Underrepresented Minority Research Articles

Bridging gaps with navigator support and its influence on breast cancer clinical trial matching and accessibility.

e13509 Background: Breast cancer patients face challenges navigating clinical trials. Online trial matching platforms like BreastCancerTrials.org (BCT) and MetastaticTrialSearch (MTS) are important resources to assist patients in identifying suitable clinical trials. However, data collected from users shows a concerning underrepresentation of ethnic minorities using this technology. Acknowledging the need to address this inequality through personalized support, we have incorporated a Clinical Trial Navigator. The navigator has engaged in partnerships with diverse community organizations and is committed to offering continuous support to patients throughout their experience. Methods: We analyzed data from our online trial matching sites spanning the period 2009–2023 (BCT) and data from our new platform MTS covering the years 2018-2023. Users visiting these sites provided details about their breast cancer type and medical history to identify appropriate clinical trials. Demographic information including race, gender, and education level was collected. The utilization and effectiveness of these features in facilitating patient access to relevant clinical trials were evaluated. Results: Analysis of the data reveals information about the characteristics of patients actively using the BreastCancerTrials.org matching service. Although BCT and MTS strives to reach a diverse patient population, 87% of BCT users identified as white women, with African American users making up only 5%. Education level of all users was high with 73% stating a college degree or higher. On the MTS site, 80% of users identified as white, while 7% identified as African American.This emphasized the need for specific interventions designed to tackle the underrepresentation of ethnic minorities and underserved populations when utilizing BCT and MTS. Conclusions: For more than 15 years, BCT has offered a patient-centric trial matching service. Within the last six years, with the enhancements to the website, BCT has served over 281,197 users. To improve minority enrollment in trials, we have developed a comprehensive clinical trial breast cancer navigation program. We plan to use this program to expand our outreach to underserved populations. Navigators can enhance patient engagement, help patients make informed decisions, and ultimately improve access to participation in breast cancer research.

Engagement of culturally diverse communities in primary care research.

The underrepresentation of ethnic minorities and low-income groups in primary care (PC) research hinders the development of effective treatments for diverse populations. To develop a framework that general practice staff and researchers can use to improve the participation of underserved groups in PC research. This study was undertaken across 10 GP practices in South London serving 150 658 patients. Practices are distributed across ethnically diverse and highly deprived communities. A mixed-methods approach was utilised. Retrospective data were collected on patient participation in research studies across the practices between July 2022 and July 2023. Professional and patient focus groups, and a patient questionnaire, were undertaken to understand awareness and knowledge of, enablers for, and barriers to research participation. Over the 12-month period, 627 patients participated in PC research studies across the 10 practices. Black African and Black Caribbean patients accounted for 26% of the practices' patient population but were significantly underrepresented in research, comprising only 11% of participants. Patients of Asian backgrounds accounted for 11% of the practices' population but made up 20% of research participants. Lack of awareness of research participation opportunities, fear of side effects, language barriers, and mistrust of researchers were some of the barriers to participation. Participants highlighted that trust in their GP, education, and transparency of research processes were key to building long-term engagement. This study provides insights into poor recruitment of specific ethnic minorities into primary care studies. The authors identified adaptations to research engagement activities, which are required to ensure that participation is improved.

Specialty Care Referral for Underrepresented Minorities Living with HIV in the United States: Experiences, Barriers, and Facilitators.

The increased incidence of chronic diseases among people with HIV (PWH) is poised to increase the need for specialty care outside of HIV treatment settings. To reduce outcome disparities for HIV-associated comorbidities in the United States, it is critical to optimize access to and the quality of specialty care for underrepresented racial and ethnic minority (URM) individuals with HIV. We explored the experiences of URM individuals with HIV and other comorbidities in the specialty care setting during their initial and follow-up appointments. We conducted qualitative interviews with participants at three large academic medical centers in the United States with comprehensive health care delivery systems between November 2019 and March 2020. The data were analyzed using applied thematic analysis. A total of 27 URM individuals with HIV were interviewed. The majority were Black or African American and were referred to cardiology specialty care. Most of the participants had positive experiences in the specialty care setting. Facilitators of the referral process included their motivation to stay healthy, referral assistance from HIV providers, access to reliable transportation, and proximity to the specialty care health center. Few participants faced individual, interpersonal, and structural barriers, including the perception of individual and facility stigma toward PWH, a lack of transportation, and a lack of rapport with providers. Future case studies are needed for those URM individuals with HIV who face barriers and negative experiences. Interventions that involve PWH and health care providers in specialty care settings with a focus on individual- and structural-level stigma can support the optimal use of specialty care.

Spirometry Interpretation After Implementation of Race-Neutral Reference Equations in Children

The implications of adopting race-neutral reference equations on spirometry interpretation in children remain unknown. To examine how spirometry results and patterns change when transitioning from Global Lung Function Initiative (GLI) race-specific reference equations (GLIR, 2012) to GLI race-neutral reference equations (GLIN, 2023). Cross-sectional study of spirometry tests conducted in children aged 6 to 21 years between 2012 and 2022 at 2 large academic pediatric institutions in the US. Data were analyzed from September 2023 to March 2024. Data on participant characteristics and raw test measurements were collected. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC z scores and percent predicted were calculated using both GLIR and GLIN. In addition, test results were categorized into normal, obstructive, suspected restrictive, mixed, suspected dysanapsis, and uncategorized patterns based on z scores calculated using GLIR or GLIN. For each spirometry result, the difference between z scores and percent predicted when transitioning from GLIR to GLIN was calculated. The proportion of tests with a normal pattern and individual spirometry patterns changed by GLI reference equation applied were also examined. Data from 24 630 children were analyzed (mean [SD] age, 12.1 [3.8] years). There were 3848 Black children (15.6%), 19 503 White children (79.2%), and 1279 children of other races (5.2%). Following implementation of GLIN, FEV1 and FVC z scores decreased in Black children (mean difference, -0.814; 95% CI, -0.823 to -0.806; P < .001; and -0.911; 95% CI, -0.921 to -0.902; P < .001, respectively), while FEV1 and FVC z scores slightly increased (0.073; 95% CI, 0.069 to 0.076; P < .001). Similar changes were found when using percent predicted. In Black children, the number of tests with a normal pattern decreased from 2642 (68.7%) to 2383 (61.9%) (χ21 = 204.81; P < .001), mostly due to tests with a normal pattern transitioning to a suspected restrictive or uncategorized pattern. Opposite, albeit smaller, changes in spirometry results and patterns were seen in White children. In adjusted models, Black children had approximately 3-fold higher odds than White children of changing spirometry pattern following the implementation of GLIN (adjusted odds ratio, 3.15; 95% CI, 2.86 to 3.48; P < .001). Pronounced differences in spirometry results and patterns were found when switching between GLI reference equations, which markedly differed by race. These findings suggest that the implementation of GLIN is likely to change the treatment of children with chronic lung diseases that are more prevalent in underrepresented minorities, such as asthma.

Advancing Diversity in Aging and Alzheimer's Disease Research and Clinical Care: Lessons Learned from Educational and Career Trajectories of Recent Mentorship Program Graduates.

Underrepresented minorities (URMs) are disproportionately affected with aging-related conditions and have inadequate representation in gerontology and geriatrics professions. The Mentorship for Advancing Undergraduate Research on Aging (MADURA) Program aims to increase inclusion of URMs by improving undergraduate retention and success, increasing rates of graduate/medical school applications, and increasing entry into aging research/clinical employment. MADURA provides cohorts with faculty and peer mentorship, research skills training, paid research lab experiences and professional development opportunities. About 87% of the 2023 MADURA cohort intends to take 1+ year after receiving a Bachelor's degree, to prepare for graduate education. Planned activities include gaining work experience, preparing for standardized tests, and obtaining formal training to strengthen graduate/medical school applications. In addition to immediate graduate program acceptances, other student outcomes should be assessed. Longitudinal research on the effectiveness of various post-graduation pathways could assist Mentorship programs in supporting their graduates' longer term educational and career goal attainment.

Minorities Face Delays to Pancreatic Cancer Treatment Regardless of Diagnosis Setting

IntroductionOur analysis was designed to characterize the demographics and disparities between the diagnosis of pancreas cancer during emergency presentation (EP) and the outpatient setting (OP) and to see the impact of our institutions pancreatic multidisciplinary clinic (PMDC) on these disparities.MethodsInstitutional review board-approved retrospective review of our institutional cancer registry and PMDC databases identified patients diagnosed/treated for pancreatic ductal adenocarcinoma between 2014 and 2022. Chi-square tests were used for categorical variables, and one-way ANOVA with a Bonferroni correction was used for continuous variables. Statistical significance was set at p < 0.05.ResultsA total of 286 patients met inclusion criteria. Eighty-nine patients (31.1%) were underrepresented minorities (URM). Fifty-seven (64.0%) URMs presented during an EP versus 100 (50.8%) non-URMs (p = 0.037). Forty-one (46.1%) URMs were reviewed at PMDC versus 71 (36.0%) non-URMs (p = 0.10). No differences in clinical and pathologic stage between the cohorts (p = 0.28) were present. URMs took 22 days longer on average to receive treatment (66.5 days vs. 44.8 days, p = 0.003) in the EP cohort and 18 days longer in OP cohort (58.0 days vs. 40.5 days, p < 0.001) compared with non-URMs. Pancreatic Multidisciplinary Clinic enrollment in EP cohort eliminated the difference in time to treatment between cohorts (48.3 days vs. 37.0 days; p = 0.151).ResultsUnderrepresented minorities were more likely to be diagnosed via EP and showed delayed times to treatment compared with non-URM counterparts. Our PMDC alleviated some of these observed disparities. Future studies are required to elucidate the specific factors that resulted in these findings and to identify solutions.

Summer undergraduate biomedical research program for underrepresented minority students in a rural, low-income state

IntroductionDiversity can enhance the agenda and quality of biomedical research, but a dearth of underrepresented minorities and women serve as biomedical researchers. The study purpose was to examine the impact of the a summer undergraduate research program on self-efficacy in research, scientific communication, and leadership as well as scientific identity, valuing objectives of the scientific community, and intent to pursue a biomedical research career.MethodsUnderrepresented minority and female undergraduate students participated in a mentored research experience in a rural, low-income state.ResultsStudents' self-efficacy in research, scientific communication, and leadership as well as scientific identity, valuing objectives of the scientific community, and intent to pursue a biomedical research career increased post-program compared to pre-program.ConclusionThis study supports implementation of a biomedical summer undergraduate research program for URM and women in a poor, rural, settings.

Perceived Effectiveness of a Surgical High School Outreach Program on Career Trajectory of Underserved High School Students

Background: The United States faces a significant physician shortage, projecting a need for 52,000 more primary care doctors by 2025.1 Underserved communities are disproportionately affected by this shortage. With underrepresented minority healthcare providers being significantly more likely to practice in underserved communities, it is essential to increase diversity in medicine.2–4 High school outreach programs introducing teenagers from minority populations to the medical field may increase availability of healthcare in socioeconomically disadvantaged areas. Our goal was to determine whether participants in the Urology High School Outreach Program experienced increased interest in pursuing a career in medicine, or STEM-related fields after receiving mentorship and exposure to the medical field. Methods: 138 underserved high school students participating in a one-day Urology High School Outreach Program (HSOP) took a pre-survey prior to a physician-led lecture, and five urology-related surgical techniques workshop stations, led by medical students. The sessions culminated with a Q&amp;A panel with the medical students, followed by the post-survey. Results: Of the 138 students that participated in the pre-survey, 110 students (79.7%) answered the post-survey. Analysis of these survey responses revealed that the Urology HSOP predominantly served a demographic consisting of Hispanic (39.1%) and Asian (32.7%) backgrounds. Question One, pertaining to the likelihood of pursuing a career in healthcare, saw a statistically significant average increase of 0.11 out of 5 (p=0.014). Question Two, pertaining to the likelihood of pursuing a career in STEM, saw the largest significant average increase of 0.34 out of 5 (p&lt;0.00001). Question Three, pertaining to interest in developing new technology, saw a statistically significant average increase of 0.28 out of 5 (p=0.001). Conclusion: In summary, a significant increase in interest towards STEM and medicine careers emerged among Urology High School Outreach Program participants. Further investigation is warranted to ascertain whether these changes are limited to the underrepresented demographic, or extend to all program participants.

The Benefits of Informal Learning Garnered Through Participation in the Curriculum and Community Environmental Restoration Science (STEM + Computer Science) Project

The Curriculum and Community Environmental Restoration Science (STEM + Computer Science) Project has several goals, with its primary focus on connecting the students of New York City with the enormous potential of restoring New York Harbor to its former self. Through the collaboration of numerous partners representing all of the facets of the city to the marginalized students living in hundreds of under-resourced communities, out-of-school experiences such as participation in the annual Science Symposium and the environmental fieldwork conducted along the shores of New York Harbor flourished. The CCERS STEM + C Project enables the merging of these entities for the good of its participants and the enormous benefit to the environment's restoration. This study consists of student surveys administered to and completed by 513 students attending schools throughout New York City's five boroughs. Of those who responded to the ethnicity section of the survey, 43.7% represent minority students. Data indicated a significant increase in STEM motivation by the CCERS STEM + C participating students, particularly those who identify as members of the under-represented minority group.

Exploring the relationship between school-supervised asthma therapy and social determinants of health in pediatric asthma care.

Social determinants of health (SDoH), including access to care, economic stability, neighborhood factors, and social context, strongly influence pediatric asthma outcomes. School-supervised asthma therapy (SST) is an evidence-based strategy that improves asthma outcomes, particularly for historically marginalized children, by providing support for daily medication adherence in school. However, little is known about the relationship between these programs and the adverse SDoH commonly affecting underrepresented minority and marginalized children with asthma. We examined qualitative data from interviews (n = 52) conducted between 2017 and 2020 with diverse multi-level partners involved in Asthma Link, a SST intervention. Participants included end-users (children and their parents), deliverers (school nurses and pediatric providers), and systems-level partners (e.g., insurers, legislators, and state officials). We used inductive coding to determine themes and subthemes and deductive coding using the Healthy People 2030 SDoH framework. Three themes emerged: (1) SST mitigates adverse SDoH (improves access to preventive healthcare and asthma health literacy), (2) SST benefits children experiencing specific adverse SDoH (provides a consistent medication routine to children with unstable family/housing situations) and (3) specific adverse SDoH impede SST implementation (economic instability, culture and language barriers). This study suggests an important relationship between SDoH and SST that warrants further evaluation in our future work on this community-based asthma intervention. Moreover, our findings underscore the importance of measuring SDoH in the implementation and evaluation of pediatric asthma interventions, particularly given the strong influence of these social factors on child health outcomes.

Current holistic admission review practices of U.S. doctor of physical therapy programs

BackgroundThe social, cultural, and ethnic diversity of healthcare workers should match that of the U.S. population to improve health outcomes and decrease health disparities. The population’s diversity is increasing, though many health care professions lack diversity in their academic programs. The holistic admissions (HA) process considers an applicant’s unique experiences, achievements, and traits in addition to academic metrics when making admission decisions. HA has been shown to be an effective strategy to increase cohort diversity by considering the whole person instead of focusing on academic metrics.PurposeThis study explored the extent to which U.S. Doctor of Physical Therapy (DPT) programs are implementing HA in their admissions process to diversify their admitted cohorts. The study further examined how programs defined diversity.MethodsUsing a cross-sectional, descriptive research design, 272 accredited DPT programs were invited to complete an online survey to collect data on admissions practices. Cross-tabulation was used to analyze coded responses. Inductive thematic analysis was used for open-ended responses.ResultsThirty-five (71.4%) of the 52 respondents reported they were currently or were planning to use HA in their respective DPT program. Most respondents (88.6%) reported a positive experience, including an increase in student cohort diversity without a decrease in graduation rate. Four themes emerged as the definition of diversity: ethnicity (i.e., under-represented minorities), other demographics, life experiences, and challenges overcome.ConclusionAlthough this study represents a sample of DPT programs, the data show most programs using HA and have experienced increased diversity without a risk to academic performance.

Faculty diversity and graduation rates: a zero-sum effect

ABSTRACT Texas higher education institutions serve some of the most diverse student populations in U.S. institutions. However, graduation rates remain among the lowest in the United States, particularly for underrepresented minority students. Diverse faculty members who act as mentors have the potential to increase underrepresented minority students’ graduation rates. Yet few studies have examined these relationships. Using data from the 2021 Integrated Post-Secondary Data System (IPEDS), this quantitative study contributes to this line of research by examining the correlations of overall faculty diversity and faculty race/ethnic match and mismatch with graduation rates of students by race/ethnicity in Texas. Similar to past research, findings suggested a zero-sum effect: a significant positive relationship between faculty and students of the same racial/ethnic background and a negative correlation between faculty diversity and the graduation rates of students from different racial/ethnic backgrounds than faculty. These results suggest that further research is needed to determine what other variables might influence such findings and how faculty can support students from different racial/ethnic backgrounds.

Abstract PO3-09-10: Minority participation in breast cancer therapeutic trials at an NCI-CCC affiliated safety-net system: Advancing equity in clinical research

Abstract Authors: Nasir Qureshi, MBBS Fabian Robles, MS Mai Badran, MBBS Nisha Unni, MD Hsiao C Li, MD Samira Syed, MD Glenda Delgado-Ramos, MD Sangeetha Reddy, MD Heather McArthur, MD Navid Sadeghi, MD Title: Minority participation in breast cancer therapeutic trials at an NCI-CCC affiliated safety-net system: Advancing equity in clinical research. Introduction: Participation of under-represented minorities (URMs) in clinical trials enhances the generalizability of the findings and can also improve clinical outcomes. Multiple factors, such as access, language barrier, distrust, and misconceptions, negatively impact URM enrollments in cancer clinical trials. Here we describe our approach to increase participation of breast cancer URMs in therapeutic trials at an academic-affiliated safety-net system. Methods: Parkland Health (PH) is a large safety-net system in Dallas County, Texas, and is affiliated with the NCI-CCC designated Harold C. Simmons Comprehensive Cancer Center (SCCC) at UT Southwestern. A dedicated team of SCCC research coordinators support the clinical trial operations at PH. In 2020, several steps were taken to increase access and enrollment of URMs in breast cancer trials at PH including review and optimization of the trial portfolio (more trials in curative intent setting), proactive screening, increasing provider awareness, and addition of a bilingual (English/Spanish) patient navigator to the research team. Data for 2018-2019 (pre-intervention) and 2021-2022 (post-intervention) is presented here. Data for 2020 is excluded due to the impact of COVID-19 pandemic on trial operations. Results: Racial and ethnic minorities composed the majority of breast cancer patients at PH (52% Hispanics, 32% Blacks). Ten percent of new patients at PH presented with metastatic disease. In 2018-2019, PH's portfolio included 13 therapeutic trials, 5 of which (38%) were in metastatic setting and 3 required a biomarker. A total of 47 breast cancer patients were enrolled in 11 therapeutic trials at PH, accounting for an average annual accrual rate of 6.1% (7.6% in 2018 and 4.5% in 2019). Accrual to trials in the metastatic setting accounted for 11% (5/47) of enrollments. Two trials in the metastatic setting had zero accruals. In 2021-2022, 16 trials were open at PH, including 7 cooperative group, 4 industry-sponsored (ISTs), and 5 Investigator-Initiated trials (IITs). Five trials (31%) were in metastatic setting and 4 required a genomic biomarker. A total of 87 patients were enrolled in 2021-22, representing an 85% increase in the accruals over the baseline (2018-2019). The annual accrual rates for 2021 and 2022 were 10.5% (43/409) and 10.4% (44/423), respectively. In 2021-22, 63 were enrolled in cooperative group studies, 20 in IITs, and 4 in ISTs. Accrual to trials in the metastatic setting accounted for 6% (5/87) of enrollments. Two studies had zero accruals. The majority of the trial participants (77/87; 89%) belonged to URMs (64 Hispanic, 13 Black). Overall participation rate was 67% (87/129) and was significantly higher in Hispanics compared to Blacks (77% vs 41% - p &amp;lt; 0.001). Among Black patients who declined participation, 42% (8/19) cited lack of interest as the reason, which may reflect distrust or misperceptions regarding clinical trials. Conclusions: The collaboration between academic centers and safety-net systems provides a unique opportunity to promote equity in clinical trials by increasing access and enrollment of URMs. Developing a balanced portfolio that matches the patient population, enhanced screening, and incorporating clinical trial patient navigation at our institution resulted in a sustained increase in the number of URM trial participants. Given the lower participation rate among eligible Black patients, we aim to expand our clinical trial navigation program to better address the distrust and misperceptions regarding clinical trials, as a strategy to further improve trial participation at our institution. Citation Format: Nasir Qureshi, Fabian Robles. Minority participation in breast cancer therapeutic trials at an NCI-CCC affiliated safety-net system: Advancing equity in clinical research [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-09-10.

Abstract PO5-05-07: Efficacy and safety of first line CDK4/6i plus endocrine therapy for patients with HR+/HER2- metastatic breast cancer:initial real-world experience at Ho Chi Minh city oncology hospital, Viet Nam

Abstract Background The cyclin-dependent kinases (CDK)4/6 inhibitors (CDK4/6i) palbociclib and ribociclib have been available in Viet Nam since 2021 for the treatment of hormone receptor-positive metastatic breast cancer (MBC). Data regarding CDK4/6i benefit in Vietnamese MBC are sparse. This study evaluated the impact of CDK4/6i in first-line HR+/HER2− MBC using real-world experience at Ho Chi Minh City Oncology Hospital. Methods A single-institution study analyzed retrospective data from 108 patients treated with palbiciclib or ribociclib with endocrine therapy in first-line in HR+/HER2– MBC patients at Ho Chi Minh city oncology hospital. Patient characteristics, PFS, treatment response, and toxicity profiles were analyzed. Results Baseline patients’ characteristics are detailed in Table 1.The median follow-up was 12.5 months (95% CI: 10.9-13.3). Best responses by the line of therapy are in Table 2. The median PFS has still not been reached. The PFS rates at 6, 12 and 18 months were 94.4%, 93.5% and 91.5%, respectively. Patients with bone-only metastasis have a better PFS than visceral metastasis (p = 0.059). Patients with recurrent disease had shorter PFS (p = 0.083) than those presenting with de novo metastasis. The most common reasons for toxicity were neutropenia (92.6%), anemia (35.2%), thrombopenia (22.2%) and the incidence of diarrhea was only 2,8%. None were related to QTc-prolongation Conclusion The real-world effectiveness and safety with CDK4/6 inhibitors in our institution HR+/HER2– MBC patients mimics that observed in the clinical trials. This finding supports the use of CDK4/6i in combination with endocrine therapy as standard of care for HR+/HER2- MBC in Viet Nam. The study also suggests the need for more study of under-represented minority populations. Further studies are ongoing to validate these findings incorporating additional cancer centers. Keywords: advanced/metastatic breast cancer, Asia, CDK4/6 inhibitors, real world Table 1. Patient Demographics and Baseline Disease Characteristics (N=108) Characteristics N (%) Age, y: Median 52 Stage Recurrent from earlier stage, stages 0–III 67 (62) De novo, newly diagnosed stage IV at enrolment 41 (38) DFI &amp;lt; 12 months 5 (4.6) 12-24 months 12 (11.1) &amp;gt; 24 months 51 (47.2) No. of metastatic sites 1 49 (45.4) 2 37 (34.3) ≥ 3 22 (20.4) Metastasis pattern Bone only 30 (27.8) Other 78 (72.2) CDK4/6i Palbociclib 35 (32.4) Ribociclib 73 (67.6) Partner ET AIs 94 (87) Fulvestrant 14 (13) Table 2. Best responses of therapy (N=108) Best responses (N,%) CR 2 (1.9) PR 29 (26.9) SD 67 (62.1) PD 10 (9.3) Total 108 (100) ORR 31 (28.8) CBR 76 (70.3) Table. Citation Format: Hoang-Quy Nguyen, Hong-Duc Phan-Thi, Thi-Hong-Van Le. Efficacy and safety of first line CDK4/6i plus endocrine therapy for patients with HR+/HER2- metastatic breast cancer:initial real-world experience at Ho Chi Minh city oncology hospital, Viet Nam [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-05-07.

Female and underrepresented minority representation in radiology

Rational and objectiveDiversity, equity, inclusion, and representation in various sectors have garnered increasing attention in the past two decades, including healthcare. In this report we investigate representation of females and underrepresented minorities (URM) in the field of radiology and asses for significant growth trends in representation in residency training programs in the United States. Materials and methodsDe-identified trainee demographic information for active radiology trainees from 2016 to 2021 was queried using the Accreditation Council for Graduate Medical Education (ACGME), and new radiology trainees using the National Resident Matching Program (NRMP)’s Main Residency Match Data and Reports databooks. ResultsIn 2021 females represented 26.7% of DR residency trainees and 22% of IR integrated trainees. In the same year URM trainees represented 11.3% of trainees and 8.7% of IR integrated trainees. From 2017 to 2021, diagnostic radiology had a compound average growth rate (CAGR) 1% (p <0.01) of female representation and 1.12% (p<0.01) of URM representation. ConclusionThis study quantifies female and underrepresented minority representation among radiology trainees for diagnostic radiology and radiology subspecialities, identifying modest uptrends in representation within both demographics.

Unlocking Diversity in Cardiovascular Clinical Research: Lessons from the Screening for Cardiac Amyloidosis With Nuclear Imaging in a Minority Populations Study

The Screening for Cardiac Amyloidosis with Nuclear Imaging in Minority Populations study seeks to determine the prevalence of transthyretin cardiac amyloidosis (ATTR-CA) among older Black or Caribbean Hispanic individuals with heart failure and an increased wall thickness. We noticed varied recruitment percentages across the recruiting sites and sought to determine the factors associated with greater percentage enrollment of eligible participants. The percentage of enrolled to eligible participants was calculated across study sites. Baseline demographic and clinical characteristics, health literacy, trust in providers, perceived discrimination, area deprivation index (ADI) and English proficiency were compared by site using Kruskal-Wallis's test or one-way ANOVA for continuous variables and the Chi-Square test or Fisher's exact test for categorical variables. Wilcoxon rank sum and Chi-Square tests, with multiple comparisons correction using the false discovery rate (FDR) method, were used as post-hoc analysis when results were statistically significant. Among the four recruiting sites, Boston Medical Center, Columbia University Irving Medical Center, Harlem Hospital and Yale University, which employed different recruitment approaches, the percentage of participants enrolled among eligible participants differed, with the highest rate at Harlem Hospital (n=149 of 310, 48%), followed by Yale University (n=27 of 67, 40%), Boston University (n=247 of 655, 38%), and Columbia University (n=137of 442, 32%), p <0.01. Direct recruitment by the primary cardiovascular care team providing clinical care was associated with higher percent enrolled across sites as were higher education levels and English proficiency. Enrollment differences across sites were not associated with the number of chronic diseases, physician trust, perceived discrimination, or health literacy. Recruitment of eligible under-represented minorities (URMs) in SCAN-MP was associated with approaches employed in recruitment, including direct initial contact by the primary cardiovascular care team providing the potential participant's clinical care. Such data may help improve approaches to more successful recruitment of URMs in clinical research.

Development of the Cardiovascular Undergraduate Research Initiative for Underrepresented Students (CURIOUS)

The Center for Cardiovascular Diseases and Sciences at LSU Health Sciences Center at Shreveport supports cardiovascular disease research at multiple levels from predoctoral fellows to established faculty. To extend our support to undergraduate students, we developed the Cardiovascular Undergraduate Research Initiative fOr Underrepresented Students (CURIOUS). CURIOUS is an 8-week summer research program (with housing) funded by an NHLBI R25 grant, and is targeted towards underrepresented groups interested in pursuing cardiovascular research as part of their scientific/clinical career goals. We primarily recruit in our region, but the program is open to students across the USA. CURIOUS provides an intensive experience at the bench alongside multiple enrichments. Professional development includes meeting administrators involved in admissions, and students from our schools of Graduate Studies, Medicine and Allied Health Professions, financial advice for planning graduate education, CV writing, and presentation skills. The students also have discussions with faculty about challenges &amp; opportunities for underrepresented minorities in research, and diversity, inclusion &amp; equity. Other enrichments cover cardiovascular basics and state-of-the-art techniques available on our campus. Students receive training in the responsible conduct of research, held in conjunction with other undergraduate programs and graduate students. We invite a nationally recognized cardiovascular researcher to give a seminar and meet with the CURIOUS students. The program ends with poster presentations for all first-year students. Several students are selected to present at national/international conferences with their mentor. In addition, 1-2 students are invited back for a second year of the program during which they have more time for research, advanced enrichments, and an oral presentation at the end of the program. To date, the acceptance rate has been 26%, with 39 students having completed the 1st year and 2 returning students. CURIOUS provided 59% of students with their first research experience. 80% of students gave the program the top rating of excellent. Based on end-of-program feedback, we have improved pre-program interaction with mentors, refined enrichments, streamlined the on-boarding process, and enhanced social activities. Of the 25 students who have graduated college, 2 are in MD/PhD programs, 1 is in a PhD program, and 10 are in medical school, with 11 others planning one of these programs (10 are working in science-related jobs during gap years). Overall, the program has successfully improved the students’ consideration of including cardiovascular research as part of their future career. Funded by the NIH National Heart, Lung and Blood Institute, Award R25HL147665, to KYS. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Feasibility of Improving Glycemic Control via Heat Therapy in individuals at risk for Alzheimer’s Disease (FIGHT-AD): a pilot study

Impaired glycemic control increases the risk for type 2 diabetes and Alzheimer’s Disease (AD). Mechanisms such as impaired energy metabolism, cellular bioenergetic function, reduced intracellular protein homeostasis, and inflammation are all potential contributors to AD pathology. Heat therapy, via hot water immersion, has been shown to improve blood glucose regulation, insulin resistance, and inflammation. Given the potential contribution of these factors to brain health, heat therapy could offer immense clinical benefit to individuals at risk for AD. We performed a pilot study to test the feasibility of utilizing heat therapy in older individuals at risk for AD due to metabolic risk. The study intervention involved two pre-visits which included a cognitive function screen, sleep, diet, and physical activity questionnaires, as well as a glucose tolerance test and MRI scan. The intervention consisted of four weeks of heat therapy (3 visits/wk) for a total of 12 visits, followed by two post-intervention study visits identical to the pre-study visits. A total of 18 individuals (9 male, 9 female), average age 71.1 ± 3.9 y completed the intervention. Participants demonstrated metabolic risk based on average HbA1c values of 6.6 ± 0.67, Body Mass Index (BMI) of 29.1 ± 5.4, and 15 of the 18 participants were on hypertensive medications. Our cohort was highly diverse, with 33% underrepresented minority group representation. We had 96% participant adherence for the study (8 missed visits out of 216 total visits), and 1 study related Adverse Event (mild dizziness/nausea) that was mild. Overall, the research participants responded to a post-intervention survey saying they enjoyed participating in the study and it was not a burden on their schedules. In addition, we obtained preliminary data demonstrating a significant effect of the heat therapy intervention on body mass index, mean arterial pressure, and cerebral perfusion (p&lt;0.05), and a trend for improved self-reported sleep quality (Pittsburgh Sleep Quality Index; p=0.06). Future studies of longer duration are needed to provide a comprehensive understanding of the impact of heat therapy on glucose homeostasis and brain health. NIH P30 AG035982 (KU ADRC), pilot funds to PCG. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Study protocol for measuring stigmatization in persistent tic disorders: development and validation of the Tourette discrimination-stigmatization scale.

Persistent Tic Disorders such as Tourette Syndrome are common neurodevelopmental disorders that are highly stigmatized. Many individuals with Persistent Tic Disorders experience peer rejection, loneliness, and self-stigma. Experiencing stigmatization during childhood can influence the persistence of moderate-to-severe tics later in life. Additionally, these factors have been associated with increased suicidal ideation, suicide attempts, and psychiatric symptom severity. There is a need for interventions to reduce stigma and stigmatization in Persistent Tic Disorders. Before developing cost-effective interventions to mitigate stigma's profound downstream health impacts, a reliable measure of stigmatization must be created. The overarching goal of this research is to develop and validate the Tourette Discrimination-Stigmatization (TD-STIGMA) Scale. This paper presents the study protocol for developing and validating the TD-STIGMA Scale. The study is designed as a mixed methods study to develop the TD-STIGMA scale and evaluate its psychometric properties. The study uses a phased approach: (1) collection of narrative and thematic content data through in-depth qualitative interviews of stakeholders, (2) development of a novel TD-STIGMA self-report scale using the Delphi Method based on these results, and (3) completion of analyses to determine the scale's psychometric properties (confirmatory factor analysis, convergent, known-group, criterion validity, and test-retest reliability). This project will result in a personalized approach to stigma measurement about youth and young adults with Persistent Tic Disorders, which to date does not exist. There are several limitations. Comorbidities or spiritual or cultural beliefs may affect perceptions of stigma and are not directly assessed in this study. We will utilize institutional resources for community outreach to purposefully sample underrepresented minorities who may be at disproportionate risk of adverse outcomes. However, this may not be fully representative of the generalized tic population. The study team will be purposeful in maintaining participant engagement for study retention. Lastly, participants from a tertiary referral center may not fully represent the generalized tic community. However, we hope our broad recruitment strategy and virtual study visits will facilitate a diverse and inclusive sampling of the patient population.

How We Do It: Surgery IMPACT - Integrated Mentorship Program for Advancing Clinical Training

Effective mentorship plays a crucial role in the professional development of surgical residents by providing guidance, support, networking, and facilitating personal, and career growth. This is particularly significant for female and underrepresented minority residents who often encounter additional challenges due to discrimination and historical lack of representation. Our objective is to present a framework for structuring a progressive and inclusive formal mentorship program- Surgery IMPACT- which embodies a panoramic perspective of surgery residency. A holistic mentorship program was created through the conceptualization of WISE Domains (Work-Life Balance, Interpersonal and cultural proficiency, Scholarly and career advancement, Effective learning and study techniques). Mentor-Mentee partnerships were created between current surgical faculty and general surgery residents. The foundation of the program is built upon four essential mentor roles: Core faculty mentor, research mentor, fellowship mentor, alongside a concurrent incorporation of peer mentorship. Over the academic year, we encouraged at least 3 formal mentorship meeting prefaced by a reflective exercise by the residents. The implementation of Surgery IMPACT has been successful in formalizing mentorship opportunities at our institution. By incorporating WISE domains, structured meeting centered on well-defined objectives, we have effectively created an all-inclusive mentorship program to foster resident growth and equal opportunities. Our ongoing commitment is to further refine and expand this innovative program with the aspiration of galvanizing similar mentorship models across diverse surgical programs.