic information was obtained from surveys, conducted at baseline and 3-, 6-, and 12-months post-stroke. The primary outcome was presence of cost concerns among family members, defined as being “very worried” or “moderately worried” about being able to pay stroke-related medical costs at any time point. Exploratory multivariable logistic regression models identified factors associated with cost concerns. A subset of participants also completed qualitative semi-structured interviews exploring the nature of cost concerns. Results: Of 2,917 stroke cases between April 2016 and September 2020, 465 were eligible, and 318 family members of 256 stroke patients participated. Patients were 52% female, 58% Mexican American (MA), with mean age of 75 (SD 14), and mean National Institutes of Health Stroke Scale score of 15 (SD 11). Family members were 76% female, 63% MA, with mean age of 56 (SD 13). Of 256 patients, 118 (46%) had a family member who reported having cost concerns. In a fully adjusted model (see Table), MA ethnicity and lack of insurance were associated with greater cost concerns. Cost concerns were less common over time and with patient death, and were less common among family members who were neither a spouse nor child of the patient. Interview data revealed that concerns were most often related to costs of post-acute care (excerpts included in the Table). Conclusions: Nearly half of all severe stroke patients have a family member with concerns about affording their medical care. Providers should seek to elicit cost concerns and provide resources to address them.

Abstract WP250: The Changing Impact of Neighborhood Socioeconomic Status on Stroke Incidence in the BASIC Project

Background: Poverty is associated with increased stroke risk, but it is unclear how this has changed over time. We sought to evaluate temporal trends in stroke incidence by neighborhood socioeconomic status (nSES) in a south Texas community. Methods: Within the BASIC project, we identified all first-ever ischemic and hemorrhagic strokes among Mexican American or non-Hispanic White persons, age >45, from 2010-2021, geocoded to census tract by patient home address (n=4,137). Using 5 year rolling average annual data from the American Community Survey, a composite nSES score was assigned to each census tract, reflecting aggregate neighborhood income, wealth, education, and occupation (range -1.60, 1.95; lower=poorer). For each year, the nSES percentile of each tract was determined. Incidence rates were estimated using Poisson regression, with annual population estimates as offsets, including a quadratic term for time to account for nonlinear trends. The model included annual nSES percentile, age, sex, ethnicity, and nSES-time and ethnicity-time interactions. Results: Incidence rates for high vs low nSES neighborhoods for the 45-65-year age group are shown in the Figure. Incidence rate ratios for nSES changed over time (p<0.01 for interaction) in a u-shaped fashion, with no association present in 2010, a significant association in 2015 (RR for 90th vs 10th percentile nSES=0.59, 95% CI=0.49-0.70), and no association in 2021 (Figure). Conclusions: The gap in stroke incidence between the richest and poorest neighborhoods peaked in 2015 and was no longer present in 2021, due to declining rates in low nSES neighborhoods. Future work should explore the causes underlying these trends.

First-line therapies in a Latino-rich cohort of US patients (pts) with hepatocellular carcinoma (HCC) and Child Pugh B (CPB) cirrhosis.

453 Background: There are limited prospective clinical trials in patients with both HCC and CPB cirrhosis. As the prevalence of HCC and cirrhosis has been rising among Latinos in South Texas, it is crucial to examine the liver dysfunction within this demographic to understand the contributing factors to treatment patterns. Therefore, we conducted a retrospective analysis of 36 patients with both HCC and Child Pugh B (CPB) cirrhosis. Methods: A dataset of 65 patients with HCC and cirrhosis from 2009 – 2019 was used to identify 36 patients with CPB treated at a Latino-Rich NCI-designated Cancer Center. We further segmented patients of Child Pugh Class B by ALBI grades (1-3) to explore variations in demographics, liver dysfunction, and first-line therapies. Results: Median age overall of the cohort is 59 (50-71). Ethnicity: Latino White (83%), Non-Latino White (14%), Black (3%). Etiology: HCV (78 %) EtOH (50%), NASH (19%), and HBV (3%). ALBI Grade: I (6%), II (50%), III (44%). First line treatment in CPB: Sorafenib (86%), Nivolumab (8%), Lenvatinib (6%). Sorafenib was used across all ALBI grades, while Lenvatinib and Nivolumab were given only in ALBI II (Table). Conclusions: Sorafenib was more often given to patients with CPB cirrhosis, in the first line setting; however, more patients were treated with nivolumab or lenvatinib with ALBI II. Further investigation of survival based on ALBI levels and the trajectory of liver function over time in response to different treatment approaches is underway in a larger cohort who has received newer immunotherapy-based regimens. With more agents approved for HCC, prospective clinical trials are needed in CPB and HCC. [Table: see text]

A high burden of diabetes and ankle brachial index abnormalities exists in Mexican Americans in South Texas

Ethnic differences exist in the United States in the interrelated problems of diabetes (DM), peripheral arterial disease (PAD), and leg amputations. The purpose of this study was to determine the prevalence and risk factor associations for subclinical PAD in a population sample of Mexican Americans using the ankle brachial (ABI) index.The ABI-High (higher of the two ankle pressures/highest brachial pressure) and ABI-Low (lower of the two ankle pressures/highest brachial pressure) were calculated to define PAD. Toe brachial index (TBI) was also calculated. 746 participants were included with an age of 53.4 ± 0.9 years, 28.3 % had diabetes mellitus (DM), 12.6 % were smokers, and 51.2 % had hypertension (HTN). Using ABI-High ≤ 0.9, the prevalence of PAD was 2.7 %. This rose to 12.7 % when an ABI-Low ≤ 0.9 was used; 4.0 % of the population had an ABI-High > 1.4. The prevalence of TBI < 0.7 was 3.9 %. DM was a significant risk factor for ABI-High ≤ 0.9 and ABI-High > 1.4, and TBI < 0.7. Increased age, HTN, smoking was associated with ABI-High ≤ 0.9, while being male was associated with ABI-High > 1.4. Increased age, smoking, and lower education were all associated with abnormal TBI.Despite relatively younger mean age than other studied Hispanic cohorts, the present population has a high burden of ABI abnormalities. DM was a consistent risk factor for PAD. These abnormalities indicate an important underlying substrate of vascular and metabolic disease that may predispose this population to the development of symptomatic PAD and incident amputations.

Sedimentary environment and benthic oxygenation history of the Upper Cretaceous Austin Chalk Group, south Texas: An integrated ichnological, sedimentological and geochemical approach

ABSTRACTOxygen concentration in the ocean is vital for sustaining marine ecosystems. While the potential impacts of deoxygenation on modern oceans are hard to predict, lessons can be learned from better characterizing past geological intervals formed under a greenhouse climate. The greenhouse Cretaceous containing several oceanic anoxic events characterized by widespread oxygen‐deficient water is ideal in this regard. The Austin Chalk Group in south Texas (USA) shows organic‐rich intervals that can be linked to oxygen depletion in the ocean, but the exact bottom water oxygenation conditions have not been estimated. This study aims to reconstruct both sediment interstitial and bottom water oxygenation history during Austin Chalk Group deposition by integrating detailed ichnological, sedimentological and geochemical (X‐ray fluorescence and X‐ray diffraction) analyses, thereby providing a consistent model that may be applicable across a range of marine shelf settings. The 141.12 m Gise #1 core contains a continuous record of the Austin Chalk Group, providing an opportunity for unravelling oxygenation and deoxygenation events. Whereas the anaerobic–exaerobic deposits are essentially nonbioturbated, four oxygen‐related ichnocoenoses are defined, further refining the transition of aerobic to dysaerobic conditions in the sediment interstitial water. Omission surfaces and glauconitic grains, products of current‐induced scouring and condensation, suggest sporadic high‐energy events in the Austin Chalk Group ramp that drove elevated terrestrial inputs. Geochemical data further help to identify anoxic bottom water conditions within the anaerobic facies. Additionally, the lowermost part of the Austin Chalk Group illustrates redox cycles, whereas dilution events characterized by elevated terrestrial input are identified throughout the rest of the Austin Chalk Group. The evolution of oxygenation levels in sediment interstitial water and bottom water disputes the existence of a long‐lasting oxygen‐deficient sea in south Texas. The refined depositional model may be applicable to coeval shelfal settings. Moreover, the results provide insights into variable, evolving palaeoclimatic and palaeoceanographic conditions of the greenhouse Late Cretaceous.

Balancing career goals and parenthood desires: results from a survey of undergraduate pre-health students at a hispanic-serving institution in Texas

Objective To examine family planning and fertility experiences and views, as well as desired parenthood timing and career plans, of diverse undergraduate pre-health students. Participants 266 pre-health undergraduate students attending a Hispanic-Serving Institution in South Texas. Methods We conducted a cross-sectional, online survey with a purposive sample of undergraduate students and analyzed data descriptively. Results Most students desired children in the future but were concerned about planning the timing of parenthood against their career training. The results highlight the need to improve both family planning and fertility knowledge, based on a high unmet need for contraceptives, low perceived knowledge about fertility/infertility treatment, and a desire to learn more about planning the timing of their career training alongside parenthood. Conclusions This study highlights potential gaps in reproductive health information and services among diverse, health-focused students needed to inform choices about the timing of their families and career training.

Facies Variability in Paleogeographic Trends from Core Data in the Lower and Middle Frio Formation in South Texas

This core-based study of the Oligoene lower and middle Frio formation in South Texas documents facies variability, depositional systems, and sandstone-body architecture in the lower and middle Frio formation in South Texas. A previous study by the Bureau of Economic Geology (BEG) in 1982 characterized the Frio Formation in terms of depositional systems, structural framework, hydrocarbon origin, migration, and exploration potential. Paleogeographic trends in the 1982 study were delineated for the lower, middle, and upper Frio Formation, based mostly on wireline-log data. Core data in this study augment and refine facies interpretations and clarify depositional styles in four paleogeographic trends from the 1982 study in the lower and middle Frio Formation. These trends include (1) lower delta plain/margin, (2) aggradational fluvial, (3) aggradational (multistoried) barrier, and (4) floodplain. With minor exceptions, this study validates and refines interpretations of the regional distribution of lower and middle Frio paleogeography in South Texas in the 1982 study. Four (4) main results of this study include (1) documenting lithology and facies types in these paleogeographic trends, (2) demonstrating that these paleogeographic trends are a composite of multiple transgressive-regressive (T–R) cycles, (3) providing evidence that these fluvial systems are mixed-load, meander belt in origin rather than coarse-grained bedload in origin, based on vertical grain-size profiles and the presence of paleosols that indicate stable, well-developed floodplains, and (4) identifying anomalous occurrences of sandstone-rich fluvial-channel systems in areas previously mapped as sandstone-poor and interpreted to be primarily floodplain in origin. Finally, this study serves as an example of the value of core data in refining interpretations of paleogeography and depositional systems in stratigraphic units that are a composite of multiple T–R episodes.

Is central line type an independent risk factor of central line-associated bloodstream infection in a neonatal intensive care unit population? Experiences at a pediatric hospital in South Texas.

Central line-associated bloodstream infection (CLABSI) causes significant harm in neonatal intensive care unit (NICU) patients. However, data regarding risk factors and prevention strategies for CLABSI in NICU patients is limited. To examine risk factors for CLABSI in a NICU population, with particular interest in central line type and site placement. Retrospective case-control study. NICU (Level IV, 67 bed) at a pediatric hospital in South Texas. All central line insertions and subsequent CLABSI cases were extracted from the EHR for NICU admissions occurring from January 1, 2018, to November 3, 2022 (N = 1,356), along with potential CLABSI risk factors. Central line insertions resulting in CLABSI (N = 35) were compared to instances without CLABSI (N = 1,321) using bivariate and multivariate analysis, with propensity score matching. Multivariate risk factors include implantable device (odds ratio [OR] = 14.5, P < .001), neck site placement (OR = 7.2, P < .001), and device dwell time (OR = 5.6, P = .001), as well as years 2021 (OR = 5.1, P = .017) and 2022 (OR = 5.9, P = .011). This indicates the odds of contracting CLABSI are 14.5 times higher when an implantable central line is used compared to the reference category (PICC devices). When cases are paired with matched controls, likelihood of CLABSI is 7.1% higher in patients with an implantable device than in similar patients with other central lines (p = 0.034). Implantable central lines are an independent risk factor for CLABSI in NICU patients at this facility.

A Path Analysis to Understanding the Epidemiology of Murine Typhus in South Texas

A Path Analysis to Understanding the Epidemiology of Murine Typhus in South Texas

Physiological carry-over effects of variable precipitation are mediated by reproductive status in a long-lived ungulate.

In the age of global climate change, extreme climatic events are expected to increase in frequency and severity. Animals will be forced to cope with these novel stressors in their environment. Glucocorticoids (i.e. 'stress' hormones) facilitate an animal's ability to cope with their environment. To date, most studies involving glucocorticoids focus on the immediate physiological effects of an environmental stressor on an individual, few studies have investigated the long-term physiological impacts of such stressors. Here, we tested the hypothesis that previous exposure to an environmental stressor will impart lasting consequences to an individual's glucocorticoid levels. In semi-arid environments, variable rainfall drives forage availability for herbivores. Reduced seasonal precipitation can present an extreme environmental stressor potentially imparting long-term impacts on an individual's glucocorticoid levels. We examined the effects of rainfall and environmental characteristics (i.e. soil and vegetation attributes) during fawn-rearing (i.e. summer) on subsequent glucocorticoid levels of female white-tailed deer (Odocoileus virginianus) in autumn. We captured 124 adult (≥2.5-year-old) female deer via aerial net-gunning during autumn of 2015, 2016 and 2021 across four populations spanning a gradient of environmental characteristics and rainfall in the semi-arid environment of South Texas, USA. We found for every 1cm decrease in summer rainfall, faecal glucocorticoid levels in autumn increased 6.9%, but only in lactating females. Glucocorticoid levels in non-lactating, female deer were relatively insensitive to environmental conditions. Our study demonstrates the long-lasting effects of environmental stressors on an individual's glucocorticoid levels. A better understanding of the long-term effects stressors impart on an individual's glucocorticoid levels will help to evaluate the totality of the cost of a stressor to an individual's welfare and predict the consequences of future climate scenarios.

Stable Isotope Analysis of Antipatharian Diets from the Northwestern Gulf of Mexico

Antipatharians, or black corals, form a key component of the benthic fauna found throughout the Gulf of Mexico (GOM). In the northwestern GOM, they are a common member of the communities found on the natural relic coral—algal banks known as the South Texas Banks as well as on artificial reefs. They are known to provide important habitat for many ecologically and economically important species in the area but are relatively understudied. Here we present a study on their trophic ecology using stable isotope analysis of carbon and nitrogen from 2 species, Antipathes atlantica and Stichopathes luetkeni from a mesophotic artificial reef in close proximity to the South Texas Banks. We observed that a large proportion of the 2 coral’s diets was composed of detrital matter, likely driven by the continuous disturbance of the benthos by high velocity benthic currents common to the region that support a persistent nepheloid layer below 30 m. Both species also show a reliance on different members of the planktonic community, with A. atlantica consuming more micro and mesozooplankton compared to S. luetkeni. Comparative analysis between soft tissue and skeletal material also indicates that A. atlantica may change its diet on a seasonal basis, while S. luetkeni appears to rely on detrital matter consistently. This study represents the first assessment of the diets of these organisms and provides valuable insight on the trophic ecology of 2 common antipatharian corals in the GOM on natural and artificial reef ecosystems.

Student Perceptions of Community-Engaged Scholarship Courses: Developing a Sociolinguistic Corpus on the U.S.–Mexico Border

Community-based sociolinguistic corpora are collections of informal interviews with community members who comprise an important dataset in sociolinguistics. Although some scholars have involved students in developing sociolinguistic corpora, few studies have examined students’ perspectives on these projects. Furthermore, very few studies examine the perceptions of underrepresented college students who are themselves members of the surrounding community. The present study analyzes the perceptions of students involved in community-engaged scholarship (CES) courses at the University of Texas Rio Grande Valley on the U.S.–Mexico border. In these CES courses, predominantly Mexican American students contribute to the documentation of language in South Texas through the Corpus Bilingüe del Valle (Christoffersen &amp; Bessett, 2019). A qualitative analysis of 38 student responses reveals six significant themes: a greater knowledge of transcription, increased connection with one’s own community, enhanced understanding from experiential learning and research experience, development of professional skills, a heightened appreciation of local language varieties, and pride in participating in a large-scale research project. These responses demonstrate the benefits of CES and serve to encourage sociolinguists to incorporate community-based corpora development in linguistics and language classes. More broadly, the results highlight the importance and impact of CES experiences for underrepresented college students, especially those incorporating course-based undergraduate research experiences.

Degree-days and off-host longevity of cattle fever ticks, Boophilus spp. (Acari: Ixodidae) in south Texas pastures.

Cattle fever ticks, Boophilus microplus (Canestrini) and Boophilus annulatus (Say), are native to Eurasia and have invaded the New World as vectors of bovine Babesiosis. Due to severe losses in livestock production, an eradication program by the USDA was established. Premises infested with Boophilus ticks are subject to regulatory oversight that includes acaricide treatment and quarantine. The quarantine duration varies between summer through winter and is based on the available information on the persistence of the off-host stages in pastures far from south Texas. The objective of this study was to assess the specific effect of thermal stress measured in degree-days on the longevity of B. annulatus and B. microplus off-host stages in south Texas pastures. Our results demonstrate that the longest off-host persistence for B. annulatus was 142 days under canopied habitat in the winter and 130 days in the summer. On the other hand, B. microplus off-host persistence was 113 days under canopy and 103 days in exposed habitat, both in winter. The results indicate that temperature was a key variable that prolonged the survival of B. annulatus but not B. microplus. In areas such as south Texas at the northernmost extent of B. microplus range, where mild winters prevail, we found a maximum persistence of less than 4 months (113 days), very close to the previous published record of 116 days. A reduction in the Texas pasture quarantine period from 9 months to 6 months would be justified for this species.

Consent searches: Evaluating the usefulness of a common and highly discretionary police practice

AbstractWe analyze the consequences of using driver consent as a basis for initializing a traffic stop‐and‐search compared to those searches based on probable cause. We find that consent searches are less likely to result in contraband recovery than are probable cause searches. Moreover, police agencies with a relatively higher reliance on consent searches find similar amounts of contraband and make a similar number of arrests as agencies doing much less searching but with a greater reliance on probable cause. These patterns are amplified along racial lines, and there is no discernible relationship between the use of consent searches and crime. We also provide causal evidence that corroborate these observational findings by examining the consequences of a Texas Highway Patrol policy, which suddenly increased the consent search rate in two South Texas counties. We show the contraband recovery rate discontinuously decreases when the consent search rate discontinuously increases.

Analysis of Depths Derived by Airborne Lidar and Satellite Imaging to Support Bathymetric Mapping Efforts with Varying Environmental Conditions: Lower Laguna Madre, Gulf of Mexico

In 2017, Bureau of Economic Geology (BEG) researchers at the University of Texas at Austin (UT Austin) conducted an airborne lidar survey campaign, collecting topographic and bathymetric data over Lower Laguna Madre, which is a shallow hypersaline lagoon in south Texas. Researchers acquired 60 hours of lidar data, covering an area of 1600 km2 with varying environmental conditions influencing water quality and surface heights. In the southernmost parts of the lagoon, in-situ measurements were collected from a boat to quantify turbidity, water transparency, and depths. Data analysis included processing of Sentinel-2 L1C satellite imagery pixel reflectance to classify locations with intermittent turbidity. Lidar measurements were compared to sonar recordings, and results revealed height differences of 5–25 cm where the lagoon was shallower than 3.35 m. Further, researchers analyzed satellite bathymetry at relatively transparent lagoon locations, and the results produced height agreement within 13 cm. The study concluded that bathymetric efforts with airborne lidar and optical satellite imaging have practical limitations and comparable results in large and dynamic shallow coastal estuaries, where in-situ measurements and tide adjustments are essential for height comparisons.

Abundant triatomines in Texas dog kennel environments: Triatomine collections, infection with Trypanosoma cruzi, and blood feeding hosts

Triatomine insects are vectors of the protozoan parasite Trypanosoma cruzi- the causative agent of Chagas disease. Chagas disease is endemic to Latin America and the southern United States and can cause severe cardiac damage in infected mammals, ranging from chronic disease to sudden death. Identifying interactions among triatomines, T. cruzi discrete typing units (DTUs), and blood feeding hosts is necessary to understand parasite transmission dynamics and effectively protect animal and human health. Through manual insect trapping efforts, kennel staff collections, and with the help of a trained scent detection dog, we collected triatomines from 10 multi-dog kennels across central and south Texas over a one-year period (2018–2019) and tested a subset to determine their T. cruzi infection status and identify the primary bloodmeal hosts. We collected 550 triatomines, including Triatoma gerstaeckeri (n = 515), Triatoma lecticularia (n = 15), Triatoma sanguisuga (n = 6), and Triatoma indictiva (n = 2), with an additional 10 nymphs and 2 adults unable to be identified to species. The trained dog collected 42 triatomines, including nymphs, from areas not previously considered vector habitat by the kennel owners. Using qPCR, we found a T. cruzi infection prevalence of 47 % (74/157), with T. lecticularia individuals more likely to be infected with T. cruzi than other species. Infected insects harbored two T. cruzi discrete typing units: TcI (64 %), TcIV (23 %), and mixed TcI/TcIV infections (13 %). Bloodmeal host identification was successful in 50/149 triatomines, revealing the majority (74 %) fed on a dog (Canis lupus), with other host species including humans (Homo sapiens), raccoons (Procyon lotor), chickens (Gallus gallus), wild pig (Sus scrofa), black vulture (Coragyps atratus), cat (Felis catus), and curve-billed thrasher (Toxostoma curviostre). Given the frequency of interactions between dogs and infected triatomines in these kennel environments, dogs may be an apt target for future vector control and T. cruzi intervention efforts.

Abstract IA045: Hepatitis C virus (HCV) screening and treatment in South Texas US-Mexico border persistent poverty counties

Abstract Background: Hepatitis C Virus (HCV) is a major risk factor for Hepatocellular carcinoma (HCC), early screening of HCV is essential for the prevention of HCC. Other risk factors for cancer are those associated with poverty including low socioeconomic status and lack of access to health care. These risk factors are prominent among hispanic populations who have higher rates of liver cancer. In 2021, Hispanic liver cancer (incidence and mortality) was almost doubled as compared to non-Hispanic whtes. In Texas, the incidence of liver cancer is higher for Hispanics and particularly for those living in South Texas. Methods: We implemented an multi-component intervention (STOP-HCC-HCV) to increase access to HCV screening and treatment in two clinic systems predominantly serving low-income Hispanic ommunities in three South Texas persistent poverty counties. We used a Hybrid type 1 implementation effectiveness study design to evaluate the program's impact using both qualitative and quantitative data. Results: Using the RE-AIM framework, we increased HCV screening rates from 10% in 2021, to 78% in 2023 among adults 18-56 years of age. We successfully naviagted uninsured patients to treatment and cure and have 100% success rate for ordering Direct Acting Antivirals. Conclusion: Using a multi-component intervention, and decreasing barriers to healthcare increased HCV screening and treatment to ultimetly decrease cancer health disparities among vulnerable populations living in persistent poverty counties. Citation Format: Bertha E. Flores, Juan Guerrero, Raudel Bobadilla, Catherine K. Craven. Hepatitis C virus (HCV) screening and treatment in South Texas US-Mexico border persistent poverty counties [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 IA045.

Developing Money Concepts with a Special Needs Student

The student for the case study was a tenth-grade student at a public high school, grades 9-12, in South Texas. In preparation for creating a successful transition from high school to the workforce, the researcher in consultation with the parent, decided to work with the student on money concepts. The researcher has previously worked with the student since elementary school years (1st to 5th grade), through middle school (6th to 8th grades), onto the current high school years (9th to 12th grades) [1], [2], [3], [4], [5], [6].

Abstract B044: Avanzando Caminos (Leading Pathways): The Hispanic/Latino cancer survivorship cohort study

Abstract Background: Advances in prevention, early detection, and treatment have resulted in a 29% reduction in cancer mortality since 1990 and unprecedented increases in the number of cancer survivors. There are more than 16.9M survivors living in the US today and 22.1M are expected by 2030. Cancer survivorship outcomes vary by race/ethnicity, socioeconomic status (SES), and more. Cancer is the leading cause of deaths in Hispanics/Latinos (H/Ls), a critical issue given that H/Ls are the largest ethnic minority group in the US and will account for 30% of the US population by 2060. H/Ls are disproportionately impacted by cancer due to inequities in SES and healthcare access, which leads to differences in risk factors/exposures and barriers to high-quality cancer prevention, early detection, and treatment. Although H/Ls have lower incidence rates for most common cancer types, significant disparities exist in prevalence, invasiveness, and mortality in specific cancers and across multiple patient-reported outcomes, such as quality of life and symptom burden. However, there is limited work documenting survivorship experiences among H/Ls. Purpose: The Avanzando Caminos multisite cohort study was established to address critical gaps in the science of H/L survivorship. It aims to examine the influence of sociocultural, medical, stress, psychosocial, lifestyle, behavioral, and biological factors on symptom burden, health-related quality of life, and clinical outcomes among H/Ls who have been previously treated for cancer. Methods: Avanzando Caminos, a collaboration between the Sylvester Comprehensive Cancer Center at the University of Miami and the Mays Cancer Center at UT Health San Antonio, is a 6-year prospective, cohort-based study of 3,000 H/Ls (1,500 in South Florida and 1,500 in South Texas) who completed primary cancer treatment within the past five years for stomach, liver, cervical, colorectal, lung, breast, kidney, or prostate cancers. Participants will complete self-report measures at baseline, 6 months, 1 year, 2 years, 3 years, 4 years, and 5 years. Blood draws to assess leukocyte gene expression, cardiometabolic markers, and genetic admixture will be collected at baseline, 1 year, 3 years, and 5 years. Medical and cancer characteristics and clinical outcomes will be extracted from the electronic medical record and/or state cancer registry at each time point. Data analysis will include general latent variable modeling with maximum likelihood robust variance estimation. Results: So far, we have recruited 398 H/L participants with a mean age of 59.49 years, 62% are female, 35% are Mexican, 57% Cuban, 24% Central/South American, 78% Puerto Rican, and 7% other. Preliminary results will include sociocultural, quality of life, stress, and other factors impacting H/Ls survivors. Conclusions: Avanzando Caminos is expected to fill critical gaps in knowledge to guide future secondary and tertiary prevention efforts to mitigate cancer disparities and optimize health-related quality of life among Hispanic/Latino cancer survivors. Citation Format: Amelie G. Ramirez, Patricia Chalela, Stephanie Rowan, Ysabel R. Lew, Victoria C. Garza, Natalie Rodriguez, Myriam N. Gonzalez, Britney E. Ortiz, Dorothy Long Parma, Edgar Muñoz, Yidong Chen, Chen-Pin Wang, Adolfo E. Diaz Duque, Luz M. Garcini, Dolores M. Perdomo, Stefanie V. Beltran, Gabrielle Montes de Oca, Maria Baraya, Akina Natori, Madeline H. Krause, Paulo S. Pinheiro, Patricia I. Moreno, Michael H. Antoni, Carmen Calfa, Olveen Carrasquillo, Gilberto Lopes, Steve Cole, Frank J. Penedo. Avanzando Caminos (Leading Pathways): The Hispanic/Latino cancer survivorship cohort 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 B044.

An innovative model using Promotores or Community Health Workers for home based dementia care

AbstractBackgroundHealth disparities and issues with trust building and relationship building are prominent in Hispanic and underserved populations in south Texas. Community health workers can play a bridging role with underserved communities and may be essential in improving the quality and value of health care. The Texas Health and Human Services Commission certifies the training Community Health Workers under the label of “promotores”.MethodCommunity health workers were integrated into the primary health care team to serve as a bridge between patient/caregiver dyads and the health care team.ResultCommunity health workers (CHWs) connected patients to social determinants of health resources such as transportation, food pantries and/or social benefits, Medicaid services, and home care provider services. Caregiver education and resources for respite care, caregiver support in person and virtually. Additionally, CHW’s provided education on dementia care resources, caregiver support, recruiting and engaging Hispanic underserve participants in research. Our team was able to increase home visits by 229% to homebound patients throughout several underserved zip codes in Bexar County. This is a success as our team was able to increase health care access to persons with dementia that are homebound that may have not been seen by a healthcare provider until they required emergency care. In fact, we saw roughly 11% decrease of inpatient admissions between 2021 and 2022.ConclusionTrust and familiarity allows the promotores to easily communicate interventions with cultural sensitivity and experiential knowledge of community values, leading to foster rapport with patients and families. The rapport and trust developed with the patients also helped to engage, and recruit Hispanic and underserved participants for research in dementia.