Young Adults Research Articles

Understanding the Relationship Between Trait Mindfulness and Perceived Stress: The Serial Multiple Mediating Roles of Basic Psychological Needs Satisfaction and Psychological Flexibility.

Although research suggests that trait mindfulness has been negatively associated with perceived stress, an integrative examination of the underlying mechanisms is lacking. Consequently, the purpose of this study was to establish an integrative model within Monitor and Acceptance Theory (MAT). This model examined the relationship between trait mindfulness and perceived stress by assessing two important psychological resources: basic psychological needs satisfaction (BPNS) and psychological flexibility. A total of 679 young adults (Mage = 19.27 years, SD = 1.06) participated in this research. They completed a set of standardized instruments that assessed trait mindfulness, BPNS, psychological flexibility, and perceived stress. Serial multiple mediation analyses showed that trait mindfulness was associated with higher levels of BPNS and psychological flexibility, which in turn were associated with less perceived stress. Furthermore, the path coefficient of the serial multiple mediation was higher than other pathways. These findings demonstrate that BPNS and psychological flexibility are important mechanisms that underlie the relationship between trait mindfulness and perceived stress, particularly when they are synergistic.

Intra-rater and inter-rater reliability of the fixed plumb line for postural and scoliosis assessment in the sagittal plane: a pilot study

Background The plumb line (PL) is a common tool for assessing the sagittal curvatures of the spine, but its accuracy depends on the ability of the physician to use it correctly. This study aimed to present a fixed plumb line (FPL) no longer held by a physician but fixed to a support, evaluating the reliability in posture assessment, comparing it with PL in both adolescent with and without scoliosis. Methods The study evaluated the sagittal distances of the spine using a PL and a FPL in 80 young adults aged between 28.7 ± 7.2 and 55 adolescents aged between 12.4 ± 2.3, with and without scoliosis. Two expert and two novice clinicians tested the patients to evaluate the intra-rater and inter-rater reliability of FPL. Each clinician assessed participants twice on the same day, with a predetermined time interval (>1 h) to reduce recall bias. Multi-factor multivariate analysis of variance and two-way analysis of variance assessed the statistical significance, while intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimum detectable change (MDC) validated FPL consistency. Results FPL provided an ICC coefficient >0.90 for all the measures, while PL an average of 0.70. On AIS patients, PL and FPL showed a significant difference for C7 p < 0.001 and T12 p < 0.001. The measured parameters were sensitive to gender and age for the FPL, furthermore, the C7 and L3 measurements were statistically different between PL and FPL (p < 0.001). Intra-rater reliability results for FPL ranged from 0.94 to 0.98 across various parameters, while the SEM and MDC values underscore the valuable precision of the FPL with changes exceeding 1 cm being meaningful. These findings suggest that FPL could be a reliable and accurate tool for measuring sagittal distances of the spine in both scoliotic and non-scoliotic patients.

Risky leisure noise exposure during the transition to adulthood and the impact of major life events – results of the OHRKAN cohort study

Objective To investigate the influence of four major life events (leaving home, full-time employment, married/cohabiting, parenthood) and socio-demographic variables on risky total leisure noise (TLN) during transition to adulthood with a special focus on visiting discotheques and listening to portable listening devices (PLDs). Design Longitudinal analysis of the OHRKAN cohort. Risky TLN covering 22 activities was defined as exceeding 85 dB(A) averaged over a 40-hour week. Potential determinants were analysed using Generalised Linear Mixed Models. Study sample A closed cohort of 2,148 students recruited in ninth grade at schools in Regensburg in 2009–2011 and surveyed five times over about 10 years. In waves 3 to 5, 1,608 individuals participated at least once. Results The prevalence of risky TLN decreased from 72.5% (median age 20) to 38.5% (median age 26). A decrease was also observed for visiting discotheques while exposure to PLD use remained relatively constant. Marriage/cohabiting and parenthood significantly reduced the prevalence of risky TLN and discotheques visits while only marriage/cohabiting reduced the prevalence of risky PLD use. Conclusions Young adults are particularly at risk to leisure noise exposure. The later major life events occur, the longer they expose themselves to risky leisure noise. Therefore, prevention is of utmost importance.

Feasibility of recruiting young adults with low socioeconomic status for formative evaluation of a smoking cessation mobile intervention.

Participant recruitment is critical to the success of smoking cessation trials. However, recruitment feasibility studies for inclusion and exclusion criteria commonly used in smoking cessation research remain scarce. We assessed the feasibility of recruiting potential research volunteers (PRVs) under two sets of inclusion criteria to inform eligibility requirements for a smoking cessation mobile intervention trial. We invited PRVs nationwide to participate in qualitative evaluation of a smoking cessation mobile application. To be eligible under Criteria I, participants were aged 18-29 years, neither four-year college graduates nor enrollees, exclusive cigarette smokers, willing to quit within 30 days, and not using cessation aids. Criteria II expanded eligibility to those using cigarettes and non-combustible tobacco products (e.g. e-cigarettes) and willing to quit within 6 months. We calculated recruitment yields and associated costs. Of 10533 PRVs screened for eligibility, 48 were enrolled. Only 54 (0.5%) participants qualified under Criteria I and 164 (1.6%) under Criteria II. Age ineligibility was the top reason for exclusion (66.7%), whereas lifetime smoking, quit timeframe, and other tobacco product use contributed to ineligibility rates ranging from 46.5% to 65.3%. Enrolled participants were equally split by sex and roughly reflected the racial/ethnic composition of the United States. American Indians, who have the highest smoking prevalence, were <5% of enrolled participants. Recruitment costs averaged $106 per PRV. Eligibility requirements used in cessation trials were restrictive for recruitment efforts. Relaxing inclusion criteria will reflect current tobacco use patterns and facilitate the timely completion of trials within budgetary thresholds.

Effects of different exposures to normobaric hypoxia on cognitive performance in healthy young adults.: Normobaric hypoxia and cognitive performance.

Normobaric hypoxia has become an innovative non-pharmacological therapy to treat cognitive dysfunction. Nevertheless, the acute effects of exposure to hypoxia on cognitive performance remain unclear. We aimed to determine the effects of different normobaric hypoxic exposures on cognitive function in healthy young adults. Nineteen participants (13 men and 6 women; 23.7±3.9 years; 172.0±8.4 cm; 69.1±12.2 kg) completed a cross-over randomized control trial with the following doses of fraction of inspired oxygen (FiO2): a) 21%, b) 15%, c) 13% or d) 11%. During experimental trials, the physiological response (blood oxygen saturation and heart rate) and the following cognitive abilities were evaluated: memory, sustained attention, anticipation, and reaction time. Sustained attention improved under hypoxia at 15% FiO2 (mean difference (MD) 0.024, 95% confidence intervals (CI) 0.005 to 0.044 s; P=0.018) compared to 11% and 21% FiO2. During 11% and 15% FiO2, participants showed improved anticipation ability compared to normoxia (MD -0.023, 95% CI -0.042 to -0.003 s, P=0.020, and MD -0.009, 95% CI -0.016 to -0.001 s, P=0.022, respectively). However, reaction time was impaired under 11% compared to 21% FiO2 (MD 0.033, 95% CI 0.008 to 0.059 s, P=0.013). Finally, we did not find significant effects of hypoxia on memory (P>0.05). Severe normobaric hypoxic exposure (11% FiO2) produces detrimental effects on reaction time, although anticipation seems to be improved, compared to normoxia. In addition, cognitive processes of attention and anticipation appear to improve with moderate hypoxic exposure (15% FiO2).

Towards a Satisfactory Future—Multiprofessional Rehabilitation for Young Persons with ADHD or ASD

There is a lack of knowledge about what kind of support should be offered in adulthood for persons with attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) to promote inclusive participation in meaningful life domains. The core components of multiprofessional rehabilitation intervention for young adults are explored from the perspective of multiprofessional teams. This qualitative study adopts a pragmatic perspective on the core components of rehabilitation. Twenty-six professionals participated in vignette-based focus group interviews (n = 5), and thematic reflexive analysis was used to abductively analyze the data. A total of ten core components were identified. Nine of them were aggregated into three categories: (1) rehabilitation readiness (two core components), (2) adaptive progress in personal goals (four core components), and (3) rehabilitation continuum (three core components). The overarching tenth core component is focusing on the personal goals of daily life, work, studies, and social interaction. A collaborative relationship between the client and professional is essential to ensure adaptive progress and to foster clients’ self-determination. The focus should be on strengths and solutions instead of deficits and challenges. To establish rehabilitation continuum, it is essential to collaborate within the clients’ networks and to promote awareness and inclusive opportunities for working and studying for people with ADHD and ASD.

Minimum Normalized Cycling Cadence to Increase Post-Cycling Gait Velocity

Background: Previous research has shown that increasing cycling cadence can result in improved post-cycling gait velocity. However, the specific threshold of cycling cadence required to bring about clinically meaningful changes in gait velocity remains unknown. This study aimed to determine the minimum increment in cycling cadence that would lead to a significant improvement in post-cycling gait velocity. Methods: A total of 42 young adults participated in our study and were randomly assigned to one of three groups: TEN, TWENTY, and THIRTY. Each group was assigned to cycle at a cadence at the corresponding percentage higher than the participant’s self-selected gait cadence. Each participant engaged in a 15-min cycling session at their respective assigned cycling cadence. Before and after cycling, participants completed a 10-meter walk test while spatiotemporal parameters of gait, ground reaction forces, lower extremity kinematics, and kinetics were recorded. Results: One-way ANOVA revealed no statistically significant changes in spatiotemporal, ground reaction force, kinematics, and kinetics variables pre- and post-cycling. However, there were both statistically significant (F(2,41) = 3.794, p = 0.031, η2 = 0.604) and clinically meaningful changes (0.07 m/s) in post-cycling gait velocity in the THIRTY group only. Conclusions: This suggests that a cycling cadence of 30% or higher is the minimum requirement to produce a clinically significant improvement in gait velocity.

Consumption of Sugar-Sweetened Beverages by Polish Young Adults: A Preliminary Study on the Importance of Sugar Tax Familiarity and Health Effects

Consumption of sugar-sweetened beverages (SSBs) contributes to the risk of developing overweight and obesity in children and adults. Thus, reducing free sugar is a globally recognized public health priority. The implementation of a sugar tax is one way of achieving this goal. This study aimed to investigate the relationship between familiarity with the sugar tax and its importance in reducing obesity, the perceived health consequences of SSBs, situations and reasons for consumption, and the frequency of SSB consumption. A cross-sectional study was conducted in May 2022 among 216 Polish adults (age 18–45). Hierarchical cluster analysis was used to identify three homogeneous clusters with regard to the perceived health consequences of consuming SSBs. A logistic regression model was used to verify the relationship between the frequency of SSB consumption (dependent variable) and other variables. Respondents with higher familiarity with the sugar tax (OR: 0.594; 95% CI: 0.42–0.85) and those in the “Unaware of disease” (OR: 0.437; 95% CI: 0.18–0.94) and “Disease-conscious” (OR: 0.484; 95% CI: 0.24–0.97) clusters were less likely to consume SSBs at least once per week than those in the “Moderately disease-conscious” cluster. Both the place of SSB consumption (i.e., restaurant—OR: 1.847; 95% CI: 1.14–3.64, work or university—OR: 3.217; 95% CI: 1.51–6.88, family home—OR: 2.877; 95% CI: 1.50–5.53) as well as a preference for their taste (OR: 4.54; 95% CI: 1.66–12.45) increased the chance of consuming SSBs at least once a week. In conclusion, it is necessary to continue educating the public about the health consequences of SSB consumption. The use of legislative measures (i.e., sugar tax) also contributes to reducing SSB consumption and can thus counteract the increasing obesity rate.

Abstract 4113411: Long Term Outcomes of Hypertension and Antihypertensive Drugs in Young Healthy Adults: A Nationwide Population-based Prospective Cohort Study in Korea

Background: Long term follow-up data on elevated blood pressure (BP) or antihypertensive drugs in young adults are scarce. The effect of hypertension (HTN) and antihypertensive medications on the cardiovascular disease incidence in young healthy adults (20~45 years) was analyzed using a large-scale population medical use database in Korea. Methods: In total, 4,590,597 young Korean adults without comorbidities who underwent regular health examination were included in this study. They were stratified into four groups according to their BP (optimal BP, normal BP, high normal BP, and HTN). The primary outcome was a composite of the incidence of myocardial infarction and ischemic and hemorrhagic stroke, obtained by tracking the medical use data of the first-ever ICD-10 codes. Subgroup analysis was conducted by categorizing the HTN group into two subgroups according to the prescription ratios of the antihypertensive drugs during the follow-up period. Results: The average age was 33.8 years and median follow-up duration was 15.9 years. HTN elevated the incidence risk of major cardiovascular disease by 2.16 times compared to that of the optimal BP group. Dyslipidemia and HTN were the most dominant risk factors for myocardial infarction and stroke, respectively. In the subgroup analysis, antihypertensive medications decreased the incidence of cardiovascular disease by 70% in all diseases. Conclusions: Cardiovascular risk factors, including HTN, contribute to major cardiovascular disease incidence in young adults. The antihypertensive medications decreased the major cardiovascular disease incidence estimates.

"The Butcher on the Bus" is Less Familiar to Older Adults than She is to Younger Adults.

The "butcher on the bus" is a term describing recognizing someone as familiar but failing to recollect how we know them. Previous studies probing this phenomenon have not used paradigms that mimic real life, and age-related differences have not been adequately addressed. In two studies, younger and older adults studied faces in scene contexts a variable number of times. In the test phases, studied faces were presented identical to the study phase, new faces were presented with new scenes, or studied faces were presented in a different context. In Study 1, this different context was the face presented with new features (pose, hairstyle, and clothing) and in a new scene. In Study 2, this different context was the same scene, but with new features. Participants made recollect, familiar, or new judgments, as well as source memory judgments for each face. In both studies, younger adults had better recognition discrimination and recollection. The critical finding of both studies was that when faces were presented with new features, in either the same scene or a different scene, older adults did not find these faces as familiar as did younger adults. Age-related declines in face recognition when features change may impact social interactions and everyday recognition tasks, highlighting the need for further research and supportive strategies to assist older adults in recognizing people.

Abstract 4136355: Investigating Changes in Hazardous and Harmful Drinking Among Young Adults Through Zoom Intervention

Introduction/Background: Hazardous drinking is a major adverse factor for young adults’ health. This study investigates the efficacy of an integrated contingency management and problem-solving Zoom intervention in addressing hazardous and harmful drinking among young adults. Research Questions/Hypothesis: Participants who receive the 8-session integrated Zoom CM-PST intervention will demonstrate a significant reduction in hazardous and harmful drinking behaviors compared to baseline measurements. Goals/Aims: The aims of this study were to evaluate the effectiveness of 8-session integrated Zoom contingency management and problem-solving Zoom intervention in reducing hazardous and harmful drinking reduction and abstinence. Methods/Approach: This pilot randomized controlled trial study employed a single-arm design with post-intervention and follow-up assessments at 12 weeks. The study targeted young adults aged 18-24 in Chicagoland who regularly consume alcohol at least once a week and have alcohol use disorder. Participants completed the Alcohol Use Disorders Identification Test (AUDIT), Drinking Motives Questionnaire-Revised (DMQ-R), and the 90-day Timeline Follow-back (TLFB) at baseline and 12 weeks after the intervention. The Zoom CM-PST intervention was administered to the participants, and a self-reported questionnaire was utilized to evaluate participants’ drinking use, severity, motivation, and hazardous drinking behavior at baseline and at the 12-week follow-up. A paired t-test, correlation, and multiple regressions were performed to investigate changes in hazardous and harmful drinking among 20 young adults aged 18-24. Results: A paired t-test showed that the participant’s level of alcohol use problem and social, coping, and enhancement motivation for alcohol use decreased from pre- to post-intervention. High drinking behaviors accounted for 40% at baseline, while 35% at post-intervention assessment. Over 12 weeks, 45% of participants demonstrated an improvement in hazardous drinking behaviors. Motivation at baseline was a significant factor affecting post-intervention alcohol use problems at 12 weeks. Conclusions: The results showed notable enhancements in alcohol use problem reduction and motivation for alcohol use at 12 weeks. The study provides useful insights into the effectiveness of web-based integrated contingency management and problem-solving Zoom interventions in mitigating hazardous and harmful drinking among young adults.

Abstract 4114461: Low-density lipoprotein cholesterol, prevalence of cardiovascular disease risk factors, and predicted cardiovascular disease risk among young adults: National Health and Nutrition Examination Survey 2015-2020

Introduction: It is unclear if young adults with hyperlipidemia are also more likely to have non-lipid cardiovascular disease (CVD) risk-factors or higher long-term CVD risk. As such, we assessed associations between low-density lipoprotein cholesterol (LDL-C) levels and non-lipid CVD risk factors as well as 10- and 30-year risk of CVD in young adults. Methods: We included a nationally representative sample of adults 20-&lt;40 years from the National Health and Nutrition Examination Survey (January 2015-March 2020). We described sociodemographic characteristics and CVD risk factors by LDL-C level. We used simple logistic regression to determine associations between LDL-C level and each CVD risk factor. We then calculated the median 10- and 30-year CVD risk by LDL-C category for each participant using the PREVENT risk estimating equations. Results: Among 2,133 (weighted estimation: 90.3 million) young adults, 51.0%, 32.6%, 12.5%, and 3.9% had an LDL-C &lt;100 mg/dL, 100-&lt;130 mg/dL, 130-&lt;160 mg/dL, and 160-&lt;190 mg/dL, respectively. Compared to participants with an LDL-C &lt;100mg/dL, those with an LDL-C 100-&lt;130 mg/dL, 130-&lt;160 mg/dL, and 160-189 mg/dL were more likely to have metabolic syndrome, an enlarged waist, hypertension, elevated glucose, diabetes mellitus, high triglycerides, and high hs-CRP (Table). The median 10-year risk of CVD was approximately 1% across all baseline LDL-C levels. Over a 30-year time horizon, the median risk of incident CVD exceeded 5% only in the 130-&lt;160mg/dL and 160-189mg/dL LDL-C categories (6.0% and 7.6%, respectively). LDL-C and the interaction between LDL-C and CVD risk enhancing factors were independently associated with 30-year predicted risk of CVD (p=0.006 and p=0.005, respectively). Discussion: Many young adults with an elevated LDL-C have concomitant high-risk CVD characteristics. The risk/benefit calculous for addressing this modifiable risk factor in these patients should be further explored.

Abstract 4136554: Comparison of short- and long-term atherosclerotic cardiovascular disease risk assessment tools in US young adults

Background: In 2023, the AHA published the PREVENT equations for estimating atherosclerotic cardiovascular disease (ASCVD) risk in adults aged 30-79 years. Research Questions: In young adults aged 20-39 years, does PREVENT improve risk prediction for 10- and 30-year ASCVD compared with existing risk assessment tools recommended in the current US guidelines (i.e., Pooled Cohort Equations [PCEs] and Pencina et al. equations)? Aims: To compare the performance of PREVENT vs. PCEs in predicting 10-year ASCVD, and PREVENT vs. Pencina equations in predicting 30-year ASCVD in young adults. Methods: We analyzed data from two complementary sources: (1) pooled data from two large cohorts: Coronary Artery Risk Development in Young Adults (CARDIA) and Framingham Heart Study (FHS; including the Offspring, Third Generation, Omni 1, and Omni 2 cohorts), and (2) electronic health records from Kaiser Permanente Southern California (KPSC). We included adults aged 20-39 years without a history of ASCVD at baseline. The outcome was incident ASCVD (defined as myocardial infarction, fatal coronary heart disease, fatal and nonfatal stroke) at 10 or 30 years. Model discrimination (Harrell’s C) and mean calibration (estimated as the ratio of predicted to observed event rates) were calculated for the overall population and stratified by sex and race/ethnicity. Results: We included 7,606 young adults (mean age 29 years, 53% female, 30% Black) from the pooled cohorts, and 284,667 (mean age 32 years, 61% female, 8% Black, 46% Hispanic) from KPSC. When predicting 10-year risk, PREVENT improved discrimination in both the pooled cohort (ΔHarrell’s C=0.052; 95% CI: 0.014, 0.095) and KPSC (ΔHarrell’s C=0.039; 95% CI: 0.028, 0.049) compared with the PCEs. PREVENT had good calibration (mean calibration ranged from 0.77 to 1.54), whereas the PCEs overestimated 10-year risk (mean calibration ranged from 1.99 to 4.82). When predicting 30-year risk, discrimination was similar for PREVENT and Pencina equations, but both algorithms underestimated 30-year risk with PREVENT showing worse calibration (mean calibration 0.61). Conclusion: PREVENT improved 10-year ASCVD risk prediction in young adults compared to the PCEs but underestimated 30-year risk.

Young Black and White adults prefer in-person to telehealth for primary care visits and group health promotion programs.

Telehealth utilization has increased since the coronavirus disease 2019 pandemic, reducing barriers to healthcare and, potentially, reducing participation in group health-promotion interventions. However, preferences for telehealth versus in-person formats have not been established. To examine preferences for telehealth and in-person format for primary care and group health-promotion interventions among Black and White women and men aged 20-39. We hypothesized that respondents would report a higher preference for telehealth than in-person appointments. This cross-sectional survey study recruited participants to answer questions about access to technology and preferences for telehealth and in-person formats of primary care and group health promotion. Respondents (n = 404) included similar proportions of White women (24.3%, 26.4 ± 4.3 years), Black women (25.0%, 29.0 ± 6.1 years), White men (25.9%, 32.8 ± 4.5 years), and Black men (24.8%, 30.6 ± 5.2 years). About 98.5% reported having a smartphone, and 80.4% had access to a computer with a camera. Preference ratings were higher for in-person visits, compared to telehealth visits, for both primary care (M = 3.86 ± 1.13 vs. M = 2.87 ± 1.18) and group health promotion (M = 3.72 ± 1.12 vs. M = 3.04 ± 1.20) F's(1,400) > 59.0, P's < .001. Most young adults have access to technology, supporting the feasibility of telehealth interventions. However, telehealth preference ratings were lower than in-person appointments. Preferences for delivery formats should be considered when designing behavioral interventions to promote health and prevent disease.

Abstract 4128457: Trends in Hypertension-Related Mortality Among Younger Adults in the United States From 1999-2021

Background: The U.S. population has seen a dramatic increase in the burden of hypertension (HTN) among younger adults. However, HTN-related mortality trends among younger adults have not been investigated. Aim: We examined the trends and demographic differences in HTN-related mortality among younger adults in the U.S. Methods: Data from the CDC WONDER database was examined from 1999 to 2021 for HTN-related mortality in adults between 15 to 45 years of age. The International Statistical Classification of Diseases and Related Health Problems-10th Revision (ICD-10) codes employed were as follows: I10-I15 (hypertensive diseases). Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent changes (APCs) with 95% confidence intervals (CIs) were calculated and stratified by year, sex, race/ethnicity, urbanization status and census region. Results: Between 1999 and 2021, 201,860 HTN-related mortalities occurred among younger adults in the U.S. The AAMR increased from 2.8 in 1999 to 5.0 in 2001 (APC, 35.3 [20.6 to 44.5]), after which it steadily increased to 9.4 in 2019 (APC 3.1, [2.7 to 3.5]), and sharply increased to 13.9 in 2021 (APC 22.3; 95% CI 15.1 to 26.4). Men had consistently higher AAMRs than women from 1999 (AAMR men: 3.6 vs women: 1.9) to 2021 (AAMR men: 18.9 vs women: 8.8). Non-Hispanic (NH) Black or African American young adults had the highest AAMR in 2020 (30.2), followed by NH American Indian/Alaska Natives (29.6), NH White (9.9), Hispanics or Latino (9.3) and NH Asian or Pacific Islanders (5.0). AAMR also varied substantially by region (overall AAMR: South 9.3; Midwest 6.4; West 5.8; Northeast 5.4), and rural areas had higher HTN-related mortality (8.5) than their urban counterparts (7.0). Figure 1. Conclusion: Following a steady increase until 2019, HTN-related mortality increased among young adults between 2020 and 2021. The highest AAMRs were observed among men and Black or African American young adults, and people residing in the Southern and non-metropolitan areas. This emphasizes the necessity of tailored interventions to mitigate the burden and reduce the current disparities in HTN-related mortality among young adults in the U.S.

Abstract 4136846: Sex Differences in Hypertension Diagnosis among Young Adults

Background: Young adults, especially men, may experience delays in diagnosis of hypertension, which subsequently affect timely treatment and control of high blood pressure (BP). Question: Compared with young adult women, how soon are young adult men diagnosed with hypertension after having high BPs during clinical encounters? Aim: To estimate the time to first diagnosis of hypertension in young adult men and women, and to identify factors associated with a delayed diagnosis of hypertension. Methods: Using electronic health records, we identified adults aged 18-39 years with systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg, based on average of three consecutive separate outpatient BPs within two years of each other, between 2009-2016 from Kaiser Permanente Southern California. We followed them from the third qualifying BP until hypertension diagnosis, membership disenrollment, end of study (12/31/2019), or death, whichever occurred first. We used the cumulative incidence function and Cox proportional hazards models to estimate the time to first diagnosis of hypertension and identify factors associated with diagnosis. Results: Among 2,443 young adults (mean age 31 years, 57% men) with high BP, 37% were diagnosed with hypertension during a median of 5.9 years. Compared with women, a lower percentage of men were diagnosed with hypertension (30% vs 47%) and men received their diagnoses later (median time to diagnosis: 2.3 vs 1.4 years) ( Figure ). Among the total population, 19% of men and 12% of women did not have follow-up BP measures within one year following their third qualifying high BP. Among those diagnosed, 80% initiated with antihypertensive medications within one year following their diagnosis. Factors associated with a delayed diagnosis of hypertension included being male, younger, having lower systolic or diastolic BP, a lower body mass index, and the absence of dyslipidemia or (pre)diabetes. Conclusion: This study highlights that young adult men are at a higher risk of delayed hypertension diagnosis, emphasizing the need for healthcare system level interventions to improve the recognition, diagnosis, and treatment of hypertension in this population.

Comparison of inflammatory mediator cytokine responses to inactivated virus platform COVID-19 vaccines between elderly and young adult populations

The coronavirus disease 2019 (COVID-19) pandemic has encouraged global vaccine research, yet vaccine effectiveness in the elderly remains a concern due to immunosenescence. The aim of this study was to compare the cytokine response elicited by an inactivated virus-based COVID-19 vaccine between elderly and young adults, focusing on key cytokines involved in cellular and humoral immunity: tumor necrosis factor-alpha (TNF-α), interleukin (IL)-2, IL-6, IL-10, and interferon-gamma (IFN-γ). A cross-sectional study was conducted in the Jakarta-Bogor region of Indonesia from January 2023 to December 2023. The study population was divided into two age cohorts: elderly (60−85 years) and younger adults (30−40 years). Blood samples were collected twice, after the first booster dose and four weeks after the second booster dose. Serum cytokine concentrations were measured using Luminex assays with microparticles conjugated to monoclonal antibodies against TNF-α, IL-2, IL-6, IL-10, and IFN-γ. Comparisons of the cytokine levels were conducted using Student’s t-tests or Mann-Whitney U tests as appropriate. A total of 74 individuals were included, with 37 each in the elderly and young adult groups. The results showed significant differences in cytokine responses between the two age groups. After the first booster, the levels of IL-6 and IFN-γ were significantly higher in young adults compared to the elderly. After the second booster, the levels of IL-6 were still significantly higher in the young adult group compared to the elderly group (p=0.001). Data indicated that after the second booster dose, the levels of TNF-α increased significantly in the young adult group only (p=0.004), while the levels of IL-2 (p=0.040) and IFN-γ (p=0.006) increased in the elderly group only compared to after the first dose. IL-10 levels increased in both groups (both had p=0.020). This study highlights that young adults had stronger pro-inflammatory responses, while the elderly relied more on IL-2 and IFN-γ for T-cell immunity, suggesting the need for vaccination strategies for the elderly to optimize immune responses.

The Relationship Between Alexithymia And Compulsive Shopping Among Young Adults

Although previous studies have investigated factors contributing to compulsive shopping, the specific role of alexithymia and its influence on emotional regulation in predicting this behavior remains underexplored. The study explores the link between alexithymia and compulsive shopping in young adults, focusing on whether emotional regulation difficulties predict problematic shopping behavior. A sample of 220 Italian young adults was assessed using the Toronto Alexithymia Scale (TAS-20) and the Shopping Behaviour Scale (SBS). Multiple regression analysis revealed that alexithymia's three dimensions explained 4.8% of the variance in compulsive shopping. Externally oriented thinking was the only significant predictor, while difficulty identifying and describing feelings were not. The findings suggest that individuals more focused on external realities are at higher risk for compulsive shopping. Improving emotional awareness and regulation may help reduce this behavior in young adults.

Abstract 4131486: Cardiovascular Mortality in Children and Young Adults: Trends and Demographic Differences in the United States, 1999 to 2021

Background: Cardiovascular disease (CVD) mortality in the U.S. younger population is on the rise. However, limited data is available on CVD-related mortality trends in this population. Aim: This study aimed to assess the temporal trends and demographic differences in CVD-related mortality among the U.S. youth. Methods: The CDC WONDER dataset was analyzed from 1999-2021 for CVD-related mortality in children and young adults (age &lt;25 years). Socio-demographic data including gender, race/ethnicity, urbanization status and census region was acquired. Age adjusted mortality rates (AAMR) per 100,000 persons and annual percent changes (APCs) with 95% confidence interval (CIs) were calculated. Results: Between 1999-2021, a total 54,283 CVD-related deaths occurred among the youth in the U.S. The overall AAMR declined from 1999-2008 (APC, -1.15 [-3.4 to 0.53]), followed by sharp decrease from 2008-2012 (APC, -3.28 [-4.68 to 0.86]). The AAMR continued to decrease steadily from 2012 to 2019 (APC: -1.20, [-3.76 to -0.06]), followed by a sharp increase in from 2019 to 2021, (APC, 3.03 [-0.66 to 5.12]). Males consistently had higher AAMRs than females from 1999 (AAMR males: 2.99 vs females: 2.3) to 2021 (AAMR males: 2.39 vs females: 1.74). Non-Hispanic (NH) Black or African Americans had the highest AAMR in 2020 (3.68), followed by NH Whites (1.71), Hispanic or Latinos (1.59), and Asian and Pacific Islanders (1.2). AAMRs also showed significant variations across different regions (overall AAMR West 1.81; Northeast 1.93; Midwest 2.3; South 2.69). Metropolitan areas (2.23) consistently had lower mortality rates than nonmetropolitan areas (2.59). Conclusion: Our analysis revealed that CVD-related mortality in the youth declined from 1999-2019, followed by an increase in 2020 to 2021. Highest mortality rates were seen in males, Black or African Americans, Western region of the U.S, and nonmetropolitan areas. Tailored interventions are necessitated to decrease the burden of CVD-related mortality in these demographics among children and young adults in the United States.

Abstract 4128549: Feasibility and Acceptability of a Combined Contingency Management and Problem-Solving Therapy Intervention to Enhance Alcohol Abstinence: A Pilot Single-Arm Mixed Methods Randomized Controlled Trial

Introduction/Background: It is crucial to develop and implement innovative behavior-change therapies that specifically target young adults with alcohol use disorder, as the prevalence of this issue is on the rise, and it has serious long-term health consequences. Research Questions/Hypothesis: How does the newly developed Contingency Management and Problem-Solving Therapy (CM-PST) intervention impact the levels of alcohol misuse or abstinence in young adults at follow-up compared to baseline.Young adults who receive the newly developed CM-PST will have lower levels of alcohol misuse or abstain from alcohol. Goals/Aims: We aimed to examine the feasibility, acceptability, and efficacy of an integrated behavior therapy of CM-PST for young adults with alcohol use disorder. Methods/Approach: This mixed methods study employed a single-arm design with post-intervention and 12-week follow-up assessments. Young adults aged 18-24 were recruited from July 2023 to May 2024. Participants underwent the newly developed integrated CM-PST intervention for 8 weeks. The assessment of feasibility was conducted by evaluating the rates of recruitment and retention, and adherence to the intervention. Acceptability was assessed by analyzing participants’ feedback and engagement data. Participants completed the Alcohol Use Disorders Identification Test (AUDIT) and the 90-day Timeline Follow back (TLFB) at baseline and 12 weeks after the intervention. Furthermore, they participated in a twice daily breathalyzer test, post-intervention interview and completed a client satisfaction scale questionnaire. Results: A total of 28 participants were recruited, with 71.43% (20/28) completing all the study procedures. Adherence to the CM-PST was 100%, indicating strong engagement. Participant feedback highlighted the influence of CM on behavior and decision-making and the efficacy of PST in addressing life challenges as well. Alcohol consumption at 12 weeks was significantly lower than those at baseline ( t =3.042, p =.007). Overall, the newly developed intervention was well-received, and 95% of participants indicated that the interventions were acceptable. Conclusions: This study showed that the integrated CM-PST intervention to promote alcohol abstinence and reduce alcohol related problems is both feasible and acceptable. Study findings indicated that the intervention has potential as a supplementary care for individuals seeking support in reducing alcohol consumption.