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Acuna N, Shariff-Marco S, Wu AH, Meltzer D, Inamdar P, Lim T, Marchand LL, Haiman CA, Wilkens LR, Cheng I, Setiawan VW. The Association of Alcohol Outlet Density with Alcohol Intake: The Multiethnic Cohort. J Stud Alcohol Drugs 2024. [PMID: 38335031 DOI: 10.15288/jsad.23-00138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Abstract
OBJECTIVE Neighborhood characteristics have been shown to influence lifestyle behaviors. Here we characterized alcohol outlet density in Los Angeles County, California, and Hawaii and assessed the association of alcohol outlet density with self-reported alcohol intake in the Multiethnic Cohort. METHOD Participants (n=178,977) had their addresses geocoded, at cohort entry (1993-1996), and appended to block group-level alcohol outlet densities (on- and off-premises). Multinomial logistic regression was performed to assess the association between self-reported alcohol intake and on- and off-premise alcohol outlet densities by each state. Stratified analysis was conducted by sex, race, and ethnicity. RESULTS Overall, we did not find associations between alcohol outlet density and self-reported alcohol intake in Los Angeles County, but we found that on-premise alcohol outlets were associated with 59% (OR=1.59, 95% CI:1.29,1.96) increased odds of consuming >2 drinks per day in Hawaii. Women living in neighborhoods with high density of on-premise alcohol outlets (Los Angeles County OR=1.15, 95% CI: 0.95,1.40) and (Hawaii OR=2.07, 95% CI: 1.43,3.01) had an increased odds of >2 drinks per day. CONCLUSION This study suggests that neighborhood factors are associated with individual level behaviors and that there may be a need for multilevel interventions.
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Affiliation(s)
- Nicholas Acuna
- Department of Population & Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Salma Shariff-Marco
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Anna H Wu
- Department of Population & Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Dan Meltzer
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
| | - Pushkar Inamdar
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
| | - Tiffany Lim
- Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Loïc Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Christopher A Haiman
- Department of Population & Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lynne R Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Iona Cheng
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Veronica Wendy Setiawan
- Department of Population & Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Acuna N, Zhou K, Pinheiro PS, Cheng I, Shariff-Marco S, Lim T, Wilkens LR, Le Marchand L, Haiman CA, Setiawan VW. Increasing risk of hepatocellular carcinoma with successive generations in the United States among Mexican American adults: The Multiethnic Cohort. Cancer 2024; 130:267-275. [PMID: 37982329 DOI: 10.1002/cncr.35000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 06/27/2023] [Accepted: 07/10/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND US-born Latinos have a higher incidence of hepatocellular carcinoma (HCC) than foreign-born Latinos. Acculturation to unhealthy lifestyle behaviors and an immigrant self-selection effect may play a role. In this study, the authors examined the influence of generational status on HCC risk among Mexican American adults. METHODS The analytic cohort included 31,377 self-reported Mexican Americans from the Multiethnic Cohort Study (MEC). Generational status was categorized as: first-generation (Mexico-born; n = 13,382), second-generation (US-born with one or two parents born in Mexico; n = 13,081), or third-generation (US-born with both parents born in the United States; n = 4914). Multivariable Cox proportional hazards regression was performed to examine the association between generational status and HCC incidence. RESULTS In total, 213 incident HCC cases were identified during an average follow-up of 19.5 years. After adjusting for lifestyle and neighborhood-level risk factors, second-generation and third-generation Mexican Americans had a 37% (hazard ratio [HR], 1.37; 95% confidence interval [CI], 0.98-1.92) and 66% (HR, 1.66; 95% CI, 1.11-2.49) increased risk of HCC, respectively, compared with first-generation Mexican Americans (p for trend = 0.012). The increased risk associated with generational status was mainly observed in males (second-generation vs. first-generation: HR, 1.60 [95% CI, 1.05-2.44]; third-generation vs. first-generation: HR, 2.08 [95% CI, 1.29-3.37]). CONCLUSIONS Increasing generational status of Mexican Americans is associated with a higher risk of HCC. Further studies are needed to identify factors that contribute to this increased risk.
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Affiliation(s)
- Nicholas Acuna
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Kali Zhou
- Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Research Center for Liver Disease, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Paulo S Pinheiro
- Sylvester Comprehensive Cancer Center, Miami, Florida, USA
- Department of Public Health Sciences, University of Miami School of Medicine, Miami, Florida, USA
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California, USA
| | - Salma Shariff-Marco
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California, USA
| | - Tiffany Lim
- Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Lynne R Wilkens
- Epidemiology Program, University of Hawai'i Cancer Center, Honolulu, Hawai'i, USA
| | - Loïc Le Marchand
- Epidemiology Program, University of Hawai'i Cancer Center, Honolulu, Hawai'i, USA
| | - Christopher A Haiman
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Veronica Wendy Setiawan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Research Center for Liver Disease, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Norris Comprehensive Cancer Center, Los Angeles, California, USA
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Acuna N, Park SY, Le Marchand L, Hébert JR, Boushey C, Wilkens LR, Wu AH, Setiawan VW. Diet quality and risk of gastric adenocarcinoma: The Multiethnic Cohort. Am J Clin Nutr 2023; 117:46-54. [PMID: 36789943 PMCID: PMC10196603 DOI: 10.1016/j.ajcnut.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/28/2022] [Accepted: 11/04/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Certain dietary patterns (i.e., low intake of fruit/vegetables and high intake of salt and processed meats) have been associated with the risk of gastric cancer. However, it is unclear whether overall diet quality assessed by predefined indices that consider the complexity of dietary intake is associated with gastric cardia and distal adenocarcinoma. OBJECTIVES To examine the association of a variety of diet indices with the risk of gastric cardia and distal adenocarcinoma and assess whether there are any subgroups that may benefit from better diets to reduce the risk of gastric adenocarcinoma. METHODS Dietary indices of interest included the Alternative Healthy Index (AHEI)-2010, Healthy Eating Index (HEI)-2015, the Dietary Approach to Stop Hypertension, alternate Mediterranean diet (aMED), and the energy-adjusted Dietary Inflammatory Index. RESULTS After an average follow-up time of 19.2 years, there were 836 incident cases of gastric distal adenocarcinoma and 207 cases of gastric cardia adenocarcinoma. We did not observe any significant associations between the dietary indices and gastric cancer for either anatomic site. Among former aspirin users, we observed an inverse association between aMED with distal cancer (HRQ5 vs. Q1: 0.64; 95% CI: 0.33, 1.23; P-trend = 0.03). Never smokers, who showed high-quality diet according to AHEI-2010, exhibited a 40% decreased risk of gastric distal cancer compared with those with the poorest-quality AHEI-2010 diet (HRQ5 vs. Q1: 0.60; 95% CI: 0.41, 0.88; P-trend = 0.08). CONCLUSIONS In a multiethnic population, we did not observe overall significant associations between these dietary quality indices and risk of gastric cancer. However, among former aspirin users and never smokers, there could be a reduction of gastric distal adenocarcinoma risk with a higher adherence to a Mediterranean diet.
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Affiliation(s)
- Nicholas Acuna
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Song-Yi Park
- Epidemiology Program, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Loïc Le Marchand
- Epidemiology Program, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - James R Hébert
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Carol Boushey
- Epidemiology Program, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Lynne R Wilkens
- Epidemiology Program, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Anna H Wu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - V Wendy Setiawan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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Acuna N, Park SY, Wu AH, Wilkens LR, Setiawan VW. Abstract 737: Diet quality and risk of gastric adenocarcinoma: The Multiethnic Cohort. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Certain diet components (i.e. low intake of fruit/vegetables and high intake of salt and processed meats) have been associated with risk of gastric cancer. However, it is unclear whether overall diet quality assessed by pre-defined indices, that take into account the complexity of dietary intake, is associated with gastric cardia and distal adenocarcinoma particularly in a racially and ethnically diverse population. Our objectives are to 1) examine the association of a variety of diet quality indices with risk of gastric cardia and distal adenocarcinoma and 2) assess if there are any subgroups that may benefit from better diets to reduce risk of gastric adenocarcinoma.
Methods: The analysis included 176,752 men and women aged 45-75 from the Multiethnic Cohort (MEC), who were African American, Japanese American, Latino, Native Hawaiian, or White, and completed a quantitative food frequency questionnaire (QFFQ) at cohort entry. Incident cases of gastric cancer (cardia ICD-O-3 C16.0 and non-cardia adenocarcinoma C16.1-C16.6) were identified by linkages with the Surveillance, Epidemiology, and End Results (SEER) cancer registries. Dietary indices, Alternative Healthy Index-2010 (AHEI-2010), Healthy Eating Index-2015 (HEI-2015), Dietary Approach to Stop Hypertension (DASH) score, alternate Mediterranean Diet (aMED) score, and Dietary Inflammatory Index (DII®), were calculated from the QFFQ and categorized into quintiles. Multivariable Cox models were used to estimate the association between dietary indices and gastric cancer risk by anatomic site. Effect modification was assessed for distal cancer by sex, smoking status, and aspirin use.
Results: A total of 207 incident cases of gastric cardia and 836 incident cases of gastric non-cardia were identified during an average follow up of 19.2 years. We did not observe any significant associations between any of the dietary indices and gastric cancer for both cardia and non-cardia tumors. However, we observed effect modification by aspirin use for aMED (P for heterogeneity = 0.01) as well as for DII (P for heterogeneity = 0.02). Among ever aspirin users, we observed an inverse association between aMED (HRQ5 vs Q1: 0.82, 95% CI: 0.53-1.26, Ptrend = 0.03) with non-cardia cancer, and the association with DII® was borderline statistically significant for the trend test (HRQ5 vs Q1: 0.86, 95% CI: 0.57-1.29, Ptrend = 0.07).
Conclusion: In a multiethnic population, we did not observe overall significant associations between these dietary quality indices and risk of gastric cancer. However, among ever aspirin users there could be a reduction of gastric non-cardia adenocarcinoma risk with a higher adherence to a Mediterranean diet.
Citation Format: Nicholas Acuna, Song-Yi Park, Anna H. Wu, Lynne R. Wilkens, V. Wendy Setiawan. Diet quality and risk of gastric adenocarcinoma: The Multiethnic Cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 737.
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Affiliation(s)
| | - Song-Yi Park
- 2University of Hawaii Cancer Center, Honolulu, HI
| | - Anna H. Wu
- 1Keck School of Medicine of USC, Los Angeles, CA
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Acuna N, Malarkey S, Plaha J, Smith N, Valera P. Examining Attitudes, Expectations, and Tobacco Cessation Treatment Outcomes Among Incarcerated Tobacco Smokers. J Correct Health Care 2022; 28:252-259. [PMID: 35704917 PMCID: PMC9529363 DOI: 10.1089/jchc.20.08.0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
People who are incarcerated have limited resources to help them quit tobacco smoking. This study assessed the association between baseline attitudes and expectations of the program with final smoking status as the outcome. A 6-week group-based counseling with nicotine patches was provided to incarcerated individuals to quit smoking. A cross-sectional survey was given at the first session. Questions surrounding attitudes such as interest, confidence, motivation, and expectations were used to assess associations with smoking cessation. Exhaled carbon monoxide (CO) levels were taken at each sessions. Participants were categorized as nonsmoking or continued smoking at a 6.0 parts per million (ppm) CO at their final session attended. Overall, 123 participants had a CO higher than 6.0 ppm or missed more than two sessions at their final session, and 54 had a CO under 6.0 ppm. A total of 102 participants completed the 6-week program. Differences among the two groups in exhaled CO began at Session 3 and continued throughout the study.
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Affiliation(s)
- Nicholas Acuna
- Department of Population & Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, California, USA.,Community Health Justice Lab, Newark, New Jersey, USA
| | - Sarah Malarkey
- Community Health Justice Lab, Newark, New Jersey, USA.,Department of Epidemiology and Biostatistics, Rutgers University School of Public Health, Piscataway, New Jersey, USA
| | - Jessica Plaha
- Community Health Justice Lab, Newark, New Jersey, USA.,Rutgers University, School of Graduate Studies, Newark, New Jersey, USA
| | - Nadia Smith
- Community Health Justice Lab, Newark, New Jersey, USA.,Department of Urban-Global Public Health, Rutgers University School of Public Health, Newark, New Jersey, USA
| | - Pamela Valera
- Community Health Justice Lab, Newark, New Jersey, USA.,Department of Urban-Global Public Health, Rutgers University School of Public Health, Newark, New Jersey, USA
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Valera P, Owens M, Malarkey S, Acuna N. Exploring Tobacco and E-Cigarette Use among Queer Adults during the Early Days of the COVID-19 Pandemic. Int J Environ Res Public Health 2021; 18:12919. [PMID: 34948530 PMCID: PMC8700781 DOI: 10.3390/ijerph182412919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 11/30/2022]
Abstract
The purpose of this narrative study is to describe the vaping and smoking characteristics of Queer people ages 18-34 before March of 2020 and to better understand how the COVID-19 pandemic has impacted those behaviors since March of 2020. In total, 31 participants were screened. Thirteen participants were screened prior to the emergence of COVID-19, and 18 were screened when study protocols transitioned to a remote setting (pre and during). Of the 27 eligible participants, a total of 25 participants completed the study. Most participants (n = 13) self-identified as male, followed by five identified as female, four self-identified as gender non-binary, and three identified as transgender. The most common sexual orientation amongst participants was gay (n = 10), with bisexual being the second-most reported. Approximately 20 Queer participants reported using cigarettes, 14 participants self-reported using electronic devices, and 11 reported using hookah. Twenty participants reported smoking ten or less, and four self-reported using 11-20 cigarettes per day. Approximately, 92% of participants (n = 23) indicate that they are using an e-cigarette and regular cigarettes, and 57% of participants (n = 12) report using one pod or cartridge per day. The three themes that emerged in this study are: (1) Queer people during COVID-19 are experiencing heightened minority stress; (2) Queer people are unfamiliar with smoking cessation; and (3) vaping and smoking are attributed to stress and anxiety. Queer participants are likely to be dual users of cigarette and vaping products. This present study provides increasing evidence that Queer people are experiencing heightened stress and anxiety and using cigarette smoking and vaping to cope during the COVID-19 pandemic.
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Affiliation(s)
- Pamela Valera
- Rutgers School of Public Health, Piscataway, NJ 08854, USA; (M.O.); (S.M.)
| | - Madelyn Owens
- Rutgers School of Public Health, Piscataway, NJ 08854, USA; (M.O.); (S.M.)
| | - Sarah Malarkey
- Rutgers School of Public Health, Piscataway, NJ 08854, USA; (M.O.); (S.M.)
| | - Nicholas Acuna
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA;
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Valera P, Alzate-Duque L, Acuna N. Abstract 2551: The development of cancer digital videos to increase participation in marginalized communities. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-2551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Social media, in the form of digital videos, targeted people with limited health literacy, as well as disadvantaged or marginalized groups, may help reduce cancer health disparities and improve health outcomes in these populations. In this article, we document the process of adapting the content from the Cancer 101 curriculum to create animated scripts about the cancer care continuum that is clear, straightforward, and in plain language. The development of the Cancer 101 digital videos required a multidisciplinary collaboration from - public health, medicine, technology, and expertise in correctional health, smoking cessation, web development, video producers, and individuals directly impacted by cancer disparities. The Cancer 101 videos were showcased at a community health fair where the videos were viewed by attendants waiting to be seen by a medical provider. While waiting for their cancer screening, thirteen individuals were selected and invited to watch all eleven videos totaling less than 60-minutes of viewing time. Overall, participants agreed that they would recommend the videos to friends/family and that they plan to watch other video modules to learn more information about cancer. Additionally, participants enjoyed the graphics and audio of the videos presented. Furthermore, participants noted that Cancer 101 digital videos described cancer in plain language, leading to a better understanding of the disease. Future research is needed to implement Cancer 101 digital videos in healthcare clinics to increase cancer information and improve cancer screening rates in marginalized communities.
Citation Format: Pamela Valera, Luis Alzate-Duque, Nicholas Acuna. The development of cancer digital videos to increase participation in marginalized communities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2551.
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Acuna N, Plascak JJ, Tsui J, Stroup AM, Llanos AAM. Oncotype DX Test Receipt among Latina/Hispanic Women with Early Invasive Breast Cancer in New Jersey: A Registry-Based Study. Int J Environ Res Public Health 2021; 18:5116. [PMID: 34065945 PMCID: PMC8151910 DOI: 10.3390/ijerph18105116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/29/2021] [Accepted: 05/06/2021] [Indexed: 11/21/2022]
Abstract
Oncotype DX® (ODX) is a valid test of breast cancer (BC) recurrence risk and chemotherapy benefit. The purpose of this study was to examine prevalence of and factors associated with receipt of ODX testing among eligible Latinas/Hispanics diagnosed with BC. Sociodemographic and tumor data of BC cases diagnosed between 2008 and 2017 among Latina/Hispanic women (n = 5777) were from the New Jersey State Cancer Registry (NJSCR). Eligibility for ODX testing were based on National Comprehensive Cancer Network guidelines. Multivariable logistic regression models of ODX receipt among eligible women were used to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI) by demographic and clinicopathologic factors. One-third of Latinas/Hispanics diagnosed with BC were eligible for ODX testing. Among the eligible, 60.9% received ODX testing. Older age (AOR 0.08, 95% CI: 0.04, 0.14), low area-level SES (AOR 0.58, 95% CI: 0.42, 0.52), and being uninsured (AOR 0.58, 95% CI: 0.39, 0.86) were associated with lower odds of ODX testing. While there was relatively high ODX testing among eligible Latina/Hispanic women with BC in New Jersey, our findings suggest that age, insurance status, and area-level SES contribute to unequal access to genetic testing in this group, which might impact BC outcomes.
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Affiliation(s)
- Nicholas Acuna
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (N.A.); (J.T.)
| | - Jesse J. Plascak
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210, USA;
| | - Jennifer Tsui
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (N.A.); (J.T.)
| | - Antoinette M. Stroup
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA;
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
- New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, NJ 08625, USA
| | - Adana A. M. Llanos
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA;
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
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LoSchiavo C, Acuna N, Halkitis PN. Evidence for the Confluence of Cigarette Smoking, Other Substance Use, and Psychosocial and Mental Health in a Sample of Urban Sexual Minority Young Adults: The P18 Cohort Study. Ann Behav Med 2021; 55:308-320. [PMID: 32720976 PMCID: PMC8025086 DOI: 10.1093/abm/kaaa052] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Sexual minority men (SMM) and transgender women (TW) are more likely to smoke cigarettes than heterosexual and cisgender peers, which may exacerbate existing disparities in mental and psychosocial health and substance use. PURPOSE As few existing studies have examined the confluence of these factors, we sought to examine tobacco use in a diverse sample of SMM and TW and describe its relationship with other substance use and health. METHODS Data were drawn from a study of syndemic conditions among SMM and TW, which included measures assessing tobacco use, substance use, and mental, psychosocial, and general health. RESULTS A majority of the racially/ethnically and socioeconomically diverse sample (n = 665) reported ever smoking a cigarette, and more than half of them were current smokers. Current smoking was associated with more frequent recent substance use and poorer mental, psychosocial, and general health. In multivariable analyses, current smoking was predicted by more frequent substance use and more severe anxiety, when adjusting for demographic, substance use, and health factors. CONCLUSIONS A syndemic approach to health conditions such as substance use, mental health, and psychosocial burden dictates a framework of interrelation and mutual exacerbation. In doing so, we found that current cigarette use was associated with more frequent alcohol and marijuana use and more severe anxiety, suggesting a confluence of cigarette smoking, other substance use, and mental health burden. We recommend a holistic approach to treating tobacco use in sexual and gender minority populations that addresses both substance use and the myriad psychosocial burdens that sexual and gender minority communities experience.
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Affiliation(s)
- Caleb LoSchiavo
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers School of Public Health, Newark, NJ
- Department of Health Behavior, Society and Policy, School of Public Health, Rutgers University, Piscataway, NJ
| | - Nicholas Acuna
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers School of Public Health, Newark, NJ
- Departments of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ
| | - Perry N Halkitis
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers School of Public Health, Newark, NJ
- Departments of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ
- Department of Urban-Global Public Health, School of Public Health, Rutgers University, Newark, NJ
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Valera P, Acuna N, Alzate-Duque L, Liang LE, Cupertino P, Merulla J. The Development and Prototype Feedback of Digital Cancer 101 Videos to Enhance Cancer Education for Marginalized Communities With Limited Health Literacy. Cancer Control 2021; 28:10732748211006055. [PMID: 33784858 PMCID: PMC8209315 DOI: 10.1177/10732748211006055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Social media, in the form of digital videos targeted to people with limited health literacy, as well as disadvantaged or marginalized groups, may help reduce cancer health disparities and improve health outcomes in these populations. In this article, we document the process of adapting the content from the Cancer 101 curriculum to create animated scripts about the cancer care continuum that is clear, straightforward, and in plain language. The development of the Cancer 101 digital videos required a multidisciplinary collaboration from-public health, medicine, technology, and expertise in correctional health, smoking cessation, web development, video producers, and individuals directly impacted by cancer disparities. The Cancer 101 videos were showcased at a community health fair where the videos were viewed by attendants waiting to be seen by a medical provider. While waiting for their cancer screening, 13 individuals were selected and invited to watch all 11 videos totaling less than 60-minutes of viewing time. They included 3 Latina women, 2 Latino men, and 8 Haitian women. All participants were between the ages of 40-65 years old. Overall, participants agreed that they would recommend the videos to friends/family (M = 4.77, SD = 0.44) and that they plan to watch other video modules to learn more information about cancer (M = 4.72, SD = 0.47). Additionally, participants enjoyed the graphics and audio of the videos presented (M = 4.85, SD = 0.38). Furthermore, participants noted that Cancer 101 digital videos described cancer in plain language, leading to a better understanding of the disease. Future research is needed to implement Cancer 101 digital videos in healthcare clinics to increase cancer information and improve cancer screening rates in marginalized communities.
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Affiliation(s)
- Pamela Valera
- Rutgers School of Public Health, Department of Urban-Global Public Health, Newark, NJ, USA.,Cancer Health Justice Lab (www.chjl.org), Newark, NJ, USA
| | - Nicholas Acuna
- Cancer Health Justice Lab (www.chjl.org), Newark, NJ, USA.,242612Rutgers School of Public Health, Piscataway, NJ, USA
| | - Luis Alzate-Duque
- Cancer Health Justice Lab (www.chjl.org), Newark, NJ, USA.,242612Rutgers New Jersey Medical School, Department of Medicine, Newark, NJ, USA
| | - Laura E Liang
- 242612Rutgers School of Public Health, Piscataway, NJ, USA
| | - Paula Cupertino
- 6923University of Rochester Medical Center, Wilmot Cancer Institute, Rochester, NY, USA
| | - Jessica Merulla
- HypnoViD Media Productions, Inc. (http://www.hypnovid.com), NY, USA
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Acuna N, Vento I, Alzate-Duque L, Valera P. Harnessing Digital Videos to Promote Cancer Prevention and Education: a Systematic Review of the Literature from 2013-2018. J Cancer Educ 2020; 35:635-642. [PMID: 31707640 DOI: 10.1007/s13187-019-01624-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Social media has transformed the way cancer patients search for information about their chronic health problems. The purpose of this systematic review is to identify the use of online digital videos to increase cancer knowledge and to understand information preference, behavioral changes, and attitudes towards online cancer education videos. The databases used for this review included MedLine, PsychINFO, and PubMed. These medical databases were used to locate peer-reviewed academic journals from 2013-2018 using the following MeSH terms: "cancer education videos," "cancer prevention videos," and "cancer education digital videos." A total of 4996 articles were retrieved from the initial search, and 33 articles were reviewed. Articles were excluded if videos did not (1) focus on cancer education and prevention; (2) posted on an online platform; and (3) assessed participants' knowledge, attitude, or beliefs about cancer. Eleven articles were found to meet inclusion criteria for final review. All of the studies focused on increasing education on preventive health behaviors (i.e., sunscreen use, smoking, and diet) and/or early detection strategies (i.e., screening testing and/or self-skin exams). While online digital health videos have the potential to improve health outcomes, issues related to technology access and health literacy must be considered when developing online health education videos.
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Affiliation(s)
- Nicholas Acuna
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, 07102, USA
- Department of Biostatistics and Epidemiology, Rutgers University School of Public Health, Piscataway, NJ, 08854, USA
| | - Ismary Vento
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, 07102, USA
- Department of Health Behavior, Society and Policy, Rutgers University School of Public Health, Piscataway, NJ, 08854, USA
| | - Luis Alzate-Duque
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, 07102, USA
- Department of Urban-Global Public Health, Rutgers University School of Public Health, Newark, NJ, 07102, USA
- Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Pamela Valera
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, 07102, USA.
- Department of Urban-Global Public Health, Rutgers University School of Public Health, Newark, NJ, 07102, USA.
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Valera P, Acuna N, Vento I. The Preliminary Efficacy and Feasibility of Group-Based Smoking Cessation Treatment Program for Incarcerated Smokers. Am J Mens Health 2020; 14:1557988320943357. [PMID: 32705965 PMCID: PMC7383630 DOI: 10.1177/1557988320943357] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/19/2020] [Accepted: 06/29/2020] [Indexed: 11/17/2022] Open
Abstract
Group-based tobacco dependence treatment has been known to help smokers to quit in general adult populations, but the feasibility and efficacy of this type of smoking cessation treatment in correctional settings remain uncertain. A 6-week group-based smoking cessation treatment with nicotine replacement therapy (NRT) in the form of nicotine patches was implemented in seven male prison facilities, in the Northeast, among smokers who were born biologically as male. Exhaled breath carbon monoxide (CO) levels were collected from participants at each session to confirm smoking status. Participants were evaluated at the 1-month post-group treatment follow-up to determine abstinence. Those who were lost to follow-up were recorded as continued smoking and not using NRT nicotine patches. The goal of the study was to explore the feasibility and preliminary efficacy of conducting a smoking cessation treatment program for incarcerated smokers. A total of 350 inmates were screened, 177 inmates were enrolled across the prison sites for the 6-week program, and 102 inmates completed the program. A majority of those enrolled reported that they began smoking when they were between 15 and 19 years of age (44.9%) and were smoking on average for 26 years. Less than half (21.3%) reported ever using electronic cigarettes at baseline and in Session 1,116 individuals who attended reported a median CO level of 18.0 parts per million (ppm). At a 1-month follow-up, 43 individuals reported a median CO level of 5.00 ppm. The study demonstrated preliminary efficacy and feasibility of group-based smoking cessation treatment with NRT nicotine patches in incarcerated smokers.
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Affiliation(s)
- Pamela Valera
- School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, USA
| | - Nicholas Acuna
- School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, USA
| | - Ismary Vento
- School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, USA
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Valera P, Acuna N. Abstract LB-252: Group-based smoking cessation treatment for incarcerated men: A pilot study. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-lb-252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction. Cigarette smoking is the leading cause of morbidity and mortality that contributes to over six million deaths worldwide and is projected to cause more than eight million deaths per year by 2030. Overall cigarette smoking rates in the United States (U.S.) is estimated at 14%, but this number increases to 50-83% of smokers within correctional populations.
Methods. Using a cohort study design, sixteen incarcerated male smokers from a Northeastern state maximum prison facility in the U.S. participated in a 4-week group-based smoking cessation treatment program with nicotine replacement therapy and a one-month follow-up period to determine quit behaviors and abstinence. The goal of this pilot study was to explore the feasibility, acceptability, and efficacy of a smoking cessation group treatment intervention for incarcerated smokers where tobacco products are permitted.
Results. In this feasibility study, the average age of participants enrolled was 43 (SD = 13.69), and their first incarceration was at 19 (SD = 7.30). The majority of the participants identified as African American/Black (62.5%), 31.3% identified as Caucasian/White, and 6.3% identified as Hispanic/Latino as their race/ethnicity. The average age where individuals started smoking was 13.8 (SD = 3.2) and the total number of years smoked is 25.6 (SD = 14.9). The mean of cigarettes smoked each day was 13.0 (SD = 9.8). More than half of the people in the study indicated that they relight their cigarettes. Additionally, the two brands that participants indicated as their favorite were Kite (18.8%) and Newport (68.8%). Of all the participants, 87.5% indicated that they smoked menthol cigarettes. Majority of the participants indicated the importance of quitting tobacco (8.80 ± 1.82) and that they had a very difficult time during their previous quit attempts (43.8%). Previous quit attempts included forced abstinence while in solitary confinement or administrative segregation. At the 4-week follow up period, half of the participants that were enrolled in the group-based smoking cessation treatment and completed the program indicated that they did not smoke or use tobacco in the past 7-days or since their initial quit date (50.0%).
Conclusion. Group-based smoking cessation treatment should be prioritized as an effective intervention to aid incarcerated smokers to quit smoking. This study builds upon our growing knowledge of tobacco dependence and smoking cessation treatment, with a focus on individuals involved in the criminal justice system.
Citation Format: Pamela Valera, Nicholas Acuna. Group-based smoking cessation treatment for incarcerated men: A pilot study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr LB-252.
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Affiliation(s)
- Pamela Valera
- Rutgers, State University of New Jersey, School of Public Health, Piscataway, NJ
| | - Nicholas Acuna
- Rutgers, State University of New Jersey, School of Public Health, Piscataway, NJ
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Abstract
To determine smoking behaviors, quit attempts, and cessation preferences among incarcerated smokers, a cross-sectional survey was given to a sample of inmates from three state prison facilities in the United States. A majority of Black smokers (62%) identified as smokers, and 38% identified as ex-smokers, as compared to 46.4 percent of smokers (and 53.6% of ex-smokers) in the non-Black group. There were significant differences in the number of cigarettes smoked per day with non-Black smokers smoking one pack (M = 20.44, standard deviation = 15.86) than Black smokers (M = 14.49, standard deviation = 13.43; t = −2.50, p = 0.014). Smoking cessation interventions are needed to reduce smoking during incarceration.
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Affiliation(s)
- Pamela Valera
- Rutgers School of Public Health, The State University of New Jersey, NJ, USA
| | - Andrea Reid
- Rutgers School of Public Health, The State University of New Jersey, NJ, USA
| | - Nicholas Acuna
- Rutgers School of Public Health, The State University of New Jersey, NJ, USA
| | - Daniel Mackey
- Lake Erie College of Osteopathic Medicine (LECOM), PA, USA
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Abstract
OBJECTIVES To analyze the spectrum of congenital malformations among fetuses with Down's syndrome sent for necropsy. Materials and methods. Necropsies following medical termination of pregnancy during the second and third trimester were performed during a 4 year period. RESULTS The incidence of each malformation was determined. Talipes equinovarus and aberrant lobation of the lung were present in 6% of cases. We are able to state precisely the incidence of 11 pairs of ribs: 11%. CONCLUSION A precise knowledge about Down's syndrome associated malformations is essential for genetic counselling. The exact incidence of each sign is important to lead ultrasound examination when this syndrome is revealed.
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Affiliation(s)
- G Grangé
- Maternité Port Royal, Centre Hospitalier Cochin Saint-Vincent-de-Paul, AP-HP, 123, boulevard de Port-Royal, 75014 Paris et Université René-Descartes, Paris
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