American Women Research Articles

Daily spiritual experiences and allostatic load trajectories: a longitudinal study of midlife African American women.

This study aimed to evaluate the association between daily spiritual experiences and allostatic load (AL) trajectories in midlife African American women. A longitudinal analysis of public-use data from 727 African American women in the Study of Women's Health Across the Nation (SWAN) was performed. We included African American women who completed the Daily Spiritual Experiences Scale at SWAN visit 4 (2000-2001) and had AL data at three or more study visits over 7 years. AL was calculated at each visit using 10 biomarkers: systolic and diastolic blood pressure, body mass index, C-reactive protein, high-density lipoprotein cholesterol, total cholesterol, waist-to-hip ratio, fasting serum glucose, triglycerides, and dehydroepiandrosterone. Group-based trajectory modeling identified women with similar patterns of AL. We used multinomial logistic regression to estimate associations between daily spiritual experiences (some days or less, most days, daily, many times a day) and AL trajectories. Our sample had a mean ± SD age of 49.9 ± 2.66 years, 47% were early perimenopausal, and 17% earned <$19,999 annually. The mean ± SD AL score was 2.52 ± 1.68. Three AL trajectories were identified: low (35.1%), moderate (44.7%), and high (20.2%). In age-adjusted models, women who reported daily comfort in religion and spirituality were less likely to follow a high AL trajectory (odds ratio, 0.41; 95% CI, 0.18-0.93); the association was attenuated when controlling for depressive symptoms (odds ratio, 0.48; 95% CI, 0.19-1.21). Findings from this study do not support an independent association between spirituality in African American women and AL trajectories in midlife. Studies with a larger sample and additional measures of spirituality are warranted in this population.

Abstract LB312: Subtype- and race-specific differences in immune landscape of breast cancer

Abstract Tumor mass comprises of not just the tumor cells but a variety of stromal cells. Immune cells residing within the tumor microenvironment modulate the growth and behavior of the tumor cells through a bi-directional crosstalk and affect the outcomes of cancer therapies. Breast cancer (BC) is a highly heterogeneous disease having four major molecular subtypes. Triple-negative breast cancer (TNBC) is the most aggressive subtype and has limited available therapeutic options. Further, it disproportionately affects African American (AA) women, with nearly two times higher incidence as compared to Caucasian American (CA) women. It is associated with an earlier onset and overall higher mortality of BC. Here, we investigated the differences in the immune landscape between TNBC and non-TNBC subtypes and examined if there existed any race-specific patterns. A total of 81 breast cancer samples with a distribution of 55 non-TNBC (28 CA and 27 AA) and 26 TNBC (12 CA and 14 AA) were selected after histopathologic analysis. Tissues were analysis using the NanoString nCounter® pancancer immune panel to determine tissue-specific immune cell populations. We observed a significantly higher presence of tumor-infiltrating lymphocytes in TNBC compared to non-TNBC, with a higher immune score for CD45+ (total lymphocytes), T-cells, B-cells and tumor-associated macrophages. Specifically, among the T-cell population, Treg cells, Th1 cells, and CD8+ cells were higher in TNBC samples. The pathway prediction indicated 'primary immunodeficiency' and 'cancer immunotherapy by PD-1 blockade' pathways being significantly up-regulated in TNBC samples. Overexpression of CTLA4, IDO1, PDL1 and PDL2 as well as Treg marker genes, such as FOXP3 and LAG3, which are involved in immunosuppressive pathways, was observed in TNBC. In race-wise comparisons of non-TNBC and TNBC sample between CA and AA patients, we found that AA non-TNBC tumors had higher Treg cell scores. On the other hand, CA TNBC samples had higher Th1 and CD8+ T-cell scores compared to AA TNBC. The pathway prediction from differentially expressed genes between CA and AA non-TNBC samples showed complement activation pathway to be down-regulated in AA patients, which could be associated with an increased presence of Treg cells. Further, when comparing CA vs AA TNBC samples, we found significant up-regulation of oncogene BMI1 and down-regulation of genes involved in T-cell activation such as CD47, CD44, FOS, and S100A8 in AA TNBC, supporting their more aggressive nature. In conclusion, our data show that TNBC patients have a higher infiltration of immune cells, which remain suppressed due to the presence of Treg cells and PD1 signaling pathway. The presence of higher Treg cells in AA non-TNBC and lower Th1 and CD8+ T-cells in AA TNBC samples suggests an overall immune suppressed microenvironment in AA patients compared to CA patients. Overall, our data suggest that TNBC could be good candidate for immune therapy. Citation Format: Amod Sharma, Kunwar Somesh Vikramdeo, Sarabjeet Kour Sudan, Mohammad Aslam Khan, Mohammad Tahir, James Elliot Carter, Cindy Nelson, Ajay P Singh, Seema Singh. Subtype- and race-specific differences in immune landscape of breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB312.

Abstract LB433: Targeting of ABI1 via DNA-based PROTACs

Abstract Breast cancer is the most commonly diagnosed non-cutaneous cancer in American women. Although current therapies reduce initial tumor burden, patients often relapse with aggressive tumors which can metastasize. Abelson Interactor 1 (ABI1) is an adaptor protein which is traditionally seen as a WAVE complex component- regulating actin polymerization, cell migration and adhesion. In this role, ABI1 serves as a driver of breast cancer metastasis. Recent studies have discovered that ABI1 contains a homeobox homology region (HHR) which is able to bind DNA and regulate transcription. In order to specifically target and degrade ABI1, we designed a novel PROteolysis-TArgeting Chimera (PROTAC) system using DNA as the bait for ABI1. We hypothesized that by linking ABI1 DNA targets to the ubiquitin system, we would be able to effectively target ABI1 for degradation. Lenalidomide, an E3 ubiquitin ligase ligand, was attached to an oligonucleotide via click chemistry. Cells were then treated with PROTAC systems via direct addition to media or via lipofection reagents, and levels of ABI1 were detected using western blotting. Using this DNA-based PROTAC system in cell-culture models of both breast and ABI1-elevated prostate cancer suggested that the system is able to target and degrade ABI1. Usage of lipofection reagents were able to improve drug delivery and effectiveness. Further research is needed to identify off-target effects and effectiveness in vivo models of disease to reduce metastasis. In conclusion, PROTACs targeting ABI1 may prove to be an effective and novel method to reduce metastasis and improve outcomes for cancer treatment. Citation Format: Kevin M. Lin, Xiang Li, Leszek Kotula. Targeting of ABI1 via DNA-based PROTACs [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB433.

Reproductive factors and risk of cardiovascular diseases and all-cause and cardiovascular mortality in American women: NHANES 2003–2018

BackgroundThe evidence regarding the association of reproductive factors with cardiovascular diseases (CVDs) is limited.AimsTo investigate the relationship of reproductive factors with the risk of CVDs, as well as all-cause and cardiovascular mortality.MethodsThis study included 16,404 adults with reproductive factors from the National Health and Nutrition Examination Survey (NHANES) and followed up until 31 December 2019. Logistic models and restricted cubic spline models were used to assess the association of reproductive factors with CVDs. COX proportional hazards models and restricted cubic spline models, with adjustment for potential confounding, were employed to analyze the relation between reproductive factors and cardiovascular and all-cause death.ResultsThere is a nonlinear relationship between age at menarche and CVDs. Age at menopause ≤ 11(OR 1.36, 95% CI 1.10–1.69) was associated with an increased risk of CVDs compared to ages 12–13 years. Age at Menopause ≤ 44 (OR 1.69, 95% CI 1.40–2.03) was associated with increased CVDs compared to age 35–49 years. Number of pregnancies ≥ 5(OR 1.26, 95% CI 1.02–1.55) was associated with an increased risk of CVDs compared to one pregnancy. In continuous variable COX regression models, a later age at menopause (HR 0.98, 95% CI 0.97–0.99) and a longer reproductive lifespan (HR 0.98, 95% CI 0.97–0.99) were associated with a decreased risk of all-cause death. A later age at menopause (HR 0.98, 95% CI 0.97–0.99) and a longer reproductive lifespan (HR 0.98, 95% CI 0.97–0.99) were associated with a decreased risk of cardiac death.ConclusionsFemale reproductive factors are significant risk factors for CVDs American women.

Exploring the Impact of Nickel Exposure on Female Fertility.

Introduction Infertility affects an estimated 186 million individuals globally and is associated with numerous mental health issues. Trace elements are essential for reproductive health, yet the role of nickel in female fertility is not well understood. Previous research has shown conflicting evidence regarding nickel's impact on ovarian function and its potential to disrupt reproductive processes. Methods We utilized data from the National Health and Nutrition Examination Survey (NHANES) focusing on a cohort of 7,839 women, with an emphasis on 1,404 women aged 18 to 35. Logistic regression was employed to investigate the relationship between urinary nickel levels and fertility status, controlling for age, BMI, and race/ethnicity. Results The fertility analysis included 880 fertile and 106 infertile women, identifying age as a significant predictor of fertility status. Nickel exposure did not demonstrate a statistically significant association with fertility. The racial distribution within the groups showed a higher proportion of non-Hispanic White women in the fertile category and Mexican American women in the infertile group, although race was not a significant predictor in the regression model. Conclusions We found no significant relationship between nickel exposure and fertility status when adjusted for race, BMI, and age. Age was the only significant factor associated with fertility. These results highlight the complexity of the interplay between environmental exposures and reproductive health, suggesting that further research is necessary to elucidate the role of nickel and other trace elements in fertility.

Abstract CT272: A cluster randomized trial to evaluate a church-based navigation model to increase breast cancer screening in Korean women (Faith In Action!): Trial in progress

Abstract Background: Breast cancer is the most commonly diagnosed cancer among Korean American women and incidence in this group is rising. Advanced-stage disease is more frequent among Korean women diagnosed with breast cancer than in other ethnicities due to low adherence to screening. Lower socioeconomic status, cultural barriers, perceived norm, distrust of healthcare system, and lack of awareness and culturally tailored communication on benefits of screening contribute to low screening utilization. Church settings offer important platforms for education as a majority of Korean American women &amp;gt;50 years regularly attend church services. Thus, the objective of this trial was to evaluate the efficacy of a culturally tailored intervention “Faith in Action!” on breast cancer screening adherence rates among Korean American women. Methods: A parallel cluster randomized trial with staggered roll-out will be conducted to evaluate the efficacy of the “Faith in Action!” intervention, a church-based small group education and lay health navigator program, delivered by trained church members, on breast cancer screening among Korean American women (NCT05298605). This study was designed and conducted in partnership with a Community Advisory Board. Trial enrollment began in July 2022 and is ongoing. Twenty-four total Korean churches in Los Angeles were randomized within blocks of 8 churches to either intervention or waitlist control conditions in a 1:1 ratio. Using a train-the-trainer approach, lay navigators from the Korean Church community nominated by church leadership are trained and certified to deliver the Faith in Action! intervention to study participants over a 6-month program period. Participants at churches randomized to the waitlist control group receive an educational presentation on physical activity and nutrition and, after 6-month follow-up, are invited to receive the Faith in Action! intervention. Eligible participants include women of Korean descent, ages 45-75 years, who: attend a participating church, do not have a breast cancer diagnosis, and did not receive mammogram in the last 2 years. The primary outcome is adherence to breast cancer screening guidelines within 6 months from end of program. Secondary outcomes include adherence to breast cancer screening within 1 year and participant knowledge about breast cancer screening practices. Qualitative interviews will be conducted to assess participants’ knowledge and barriers surrounding cancer screening decisions and program acceptability. To date, 16 churches (149 total participants) have been enrolled in the study and are being followed. It is expected that findings from this research will inform community-based efforts to increase breast cancer screening adherence among Korean American women and improve understanding of screening barriers in this group that is disproportionately impacted by breast cancer, while building capacity and opportunities for sustainability in the Korean faith community. Citation Format: Gillian Gresham, Christie Y. Jeon, Dong Hee Kim, Min Jung Sung, Laurel J. Finster, Marcio A. Diniz, Michael Fine, Zul Surani, Alison K. Herrmann, Jeong Yup Lee, Robert W. Haile. A cluster randomized trial to evaluate a church-based navigation model to increase breast cancer screening in Korean women (Faith In Action!): Trial in progress [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr CT272.

The Lived Experience of Postpartum Intergenerational Conflict of Vietnamese American Women with their Vietnamese Immigrant Parents: It's A Generational Thing!

US-born Vietnamese women who are in their childbearing years are more likely to identify with "western" perspectives when compared to their immigrant mothers who were born in Vietnam. Still, a gap in knowledge exists of their intergenerational differences. The purpose of this study was to explore and better understand Vietnamese American women's experiences of postpartum intergenerational conflict. van Manen's methodological approach (1997) was used. The purposive sample included 11 US-born Vietnamese women who experienced postpartum intergenerational conflict with their parents. Data were transcribed verbatim and analyzed using thematic analysis. The researcher transcended the themes through music. Songs and lyrics were arranged for guitar to bring the phenomenon to life. Four themes were identified: (1) "It's a Generational Thing!" (Một điều thế hệ): Leaning both ways; (2) "To rebel or not" (Nổi loạn hay không): Weighing the evidence of postpartum cultural practices; (3) "Stand My Ground" (Giữ vững lập trường của tôi): Keeping my newborn safe and healthy; and (4) "See Me" (Nhìn con): My mental health overshadowed by my mother's thoughts. This study revealed that the intergenerational conflict was influenced by the family's understanding over the division of infant care tasks, disagreements over cultural practices, and generational differences such as age, consistent with previous research. Tailored interventions for Vietnamese American women should consider the family as a whole. Nurses can assess proactively in prenatal care if there are cultural issues such as family hierarchy, gender, and history influencing one's choices or maternal autonomy.

The Lived Experience of Postpartum Intergenerational Conflict of Vietnamese American Women with their Vietnamese Immigrant Parents: It's A Generational Thing!

The Lived Experience of Postpartum Intergenerational Conflict of Vietnamese American Women with their Vietnamese Immigrant Parents: It's A Generational Thing!

Predictors of healthcare usage among Asian Americans during the COVID-19 pandemic in California

ABSTRACT The purpose of this study was to examine the role of gender in determining healthcare usage among Asian Americans, with specific attention to preventive care and early intervention through doctor visits during COVID-19. The authors used retrospective data from the 2021 California Health Interview Survey (CHIS) by selecting 3,962 Asian Americans who resided in California during the pandemic. The logistic regression analysis found several predictors of healthcare usage. The study concluded that Asian American women are more likely to use both preventive care and doctor visits than Asian American men. In addition, married and older Asian residents are significantly more likely to use both preventive care and doctor visits than their married and younger counterparts. Having health difficulties increases the likelihood of using both preventive care and doctor visits. Interestingly, being employed decreased the likelihood of using preventive care. Lack of use of health care services by Asians with specific backgrounds warrants appropriate health interventions.

Breastfeeding Support for Minority Women Postdischarge: A Pilot Program

Objective:Human milk is the preferred source of nutrition for infants in their first 6 months of life. A majority of American women will initiate breastfeeding, but many will not continue due to the many challenges that arise, creating a significant gap between initiation and the long-term exclusivity rate. This quality improvement project aimed to increase postpartum lactation support encounters, fostering the mother’s knowledge and self-efficacy, which are known predictors for breastfeeding success.Methods:Program participants received proactive lactation support via telephone every 24–72 hours throughout the first 2 weeks postpartum. Breastfeeding knowledge, self-efficacy, and exclusivity pre- and postprogram were assessed.Results:All outreach attempts to participants were made as planned. Eight out of 20 enrolled participants completed the program and maintained breastfeeding exclusivity at 2 weeks. Breastfeeding knowledge scores were significantly higher at the completion of program compared with preprogram scores. Pre- and postprogram breastfeeding self-efficacy scores were not statistically significantly different; however, the mean was high for all participants, exceeding 65 both pre- and post-program.Conclusions:Transferrable knowledge from this quality improvement project will support sustainable improvement of lactation support across other institutions.

Economic, Cultural, Social Determinants of Black Women Obesity

Obesity is a widespread problem in the United States, particularly affecting Black communities. It is a public health problem, a long-term, cumulative issue of economic and social justice and inequality for this demographic group. Thus, the key to solving it is to eliminate persistent structural root causes. According to the Centers for Disease Control and Prevention (CDC), in 2022, the prevalence of obesity among African American adults is 49.5%, with Black women having the highest prevalence compared to other racial and ethnic groups. The main purpose of this study is to provide a comprehensive literature review that examines the multifaceted factors contributing to obesity among African American women, as well as systematise the determinants related to the economic well-being of the community, social factors, cultural patterns of lifestyle in the community, etc. The analysis revealed a clear inverse relationship between income and obesity among African Americans, with this trend being particularly pronounced among women than men and differing across age groups in black communities. The economic determinants of obesity in Black women are related to the fact that low-income households have limited access to affordable and nutritious food and are regularly exposed to stress related to financial difficulties, with so-called “food swamps” and “food deserts” being common in low-income areas. The social determinants of obesity are related to the fact that Black women face higher levels of racism and sexism than other demographic groups, and unequal social conditions cause structural disparities in health, education and employment. Psycho-social and cultural determinants (cultural norms of body image, social influencers, religion, social networks and family upbringing, etc.) play a key role in the emergence of the problem under study, so Black women often model their eating and physical activity habits by cultural traditions, and those who struggle with overweight may face stigma, social isolation and discrimination. The article makes recommendations for reducing obesity among Black women, which primarily relate to the development of culturally sensitive nutrition education programs, community-based health promotion programs, community-centered food policy advocacy, technology-based health platforms, public-private partnerships for affordable healthy food retail, etc.

The expatriation act of 1907, marital assimilation, and citizenship-based intermarriage in the U.S.

ABSTRACT As both a marriage act and an immigration act, the Expatriation Act of 1907 restricted U.S. women’s freedom of marriage by stating that marrying aliens would lead to loss of U.S. citizenship. To study the effects of the Expatriation Act, I conduct a statistical analysis using 1910 full-count U.S. census data. I find that the Expatriation Act of 1907 generated significantly negative effects on intermarriage between American women and foreign-born men, particularly noncitizens. In particular, I find that it was the citizenship, rather than men’s non-U.S. origin, that accounted for the negative effects of the Expatriation Act of 1907 on intermarriage. These results show a decline in male immigrants’ marital assimilation, and potentially social and economic assimilation. As for the magnitude, the effects were large: the decline in intermarriage was at least 15 percent relative to the pre-Act intermarriage rate. Besides these main results, selective emigration to Canada and Europe driven by intermarriage cannot explain the main empirical results of the paper. The Expatriation Act of 1907 also had no significant effects on women’s entry into the marriage market. Finally, the effects of the Expatriation Act of 1907 on intermarriage were heterogeneous by family immigration background, but less so by geographic region.

Lichen planopilaris in 24 African American women.

Lichen planopilaris in 24 African American women.

An examination of the role and legacy of the first USFHA-funded British women’s field hockey coaches to travel to America in 1922

ABSTRACT In October 1920, 15 American women arrived in Plymouth, England, to take part in the first transatlantic field hockey tour. Three more exchanges between the nations would take place before the end of the decade, and an Irish team also visited the US in 1925. English physical educationalists had introduced field hockey to America in the late-1890s and numerous physical training college graduates were employed by US colleges to teach the game prior to World War One. But demand for British coaches grew exponentially after the Americans’ tour and the subsequent visit to the US of an All England Women’s Hockey Association (AEWHA) team in October 1921. After the United States Field Hockey Association (USFHA) was formed in January 1922, one of the first things it did was ask the AEWHA to source suitably qualified coaches to travel to the US. Eight women were selected and would play a pivotal role in not only exchanging sporting knowledge, but also in fostering the friendships and comradery that would influence field hockey’s development globally in the interwar period.

A Comprehensive Integration of Data Regarding the Correlation of TNF-α rs1800629 Polymorphism with Susceptibility to Cervical Cancer.

Cervical cancer, globally, ranks as the runner-up among the most prevalent forms of cancer affecting women. The role of the tumor necrosis factor alpha (TNF-α) polymorphism in the susceptibility to cervical cancer has been a subject of interest. However, the current evidence regarding this association remains inconclusive. To address this uncertainty, eligible studies were systematically searched and retrieved from various databases including Cochrane Library, EMBASE, PubMed, Web of Science, CNKI, and Wanfang database. The search was conducted until September 01, 2023. The collected literature was then subjected to independent analysis by two authors. The pooled odds ratio along with the corresponding 95% confidence interval was calculated using different genetic models. Additionally, sensitivity and cumulative analyses were performed to assess the stability of the obtained results. A total of 29 case-control studies involving 8850 cases and 9286 controls were included in the present analysis. The findings revealed that the TNF-α rs1800629 polymorphism increased the risk of cervical cancer under the allele genetic model (A vs. G: OR = 1.277, 95% CI = 1.104-1.477, P = 0.001) in the general population. Subgroup analysis based on ethnicity demonstrated that this polymorphism was associated with an increased risk of cervical cancer in Caucasian and African women, but not in Asians. Furthermore, subgroup analysis based on country of origin indicated a significant correlation between the TNF-α rs1800629 polymorphism and an increased risk of cervical cancer in American and Chinese women, but not in Iranian women. The findings from this meta-analysis suggest that the TNF-α rs1800629 polymorphism is a risk factor for cervical cancer in the general population, particularly in Caucasian and African women. However, further well-designed studies are warranted to validate these findings.

264 Building Empowerment through FITness (BeFIT)

OBJECTIVES/GOALS: Improving physical activity of African American women experiencing disproportionate health risks from sedentarism, educational and socio-environmental barriers. BeFit: Building Empowerment through Fitness is based on “What I Learned At Home” project, run by Women Under Construction Network, for residents of the Birmingham Housing Authority. METHODS/STUDY POPULATION: A qualitative study design to understand unique cultural context and challenges faced by African American women residing in the Birmingham Housing Authority, regarding physical activity engagement, including sedentarism. A needs assessment approach will help determine barriers, support systems, and social networks. Semi-structured, pre, mid, and post program focus groups will identify challenges and opportunities for health, such as diet and exercise, and will be analyzed by hand with a thematic analysis. The project framework uses exercise and home repair tools with a life-building/life repair curriculum to influence health, self-efficacy, and program engagement. The Study enrollment will include 50 women over two cohorts in a 12-week project. RESULTS/ANTICIPATED RESULTS: This research addresses the urgent health needs of African American women in low-income communities. These women face heightened health risks due to sedentary lifestyles, educational gaps, and socio-environmental barriers. This project targets the pronounced prevalence of allostatic burden in this population by applying a culturally sensitive, bottom-up approach. Our goal of incorporating healthy lifestyles to improve health in at-risk women and their families requires multiple projects. This project is a necessary first step in engaging with a community to identify local environmental circumstances and barriers to increasing the relevance of physical activity within the home. These barriers can then be addressed by adapting an exercise promotion program to the needs of this community. DISCUSSION/SIGNIFICANCE: Black women in under-resourced communities are more likely to be sedentary and have poor health. Exercise programs can be a powerful tool to address disparities and help prioritize health. The circumstances of women in public housing in Birmingham, AL, need community partners to adapt exercise engagement programs to meet environmental challenges.

285 “Stages” of Hope: Theater as a Research and Outreach Modality for Generating Knowledge, Understanding, and Healing

OBJECTIVES/GOALS: Theater has always served as a means of reflecting and understanding the human condition. Participatory theater further offers the option for viewers to participate in and thus additionally benefit from the performance itself. We use Playback Theater for outreach and research, eliciting information to guide research, education, and engagement. METHODS/STUDY POPULATION: Playback Theater is a type of improvisation that involves audience members recounting personal experiences which are then enacted by a theater troupe. Playback has evolved to include storytelling as a means of expressing and understanding difficult life experiences such as violence, bullying, incarceration, disaster, illness, etc. While not intended as therapy, it has been found to provoke insight and catharsis when used by trained practitioners. We are conducting Playback theater with LGBTQ+ and African American women to elucidate health disparities related to HIV/AIDS. Black/African Americans accounted for 42.1% of cases in 2019, and African American females are 15 times more likely to develop AIDS than white females. We hope to elucidate barriers to screening and treatment to inform early intervention. RESULTS/ANTICIPATED RESULTS: In community engagement, we employ a variety of strategies involving storytelling, since this simple act fosters multiple positive outcomes. For example, by talking about their experiences participants might find clarity about a difficult experience, facilitating coping or healing, or even letting go. By sharing their stories, others (clinicians, researchers, other patients, or the public) can learn what it is like to go through a particular illness or event. This knowledge can be used to allay patient fears or help researchers or clinicians to develop programming that better responds to needs. This novel approach to knowledge sharing also allows communication that may not otherwise be possible. Discussions about sensitive topics are enabled, often leading to shared understanding and potential solutions. DISCUSSION/SIGNIFICANCE: Through Playback Theater, we hope to identify and thus be able to address barriers to early screening and treatment for African American women and the LGBTQ+ population. We are also planning an event with children with cancer and their families to better understand their experiences and needs in both the clinical and familial settings.

Are Rural Areas Holdouts in the Second Demographic Transition? Evidence From Canada and the United States

A central premise of the first demographic transition theory is that demographic change would occur more slowly in rural than urban areas. Few studies, however, have investigated whether rural areas remain holdouts during the second demographic transition. To address this gap, this study (1) examines trends among rural and urban families in Canada and the United States over a 30-year period and (2) determines whether compositional differences in demographic, socioeconomic, and religious factors explain current differences between rural and urban families. We find that rural Canadian women continue to have, on average, 0.6 more children than urban women. However, rural families do not trail behind urban families on any other indicator of family change. In fact, rural women in both countries are now significantly more likely to cohabit and roughly 10 percentage points more likely to have children outside of marriage than urban women. These differences are largely explained by lower levels of education and income among rural American women and fewer immigrants in rural Canada. Examining family change through a rural–urban lens fills important empirical gaps and yields novel insights into current debates on the fundamental causes of ongoing family change in high-income countries.

242 Beyond the Stereotypes: Nurturing Success and Retaining Black Women Neurosurgeons

INTRODUCTION: The underrepresentation of African American women in clinical neurosurgery, with fewer than 50 practicing neurosurgeons in the United States, highlights the significant barriers they face due to the intersection of race and gender. These challenges underscore the need for targeted efforts to recruit, retain, and support Black women in neurosurgery. METHODS: The study employed a comprehensive identification process to recruit Black women who identified as neurosurgical trainees or clinical neurosurgeons. Virtual interviews were conducted from January 2021 to May 2021, using structured questions to explore various aspects of the participants' experiences navigating neurosurgery as Black women. A thematic analysis was performed on the recorded and transcribed interviews to identify overarching themes. RESULTS: The thematic analysis identified key findings regarding Black women in neurosurgery. Mentorship was crucial, with mentors shaping career paths and fostering confidence. Residency program culture, encompassing faculty diversity, family-oriented values, and gender-specific challenges, significantly influenced experiences. Positive and negative experiences underscored the importance of representation, challenges related to racial biases, and the need for a supportive network. Building an equitable and diverse workplace was deemed vital, requiring actions to improve retention, promote Black women to leadership roles, and reduce hierarchical boundaries. Recommendations included diverse leadership, educational initiatives, and programs supporting aspiring neurosurgeons to enhance Black women's representation. CONCLUSIONS: The achievements of trailblazing Black women in neurosurgery showcase progress, yet significant disparities persist due to the intersection of race and gender. By addressing these challenges, support can be provided to enhance representation. The study highlights the importance of diverse leadership, comprehensive initiatives, and recognizing the impact of intersectionality in promoting Black women to leadership roles in neurosurgery.

Protocol for a pilot study assessing a virtual mindfulness intervention for postpartum African American women

Elevated perinatal depressive symptoms are more common among disadvantaged African American women, and they are almost four times as likely to have postpartum posttraumatic stress compared to white women. For new mothers, depressive symptoms and posttraumatic stress can lead to negative parenting, poor mother-infant bonding, and delayed infant development. For African American women, a culturally adapted mindfulness-based intervention offers great potential as an acceptable approach to reduce psycho-behavioral symptoms and improve mother-infant interactions (i.e., bonding). Additionally, it is critical that mindfulness interventions consider time constraints of new mothers, provide accessible intervention delivery, address parenting, and consider the challenges of caring for an infant. Given these considerations, we describe a pilot research protocol in which we evaluate a culturally adapted mindfulness program: Mindfulness for African Americans Postpartum (MAAP). The intervention is based upon Kabat-Zinn’s Mindfulness Based Stress Reduction program, but is adapted to include culturally relevant concepts of spirituality, inter-dependence, self-empowerment, and storytelling, which are salient to African American culture. To accommodate the needs of new mothers, a certified mindfulness interventionist delivers each session virtually using Zoom. The investigation uses a randomized controlled design in which African American women within 12 months of giving birth are randomized either to the MAAP intervention or to an Education Program. The primary aim is to determine the extent to which the MAAP intervention decreases maternal psycho-behavioral symptoms (perceived stress, depressive symptoms, anxiety, poor sleep, posttraumatic stress, and fatigue) and improves mother-infant bonding. A secondary aim is to explore the effects of MAAP on proinflammatory cytokines and oxytocin. Culturally adapted mindfulness interventions delivered virtually will make mindfulness more accessible and meaningful to populations, like African American new mothers, who are at higher risk for postpartum mood disorders and poor infant outcomes.