Trends Survey Research Articles

A tale of two patients – How did the pandemic impact patients’ usage of health portals

Objective: The study examines whether patient health portal usage significantly increased during the COVID-19 pandemic between 2019 and 2022.Methods: In order to measure patient usage of patient portals before and during the first year of the COVID-19 pandemic, this study used the Health Information National Trends Survey results for 2019, 2020, 2021, and 2022. It was compared, using a least square regression model, to see if there was a significant relationship between increased use of telehealth, the usage of health portals, and the number of times seen by a regular healthcare provider.Results: The number of patients who saw their health care provider thrice a year and used their patient portal pre- and postpandemic increased. However, the overall increase in patients using their portals before and during the first two years of the pandemic remains below 50%.Conclusions: Overall, the pandemic increased patients’ use of telemedicine but only significantly increased their usage of patient portals for those patients who saw their provider three or more times a year. These findings indicate that more interaction with providers might impact future portal usage.

Individuals' top values and health behavior engagement: results of a National US Survey.

Although linked with subjective wellbeing, little research has examined relations of values with health behaviors and health. Because values are principles that guide behavior across situations, this exploratory retrospective study examined how individuals' highest value relates to their health behaviors and health. Participants were 3865 (aged 18-89 years) adults who completed the Health Information National Trends Survey (HINTS), a nationally-representative survey administered by the US National Cancer Institute. HINTS 5 Cycle 4 data were collected early in 2020. Participants selected the value most important to them in their day-to-day life from a set of seven values. Five categories of health-related measures were assessed in relation to values: substance use, physical activity, cancer screening, general health, and coping. Top values were safety of family (29.9%), happiness (20.9%), and autonomy (14.1%). Findings indicated that some top values, such as health and religion, were associated favorably with some health behaviors, while other top values, such as happiness or autonomy, were in some instances associated with poorer health behaviors. These results, while exploratory, suggest that individuals' highest value may be meaningfully related to their health behaviors and self-reported health status. Future research into values and health appears warranted.

Young Black Women's Breast Cancer Knowledge and Beliefs: A Sequential Explanatory Mixed MethodsStudy.

Black women under the age of 50 have a 111% higher breast cancer mortality rate than their White counterparts. The breast cancer mortality disparities among young Black women may be due in part to the fact that they are more likely to be diagnosed with late-stage, invasive breast cancer tumors. Psychosocial factors, such as lack of perceived risk for breast cancer, lack of awareness of breast cancer risk factors, and ambiguity about breast cancer screening guidelines are areas that are under investigated among young Black women. The purpose of this study was to identify young Black women's cancer beliefs and level of breast cancer risk knowledge. A sequential explanatory mixed methods study was conducted using quantitative data from the Health Information Trends Survey 6 (HINTS 6) (n = 25) and qualitative data from interviews with young Black female college students (n = 13). The results of the quantitative data analysis were used to guide the development of the qualitative interview guide. Data regarding participants' cancer beliefs, cancer risk factor knowledge, perceived cancer risk, and ambiguity about cancer screening behaviors were analyzed. The findings indicated young Black women have low perceived risk of developing cancer. Most participants were not aware of cancer recommendations that were targeted towards women under the age of 40. In addition, knowledge about lifestyle behavior risk factors for breast cancer was relatively low. Our findings underscore the importance of developing, disseminating, and implementing breast cancer education interventions that are targeted towards young Black women.

The Intersection of Sexual Orientation, Substance Use, and Mental Health: Findings from Hints 5.

The data for this study were obtained from the Health Information National Trends Survey (HINTS 5, Cycle 4). Sample participants included 3583 adults (93.87% heterosexuals). We used multinomial regression to measure the relative risk ratios (RRRs) of being a former and current user versus never a user of tobacco and e-cigarettes and binomial regression to measure the odds ratios of depression between the LGBTQ and heterosexuals. Current smoking prevalence is higher among LGBTQ participants (17.3%) compared to heterosexuals (11.0%). The disparity is even greater for e-cigarette use, with 7.3% of LGBTQ participants being current users versus 2.8% of heterosexuals and 24.5% of LGBTQ participants being former users compared to 9.3% of heterosexuals. Compared to heterosexuals, the relative risk ratio of being a current tobacco user among the LGBTQ participants was about 1.75 times higher [RRR = 1.75, 95%CI = 1.16, 2.64], and that of e-cigarette use was about 2.8 times higher [RRR = 2.81, 95%CI = 1.57, 5.05]. Among current e-cigarette users, heterosexual participants had 1.9 percentage points [risk difference = 1.94, 95%CI = 1.20, 3.13] higher probability of depression, whereas among the LGBTQ participants, the risk was about 3.7 times higher [OR = 3.67, 95%CI = 1.06, 12.74]. Our findings conclude that the LGBTQ are more likely to use tobacco and e-cigarettes compared to heterosexuals and that the risk of depression from e-cigarette smoking is more pronounced among the LGBTQ participants.

An Updated Survey of Trends in the Surgical Management of Thumb Carpometacarpal Arthritis - The Increasing Popularity of the Suture Suspension Arthroplasty.

Background: The purpose of this study was to conduct an updated survey of American Society for Surgery of the Hand (ASSH) membership to evaluate current preferences for surgical management of thumb CMC arthritis. Past surveys have demonstrated LRTI to be the most preferred surgical technique. We hypothesised that current surgical preferences for thumb CMC arthritis have changed over the last several years due to rising popularity of high-strength suture implants. Methods: A 22-question survey inquired about the preferences for the surgical management of basal joint arthritis and was sent to the ASSH membership. Descriptive statistics were calculated on all survey questions. Chi-squared analysis was used to compare differences in thumb CMC arthroplasty preferences across respondents. Results: A total of 1,499 responses were available for analysis, yielding a response rate of 29.9%. For surgical management of basal joint arthritis in the primary setting, the largest percentage of respondents preferred open trapeziectomy with suture suspension arthroplasty (39.2%); amongst them, over half (56%) used a high-strength suture implant. This was followed by open trapeziectomy with LRTI (38.3%). In the revision setting, most respondents preferred open trapeziectomy with suture suspension arthroplasty (53.5%), followed by LRTI (24.6%). In determining the choice of procedure, respondents felt some form of metacarpal suspension and implant cost to be more important factors than ligament reconstruction and interposition. A higher proportion of international members (16.2%) utilised implant arthroplasty than US/Canadian members (1.1%; p<0.01). Conclusions: Past surveys have demonstrated LRTI to be the most preferred surgical technique. The current survey demonstrates open trapeziectomy and suture suspension arthroplasty, especially using high-strength suture implants, gaining popularity amongst surgeons, while open trapeziectomy and LRTI decreasing in preference. Suture suspension arthroplasty is now the preferred surgical technique in both the primary and revision setting. Level of Evidence: Level IV (Therapeutic).

Clinical trial knowledge among cancer survivors in the United States: the role of health information technology.

Clinical trials are essential to the advancement of cancer care. However, clinical trial knowledge and participation remain critically low among adult patients with cancer. Health information technology (HIT) could play an important role in improving clinical trial knowledge and engagement among cancer survivors. We used data from 3,794 adults who completed the 2020 Health Information National Trends Survey, 626 (16.2%) of whom were cancer survivors. We examined the prevalence of HIT use in the study population and by cancer history using chi-squared tests. We used multivariable logistic regression models to examine the impact of HIT use on clinical trial knowledge for cancer survivors and respondents with no cancer history, respectively. Approximately 63.8% of cancer survivors reported having some knowledge of clinical trials. Almost half of the cancer survivors used HIT to communicate with doctors (47.1%) and make health appointments (49.4%), 68.0% used HIT to look up health information online and 42.2% used it to check test results. In the adjusted models, the use of HIT in communicating with doctors [OR 2.79; 95% CI (1.41, 5.54)], looking up health information online [OR 2.84; 95% CI (1.04, 7.77)], and checking test results [OR 2.47; 95% CI (1.12, 5.43)] was associated with having some knowledge of clinical trials. HIT use for engaging with the healthcare team and health information gathering is associated with higher clinical trial knowledge in cancer survivors. Given the rapid increase in mobile technology access globally and the increased use of HIT, digital technology can be leveraged to improve clinical trial knowledge and engagement among cancer survivors.

How Online Patient-Provider Communication Alleviates Psychological Distress Among Patients with Chronic Diseases: The Role of Perceived Patient-Centered Communication and Adaptive Coping Strategies

ABSTRACT Chronic diseases, which require long-term continuous care due to the long clinical courses, may cause severe harm to the psychological well-being of a large population in the U.S. Providing convenient and affordable access to healthcare, online patient-provider communication (OPPC) is considered a potentially effective means in safeguarding psychological well-being among patients with chronic diseases. However, what underlying mechanism OPPC helps patients deal with psychological issues is largely unknown in the context of chronic diseases. Thus, drawing on the health communication pathway model, this study seeks to address the gap by investigating the psychological and behavioral mechanism of how OPPC alleviates psychological distress among patients with chronic diseases. Analyzing secondary data derived from the Health Information National Trends Survey (HINTS 5, Cycle 3, N = 879), this study reveals that OPPC can elicit perceptions of patient-centered communication (PCC) and facilitate patients to take adaptive coping strategies, including problem-oriented and emotion-oriented coping, thus alleviating psychological distress among patients with chronic diseases. However, only emotion-oriented coping in this process significantly reduces psychological distress. On this basis, this study advances the understanding of the therapeutic effect of OPPC among patients with chronic diseases and extends the health communication pathway model by examining the role of patient-provider communication in facilitating adaptive coping strategies.

Patterns of dietary quality, physical activity, and sleep duration among cancer survivors and caregivers.

Fruit and vegetable intake (FVI), moderate-to-vigorous physical activity (MVPA), and sleep duration are each independently associated with cancer-related and general health outcomes among cancer survivors. Past research suggests that health behaviors cluster among cancer survivors, with caregivers demonstrating similar patterns. This analysis examined co-occurrence of FVI, MVPA, and sleep duration among cancer survivors and informal cancer caregivers and identified sociodemographic and clinical correlates of health behavior engagement. Using data from the Health Information National Trends Survey (HINTS), an exploratory latent profile analysis (LPA) was conducted among those self-reporting a history of cancer or identifying as a cancer caregiver. The LPA model was fit with daily self-reported FVI (cups/d), MPVA (minutes/d) and sleep duration (hours/d). Multinomial logistic regression models were used to predict profile membership based on sociodemographic and clinical characteristics. Four health behavior profiles were identified (Least Engaged-No MVPA, Least Engaged-Low MVPA, Moderately Engaged, and Highly Engaged). The largest profile membership was Least Engaged-No MVPA, capturing 37% of the sample. Profiles were most distinguished by MVPA, with the lowest variance in sleep duration. Participants reporting higher FVI also often reported greater MVPA and longer sleep duration. Profile membership was significantly associated with age, relationship status, education, income, rurality, alcohol use, self-efficacy, psychological distress, BMI, and cancer type. This study identified four health behaviors patterns and sociodemographic correlates that distinguished those patterns among cancer survivors and caregivers drawn from a nationally representative sample. Results may help identify for whom health behavior interventions could be of greatest benefit.

Telehealth service use and quality of care among US adults with diabetes: A cross-sectional study of the 2022 health information national trends survey.

To characterise telehealth use, reasons for using or not using telehealth and the factors associated with telehealth use among US adults with diabetes. A cross-sectional study. Data were sourced from the 2022 Health Information National Trends Survey. US adults aged 18 years or older with self-reported diagnosis of diabetes (both type 1 and type 2). Past 12-month utilisation of telehealth services, modality (eg, video, voice only), overall perception of quality of care, perceived trust in healthcare system and patient-centred communication score. In an analysis of 1116 US adults with diabetes, representing 33.6 million individuals, 48.1% reported telehealth use in the past year. Telehealth users were likely to be younger, women, with higher income, and urban dwellers. Older adults (≥65 years) were less likely to use telehealth compared with those aged 18-49 years (OR 0.43, 95% CI 0.20 to 0.90). Higher income and more frequent healthcare visits were predictors of telehealth usage, with no significant differences across race, education or location. Across respondents with telehealth usage, 39.3% reported having video-only, 35.0% having phone (voice)-only and 25.7% having both modalities. The main motivations included provider recommendation, convenience, COVID-19 avoidance and guidance on in-person care needs. Non-users cited preferences for in-person visits, privacy concerns and technology challenges. Patient-reported quality-of-care outcomes were comparable between telehealth users and non-users, with no significant differences observed by telehealth modality or area of residence (metro status). Around half of US adults with diabetes used telehealth services in the past year. Patient-reported care quality was similar for telehealth and in-person visits. However, further efforts are needed to address key barriers to telehealth adoption, including privacy concern, technology difficulties, and care coordination issues.

Online patient-provider communication and healthy ageing: the roles of health literacy and health self-efficacy.

eHealth involves using digital technologies, like electronic health records and telemedicine, to enhance healthcare delivery and outcomes. For older adults, eHealth helps manage chronic conditions, access services remotely, and engage in preventive health, improving physical and psychological well-being. This study investigates the association between online patient-provider communication (OPPC) and older adults' quality of life (QoL, i.e. sleep quality, exercise and psychological health). The study also explores how health literacy and health self-efficacy mediate the relationship between OPPC and QoL. This study utilized data from the National Cancer Institute's Health Information National Trends Survey, collected in 2019 (HINTS 5 Cycle 3), specifically targeting individuals aged ≥ 60 (N = 2587). The associations among variables were analysed using structural equation modelling. OPPC was positively and significantly associated with health literacy (β = 0.53, p < 0.001). Health literacy was positively and significantly related to health self-efficacy (β = 0.02, p < 0.001). Health self-efficacy was significantly related to five dimensions of QoL: sleep quality (β = 0.20, p < 0.001), fruit and vegetable consumption (β = 0.13, p < 0.010), exercise (β = 0.59, p < 0.001), sedentariness (β = -0.58, p < 0.001) and psychological health (β = 0.24, p < 0.001). Besides, health literacy and health self-efficacy also mediated the influence of OPPC on QoL sequentially, being identificators as two serial mediators between OPPC and older adults' QoL. This study suggests that OPPC plays an important role in older adults' QoL.

Telehealth utilization and adherence to cervical cancer screening among women in the United States.

383 Background: Cervical cancer (CC) screening has dramatically reduced incidence and mortality from cervical cancer over the last 5 decades. However, the prevalence of overdue screenings is increasing in the United States (US). Telehealth helps facilitate access to health care and services, but its impact on CC screening adherence is unknown. Methods: Data for this cross-sectional study were obtained from the 2022 Health Information and National Trends Survey, including female respondents aged 21-65 years. Women with a history of CC and missing data were excluded. Telehealth utilization (yes/no) was defined as having received care from a doctor or health professional using telehealth (i.e., phone and/or video) in the past 12 months. The outcome was adherence to CC screening (yes/no), measured as having a Pap test within the last 3 years. Weighted percentages and 95% CIs were compared using Chi-squared tests. Multivariable logistic regression models were fit to assess the association between telehealth utilization and adherence to CC screening, overall and by race/ethnicity. All analyses accounted for survey weights. Results: The study sample included 2,029 unweighted respondents, representing a weighted sample of 81,500,000 US women eligible for CC screening. Overall, 46.2% had a telehealth visit in the past 12 months. The mean age was 44 years; 57% were Non-Hispanic White, 19% were Hispanic, 13% were Non-Hispanic Black, and 11% were Asian or Pacific Islander. Telehealth users were more likely to be college graduates (43% vs. 35%, p=.047), insured (93% vs. 87%, p&lt;.001), and to have had at least one comorbidity condition (69% vs. 48%, p&lt;.001). After controlling for covariates, telehealth users had higher odds of adherence to CC screening than non-users (adjusted odds ratio [aOR] 1.63, 95% CI: 1.14-2.33). When stratified by race/ethnicity, among Hispanic women, those who utilized telehealth had greater odds of CC screening adherence compared to those who did not (aOR 2.83, 95% CI: 1.27-6.28). There were no significant associations between telehealth use and adherence to CC screening among other racial groups. Conclusions: Telehealth use was prevalent among US women and was associated with an increased likelihood of CC screening adherence, particularly among Hispanic women. These findings suggest that telehealth could be a significant tool in improving dwindling CC screening rates. Future research is also needed to explore the barriers to telehealth access to optimize its benefits among women eligible for CC screening.

Exploring the use of health information technology in the awareness of genetic testing among individuals with a family history of cancer.

416 Background: Genetic testing plays a critical role in identifying individuals at high risk for certain cancers. Despite its significance, recent studies have demonstrated a lack of genetic testing awareness in the general population. This study aimed to illuminate potential avenues for improving the understanding of cancer genetic testing,specifically the association between health information technology (HIT) use and genetic testing awareness. Methods: In this cross-sectional study, we analyzeddata from the 2020 Health Information National Trends Survey (HINTS). Respondents ≥18 years with a family history of cancer were eligible. We excluded respondents without an electronic device or with a prior cancer diagnosis. HIT use (yes vs. no) was defined as having used electronic devices to look up health information, fill prescriptions, schedule medical appointments, or communicate with a health provider. The outcome measure was awareness of cancer genetic testing (yes vs. no). Descriptive statistics was used to compare baseline characteristics by HIT use. Multivariable logistic regression models were fit to calculate adjusted odds ratios (AOR) with 95% CIs. Results: Among a total of 2,075 respondents, 1,772 (85.4%) used one form of HIT and only 830 (40.0%) were aware of cancer genetic testing. The median age of the study population was 47 years. Patients who used HIT were younger, female, insured, married, had a relatively higher level of education and better access to a primary care provider. On multivariable analysis, overall HIT use was associated with increased awareness of cancer genetic testing, though not statistically significant (AOR 1.76; 95% CI: 0.82, 3.75). Stratifying by subgroups, having used HIT to communicate with doctors (AOR 0.83; 95% CI: 0.66, 1.05), check test results (AOR 0.91; 95% CI: 0.77, 1.08), look up health information online (AOR 0.78; 95% CI: 0.51, 1.22), or make health appointments (AOR 0.90; 95% CI: 0.77, 1.05) was not significantly associated with increased awareness of cancer genetic testing. Conclusions: Our study demonstrates a high prevalence of HIT use, with no statistically significant associations with awareness of genetic testing among individuals with a family history of cancer. Findings prompt a reevaluation of other targeted health educational strategies to close the knowledge gap of cancer genetic testing for this high-risk population.

Associations Between Social Media Use, Social Isolation, and Nutrition-related Chronic Disease: An Exploratory Cross-sectional Analysis of Health Information National Trends Survey (HINTS) Data

Associations Between Social Media Use, Social Isolation, and Nutrition-related Chronic Disease: An Exploratory Cross-sectional Analysis of Health Information National Trends Survey (HINTS) Data

Changes in adherence to cervical cancer screening guidelines before and after the COVID-19 pandemic in the United States.

73 Background: The COVID-19 pandemic disrupted several aspects of routine healthcare delivery, many of which have yet to return to pre-pandemic levels of operation. In this study, we compared the adherence rates to cervical cancer screening guidelines in a nationally representative sample of American adults before and following the COVID-19 pandemic. Methods: We included female adults aged 21-65 who participated in the Health Information National Trends Survey (HINTS) 2019 and 2022. Adherence to cervical cancer screening was assessed based on the timing of their last Pap smear test. Participants were classified as non-adherent to cervical cancer guidelines if their last Pap smear test was more than three years ago. Survey-weighted Poisson regression models [adjusted for age, race, and education] were used to explore adherence ratios before and following the COVID-19 pandemic. Results: In 2019, among 1,944 female adults, representing a population of 93,477,003 adults, the mean age (standard deviation [SD]) was 44.5(12.6) years, 61.1% were non-Hispanic White, and 35.2% had a college education or higher. The prevalence of non-adherence to cervical cancer screening was 19.2% [95% CI: 16.3, 22.5]. In adjusted models, being non-Hispanic Black was associated with a lower risk of non-adherence (0.49 [95% CI: 0.30, 0.77] vs. non-Hispanic White), having lower education (less than high school vs. college graduate or higher) was associated with 2.28 [95% CI: 1.21, 4.31] higher likelihood of non-adherence to cervical cancer screening guidelines, while age was not (p&gt;0.05). In 2022, the prevalence of non-adherence to cervical cancer screening was 25.8% [95% CI: 22.9, 29.1]. In adjusted models, having lower education was associated with 1.90 [95% CI: 1.22, 2.97] higher likelihood of non-adherence to cervical cancer screening guidelines, while age and race were not (p&gt;0.05). Compared to 2019, non-adherence rates increased by 6.6% in 2022. When stratified by race, non-Hispanic White adults showed an increase of 5.6% [95% CI: 5.4, 5.6] in non-adherence rates, while non-Hispanic Black adults showed an increase of 13.9% [95% CI: 12.0, 15.2]. Conclusions: There was a decline in adherence to cervical cancer screening guidelines among adult females in the US by about 7% following the COVID-19 pandemic. Additionally, non-Hispanic Black adults and those with lower education showed a disproportionately greater increase in non-adherence rates. These findings are relevant in advancing cervical cancer surveillance in the United States. Further studies are needed to elucidate barriers associated with greater non-adherence rates in minority groups following the pandemic and identify methods to provide more equitable access to healthcare services.

Digital Twins in Manufacturing: A Survey of Current Practices and Future Trends

Digital Twin (DT) is the advanced tool of smart manufacturing which provides a proper way to model, analyse, and control the physical systems. A DT is the lifelike rendition of a physical object or phenomenon that uses real-time actual phenomena data to depict its actions, efficiency, and responses within the surrounding context. This technology allows electronic manufacturers to obtain a real-time stream of their systems, in which predictive maintenance, increased operation effectiveness, and improved product quality can be attained. By developing an ever-evolving replica of the physical structures, systems or even operation lines, Digital Twins enable the functionality of exploring various demanding circumstances and schemata, all in order to make effective decisions. When the manufacturing environments are rapidly changing, and there are more interconnections between them, the use of Digital Twins is especially useful. They continue improvement by highlighting problems, forecasting failure, and making choices based on data. The purpose of this article is to examine smart manufacturing via the lens of IoT DT technology. It gives general information about its uses, such as in the processes, time-saving and safety measures. As well, the paper considers the difficulties related to the practical application of DT, including costs, data management, and requirements for the formation of standards. Thus, based on analysing future developments and the role of Digital Twins as an innovation enabler in different industries, this study can benefit scholars, practitioners, and politicians who look forward to unlocking the potential of this innovative solution.

Perceptions and Interest in Lung Cancer Screening by Smoking Status: A Cross-Sectional Study of HINTS 6 (2022).

Lung cancer screening guidelines prioritize individuals with a history of smoking due to their higher risk of the disease. Our study examines the awareness and interest in low-dose computed tomography (LDCT) lung cancer screening among different smoking statuses using data from the National Cancer Institute's Health Information National Trends Survey (HINTS) 6 (2022). We analyzed data from HINTS 6, including 3915 participants on smoking status, LDCT screening, and telehealth use. Participants were categorized as current smokers, former smokers, and non-smokers. Current smokers had the highest likelihood of being recommended for LDCT screening (OR: 7.1, aOR: 10.4) compared with non-smokers. Former smokers also had increased odds of screening recommendations (OR: 3.1, aOR: 3.4) than non-smokers. Despite higher screening recommendations, current smokers exhibited significantly lower interest in cancer screening (interest rating score: 2.1) compared with non-smokers (interest rating score: 2.4) and former smokers (interest rating score: 2.5). Current smokers rated their telehealth care experiences more positively in terms of care quality compared with non-smokers. Our findings underscore a gap in cancer screening interest among current smokers despite their higher likelihood of being recommended for LDCT screening. The favorable perception of telehealth among current smokers provides an opportunity to enhance engagement and promote LDCT scan through telehealth care.

Examining Differences in Health-Related Technology Use between Millennial and Older Generations of Caregivers.

Caregivers from the Millennial generation are an emerging and understudied group of unpaid care providers in America who may benefit from digitally delivered support. To inform the design/tailoring of interventions for this group, we aimed to understand how Millennials may differ from other generations of caregivers regarding digital health-related technology use. Using the Health Information National Trends Survey (HINTS), Version 6, we conducted a cross-sectional study comparing health technology access and use across four generations of unpaid caregivers (n = 545; Millennials, Gen X, Baby Boomers, and Silent Generation) of adults with chronic conditions using chi-square and Kruskal-Wallis non-parametric tests. Compared to Baby Boomer and Silent Generation caregivers, Millennial caregivers more frequently reported having a cellular internet connection, using a wearable activity device, a health/wellness mobile application, choosing telehealth appointments for convenience, and most frequently used social media in general and to view health-related videos (ps < 0.005). Additionally, Millennials were more likely to report possessing a smartphone (compared to Gen X and Silent Generation) and more frequently used social media for peer interaction about health (compared to all older generations; ps < 0.005). Millennials differ from older generations of caregivers regarding health-related technology access and use, which may have implications for intervention design and tailoring.

Abstract A016: Understanding the Impact of Numerous Cancer Prevention Guidelines on Public Adherence

Abstract Background: Organizations like the American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF) have developed comprehensive cancer prevention guidelines focusing on nutrition, physical activity, cancer screening, and vaccination with a goal of reducing cancer incidence and improving cancer health outcomes. However, the abundance and complexity of these guidelines can lead to public confusion and potentially hinder adherence. This study investigates public perception of the multitude of cancer prevention guidelines and their potential impact on compliance. Methods: Data were derived from the 2020 Health Information National Trends Survey (HINTS 5, Cycle 4, 2020), conducted via a mail survey from February to June 2020. We examined public perception about cancer prevention recommendations and if the number of recommendations made it more difficult to determine which ones to follow. Multivariable Logistic regression was used to examine the factors that are associated with agreement with the statement: “there are so many different recommendations about preventing cancer, it's hard to know which ones to follow.” Results: Survey respondents consisted of 3,747 U.S. adults. Approximately 74.1% of respondents agreed with the statement, "There are so many different recommendations about preventing cancer, it's hard to know which ones to follow." Non-Hispanic Black respondents had the highest proportion of agreement (80.6%) Level of education was statistically significantly associated with agreement with the statement "there are so many different recommendations about preventing cancer, it's hard to know which ones to follow." As education level increased, the odds of agreeing with the statement decreased. Specifically, college graduates (aOR 0.58; 95% CI: 0.36-0.94), and those with postgraduate education had an aOR of 0.38 (95% CI: 0.22-0.67). Conclusion: The study highlights significant public perception challenges regarding the abundance of cancer prevention guidelines. These findings suggest a need for streamlined communication and education strategies to enhance guideline adherence and optimize cancer prevention efforts. Citation Format: Tochukwu Nzeako, Onyema Chido-Amajuoyi. Understanding the Impact of Numerous Cancer Prevention Guidelines on Public Adherence [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A016.

Abstract A123: Awareness of human papillomavirus (HPV) and its vaccine and telehealth: Results from the Health Information National Trends Survey (HINTS) 6, 2022 in the United States

Abstract Background: Human Papillomavirus (HPV) vaccination is essential to prevent occurrences of a variety of HPV associated cancers. The awareness of HPV and its vaccine could be associated with the use of telehealth. The aims of this study were to examine the association between awareness of HPV and HPV vaccine with receiving telehealth for health care within the past year. Methods: Data from the Health Information National Trends Survey (HINTS) 6 (N=5,887) were utilized. Dependent variable was awareness of HPV and HPV vaccine. The independent variable was those who received care from a doctor or health professional using telehealth. Weighted multivariable logistic regression was performed to determine association of awareness of HPV and its vaccine with receiving healthcare using telehealth while adjusting for age, gender, race, education, and census region. Results: The study sample consisted of 68.28% awareness of HPV and 63.47% awareness of HPV vaccine. After controlling for covariates, we found those who were aware of HPV and HPV vaccine have received telehealth care (aOR=1.40, 95%CI:1.11-1.78; aOR= 1.40, 95%CI:1.09 -1.80), respectively. In the adjusted model, the awareness of HPV for being female (aOR=2, 95%CI:1.60-2.48) and college graduates (aOR=3.80, 95%CI: 2.59-6.56). In the adjusted model, the awareness of HPV vaccine for being female (aOR= 2.68, 95%CI:2.13-3.36) and college graduates (aOR=4.68,95%CI:2.77-7.91). HPV and HPV vaccine awareness, Non Hispanic Whites had significantly higher adjusted odds compared to other race/ethnicity groups. Conclusion: Hence public health programs could be directed to promote use of telehealth to increase awareness of HPV causing cancers, reduce stigma associated with vaccination, boost healthcare recommendation and uptake of HPV vaccination considering socio demographic factors. Citation Format: Manali Desai, Iman Igab, Ogochukwu Ezeigwe, Devesh Malgave. Awareness of human papillomavirus (HPV) and its vaccine and telehealth: Results from the Health Information National Trends Survey (HINTS) 6, 2022 in the United States [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A123.

The Role of Social Determinants of Health in Self-Reported Psychological Distress among United States Adults Post-COVID-19 Pandemic.

Psychological distress, an emotional condition with symptoms of anxiety and depression, leads to impaired function, behavior, and personal traits. The current study examined the association between social determinants of health and the severity of psychological distress among adults in the United States after the COVID-19 pandemic. Using multinomial multivariable logistic regression, we analyzed data from 5106 (n = 5106) participants in the Health Information National Trends Survey (HINTS) 6. Compared to non-Hispanic Whites, African Americans (AOR = 0.62, CI = 0.42-0.93) had lower odds of reporting mild psychological distress rather than no stress. Other variables associated with a higher likelihood of reporting moderate to severe psychological distress, rather than no distress, are being in the 50-64 years age group (AOR = 2.77, CI = 1.45-5.28), divorced (AOR = 2.50, CI = 1.70-3.69), and widowed (AOR = 3.78, CI = 2.15-6.64). Respondents living in an urban area had lower odds of reporting moderate to severe psychological distress (AOR = 0.56, CI = 0.39-0.80) compared to those living in rural areas. Our findings identify several risk factors for psychological distress by sociodemographic characteristics such as age, race, marital status, and urban living, providing empirical evidence for interventions in behavioral health. These findings suggest there is an utmost need for a multi-sectoral approach to address the social determinants of health associated with psychological distress post-COVID-19 pandemic.