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Koller KR, Nash SH, Beans JA, Day GM, Hiratsuka VY, Lin AL, Narayanan M, Patten CA, Hammock SA, Howard BV, Umans JG. Evidence-based screening, clinical care and health education recommendations for Alaska Native peoples with prediabetes living in southcentral Alaska: findings from the Alaska EARTH follow-up study. Int J Circumpolar Health 2024; 83:2343143. [PMID: 38691019 PMCID: PMC11064735 DOI: 10.1080/22423982.2024.2343143] [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: 11/29/2023] [Accepted: 04/10/2024] [Indexed: 05/03/2024] Open
Abstract
Pre-diabetes (pre-DM) is a strong predictor of diabetes (DM) over time. This study investigated how much of the recent increase in pre-DM identified among Alaska Native (AN) peoples living in urban southcentral Alaska may be due to changes in diagnostic methods. We used clinical and demographic data collected at baseline between 2004 and 2006 and at follow-up collected between 2015 and 2017 from the urban southcentral Alaska Education and Research Towards Health (EARTH) cohort. We used descriptive statistics and logistic regression to explore differences in demographic and clinical variables among the identified pre-DM groups. Of 388 participants in the follow-up study, 243 had A1c levels indicating pre-DM with only 20 demonstrating pre-DM also by fasting blood glucose (FBG). Current smoking was the sole predictor for pre-DM by A1c alone while abdominal obesity and elevated FBG-predicted pre-DM by A1c+FBG. No participants had an elevated FBG without an A1c elevation. A substantial portion of the rise in pre-DM found among urban southcentral AN peoples in the EARTH follow-up study was due to the addition of A1c testing. Pre-DM by A1c alone should be used to motivate behavioural changes that address modifiable risk factors, including smoking cessation, physical activity and weight management.
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Affiliation(s)
- Kathryn R. Koller
- Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Sarah H. Nash
- Department of Epidemiology, College of Public Health, University of Iowa, Anchorage, AK, USA
| | - Julie A. Beans
- Research Department, Southcentral Foundation, Anchorage, AK, USA
| | - Gretchen M. Day
- Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | | - Ai-Ling Lin
- Diabetes Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Meera Narayanan
- Diabetes Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Christi A Patten
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, Rochester, MN, USA
| | - Sherry A. Hammock
- Pediatric Endocrinology, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | | - Jason G. Umans
- MedStar Health Research Institute, Hyattsville, MD, USA
- Georgetown University, Washington, USA
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Sinicrope PS, Tranby BN, Young AM, Koller KR, King DK, Lee FR, Sabaque CV, Prochaska JJ, Borah BJ, Decker PA, McDonell MG, Stillwater B, Thomas TK, Patten CA. Adapting a Financial Incentives Intervention for Smoking Cessation with Alaska Native Families: Phase 1 Qualitative Research to Inform the Aniqsaaq (To Breathe) Study. Nicotine Tob Res 2024:ntae092. [PMID: 38642396 DOI: 10.1093/ntr/ntae092] [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] [Received: 10/06/2023] [Indexed: 04/22/2024]
Abstract
INTRODUCTION Alaska Native and American Indian (ANAI) peoples in Alaska currently experience a disproportionate burden of morbidity and mortality from tobacco cigarette use. Financial incentives for smoking cessation are evidence-based, but a family-level incentive structure has not been evaluated. We used a community-based participatory research and qualitative approach to culturally adapt a smoking cessation intervention with ANAI families. METHODS We conducted individual, semi-structured telephone interviews with 12 ANAI adults who smoke, 12 adult family members, and 13 Alaska Tribal Health System stakeholders statewide between November 2022-March 2023. Through content analysis, we explored intervention receptivity, incentive preferences, culturally aligned recruitment and intervention messaging, and future implementation needs. RESULTS Participants were receptive to the intervention. Involving a family member was viewed as novel and aligned with ANAI cultural values of commitment to community and familial interdependence. Major themes included choosing a family member who is supportive and understanding, keeping materials positive and encouraging, and offering cash and non-cash incentives for family members to choose (e.g., fuel, groceries, activities). Participants indicated that messaging should emphasize family collaboration and that cessation resources and support tips should be provided. Stakeholders also reinforced that program materials should encourage the use of other existing evidence-based cessation therapies (e.g., nicotine replacement, counseling). CONCLUSIONS Adaptations, grounded in ANAI cultural strengths were made to the intervention and recruitment materials based on participant feedback. Next steps include a beta-test for feasibility and a randomized controlled trial for efficacy. IMPLICATIONS This is the first study to design and adapt a financial incentives intervention promoting smoking cessation among Alaska Native or American Indian (ANAI) peoples and the first to involve the family system. Feedback from this formative work was used to develop a meaningful family-level incentive structure with ANAI people who smoke and family members and ensure intervention messaging is supportive and culturally aligned. The results provide qualitative knowledge that can inform future family-based interventions with ANAI communities, including our planned randomized controlled trial of the intervention.
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Affiliation(s)
- Pamela S Sinicrope
- Department of Psychiatry and Psychology Behavioral Health Research Program, Mayo Clinic, 200 1st St SW, Rochester, MN
| | - Brianna N Tranby
- Department of Psychiatry and Psychology Behavioral Health Research Program, Mayo Clinic, 200 1st St SW, Rochester, MN
| | - Antonia M Young
- Department of Psychiatry and Psychology Behavioral Health Research Program, Mayo Clinic, 200 1st St SW, Rochester, MN
| | - Kathryn R Koller
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK
| | - Diane K King
- Center for Behavioral Health Research and Service, University of Alaska Anchorage, 3211 Providence Dr, SBB 303F, Anchorage, AK
| | - Flora R Lee
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK
| | - Corinna V Sabaque
- Center for Health Equity and Community Engagement Research, Mayo Clinic, 200 1st St SW, Rochester, MN
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, 1265 Welch Road, Stanford, CA
| | - Bijan J Borah
- Health Care Policy and Research, Center for the Science of Health Care Delivery, Mayo Clinic, 200 1st St SW, Rochester, MN
| | - Paul A Decker
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, 200 1st St SW, Rochester, MN
| | | | - Barbara Stillwater
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK
| | - Timothy K Thomas
- Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK
| | - Christi A Patten
- Department of Psychiatry and Psychology Behavioral Health Research Program, Mayo Clinic, 200 1st St SW, Rochester, MN
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Orakwue K, Hing AK, Chantarat T, Hersch D, Okah E, Allen M, Patten CA, Enders FT, Hardeman R, Phelan SM. The C2DREAM framework: Investigating the structural mechanisms undergirding racial health inequities. J Clin Transl Sci 2024; 8:e80. [PMID: 38745879 PMCID: PMC11091923 DOI: 10.1017/cts.2024.518] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/07/2024] [Accepted: 04/09/2024] [Indexed: 05/16/2024] Open
Abstract
Racism shapes the distribution of the social determinants of health (SDoH) along racial lines. Racism determines the environments in which people live, the quality of housing, and access to healthcare. Extensive research shows racism in its various forms negatively impacts health status, yet few studies and interventions seriously interrogate the role of racism in impacting health. The C2DREAM framework illuminates how exposure to racism, in multiple forms, connects to cardiovascular disease, hypertension, and obesity. The goal of the C2DREAM framework is to guide researchers to critically think about and measure the role of racism across its many levels of influence to better elucidate the ways it contributes to persistent health inequities. The conceptual framework highlights the interconnectedness between forms of racism, SDoH, and the lifecourse to provide a greater context to individual health outcomes. Utilizing this framework and critically contending with the effects of racism in its multiple and cumulative forms will lead to better research and interventions.
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Affiliation(s)
- Kene Orakwue
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
- Center for Antiracism Research for Health Equity, Minneapolis, MN, USA
| | - Anna K. Hing
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
- Center for Antiracism Research for Health Equity, Minneapolis, MN, USA
| | - Tongtan Chantarat
- Center for Antiracism Research for Health Equity, Minneapolis, MN, USA
| | - Derek Hersch
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ebiere Okah
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Michele Allen
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
- University of Minnesota Clinical Translational Science Institute, Minneapolis, MN, USA
| | - Christi A. Patten
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Felicity T. Enders
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Rachel Hardeman
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
- Center for Antiracism Research for Health Equity, Minneapolis, MN, USA
| | - Sean M. Phelan
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery & Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA
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Vencill JA, Kirsch JL, McPherson K, Sprankle E, Patten CA, Campana K, Brockman T, Bronars C, Hughes C, Gastineau D, Ehlers SL. Prospective Association of Psychological Distress and Sexual Quality of Life Among Hematopoietic Stem Cell Transplant Survivors. J Clin Psychol Med Settings 2024:10.1007/s10880-024-10013-9. [PMID: 38615280 DOI: 10.1007/s10880-024-10013-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 04/15/2024]
Abstract
Sexual health concerns are one of the most common late effects facing hematopoietic stem cell transplant (HSCT) survivors. The current study tested whether self-reported depression and anxiety symptoms before transplant were associated with embedded items assessing two specific areas of sexual health-sexual interest and sexual satisfaction-one year post-HSCT. Of the 158 study participants, 41% were diagnosed with a plasma cell disorder (n = 60) and most received autologous transplantation (n = 128; 81%). At post-HSCT, 21% of participants reported they were not at all satisfied with their sex life, and 22% were not at all interested in sex. Greater pre-HSCT depressive symptomology was significantly predictive of lower sexual interest (β = -.27, p < .001) and satisfaction (β = -.39, p < .001) at post-HSCT. Similarly, greater pre-HSCT trait anxiety was significantly predictive of lower sexual interest (β = -.19, p = .02) whereas higher levels of state and trait anxiety were both predictive of lower satisfaction (β = -.22, p = .02 and β = -.29, p = .001, respectively). Participant sex significantly moderated the relationship between state anxiety and sexual satisfaction (b = -.05, t = -2.03, p = .04). Additional research examining the factors that contribute to sexual health post-HCST is needed to inform and implement clinical interventions to address these commonly overlooked survivorship concerns.
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Affiliation(s)
- Jennifer A Vencill
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Janae L Kirsch
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | - Keagan McPherson
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
- Minnesota State University, Mankato, MN, USA
| | | | - Christi A Patten
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | | | - Tabetha Brockman
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | - Carrie Bronars
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | - Christine Hughes
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | - Dennis Gastineau
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA
| | - Shawna L Ehlers
- Department of Psychiatry & Psychology, Mayo Clinic, 200, 1st Street SW, Rochester, MN, 55905, USA.
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Tranby BN, Sia IG, Clark MM, Novotny PJ, Lohr AM, Pardo LS, Patten CA, Iteghete SO, Zeratsky KA, Rieck TM, Molina L, Capetillo GP, Ahmed Y, Drie H, Wieland ML. Negative Mood is Associated with Sociobehavioral Factors Contributing to Cardiovascular Risk in an Immigrant Population. Res Sq 2024:rs.3.rs-3934645. [PMID: 38559259 PMCID: PMC10980105 DOI: 10.21203/rs.3.rs-3934645/v1] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background Immigrants to the United States, on average, accumulate cardiovascular risk after resettlement, including obesity. There is a need to co-create interventions to address these disparities, and mood may be an important mediating factor. Methods The Healthy Immigrant Community (HIC) study, set in southeast Minnesota, enrolled 475 adult participants in a weight loss intervention to reduce cardiovascular risk. Baseline questionnaires assessed mood, nutrition, physical activity, self-efficacy for healthy eating and physical activity, social support, and cohesion. A single-item mood rating of poor or fair was considered "negative", while ratings of good, very good, or excellent were considered "positive". Results A total of 449 HIC participants (268 Hispanic/Latino and 181 Somali) with complete baseline measures and were included in this analysis. Participants endorsing negative mood compared to those endorsing positive mood had lower scores for healthy eating (p = 0.02) and physical activity levels (p = 0.03), lower confidence in eating a healthy diet (p = 0.001), and felt less of a sense of belonging to their community (p = 0.01). Those endorsing negative mood also reported receiving less social support from their family and friends to eat healthy (p = < 0.001) and be physically active (p = 0.01), and less often accessed community resources for healthy eating (p = 0.001) and physical activity (p = < 0.01) compared to participants reporting positive mood. Conclusions Negative mood was associated with less healthy nutrition, lower confidence in eating healthy, sedentary lifestyle, and perceived lack of belonging to the community. Integrating mood management and self-efficacy strategies may enhance the effectiveness of lifestyle interventions among immigrants who report negative mood. ClinicalTrialsgov registration NCT05136339; April 23, 2022.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Hana Drie
- Rochester Healthy Community Partnership
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Young A, Sinicrope P, Kelpin S, Roche AI, Sabaque C, Pham C, Marsch LA, Campbell ANC, Venner K, Bastian E, Nord T, Mason G, Baker L, Wyatt T, Fish A, Bart G, Patten CA. Wiidookaage'Win: A Community-Based Qualitative Approach to Developing a Facebook Group Intervention for Native Women to Support Recovery From Opioid Use. Am J Health Promot 2024; 38:205-218. [PMID: 37955409 PMCID: PMC10859867 DOI: 10.1177/08901171231205355] [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] [Indexed: 11/14/2023]
Abstract
PURPOSE To develop a culturally-tailored American Indian/Alaska Native (AI/AN) women's Facebook group supporting opioid recovery as an adjunct to medication. DESIGN Community-based, qualitative approach. SETTING Minnesota, U.S. PARTICIPANTS AI/AN women in opioid recovery, interested parties, and a Community Advisory Committee (CAC) of AI/AN women with lived experience, health care providers, and community members. INTERVENTION We developed evidence-based content focusing on stress/trauma and substance use, mindfulness, responding to triggers, and supportive community resources. Additional content centered on AI/AN culture was also selected. METHOD Interviews were conducted by two women, then transcribed and coded using content analysis with NVivo software. Results were presented to CAC for further content refinement. RESULTS CAC members (n = 10) guided study methods, intervention development, and dissemination activities. 14 AI/AN women (mean age 36.4 years; mean 6.7 months opioid abstinence) and 12 interested parties (7 men, 5 women) were receptive to an AI/AN gender-specific Facebook group, preferring content with AI/AN people and/or text resonating with AI/AN culture (e.g., Native traditions, family, personal stories, historical trauma). Recommendations included (1) protect confidentiality, (2) retain positivity, (3) incorporate resources and exercises to build coping skills, and (4) moderators should be authentic and relatable to build trust. CONCLUSIONS Our approach provides a model for developing culturally tailored, appealing and effective social media interventions to support AI/AN women in recovery from opioid use disorder.
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Affiliation(s)
- Antonia Young
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Pamela Sinicrope
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Sydney Kelpin
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Anne I. Roche
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Corinna Sabaque
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Cuong Pham
- Division of General Internal Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Aimee N. C. Campbell
- Department of Psychiatry, Columbia University Irving Medical Center, New York, USA
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, USA
| | - Kamilla Venner
- Department of Psychology and Center on Alcohol, Substance Use and Addictions, University of New Mexico, NM, USA
| | | | - Teresa Nord
- ICWA Law Center, American Indian Prison Project, Minneapolis, MN, USA
| | - Gail Mason
- Native American Community Clinic, Minneapolis, MN, USA
| | - Laiel Baker
- Counseling and Recovery Services, Indian Health Board of Minneapolis, Inc, Minneapolis, MN, USA
| | - Thomas Wyatt
- Department of Emergency Medicine, Hennepin Healthcare, Minneapolis, MN, USA
| | - Amy Fish
- Minnesota Indian Women’s Resource Center, Minneapolis, MN, USA
| | - Gavin Bart
- Hennepin Healthcare, Minneapolis, MN, USA
| | - Christi A. Patten
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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Jacobs W, Jackson A, Tan ASL, Martinez SA, Addicott M, Denlinger RL, Kypriotakis G, Mithi V, Patten CA, Castro Y. Perceived Impact of Society for Research on Nicotine and Tobacco Health Equity Network's Preconference Workshops on Attendees' Professional Development. Nicotine Tob Res 2024:ntae018. [PMID: 38297962 DOI: 10.1093/ntr/ntae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Indexed: 02/02/2024]
Affiliation(s)
- Wura Jacobs
- Department of Applied Health Science, School of Public Health, Indiana University, 1025 E. 7th St., SPH 116, Bloomington, IN
- Society for Research on Nicotine and Tobacco Health Equity Network Evaluation Committee
| | - Asti Jackson
- Society for Research on Nicotine and Tobacco Health Equity Network Evaluation Committee
| | - Andy S L Tan
- Society for Research on Nicotine and Tobacco Health Equity Network Evaluation Committee
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - Sydney A Martinez
- Society for Research on Nicotine and Tobacco Health Equity Network Evaluation Committee
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Hudson College of Public Health, OK, USA
| | - Merideth Addicott
- Society for Research on Nicotine and Tobacco Health Equity Network Evaluation Committee
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Rachel L Denlinger
- Society for Research on Nicotine and Tobacco Health Equity Network Evaluation Committee
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - George Kypriotakis
- Society for Research on Nicotine and Tobacco Health Equity Network Evaluation Committee
- Behavioral Science Department, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Vita Mithi
- Society for Research on Nicotine and Tobacco Health Equity Network Evaluation Committee
| | - Christi A Patten
- Society for Research on Nicotine and Tobacco Health Equity Network Evaluation Committee
- Division of Behavioral Health Research, Mayo Clinic, Rochester, MN, USA
| | - Yessenia Castro
- Society for Research on Nicotine and Tobacco Health Equity Network Evaluation Committee
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA
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Tadese K, Jenkins S, Aycock D, Jones C, Hayes SN, Burke LE, Cooper LA, Patten CA, Brewer LC. Factors Facilitating Academic-Community Research Partnerships With African American Churches: Recruitment Process for a Community-Based, Cluster Randomized Controlled Trial During the COVID-19 Pandemic. Health Promot Pract 2024; 25:8-12. [PMID: 36189723 DOI: 10.1177/15248399221118394] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
African American (AA) churches are valuable partners in implementing health promotion programming (HPP) to combat health disparities. The study purpose was to evaluate AA church characteristics associated with enrollment into the FAITH! (Fostering African American Improvement in Total Health) Trial, a community-based, cluster randomized controlled trial (RCT) of a mobile health intervention for cardiovascular health promotion among AA churches. Churches located in Minneapolis-St. Paul and Rochester, Minnesota were invited to complete an electronic screening survey and follow-up telephone interview including the PREACH (Predicting Readiness to Engage African American Churches in Health) tool to assess church characteristics and infrastructure for HPP. The primary outcome was church enrollment in the FAITH! Trial. Key predictors included overall PREACH scores and its subscales (Personnel, Physical Structure, Faith-based Approach, Funding), congregation size, and mean congregation member age. Of the 26 churches screened, 16 (61.5%) enrolled in the trial. The enrolled churches had higher overall mean PREACH scores (36.1 vs. 30.2) and subscales for Personnel (8.8 vs. 5.6), Faith-based Approach (11.0 vs. 9.6), and Funding (7.3 vs. 4.8) compared with non-enrolled churches; all differences were not statistically significant due to small sample size. Twelve (75.0%) of the enrolled churches had >75 members versus six (60.0%) of the non-enrolled churches. Twelve (80.0%) of the enrolled churches had an average congregation member age ≤54 years versus six (67.0%) of the non-enrolled churches. AA churches enrolling into a community-based RCT reported greater infrastructure for HPP, larger congregations, and members of younger age. These characteristics may be helpful to consider among researchers partnering with AA churches for HPP studies.
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Affiliation(s)
| | - Sarah Jenkins
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | | | - Sharonne N Hayes
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | | | - Lisa A Cooper
- The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - LaPrincess C Brewer
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
- Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, USA
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Adedinsewo D, Eberly L, Sokumbi O, Rodriguez JA, Patten CA, Brewer LC. Health Disparities, Clinical Trials, and the Digital Divide. Mayo Clin Proc 2023; 98:1875-1887. [PMID: 38044003 PMCID: PMC10825871 DOI: 10.1016/j.mayocp.2023.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 05/03/2023] [Indexed: 12/05/2023]
Abstract
In the past few years, there have been rapid advances in technology and the use of digital tools in health care and clinical research. Although these innovations have immense potential to improve health care delivery and outcomes, there are genuine concerns related to inadvertent widening of the digital gap consequentially exacerbating health disparities. As such, it is important that we critically evaluate the impact of expansive digital transformation in medicine and clinical research on health equity. For digital solutions to truly improve the landscape of health care and clinical trial participation for all persons in an equitable way, targeted interventions to address historic injustices, structural racism, and social and digital determinants of health are essential. The urgent need to focus on interventions to promote health equity was made abundantly clear with the coronavirus disease 2019 pandemic, which magnified long-standing social and racial health disparities. Novel digital technologies present a unique opportunity to embed equity ideals into the ecosystem of health care and clinical research. In this review, we examine racial and ethnic diversity in clinical trials, historic instances of unethical research practices in biomedical research and its impact on clinical trial participation, and the digital divide in health care and clinical research, and we propose suggestions to achieve digital health equity in clinical trials. We also highlight key digital health opportunities in cardiovascular medicine and dermatology as exemplars, and we offer future directions for development and adoption of patient-centric interventions aimed at narrowing the digital divide and mitigating health inequities.
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Affiliation(s)
| | - Lauren Eberly
- Division of Cardiovascular Medicine, Perelman School of Medicine, Center for Cardiovascular Outcomes, Quality, and Evaluative Research, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
| | - Olayemi Sokumbi
- Department of Dermatology, Mayo Clinic, Jacksonville, FL; Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL
| | - Jorge Alberto Rodriguez
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - LaPrincess C Brewer
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN; Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN.
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Abstract
Hallucinogenic mushrooms have been used in religious and cultural ceremonies for centuries. Of late, psilocybin, the psychoactive compound in hallucinogenic mushrooms, has received increased public interest as a novel drug for treating mood and substance use disorders (SUDs). In addition, in recent years, some states in the United States have legalized psilocybin for medical and recreational use. Given this, clinicians need to understand the potential benefits and risks related to using psilocybin for therapeutic purposes so that they can accurately advise patients. This expert narrative review summarizes the scientific basis and clinical evidence on the safety and efficacy of psilocybin-assisted therapy for treating psychiatric disorders and SUDs. The results of this review are structured as a more extensive discussion about psilocybin's history, putative mechanisms of action, and recent legislative changes to its legal status. There is modest evidence of psilocybin-assisted therapy for treating depression and anxiety disorders. In addition, early data suggest that psilocybin-assisted therapy may effectively reduce harmful drinking in patients with alcohol use disorders. The evidence further suggests psilocybin, when administered under supervision (psilocybin-assisted therapy), the side effects experienced are mild and transient. The occurrence of severe adverse events following psilocybin administration is uncommon. Still, a recent clinical trial found that individuals in the psilocybin arm had increased suicidal ideations and non-suicidal self-injurious behaviors. Given this, further investigation into the safety and efficacy of psilocybin-assisted therapy is warranted to determine which patient subgroups are most likely to benefit and which are most likely to experience adverse outcomes related to its use.
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Affiliation(s)
- Pravesh Sharma
- Department of Psychiatry and Psychology, Mayo Clinic Health System, Eau Claire, WI, USA
- Behavioral Health Research Program, Department of Psychology and Psychiatry Research, Mayo Clinic, Rochester, MN, USA
| | - Quang Anh Nguyen
- Behavioral Health Research Program, Department of Psychology and Psychiatry Research, Mayo Clinic, Rochester, MN, USA
| | - Sadie J Matthews
- Department of Psychology, University of Wisconsin (Eau Claire), Eau Claire, WI, USA
| | | | - Douglas B Mathews
- Department of Psychology, University of Wisconsin (Eau Claire), Eau Claire, WI, USA
| | - Christi A Patten
- Behavioral Health Research Program, Department of Psychology and Psychiatry Research, Mayo Clinic, Rochester, MN, USA
| | - Christopher J Hammond
- Division of Child and Adolescent Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Fu SS, Nelson D, Do T, Burgess DJ, Patten CA, Zhu SH, Martinson BC. Connecting Vietnamese-Speaking Immigrants who Smoke to the Asian Smokers Quitline: A Feasibility Pilot of Proactive Outreach Interventions. Nicotine Tob Res 2023; 25:1691-1697. [PMID: 37294675 DOI: 10.1093/ntr/ntad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Cigarette smoking is highly prevalent among Asian American immigrant subgroups. Previously, Asian-language telephone Quitline services were only available in California. In 2012, the Centers for Disease Control and Prevention (CDC) funded the national Asian Smokers' Quitline (ASQ) to expand Asian-language Quitline services nationally. However, there are relatively few calls to the ASQ from outside California. AIMS AND METHODS This pilot study assessed the feasibility of two proactive outreach interventions to connect Vietnamese-speaking participants who smoke to the ASQ. Both interventions, (1) proactive telephone outreach with a counselor trained in motivational interviewing (PRO-MI) and (2) proactive telephone outreach with interactive voice response (PRO-IVR), were adapted to be culturally and linguistically appropriate for Vietnamese-speaking participants. Participants were randomly assigned 2:1 to PRO-IVR versus PRO-MI. Assessments were conducted at baseline and 3 months post-enrollment. Feasibility indicators were the recruitment rate and initiation of ASQ treatment. RESULTS Using the HealthPartners electronic health record, a large health system in Minnesota, we identified approximately 343 potentially eligible Vietnamese participants who were mailed invitation letters and baseline surveys with telephone follow-up. We enrolled 86 eligible participants (25% recruitment rate). In the PRO-IVR group 7/58 participants were directly transferred to the ASQ (12% initiation rate) and in the PRO-MI group 8/28 participants were warm transferred to the ASQ (29% initiation rate). CONCLUSIONS This pilot study demonstrates the feasibility of our recruitment methods and of implementing proactive outreach interventions to promote the initiation of smoking cessation treatment with the ASQ. IMPLICATIONS This pilot study contributes novel data on the uptake of Asian Smokers' Quitline (ASQ) services among Vietnamese-speaking people who smoke (PWS) with two proactive outreach interventions: (1) proactive telephone outreach with a counselor trained in motivational interviewing (PRO-MI) and (2) proactive telephone outreach with interactive voice response (PRO-IVR). We found that it is feasible to implement these proactive outreach interventions to promote the initiation of ASQ cessation treatment among Vietnamese-language speaking PWS. Future large trials are needed to rigorously compare PRO-MI and PRO-IVR and conduct budget impact analyses to understand the most efficient strategies for incorporation into health system settings.
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Affiliation(s)
- Steven S Fu
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Dave Nelson
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Tam Do
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Diana J Burgess
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Shu-Hong Zhu
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Brian C Martinson
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
- HealthPartners Institute for Education and Research, Minneapolis, MN, USA
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Maciejko LA, Fox JM, Steffens MT, Patten CA, Newman HR, Decker PA, Wheeler P, Juhn YJ, Wi CI, Gorfine M, Brewer L, Sinicrope PS. Rural and urban residents' attitudes and preferences toward COVID-19 prevention behaviors in a midwestern community. PLoS One 2023; 18:e0286953. [PMID: 37352298 PMCID: PMC10289401 DOI: 10.1371/journal.pone.0286953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 05/30/2023] [Indexed: 06/25/2023] Open
Abstract
Rural populations are more vulnerable to the impacts of COVID-19 compared to their urban counterparts as they are more likely to be older, uninsured, to have more underlying medical conditions, and live further from medical care facilities. We engaged the Southeastern MN (SEMN) community (N = 7,781, 51% rural) to conduct a survey of motivators and barriers to masking to prevent COVID-19. We also assessed preferences for types of and modalities to receive education/intervention, exploring both individual and environmental factors primarily consistent with Social Cognitive Theory. Our results indicated rural compared to urban residents performed fewer COVID-19 prevention behaviors (e.g. 62% rural vs. 77% urban residents reported wearing a mask all of the time in public, p<0.001), had more negative outcome expectations for wearing a mask (e.g. 50% rural vs. 66% urban residents thought wearing a mask would help businesses stay open, p<0.001), more concerns about wearing a mask (e.g. 23% rural vs. 14% urban were very concerned about being 'too hot', p<0.001) and lower levels of self-efficacy for masking (e.g. 13.9±3.4 vs. 14.9±2.8, p<0.001). It appears that masking has not become a social norm in rural SEMN, with almost 50% (vs. 24% in urban residents) disagreeing with the expectation 'others in my community will wear a mask to stop the spread of Coronavirus'. Except for people (both rural and urban) who reported not being at all willing to wear a mask (7%), all others expressed interest in future education/interventions to help reduce masking barriers that utilized email and social media for delivery. Creative public health messaging consistent with SCT tailored to rural culture and norms is needed, using emails and social media with pictures and videos from role models they trust, and emphasizing education about when masks are necessary.
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Affiliation(s)
- Laura A. Maciejko
- Mayo Clinic Alix School of Medicine, Rochester, MN, United States of America
| | - Jean M. Fox
- Department of Gastroenterology, Mayo Clinic, Rochester, MN, United States of America
| | | | - Christi A. Patten
- Community Engagement Program, Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States of America
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States of America
| | - Hana R. Newman
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ, United States of America
| | - Paul A. Decker
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States of America
| | - Phil Wheeler
- Precision Population Science Lab, Department of Pediatric & Adolescent Medicine, Mayo Clinic, Rochester, United States of America
| | - Young J. Juhn
- Precision Population Science Lab, Department of Pediatric & Adolescent Medicine, Mayo Clinic, Rochester, United States of America
| | - Chung-Il Wi
- Precision Population Science Lab, Department of Pediatric & Adolescent Medicine, Mayo Clinic, Rochester, United States of America
| | - Mary Gorfine
- Community Engagement Program, Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States of America
| | - LaPrincess Brewer
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, United States of America
- Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, United States of America
| | - Pamela S. Sinicrope
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States of America
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Ehlers SL, Gudenkauf LM, Kacel EL, Hanna SM, Sinicrope PS, Patten CA, Morrison EL, Snuggerud J, Bevis D, Kirsch JL, Staab JP, Price KAR, Wahner-Hendrickson AE, Ruddy KJ. Real-World Implementation of Best-Evidence Cancer Distress Management: Truly Comprehensive Cancer Care. J Natl Compr Canc Netw 2023; 21:627-635. [PMID: 37308123 DOI: 10.6004/jnccn.2023.7009] [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] [Received: 09/09/2022] [Accepted: 02/03/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Cancer distress management is an evidence-based component of comprehensive cancer care. Group-delivered cognitive behavioral therapy for cancer distress (CBT-C) is the first distress treatment associated with replicated survival advantages in randomized clinical trials. Despite research supporting patient satisfaction, improved outcomes, and reduced costs, CBT-C has not been tested sufficiently within billable clinical settings, profoundly reducing patient access to best-evidence care. This study aimed to adapt and implement manualized CBT-C as a billable clinical service. PATIENTS AND METHODS A stakeholder-engaged, mixed-methods, hybrid implementation study design was used, and the study was conducted in 3 phases: (1) stakeholder engagement and adaptation of CBT-C delivery, (2) patient and therapist user testing and adaptation of CBT-C content, and (3) implementation of practice-adapted CBT-C as a billable clinical service focused on evaluation of reach, acceptability, and feasibility across stakeholder perspectives. RESULTS A total of 40 individuals and 7 interdisciplinary group stakeholders collectively identified 7 primary barriers (eg, number of sessions, workflow concerns, patient geographic distance from center) and 9 facilitators (eg, favorable financial model, emergence of oncology champions). CBT-C adaptations made before implementation included expanding eligibility criteria beyond breast cancer, reducing number of sessions to 5 (10 total hours), eliminating and adding content, and revising language and images. During implementation, 252 patients were eligible; 100 (40%) enrolled in CBT-C (99% covered by insurance). The primary reason for declining enrollment was geographic distance. Of enrollees, 60 (60%) consented to research participation (75% women; 92% white). All research participants completed at least 60% of content (6 of 10 hours), with 98% reporting they would recommend CBT-C to family and friends. CONCLUSIONS CBT-C implementation as a billable clinical service was acceptable and feasible across cancer care stakeholder measures. Future research is needed to replicate acceptability and feasibility results in more diverse patient groups, test effectiveness in clinical settings, and reduce barriers to access via remote delivery platforms.
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Affiliation(s)
- Shawna L Ehlers
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Lisa M Gudenkauf
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Elizabeth L Kacel
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Sherrie M Hanna
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Pam S Sinicrope
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Eleshia L Morrison
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Jill Snuggerud
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Danielle Bevis
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Janae L Kirsch
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Jeffrey P Staab
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
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Rusk AM, Giblon RE, Chamberlain AM, Patten CA, Felzer JR, Bui YT, Wi CI, Destephano CC, Abbott BA, Kennedy CC. Smoking Behaviors Among Indigenous Pregnant People Compared to a Matched Regional Cohort. Nicotine Tob Res 2023; 25:889-897. [PMID: 36250476 PMCID: PMC10077929 DOI: 10.1093/ntr/ntac240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 10/05/2022] [Accepted: 10/14/2022] [Indexed: 04/12/2023]
Abstract
INTRODUCTION Smoking commercial tobacco products is highly prevalent in American Indian and Alaska Native (Indigenous) pregnancies. This disparity directly contributes to maternal and fetal mortality. Our objective was to describe cigarette smoking prevalence, cessation intervention uptake, and cessation behaviors of pregnant Indigenous people compared to sex and age-matched regional cohort. AIMS AND METHODS Pregnancies from an Indigenous cohort in Olmsted County, Minnesota, identified in the Rochester Epidemiology Project, were compared to pregnancies identified in a sex and age-matched non-Indigenous cohort from 2006 to 2019. Smoking status was defined as current, former, or never. All pregnancies were reviewed to identify cessation interventions and cessation events. The primary outcome was smoking prevalence during pregnancy, with secondary outcomes measuring uptake of smoking cessation interventions and cessation. RESULTS The Indigenous cohort included 57 people with 81 pregnancies, compared to 226 non-Indigenous people with 358 pregnancies. Smoking was identified during 45.7% of Indigenous pregnancies versus 11.2% of non-Indigenous pregnancies (RR: 3.25, 95% CI = 1.98-5.31, p ≤ .0001). Although there was no difference in uptake of cessation interventions between cohorts, smoking cessation was significantly less likely during Indigenous pregnancies compared to non-Indigenous pregnancies (OR: 0.23, 95% CI = 0.07-0.72, p = .012). CONCLUSIONS Indigenous pregnant people in Olmsted County, Minnesota were more than three times as likely to smoke cigarettes during pregnancy compared to the non-indigenous cohort. Despite equivalent uptake of cessation interventions, Indigenous people were less likely to quit than non-Indigenous people. Understanding why conventional smoking cessation interventions were ineffective at promoting cessation during pregnancy among Indigenous women warrants further study. IMPLICATIONS Indigenous pregnant people in Olmsted County, Minnesota, were greater than three times more likely to smoke during pregnancy compared to a regional age matched non-Indigenous cohort. Although Indigenous and non-Indigenous pregnant people had equivalent uptake of cessation interventions offered during pregnancy, Indigenous people were significantly less likely to quit smoking before fetal delivery. This disparity in the effectiveness of standard of care interventions highlights the need for further study to understand barriers to cessation in pregnant Indigenous people.
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Affiliation(s)
- Ann M Rusk
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester MN, USA
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester MN, USA
- Respiratory Health Equity Clinical Research Laboratory at Mayo Clinic, Rochester MN, USA
| | - Rachel E Giblon
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester MN, USA
| | - Alanna M Chamberlain
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester MN, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester MN, USA
| | - Christi A Patten
- Division of Behavioral Health Research, Mayo Clinic, Rochester MN, USA
| | - Jamie R Felzer
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester MN, USA
- Respiratory Health Equity Clinical Research Laboratory at Mayo Clinic, Rochester MN, USA
| | - Yvonne T Bui
- Mayo Clinic Alix School of Medicine, Rochester MN, USA
| | - Chung-Il. Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester MN, USA
| | - Christopher C Destephano
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester MN, USA
- Division of Obstetrics and Gynecology, Mayo Clinic, Jacksonville FL, USA
| | - Barbara A Abbott
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester MN, USA
| | - Cassie C Kennedy
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester MN, USA
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester MN, USA
- Respiratory Health Equity Clinical Research Laboratory at Mayo Clinic, Rochester MN, USA
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Patten CA, Koller KR, King DK, Prochaska JJ, Sinicrope PS, McDonell MG, Decker PA, Lee FR, Fosi JK, Young AM, Sabaque CV, Brown AR, Borah BJ, Thomas TK. Aniqsaaq (To Breathe): Study protocol to develop and evaluate an Alaska Native family-based financial incentive intervention for smoking cessation. Contemp Clin Trials Commun 2023; 33:101129. [PMID: 37091507 PMCID: PMC10120296 DOI: 10.1016/j.conctc.2023.101129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/27/2023] [Accepted: 04/01/2023] [Indexed: 04/05/2023] Open
Abstract
Background Alaska Native and American Indian (ANAI) communities in Alaska are disproportionately affected by commercial tobacco use. Financial incentive interventions promote cigarette smoking cessation, but family-level incentives have not been evaluated. We describe the study protocol to adapt and evaluate the effectiveness and implementation of a remotely delivered, family-based financial incentive intervention for cigarette smoking among Alaskan ANAI people. Methods The study has 3 phases: 1) qualitative interviews with ANAI adults who smoke, family members, and stakeholders to inform the intervention, 2) beta-test of the intervention, and 3) randomized controlled trial (RCT) evaluating intervention reach and effectiveness on verified, prolonged smoking abstinence at 6- and 12-months post-treatment. In the RCT, adult dyads (ANAI person who smokes [index participant] and family member) recruited throughout Alaska will be randomized to a no-incentives control condition (n = 328 dyads) or a 6-month incentive intervention (n = 328 dyads). All dyads will receive cessation support and family wellness materials. Smoking status will be assessed weekly for four weeks and at three and six months. Intervention index participants will receive escalating incentives for verified smoking abstinence at each time point (maximum $750 total); the family member will receive rewards of equal value. Results A community advisory committee contributed input on the study design and methods for relevance to ANAI people, particularly emphasizing the involvement of families. Conclusion Our study aligns with the strength and value AIAN people place on family. Findings, processes, and resources will inform how Indigenous family members can support smoking cessation within incentive interventions. Clinical Trials Registry NCT05209451.
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Patten CA, Koller KR, Sinicrope PS, Prochaska JJ, Young C, Resnicow K, Decker PA, Hughes CA, Merritt ZT, McConnell CR, Huang M, Thomas TK. Facebook Intervention to Connect Alaska Native People With Resources and Support to Quit Smoking: CAN Quit Pilot Randomized Controlled Trial. Nicotine Tob Res 2023; 25:803-813. [PMID: 36130170 PMCID: PMC10032195 DOI: 10.1093/ntr/ntac221] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/22/2022] [Accepted: 09/19/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION There is some evidence that social media interventions can promote smoking cessation. This randomized controlled pilot study is the first to evaluate the feasibility and potential efficacy of a Facebook smoking cessation intervention among Alaska Native (AN) adults. AIMS AND METHODS Recruitment and data collection occurred from December 2019 to March 2021. Participants were recruited statewide in Alaska using Facebook advertisements with a targeted sample of 60 enrolled. Participants were stratified by gender, age, and rural or urban residence and randomly assigned to receive referral resources on evidence-based cessation treatments (EBCTs) (control, n = 30) or these resources plus a 3-month, closed (private), culturally tailored, Facebook group (intervention, n = 31) that connected participants to EBCT resources and was moderated by two Alaska Native Trained Tobacco Specialists. Assessments were conducted online post-randomization at 1, 3, and 6 months. Outcomes were feasibility (recruitment, retention, and intervention engagement), self-reported use of EBCTs, and biochemically confirmed seven-day point-prevalence smoking abstinence. RESULTS Of intervention participants, 90% engaged (eg posted, commented) more than once. Study retention was 57% at 6 months (no group differences). The proportion utilizing EBCTs was about double for intervention compared with the control group participants at 3 and 6 months. Smoking abstinence was higher for intervention than control participants at 3 months (6.5% vs. 0%, p = .16) but comparable at 6 months (6.4% vs. 6.7%, p = .97). CONCLUSIONS While additional research is needed to promote long-term cessation, this pilot trial supports recruitment feasibility during the Coronavirus Disease 2019 (COVID-19) pandemic, consumer uptake, and a signal for intervention efficacy on the uptake of cessation treatment and short-term smoking abstinence. IMPLICATIONS This study is the first evaluation of a social media intervention for smoking cessation among Indigenous people. We learned that statewide Facebook recruitment of AN adults who smoke was feasible and there was a signal for the efficacy of a Facebook intervention on the uptake of EBCT and short-term (3 months) biochemically verified smoking abstinence. Clinically, social media platforms may complement current care models by connecting AN individuals and others living in hard-to-reach communities to cessation treatment resources.
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Affiliation(s)
- Christi A Patten
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Kathryn R Koller
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
| | - Pamela S Sinicrope
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Judith J Prochaska
- Department of Medicine, Stanford Prevention Research Center, Stanford University, 1265 Welch Road, Stanford, CA, 94305-5411, USA
| | - Colleen Young
- Division of Consumer Communications, Social and Digital Innovation, Mayo Clinic Connect, 200 First St SW, Rochester, MN, 55905, USA
| | - Kenneth Resnicow
- School of Public Health, University of Michigan, 109 S. Observatory, 3867 SPH1, Ann Arbor, MI, 48109, USA
| | - Paul A Decker
- Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Christine A Hughes
- Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Zoe T Merritt
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
| | - Clara R McConnell
- Wellness and Prevention, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
| | - Ming Huang
- Department of Artificial Intelligence and Informatics, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Timothy K Thomas
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
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McColl ER, Kwok J, Benowitz NL, Patten CA, Hughes CA, Koller KR, Flanagan CA, Thomas TK, Hiratsuka VY, Tyndale RF, Piquette-Miller M. The Effect of Tobacco Use on the Expression of Placental Transporters in Alaska Native Women. Clin Pharmacol Ther 2023; 113:634-642. [PMID: 36053152 PMCID: PMC10234256 DOI: 10.1002/cpt.2737] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/22/2022] [Accepted: 08/30/2022] [Indexed: 11/09/2022]
Abstract
Prenatal tobacco use among Alaska Native (AN) women has decreased substantially over the past two decades. Previous research suggests that providing AN women with feedback regarding fetal exposure to tobacco may further promote cessation. Transporters in the placenta regulate fetal exposure to nutrients and xenobiotics, including compounds associated with tobacco use. We examined whether prenatal tobacco use impacts transporter expression in the placenta, and whether this is influenced by fetal sex, degree of tobacco exposure, or transporter genotype. At delivery, we obtained placental samples from AN research participants who smoked cigarettes, used commercial chew or iqmik (oral tobacco), or did not use tobacco during pregnancy. Transporter expression was evaluated using qRT-PCR and Western blotting and tested for correlations between transcript levels and urinary biomarkers of tobacco use. The impact of BCRP/ABCG2 and OATP2B1/SLCO2B1 genotypes on protein expression was also examined. Oral tobacco use was associated with decreased P-gp and increased MRP1, MRP3, LAT1, and PMAT mRNA expression. Transcript levels of multiple transporters significantly correlated with tobacco biomarkers in maternal and fetal urine. In women carrying male fetuses, both smoking and oral tobacco were associated with decreased P-gp. Oral tobacco was also associated with decreased LAT1 in women carrying female fetuses. BCRP and OATP2B1 genotypes did not appear to impact protein expression. In conclusion, prenatal tobacco use is associated with altered expression of multiple placental transporters which differs by fetal sex. As transcript levels of multiple transporters were significantly correlated with tobacco use biomarkers, eliminating prenatal tobacco use should alleviate these changes.
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Affiliation(s)
- Eliza R. McColl
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Jacinda Kwok
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Neal L. Benowitz
- Department of Medicine, Division of Cardiology and Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA, USA
| | - Christi A. Patten
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, Rochester, MN, USA
| | - Christine A. Hughes
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, Rochester, MN, USA
| | - Kathryn R. Koller
- Clinical and Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium (ANTHC), Anchorage, AK, USA
| | - Christie A. Flanagan
- Clinical and Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium (ANTHC), Anchorage, AK, USA
| | - Timothy K Thomas
- Clinical and Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium (ANTHC), Anchorage, AK, USA
| | | | - Rachel F. Tyndale
- Departments of Pharmacology and Toxicology, and Psychiatry, Temerty Faculty of Medicine, University of Toronto, and Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Micheline Piquette-Miller
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
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Lohr AM, Vickery KD, Hernandez V, Ford BR, Gonzalez C, Kavistan S, Patten CA, Njeru JW, Novotny PJ, Larkey LK, Singh D, Wieland ML, Sia IG. Stories for change protocol: A randomized controlled trial of a digital storytelling intervention for Hispanic/Latino individuals with type 2 diabetes. Contemp Clin Trials 2023; 126:107093. [PMID: 36682492 PMCID: PMC9998363 DOI: 10.1016/j.cct.2023.107093] [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: 09/30/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
BACKGROUND Hispanic/Latino adults are disproportionately impacted by type 2 diabetes mellitus (T2D). The Stories for Change (S4C) Diabetes digital storytelling intervention promotes T2D self-management among Hispanic/Latino people. We describe the S4C protocol and participant baseline characteristics. METHODS Study eligibility criteria: Hispanic or Latino, age 18-70 years, ≥1 office visit within a year at a participating clinic, T2D diagnosis for ≥6 months, HbA1c ≥ 8%, and intention to continue care at the recruitment clinic. We used a two-group, parallel randomized controlled trial design and an intervention derived through a community-based participatory research approach. All participants received usual diabetes care and two cards describing how to engage healthcare teams and access diabetes-related resources. At baseline, the intervention group additionally viewed the 12-min, intervention video (four stories about diabetes self-management). To encourage subsequent video viewing, participants received five monthly text messages. The messages prompted them to self-rate their motivation and self-efficacy for T2D management. The control group received no additional intervention. Bilingual (English/Spanish) staff collected data at baseline, six weeks, three months, and six months including biometric measurements and a survey on diabetes self-management outcomes, theory-based measures, and the number of video views. We reviewed the number of diabetes-related appointments attended using electronic medical record data. RESULTS Participants (n = 451; 70% women, mean age = 53 years) had an average HbA1C ≥9%. Intervention participants reported identifying with the storytellers and engaging with the stories. CONCLUSION We present a digital storytelling intervention protocol that provides a template for future health promotion interventions prioritizing health disparity populations. CLINICALTRIAL gov#NCT03766438.
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Affiliation(s)
- Abby M Lohr
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA; Center for Clinical and Translational Science, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA.
| | - Katherine Diaz Vickery
- Health, Homelessness & Criminal Justice Lab, Hennepin Healthcare Research Institute, 730 S 8th St, Minneapolis, MN 55415, USA
| | | | - Becky R Ford
- Health, Homelessness & Criminal Justice Lab, Hennepin Healthcare Research Institute, 730 S 8th St, Minneapolis, MN 55415, USA
| | - Crystal Gonzalez
- Mountain Park Health Center, 635 E Baseline Rd, Phoenix, AZ 85042, USA
| | - Silvio Kavistan
- Health, Homelessness & Criminal Justice Lab, Hennepin Healthcare Research Institute, 730 S 8th St, Minneapolis, MN 55415, USA
| | - Christi A Patten
- Center for Clinical and Translational Science, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA; Department of Psychiatry and Psychology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Jane W Njeru
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Paul J Novotny
- Division of Biomedical Statistics and Informatics, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Linda K Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, 550 N 3rd Street Ac, Phoenix, AZ 85004, USA
| | - Davinder Singh
- Mountain Park Health Center, 635 E Baseline Rd, Phoenix, AZ 85042, USA
| | - Mark L Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA; Center for Clinical and Translational Science, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Irene G Sia
- Center for Clinical and Translational Science, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA; Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
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Sharma P, Mathews DB, Nguyen QA, Rossmann GL, A Patten C, Hammond CJ. Old Dog, New Tricks: A Review of Identifying and Addressing Youth Cannabis Vaping in the Pediatric Clinical Setting. Clin Med Insights Pediatr 2023; 17:11795565231162297. [PMID: 36993933 PMCID: PMC10041590 DOI: 10.1177/11795565231162297] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 02/20/2023] [Indexed: 03/31/2023] Open
Abstract
Cannabis vaping has emerged as a predominant mode of cannabis use among United States (US) adolescents and young adults (AYA) primarily due to the popularity of modifiable designs of vaping devices coupled with changes in cannabis policies and increased availability of cannabinoid products. New methods for cannabis vaping by e-liquid/oil vaping, dry plant vaping, and cannabis concentrate vaping (ie, dabbing) have had high uptake among American youth with unclear long-term health implications. Issues with contamination, mislabeling, and expansion of the vaped cannabis market to include not only delta-9-tetrahydrocannabinol (delta-9-THC) and cannabidiol (CBD) but also delta-9-THC analogs (eg, delta-8 and delta-10) sold as hemp-derived "legal highs" further complicated this healthcare space. Recent research suggests that cannabis/THC vaping carries distinct and overlapping risks when compared to cannabis smoking and may be associated with greater risk for acute lung injuries, seizures, and acute psychiatric symptoms. Primary care clinicians providing care for AYA are in an ideal position to identify cannabis misuse and intervene early to address cannabis vaping. To improve public health outcomes, a need exists for pediatric clinicians to be educated about different ways/methods that youth are vaping cannabinoid products and associated risks related to cannabinoid vaping. Further, pediatric clinicians need to be trained how to effectively screen for and discuss cannabis vaping with their youth patients. In the current article, we present a clinically focused review of cannabis vaping among young people with 3 main aims to: (1) identify and describe the cannabis vaping products commonly used by American youth; (2) review the health correlates of youth cannabis vaping; and (3) discuss clinical considerations related to identifying and treating youth who vape cannabis.
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Affiliation(s)
- Pravesh Sharma
- Behavioral Health Research Program, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Division of Child and Adolescent Psychiatry, Mayo Clinic Health System, Eau Claire, WI, USA
- Pravesh Sharma, Department of Psychiatry and Psychology, Division of Child and Adolescent Psychiatry, Mayo Clinic Health System, 1221 Whipple St., Eau Claire, WI 54703, USA.
| | | | - Quang Anh Nguyen
- Behavioral Health Research Program, Mayo Clinic, Rochester, MN, USA
| | | | - Christi A Patten
- Behavioral Health Research Program, Mayo Clinic, Rochester, MN, USA
| | - Christopher J Hammond
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Pebley K, Wang XQ, Fahey MC, Patten CA, Mallawaarachchi I, Talcott GW, Klesges RC, Little MA. Examination of Tobacco-Related Messaging and Tobacco Use over Time among U.S. Military Young Adults. Subst Use Misuse 2022; 58:146-152. [PMID: 36476101 PMCID: PMC10116438 DOI: 10.1080/10826084.2022.2151313] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: People from minoritized populations have historically been targeted by tobacco companies. Little is known about exposure to tobacco-related messages among military personnel from disadvantaged backgrounds. Objectives: The current study aimed to examine exposure to tobacco-related messaging across many nicotine products and through a variety of mediums (i.e., family, friends, advertisements, event promotions, social media) among diverse military populations and use one year later in a sample of young adults who recently enlisted in the U.S. Air Force. Methods: In this study, 8,901 U.S. Air Force trainees reported on demographics, tobacco use, and exposure to positive tobacco messages from social sources (i.e., friends, family, social media) and environmental sources (i.e., advertisements and promotions). Tobacco use was reported one-year later. Results: Compared to others of the same reported racial/ethnic background, Latino/a/x (Relative Risk Ratio [RRR] = 1.354, 95% CI: [1.145, 1.563]) and multiracial (RRR = 1.594, 95% CI: [1.173, 2.016]) participants who were exposed to positive tobacco messages from social sources were significantly more likely to report tobacco product use at one-year follow-up than those who were not exposed to social messages. Exposure to positive tobacco messages from environmental sources were not significantly associated with tobacco use one year later. Conclusions: Social messages may play an important role in increasing risk of tobacco use among some minoritized populations. Cultural as well as systemic factors could be addressed in future tobacco prevention programs to decrease the potency of positive tobacco-related social messages among Latino/a/x and multiracial communities.
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Affiliation(s)
- Kinsey Pebley
- The University of Memphis, Department of Psychology, 400 Innovation Drive, Memphis, TN 38152
| | - Xin-Qun Wang
- University of Virginia, School of Medicine Department of Public Health Sciences, 560 Ray C. Hunt Drive, Charlottesville, VA, 22903
| | - Margaret C. Fahey
- The University of Memphis, Department of Psychology, 400 Innovation Drive, Memphis, TN 38152
| | - Christi A. Patten
- The Mayo Clinic, Department of Psychiatry & Psychology, Rochester, 200 First Street, SW Colonial 3, Rochester, MN 55902
| | - Indika Mallawaarachchi
- University of Virginia, School of Medicine Department of Public Health Sciences, 560 Ray C. Hunt Drive, Charlottesville, VA, 22903
| | - G. Wayne Talcott
- University of Virginia, School of Medicine Department of Public Health Sciences, 560 Ray C. Hunt Drive, Charlottesville, VA, 22903
- The Mayo Clinic, Department of Psychiatry & Psychology, Rochester, 200 First Street, SW Colonial 3, Rochester, MN 55902
- Wilford Hall Ambulatory Surgical Center, 59 MDW/ 59 SGOWMP, 1100 Wilford Hall Loop, Bldg 4554, Joint Base Lackland AFB, TX 78236
| | - Robert C. Klesges
- University of Virginia, School of Medicine Department of Public Health Sciences, 560 Ray C. Hunt Drive, Charlottesville, VA, 22903
| | - Melissa A. Little
- University of Virginia, School of Medicine Department of Public Health Sciences, 560 Ray C. Hunt Drive, Charlottesville, VA, 22903
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Harmon DM, Adedinsewo D, Van't Hof JR, Johnson M, Hayes SN, Lopez-Jimenez F, Jones C, Attia ZI, Friedman PA, Patten CA, Cooper LA, Brewer LC. Community-based participatory research application of an artificial intelligence-enhanced electrocardiogram for cardiovascular disease screening: A FAITH! Trial ancillary study. Am J Prev Cardiol 2022; 12:100431. [PMID: 36419480 PMCID: PMC9677088 DOI: 10.1016/j.ajpc.2022.100431] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/12/2022] [Indexed: 11/15/2022] Open
Abstract
Objective With the emergence of artificial intelligence (AI)-based health interventions, systemic racism remains a concern as these advancements are frequently developed without race-specific data analysis or validation. To evaluate the potential utility of an AI-based cardiovascular diseases (CVD) screening tool in an under-resourced African-American cohort, we reviewed the AI-enhanced electrocardiogram (ECG) data of participants enrolled in a community-based clinical trial as a proof-of-concept ancillary study for community-based screening. Methods Enrollees completed cardiovascular testing including standard 12-lead ECG and a limited echocardiogram (TTE). All ECGs were analyzed using previously published institution-based AI algorithms. AI-ECG predictions were generated for age, sex, and decreased left ventricular ejection fraction (LVEF). Diagnostic accuracy of the AI-ECG for decreased LVEF and sex was quantified using area under the receiver operating characteristic curve (AUC). Correlation between actual age and AI-ECG predicted age was assessed using Pearson correlation coefficients. Results Fifty-four participants completed both an ECG and TTE (mean age 55 years [range 31-87 years]; 66.7% female). All participants were in sinus rhythm, and the median LVEF of the cohort was 60-65%. The AI-ECG for decreased LVEF demonstrated excellent performance with an AUC of 0.892 (95% confidence interval [CI] 0.708-1); sensitivity=50% (95% CI 9.5-90.5%; n=1/2) and specificity=96% (95% CI 86.8-98.9%; n=49/51). The AI-ECG for participant sex demonstrated similar performance with AUC of 0.944 (95% CI 0.891-0.998); sensitivity=100% (95% CI 82.4-100.0%; n=18/18) and specificity=77.8% (95% CI 61.9-88.3%; n=28/36). The AI-ECG predicted mean age was 55 years (range 26.9-72.6 years) with a strong correlation to actual age (R=0.769; p<0.001). Conclusion Our analyses of previously developed AI-ECG algorithms for prediction of age, sex, and decreased LVEF demonstrated reliable performance in this community-based, African-American cohort. This novel, community-centric delivery of AI could provide valuable screening resources and appropriate referrals for early detection of highly-morbid CVD for under-resourced patient populations.
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Key Words
- ADI, Area Deprivation Index
- AHA, American Heart Association
- Artificial intelligence
- CBPR, community-based participatory research
- CVD, cardiovascular disease
- CVH, cardiovascular health
- Disparities
- Electrocardiogram
- FAITH!, Fostering African-American Improvement in Total Health!
- LS7, Life's Simple 7
- LVEF, left ventricular ejection fraction
- Race
- SDOH, Social determinants of health
- TTE, transthoracic echocardiogram
- mHealth, mobile health
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Affiliation(s)
- David M. Harmon
- Department of Cardiovascular Disease, Mayo Clinic College of Medicine, Rochester, MN, USA
| | | | - Jeremy R. Van't Hof
- Cardiovascular Division, University of Minnesota Medical School, Minneapolis, MN
| | - Matthew Johnson
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Sharonne N. Hayes
- Department of Cardiovascular Disease, Mayo Clinic College of Medicine, Rochester, MN, USA
| | | | | | - Zachi I. Attia
- Department of Cardiovascular Disease, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Paul A. Friedman
- Department of Cardiovascular Disease, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Christi A. Patten
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN
| | - Lisa A. Cooper
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - LaPrincess C. Brewer
- Department of Cardiovascular Disease, Mayo Clinic College of Medicine, Rochester, MN, USA
- Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, USA
- Corresponding author at: Department of Cardiovascular Disease, 200 1st Street SW, Rochester, MN 55905.
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22
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Rusk AM, Giblon RE, Chamberlain AM, Patten CA, Felzer JR, Bui YT, Wi CI, Destephano CC, Abbott BA, Kennedy CC. Indigenous Smoking Behaviors in Olmsted County, Minnesota: A Longitudinal Population-Based Study. Mayo Clin Proc 2022; 97:1836-1848. [PMID: 36202495 PMCID: PMC9918799 DOI: 10.1016/j.mayocp.2022.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/03/2022] [Accepted: 03/18/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To describe smoking behaviors and pharmaceutical cessation aid uptake in a population-based Indigenous cohort compared with an age- and sex-matched non-Indigenous cohort. PATIENTS AND METHODS Using the health record-linkage system of the Rochester Epidemiology Project (January 1, 2006, to December 31, 2019), smoking data of Indigenous residents of Olmsted County in Minnesota were abstracted to define the smoking prevalence, incidence, cessation, relapse after cessation, and pharmaceutical smoking cessation aid uptake compared with a matched non-Indigenous cohort. Prevalence was analyzed with a modified Poisson regression; cessation and relapse were evaluated with generalized estimating equations. Incidence was evaluated with a Cox proportional hazards model. RESULTS Smoking prevalence was higher in the Indigenous cohort (39.0% to 47.0%; n=898) than the matched cohort (25.6% to 30.3%; n=1780). Pharmaceutical uptake was higher among the Indigenous cohort (35.8% of n=584 ever smokers vs 16.3% of n=778 ever smokers; P<.001). Smoking cessation events occurred more frequently in the Indigenous cohort (relative risk, 1.10; 95% CI, 1.06 to 1.13; P<.001). Indigenous former smokers were more likely to resume smoking (relative risk, 3.03; 95% CI, 2.93 to 3.14; P<.001) compared with the matched cohort. These findings were independent of socioeconomic status, age, and sex. CONCLUSION Smoking in this Indigenous cohort was more prevalent compared with a sex- and age-matched non-Indigenous cohort despite more smoking cessation events and higher use of smoking cessation aids in the Indigenous cohort. The relapse rate after achieving cessation in the Indigenous cohort was more than three times higher than the non-Indigenous cohort. This finding has not been previously described and represents a potential target for relapse prevention efforts in US Indigenous populations.
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Affiliation(s)
- Ann M Rusk
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA; Respiratory Health Equity Clinical Research Laboratory at Mayo Clinic, Rochester, MN
| | - Rachel E Giblon
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Alanna M Chamberlain
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Christi A Patten
- Division of Behavioral Health Research, Mayo Clinic, Rochester, MN, USA
| | - Jamie R Felzer
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA; Respiratory Health Equity Clinical Research Laboratory at Mayo Clinic, Rochester, MN
| | - Yvonne T Bui
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Christopher C Destephano
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA; Division of Obstetrics and Gynecology, Mayo Clinic, Jacksonville, FL, USA
| | - Barbara A Abbott
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Cassie C Kennedy
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA; Respiratory Health Equity Clinical Research Laboratory at Mayo Clinic, Rochester, MN.
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23
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Kamath CC, Kelpin SS, Patten CA, Rummans TA, Kremers HM, Oesterle TS, Williams MD, Breitinger SA. Shaping the Screening, Behavioral Intervention, and Referral to Treatment (SBIRT) Model for Treatment of Alcohol Use Disorder in the COVID-19 Era. Mayo Clin Proc 2022; 97:1774-1779. [PMID: 36202491 PMCID: PMC9293785 DOI: 10.1016/j.mayocp.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/15/2022] [Accepted: 07/13/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Celia C Kamath
- Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN; Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
| | - Sydney S Kelpin
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN; Center for Clinical and Translational Science
| | - Teresa A Rummans
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Hilal Maradit Kremers
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN; Department of Orthopedic Surgery (H.M.K.), Mayo Clinic, Rochester, MN
| | - Tyler S Oesterle
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Mark D Williams
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
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24
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Huang M, Wen A, He H, Wang L, Liu S, Wang Y, Zong N, Yu Y, Prigge JE, Costello BA, Shah ND, Ting HH, Doubeni C, Fan J, Liu H, Patten CA. Midwest rural-urban disparities in use of patient online services for COVID-19. J Rural Health 2022; 38:908-915. [PMID: 35261092 PMCID: PMC9115171 DOI: 10.1111/jrh.12657] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE Rural populations are disproportionately affected by the COVID-19 pandemic. We characterized urban-rural disparities in patient portal messaging utilization for COVID-19, and, of those who used the portal during its early stage in the Midwest. METHODS We collected over 1 million portal messages generated by midwestern Mayo Clinic patients from February to August 2020. We analyzed patient-generated messages (PGMs) on COVID-19 by urban-rural locality and incorporated patients' sociodemographic factors into the analysis. FINDINGS The urban-rural ratio of portal users, message senders, and COVID-19 message senders was 1.18, 1.31, and 1.79, indicating greater use among urban patients. The urban-rural ratio (1.69) of PGMs on COVID-19 was higher than that (1.43) of general PGMs. The urban-rural ratios of messaging were 1.72-1.85 for COVID-19-related care and 1.43-1.66 for other health care issues on COVID-19. Compared with urban patients, rural patients sent fewer messages for COVID-19 diagnosis and treatment but more messages for other reasons related to COVID-19-related health care (eg, isolation and anxiety). The frequent senders of COVID-19-related messages among rural patients were 40+ years old, women, married, and White. CONCLUSIONS In this Midwest health system, rural patients were less likely to use patient online services during a pandemic and their reasons for its use differ from urban patients. Results suggest opportunities for increasing equity in rural patient engagement in patient portals (in particular, minority populations) for COVID-19. Public health intervention strategies could target reasons why rural patients might seek health care in a pandemic, such as social isolation and anxiety.
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Affiliation(s)
- Ming Huang
- Department of Artificial Intelligence and InformaticsMayo ClinicRochesterMinnesotaUSA
| | - Andrew Wen
- Department of Artificial Intelligence and InformaticsMayo ClinicRochesterMinnesotaUSA
| | - Huan He
- Department of Artificial Intelligence and InformaticsMayo ClinicRochesterMinnesotaUSA
| | - Liwei Wang
- Department of Artificial Intelligence and InformaticsMayo ClinicRochesterMinnesotaUSA
| | - Sijia Liu
- Department of Artificial Intelligence and InformaticsMayo ClinicRochesterMinnesotaUSA
| | - Yanshan Wang
- Department of Artificial Intelligence and InformaticsMayo ClinicRochesterMinnesotaUSA
| | - Nansu Zong
- Department of Artificial Intelligence and InformaticsMayo ClinicRochesterMinnesotaUSA
| | - Yue Yu
- Department of Artificial Intelligence and InformaticsMayo ClinicRochesterMinnesotaUSA
| | | | | | - Nilay D. Shah
- Department of Artificial Intelligence and InformaticsMayo ClinicRochesterMinnesotaUSA
| | - Henry H. Ting
- Department of Artificial Intelligence and InformaticsMayo ClinicRochesterMinnesotaUSA
- Department of Cardiovascular MedicineMayo ClinicRochesterMinnesotaUSA
| | - Chyke Doubeni
- Department of Family MedicineMayo ClinicRochesterMinnesotaUSA
| | - Jung‐Wei Fan
- Department of Artificial Intelligence and InformaticsMayo ClinicRochesterMinnesotaUSA
| | - Hongfang Liu
- Department of Artificial Intelligence and InformaticsMayo ClinicRochesterMinnesotaUSA
| | - Christi A. Patten
- Center for Clinical and Translational Science, Community Engagement ProgramMayo ClinicRochesterMinnesotaUSA
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
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25
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Brewer LC, Bowie J, Slusser JP, Scott CG, Cooper LA, Hayes SN, Patten CA, Sims M. Religiosity/Spirituality and Cardiovascular Health: The American Heart Association Life's Simple 7 in African Americans of the Jackson Heart Study. J Am Heart Assoc 2022; 11:e024974. [PMID: 36000432 PMCID: PMC9496409 DOI: 10.1161/jaha.121.024974] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Religiosity/spirituality is a major coping mechanism for African Americans, but no prior studies have analyzed its association with the American Heart Association Life's Simple 7 (LS7) indicators in this group. Methods and Results This cross‐sectional study using Jackson Heart Study (JHS) data examined relationships between religiosity (religious attendance, private prayer, religious coping) and spirituality (theistic, nontheistic, total) with LS7 individual components (eg, physical activity, diet, smoking, blood pressure) and composite score among African Americans. Multivariable logistic regression assessed the odds of achieving intermediate/ideal (versus poor) LS7 levels adjusted for sociodemographic, behavioral, and biomedical factors. Among the 2967 participants (mean [SD] age=54.0 [12.3] years; 65.7% women), higher religious attendance was associated with increased likelihood (reported as odds ratio [95% CI]) of achieving intermediate/ideal levels of physical activity (1.16 [1.06–1.26]), diet (1.10 [1.01–1.20]), smoking (1.50 [1.34–1.68]), blood pressure (1.12 [1.01–1.24]), and LS7 composite score (1.15 [1.06–1.26]). Private prayer was associated with increased odds of achieving intermediate/ideal levels for diet (1.12 [1.03–1.22]) and smoking (1.24 [1.12–1.39]). Religious coping was associated with increased odds of achieving intermediate/ideal levels of physical activity (1.18 [1.08–1.28]), diet (1.10 [1.01–1.20]), smoking (1.32 [1.18–1.48]), and LS7 composite score (1.14 [1.04–1.24]). Total spirituality was associated with increased odds of achieving intermediate/ideal levels of physical activity (1.11 [1.02–1.21]) and smoking (1.36 [1.21–1.53]). Conclusions Higher levels of religiosity/spirituality were associated with intermediate/ideal cardiovascular health across multiple LS7 indicators. Reinforcement of religiosity/spirituality in lifestyle interventions may decrease overall cardiovascular disease risk among African Americans.
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Affiliation(s)
- LaPrincess C Brewer
- Department of Cardiovascular Medicine Mayo Clinic Rochester MN.,Center for Health Equity and Community Engagement Research Mayo Clinic Rochester MN
| | - Janice Bowie
- Department of Health, Behavior and Society Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Joshua P Slusser
- Division of Clinical Trials and Biostatistics Mayo Clinic Rochester MN
| | | | - Lisa A Cooper
- Department of Health, Behavior and Society Johns Hopkins Bloomberg School of Public Health Baltimore MD.,Department of Medicine Johns Hopkins University School of Medicine Baltimore MD
| | | | - Christi A Patten
- Center for Health Equity and Community Engagement Research Mayo Clinic Rochester MN.,Department of Psychiatry and Psychology Mayo Clinic Rochester MN
| | - Mario Sims
- Department of Medicine University of Mississippi Medical Center Jackson MS
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26
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Sharma P, Patten CA. A Need for Digitally Inclusive Health Care Service in the United States: Recommendations for Clinicians and Health Care Systems. Perm J 2022; 26:149-153. [DOI: 10.7812/tpp/21.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Pravesh Sharma
- Department of Psychiatry and Psychology, Mayo Clinic Health System–Northwest Wisconsin Region, Eau Claire, WI, USA
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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27
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Brewer LC, Jenkins S, Hayes SN, Kumbamu A, Jones C, Burke LE, Cooper LA, Patten CA. Community-Based, Cluster-Randomized Pilot Trial of a Cardiovascular Mobile Health Intervention: Preliminary Findings of the FAITH! Trial. Circulation 2022; 146:175-190. [PMID: 35861762 PMCID: PMC9287100 DOI: 10.1161/circulationaha.122.059046] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND African Americans continue to have suboptimal cardiovascular health (CVH) based on the American Heart Association Life's Simple 7 (LS7), 7 health-promoting behaviors and biological risk factors (eg, physical activity, blood pressure). Innovative, community-level interventions in partnership with trusted institutions such as African American churches are potential means to improve CVH in this population. METHODS Using a community-based participatory research approach, the FAITH! Trial (Fostering African American Improvement in Total Health) rigorously assessed the feasibility and preliminary efficacy of a refined, community-informed, mobile health intervention (FAITH! App) for promoting CVH among African Americans in faith communities using a cluster randomized controlled trial. Participants from 16 churches in Rochester and Minneapolis-St Paul, MN, were randomized to receive the FAITH! App (immediate intervention) or were assigned to a delayed intervention comparator group. The 10-week intervention core features included culturally relevant and LS7-focused education modules, diet/physical activity self-monitoring, and a group sharing board. Data were collected via electronic surveys and health assessments. Primary outcomes were average change in mean LS7 score (continuous measure of CVH ranging from poor to ideal [0-14 points]) from baseline to 6 months post-intervention (using generalized estimating equations) and app engagement/usability (by the Health Information Technology Usability Evaluation Scale; range, 0-5). RESULTS Of 85 enrolled participants (randomized to immediate [N=41] and delayed [control] intervention [N=44] groups), 76 and 68 completed surveys/health assessments at baseline and 6 months post-intervention, respectively (80% retention rate with assessments at both baseline and 6-month time points); immediate intervention [N=30] and control [N=38] groups). At baseline, the majority of participants (mean age [SD], 54.2 [12.3] years, 71% female) had <4-year college education level (39/66, 59%) and poor CVH (44% in poor category; mean LS7 score [SD], 6.8 [1.9]). The mean LS7 score of the intervention group increased by 1.9 (SD 1.9) points compared with 0.7 (SD 1.7) point in the control group (both P<0.0001) at 6 months. The estimated difference of this increase between the groups was 1.1 (95% CI, 0.6-1.7; P<0.0001). App engagement/usability was overall high (100% connection to app; >75% completed weekly diet/physical activity tracking; Health Information Technology Usability Evaluation Scale, mean [SD], 4.2 [0.7]). CONCLUSIONS On the basis of preliminary findings, the refined FAITH! App appears to be an efficacious mobile health tool to promote ideal CVH among African Americans. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT03777709.
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Affiliation(s)
- LaPrincess C. Brewer
- Department of Cardiovascular Medicine (L.C.B., S.N.H.), Mayo Clinic College of Medicine, Rochester, MN
- Center for Health Equity and Community Engagement Research (L.C.B.), Mayo Clinic, Rochester, MN
| | - Sarah Jenkins
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences (S.J.), Mayo Clinic, Rochester, MN
| | - Sharonne N. Hayes
- Department of Cardiovascular Medicine (L.C.B., S.N.H.), Mayo Clinic College of Medicine, Rochester, MN
| | - Ashok Kumbamu
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery (A.K.), Mayo Clinic, Rochester, MN
| | | | - Lora E. Burke
- School of Nursing, Department of Health and Community Systems, University of Pittsburgh, PA (L.E.B.)
| | - Lisa A. Cooper
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (L.A.C.)
| | - Christi A. Patten
- Department of Psychiatry and Psychology (C.A.P.), Mayo Clinic College of Medicine, Rochester, MN
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Golembiewski EH, Gravholt DL, Torres Roldan VD, Lincango Naranjo EP, Vallejo S, Bautista AG, LaVecchia CM, Patten CA, Allen SV, Jaladi S, Boehmer KR. Rural Patient Experiences of Accessing Care for Chronic Conditions: A Systematic Review and Thematic Synthesis of Qualitative Studies. Ann Fam Med 2022; 20:266-272. [PMID: 35606138 PMCID: PMC9199043 DOI: 10.1370/afm.2798] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 09/09/2021] [Accepted: 09/29/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Access to health care is a long-standing concern for rural patients; however, administrative measures fail to capture the subjective patient experience of accessing health care. The purpose of this review was to synthesize the qualitative literature on patient and caregiver experiences of accessing health care services for chronic disease management among US residents of rural areas. METHODS We searched Embase, MEDLINE, PsycInfo, CINAHL, and Scopus to identify qualitative studies published during 2010-2019. A thematic synthesis approach was used to analyze findings from included studies. RESULTS A total of 62 studies involving 1,354 unique participants were included. The largest share of studies (24.2%) was focused on the experience of patients with cancer, followed by behavioral health (16.1%), HIV and AIDS (14.5%), and diabetes (12.9%). We identified 4 primary analytic themes of barriers and facilitators associated with the experience of accessing health care services for chronic disease management in rural areas: (1) navigating the rural environment, (2) navigating the health care system, (3) financing chronic disease management, and (4) rural life (ie, common elements of a distinct "rural" way of thinking and behaving). CONCLUSIONS In this comprehensive review, we found that important cultural, structural, and individual factors influenced the rural patient's experience of health care access and use, including barriers and facilitators posed by geographic and built environments, and distinct rural mores. Our findings can inform policies and programs that both facilitate structural aspects of access and include culturally appropriate interventions.VISUAL ABSTRACT.
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Affiliation(s)
| | - Derek L Gravholt
- Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, Minnesota
| | | | - Eddy P Lincango Naranjo
- Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, Minnesota.,Hospital Vozandes Quito, Quito, Ecuador
| | | | | | - Christina M LaVecchia
- Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, Minnesota.,School of Arts and Sciences, Neumann University, Aston, Pennsylvania
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Summer V Allen
- Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, Minnesota
| | - Soumya Jaladi
- School of Medicine, University of Louisville, Louisville, Kentucky
| | - Kasey R Boehmer
- Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, Minnesota.,Division of Healthcare Delivery Research, Mayo Clinic, Rochester, Minnesota
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Patten CA, Hiratsuka VY, Nash SH, Day G, Redwood DG, Beans JA, Howard BV, Umans JG, Koller KR. Smoking Patterns Among Urban Alaska Native and American Indian Adults: The Alaska EARTH 10-Year Follow-up Study. Nicotine Tob Res 2022; 24:840-846. [PMID: 34850172 PMCID: PMC9048910 DOI: 10.1093/ntr/ntab245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Data on cigarette smoking prevalence among Alaska Native and American Indian (ANAI) people are limited to cross-sectional studies or specific subpopulations. Using data from the Alaska Education and Research toward Health (EARTH) Study 10-year follow-up, this study assessed patterns of smoking from baseline and factors associated with current use. AIMS AND METHODS EARTH Study urban south central ANAI participants (N = 376; 73% women) provided questionnaire data on smoking at baseline and 10-year follow-up. Multivariable-adjusted logistic regression assessed whether gender, cultural factors (Tribal identity, language spoken in the home), depressive symptoms (PHQ-9), baseline smoking status, and baseline cigarettes per day (CPD) were associated with current smoking at follow-up. RESULTS Current smoking was 27% and 23% at baseline and follow-up, respectively. Of baseline smokers, 60% reported smoking at follow-up (77% men, 52% women). From multivariable-adjusted analyses, the odds of current smoking at follow-up were lower among women than men, those who never or formerly smoked versus currently smoked at baseline, and smoking <10 CPD compared with ≥10 CPD at baseline. PHQ-9 score or cultural variables were not associated with smoking at follow-up. Smoking fewer baseline CPD was associated with former smoking status (ie, quitting) at follow-up among women, but not men. CONCLUSIONS Our project is among the first to longitudinally explore smoking within an ANAI cohort. While we observed persistent smoking during a 10-year period, there were important differences by gender and CPD in quitting. These differences may be important to enhance the reach and efficacy of cessation interventions for ANAI people. IMPLICATIONS This study contributes novel longitudinal information on cigarette smoking prevalence during a 10-year period among Alaska Native and American Indian (ANAI) people. Prior data on smoking prevalence among ANAI people are limited to cross-sectional studies or specific subpopulations. Our project is among the first to longitudinally explore smoking prevalence within an ANAI cohort. We observed persistent smoking during a 10-year period. The study also contributes information on differences by gender and cigarettes smoked per day in quitting. These findings have implications for enhancing the reach and efficacy of cessation interventions for ANAI people.
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Affiliation(s)
- Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Vanessa Y Hiratsuka
- Center for Human Development, University of Alaska Anchorage, Anchorage, AK, USA
- Research Department, Southcentral Foundation, Anchorage, AK, USA
| | - Sarah H Nash
- Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Gretchen Day
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Diana G Redwood
- Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Julie A Beans
- Research Department, Southcentral Foundation, Anchorage, AK, USA
| | - Barbara V Howard
- MedStar Health Research Institute, Hyattsville, MD, USA
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA
| | - Jason G Umans
- MedStar Health Research Institute, Hyattsville, MD, USA
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA
| | - Kathryn R Koller
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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Sharma P, Sinicrope AR, Sinicrope P, Brockman TA, Reinicke NM, West IW, Wiepert LM, Glasgow AE, Sangaralingham LR, Holland AL, Patten CA. Patient Telemedicine Perceptions During the COVID-19 Pandemic within a Multi-State Medical Institution: A Qualitative Study. JMIR Form Res 2022; 6:e37012. [PMID: 35452401 PMCID: PMC9109780 DOI: 10.2196/37012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/22/2022] [Accepted: 04/21/2022] [Indexed: 02/06/2023] Open
Abstract
Background During the COVID-19 pandemic, to prevent the spread of the virus, federal regulatory barriers around telemedicine were lifted, and health care institutions encouraged patients to use telemedicine, including video appointments. Many patients, however, still chose face-2-face (f2f) appointments for nonemergent clinical care. Objective We explored patients’ personal and environmental barriers to the use of video appointments from April 2020 to December 2020. Methods We conducted qualitative telephone interviews of Mayo Clinic patients who attended f2f appointments at the Mayo Clinic from April 2020 to December 2020 but did not utilize Mayo Clinic video appointment services during that time frame. Results We found that, although most patients were concerned about preventing COVID-19 transmission, they trusted Mayo Clinic to keep them safe when attending f2f appointments. Many expressed that a video appointment made it difficult to establish rapport with their providers. Other common barriers to video appointments were perceived therapeutic benefits of f2f appointments, low digital literacy, and concerns about privacy and security. Conclusions Our study provides an in-depth investigation into barriers to engaging in video appointments for nonemergent clinical care in the context of the COVID-19 pandemic. Our findings corroborate many barriers prevalent in the prepandemic literature and suggest that rapport barriers need to be analyzed and problem-solved at a granular level.
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Affiliation(s)
- Pravesh Sharma
- Behavioral Health Research Program, Psychiatry and Pyschology, Mayo Clinic Health System, 221 Whipple St., Eau Claire, US
| | | | - Pamela Sinicrope
- Behavioral Health Research Program, Psychology, Mayo Clinic, Rochester, US
| | - Tabetha A Brockman
- Behavioral Health Research Program, Psychology, Mayo Clinic, Rochester, US
| | - Nicole M Reinicke
- Behavioral Health Research Program, Psychology, Mayo Clinic, Rochester, US
| | - Ian W West
- Behavioral Health Research Program, Psychology, Mayo Clinic, Rochester, US
| | - Liana M Wiepert
- Behavioral Health Research Program, Psychology, Mayo Clinic, Rochester, US
| | - Amy E Glasgow
- Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, US
| | | | - Ashley L Holland
- Department of Psychiatry and Psychology, Mayo Clinic Health System, Eau Claire, US
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Santiago-Torres M, Mull KE, Sullivan BM, Kwon DM, Nez Henderson P, Nelson LA, Patten CA, Bricker JB. Efficacy and Utilization of Smartphone Applications for Smoking Cessation Among American Indians and Alaska Natives: Results From the iCanQuit Trial. Nicotine Tob Res 2022; 24:544-554. [PMID: 34644389 PMCID: PMC8887580 DOI: 10.1093/ntr/ntab213] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION There is tremendous need for efficacious and accessible interventions for smoking cessation among American Indians and Alaska Natives. We tested the efficacy of an Acceptance and Commitment Therapy (ACT)-based smartphone application (iCanQuit) versus US Clinical Practice Guidelines-based smartphone application (QuitGuide) for smoking cessation among American Indians and Alaska Natives. AIMS AND METHODS We compared cessation, changes in ACT-based processes, engagement and satisfaction between American Indian and Alaska Native iCanQuit (n = 89) and QuitGuide (n = 80) participants enrolled in the iCanQuit trial. The primary outcome was self-reported, complete-case, 30-day point-prevalence abstinence. Follow-up timepoints were 12, 6, and 3 months. RESULTS Randomized American Indians and Alaska Natives from 31 US states (70% urban, 30% rural, with 25% of participants residing on tribal land). The outcome data retention rates were 93%, 92%, and 90% at the 12-, 6-, and 3-month follow-ups, respectively, with no differential retention between arms. The 30-day point-prevalence abstinence for iCanQuit versus QuitGuide was 30% versus 18% at 12 months (odds ratio [OR] = 1.96; 95% confidence interval [CI]: 0.90 to 4.26) 25% versus 11% at 6 months (OR = 2.62; 95% CI: 1.06 to 6.45), and 15% versus 6% at 3 months (OR = 2.93; 95% CI: 0.90 to 9.59). Increases in acceptance of internal cues to smoke mediated the effect of treatment on smoking cessation at 12 months. iCanQuit arm participants were also significantly more engaged and satisfied with their assigned application. CONCLUSIONS In a nationwide sample with high data retention and participant engagement, this is the first study to show that a digital intervention may be efficacious for helping American Indians and Alaska Natives quit smoking. IMPLICATIONS This is the first study to provide evidence of an efficacious, accessible, and engaging treatment for helping American Indians and Alaska Natives quit smoking. Compared to a US Clinical Practice Guidelines-based smartphone application (QuitGuide), an ACT-based smartphone application (iCanQuit) was more efficacious, engaging, and satisfactory among American Indians and Alaska Natives nationwide. Our results will inform the tailoring of the iCanQuit smartphone application for American Indian and Alaska Native tribal communities and organizations with potential for broad dissemination and high impact.
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Affiliation(s)
| | - Kristin E Mull
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Brianna M Sullivan
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Diana M Kwon
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Psychology, University of Washington, Seattle, WA,USA
| | | | - Lonnie A Nelson
- Initiative for Research and Education to Advance Community Health, Washington State University, Spokane, WA, USA
- Washington State University College of Nursing, Spokane, WA, USA
| | - Christi A Patten
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, Rochester, MN, USA
| | - Jonathan B Bricker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Psychology, University of Washington, Seattle, WA,USA
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Cha J, West IW, Brockman TA, Soto MV, Balls-Berry JE, Eder M, Patten CA, Cohen EL. Use of Live Community Events on Facebook to Share Health and Clinical Research Information With a Minnesota Statewide Community: Exploratory Study. JMIR Form Res 2022; 6:e30973. [PMID: 35179514 PMCID: PMC8900910 DOI: 10.2196/30973] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 11/18/2021] [Accepted: 12/18/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Community engagement can make a substantial difference in health outcomes and strengthen the capacity to deal with disruptive public health events such as the COVID-19 pandemic. Social media platforms such as Facebook are a promising avenue to reach the broader public and enhance access to clinical and translational science, and require further evaluation from the scientific community. OBJECTIVE This study aims to describe the use of live community events to enhance communication about clinical and health research through a Facebook platform case study (Minnesota [MN] Research Link) with a Minnesota statewide community. We examined variables associated with video engagement including video length and type of posting. METHODS From June 2019 to February 2021, MN Research Link streamed 38 live community events on its public Facebook page, MN Research Link. Live community events highlighted different investigators' clinical and health research in the areas of mental health, health and wellness, chronic diseases, and immunology/infectious diseases. Facebook analytics were used to determine the number of views, total minutes viewed, engagement metrics, and audience retention. An engagement rate was calculated by the total number of interactions (likes, shares, and comments) divided by the total length of the live event by the type of live community event. RESULTS The 38 live community events averaged 23 minutes and 1 second in duration. The total time viewed for all 38 videos was 10 hours, 44 minutes, and 40 seconds. Viewers' watch time averaged 23 seconds of content per video. After adjusting for video length, promotional videos and research presentations had the highest engagement and retention rates. Events that included audience participation did not have higher retention rates compared to events without audience participation. CONCLUSIONS The use of live community events showed adequate levels of engagement from participants. A view time of 23 seconds on average per video suggests that short informational videos engage viewers of clinical and translational science content. Live community events on Facebook can be an effective method of advancing health promotion and clinical and translational science content; however, certain types of events have more impact on engagement than others.
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Affiliation(s)
- Jinhee Cha
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, United States
| | - Ian W West
- Center for Clinical and Translational Sciences, Mayo Clinic, Rochester, MN, United States
| | - Tabetha A Brockman
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, United States
| | - Miguel Valdez Soto
- Center for Clinical and Translational Sciences, Mayo Clinic, Rochester, MN, United States
| | - Joyce E Balls-Berry
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St Louis, MO, United States
| | - Milton Eder
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, United States
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, United States
| | - Christi A Patten
- Center for Clinical and Translational Sciences, Mayo Clinic, Rochester, MN, United States
| | - Elisia L Cohen
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, United States
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Sinicrope PS, Young CD, Resnicow K, Merritt ZT, McConnell CR, Hughes CA, Koller KR, Bock MJ, Decker PA, Flanagan CA, Meade CD, Thomas TK, Prochaska JJ, Patten CA. Lessons Learned From Beta-Testing a Facebook Group Prototype to Promote Treatment Use in the "Connecting Alaska Native People to Quit Smoking" (CAN Quit) Study. J Med Internet Res 2022; 24:e28704. [PMID: 35175208 PMCID: PMC8895280 DOI: 10.2196/28704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/21/2021] [Accepted: 12/01/2021] [Indexed: 12/14/2022] Open
Abstract
Social media provides an effective tool to reach, engage, and connect smokers in cessation efforts. Our team developed a Facebook group, CAN Quit (Connecting Alaska Native People to Quit smoking), to promote use of evidence-based smoking cessation resources for Alaska Native people living in Alaska, which are underused despite their effectiveness. Often separated by geography and climate, Alaska Native people prefer group-based approaches for tobacco cessation that support their culture and values. Such preferences make Alaska Native people candidates for social media-based interventions that promote connection. This viewpoint discusses the steps involved and lessons learned in building and beta-testing our Facebook group prototype, which will then be evaluated in a pilot randomized controlled trial. We describe the process of training moderators to facilitate group engagement and foster community, and we describe how we developed and tested our intervention prototype and Facebook group. All parts of the prototype were designed to facilitate use of evidence-based cessation treatments. We include recommendations for best practices with the hope that lessons learned from the CAN Quit prototype could provide a model for others to create similar platforms that benefit Alaska Native and American Indian people in the context of smoking cessation.
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Affiliation(s)
- Pamela S Sinicrope
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Colleen D Young
- Division of Consumer Communications, Social and Digital Innovation, Mayo Clinic Connect, Rochester, MN, United States
| | - Ken Resnicow
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Zoe T Merritt
- Clinical & Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Clara R McConnell
- Wellness and Prevention, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Christine A Hughes
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Kathryn R Koller
- Clinical & Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Martha J Bock
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Paul A Decker
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Christie A Flanagan
- Clinical & Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Crystal D Meade
- Wellness and Prevention, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Timothy K Thomas
- Clinical & Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, United States
| | - Christi A Patten
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
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Wieland ML, Njeru JW, Asiedu GB, Zeratsky KA, Clark MM, Goetze R, Patten CA, Kelpin SS, Novotny P, Lantz K, Ahmed Y, Molina L, Porraz Capetillo G, Osman A, Goodson M, Sia I. Pilot Social Network Weight Loss Intervention With Two Immigrant Populations During the COVID-19 Pandemic. Am J Health Promot 2022; 36:458-471. [PMID: 35073499 PMCID: PMC8792912 DOI: 10.1177/08901171211053450] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To examine the feasibility and acceptability of a social network weight loss intervention delivered by lay health promoters (HPs) to immigrant populations. Design Single-arm, non-randomized, pilot study of a social network weight loss intervention developed by a community-based participatory research partnership and delivered by HPs. Setting Community-based setting in Southeastern Minnesota, United States. Sample Somali and Hispanic immigrants to the United States: 4 social networks of adults (2 Hispanic and 2 Somali) with 39 network participants. Intervention Twelve-week behavioral weight loss intervention delivered by HPs (4 weeks in-person and then 8 weeks virtual). Measures Feasibility was assessed by recruitment and retention rates. Acceptability was assessed by surveys and focus groups with HPs and participants. Behavioral measures included servings of fruits and vegetables, drinking soda, and physical activity. Physiologic measures included weight, blood pressure, glucose, cholesterol, and triglycerides. Analysis Paired t-tests of pre- to post-intervention changes at the end of 12 weeks of treatment. Results Recruitment was feasible and post-intervention was 100%. Participants highly rated the intervention on satisfaction, motivation, and confidence to eat a healthy diet, be physically active, and lose weight. Participants were motivated by group social support and cohesion of their social networks. On average, participants lost weight (91.6 ± 15.9 to 89.7 ± 16.6 kg, P < .0001), lowered their systolic blood pressure (133.9±16.9 to 127.2 ± 15.8 mm Hg; P < .001), lowered their diastolic blood pressure (81 ± 9.5 to 75.8 ± 9.6 mm Hg; P < .0001), had more servings of vegetables per day (1.9 ± 1.2 to 2.6 ± 1.4; P < .001), and increased their physical activity (2690 ± 3231 to 6595 ± 7322 MET-minutes per week; P = .02). Conclusion This pilot study of 2 immigrant communities who participated in a peer-led weight loss social network intervention delivered during the COVID-19 pandemic demonstrated high feasibility and acceptability. Participants lost weight, improved their health status, and improved their health behaviors.
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Affiliation(s)
- Mark L Wieland
- Division of Community Internal Medicine, 6915Mayo Clinic, Rochester, MN, USA
| | - Jane W Njeru
- Division of Community Internal Medicine, 6915Mayo Clinic, Rochester, MN, USA
| | - Gladys B Asiedu
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 6915Mayo Clinic, Rochester, MN, USA
| | - Katherine A Zeratsky
- Division of Endocrinology, Department of Nutrition, 6915Mayo Clinic, Rochester, MN, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, 6915Mayo Clinic, Rochester, MN, USA
| | - Rachel Goetze
- Department of Psychiatry and Psychology, 6915Mayo Clinic, Rochester, MN, USA
| | - Christi A Patten
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 6915Mayo Clinic, Rochester, MN, USA
| | - Sydney S Kelpin
- Department of Psychiatry and Psychology, 6915Mayo Clinic, Rochester, MN, USA
| | - Paul Novotny
- Health Sciences Research, Biomedical Statistics and Informatics, 6915Mayo Clinic, Rochester, MN, USA
| | - Kiley Lantz
- Division of Infectious Diseases, 6915Mayo Clinic, Rochester, MN, USA
| | - Yahye Ahmed
- Somali American Social Services Association, Rochester, MN, USA
| | - Luz Molina
- Language Services, 6915Mayo Clinic, Rochester, MN, USA
| | | | - Ahmed Osman
- Intercultural Mutual Assistance Association, Rochester, MN, USA
| | - Miriam Goodson
- Alliance of Chicanos, Hispanics and Latin Americans, Rochester, MN, USA
| | - Irene Sia
- Division of Infectious Diseases, 6915Mayo Clinic, Rochester, MN, USA
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Brewer LC, Cyriac J, Kumbamu A, Burke LE, Jenkins S, Hayes SN, Jones C, Cooper LA, Patten CA. Sign of the times: Community engagement to refine a cardiovascular mHealth intervention through a virtual focus group series during the COVID-19 Pandemic. Digit Health 2022; 8:20552076221110537. [PMID: 35874864 PMCID: PMC9297470 DOI: 10.1177/20552076221110537] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 11/16/2022] Open
Abstract
Background African-Americans are underrepresented in mobile health intervention research studies which can perpetuate health inequities and the digital divide. A community-based, user-centered approach to designing mobile health interventions may increase their sociocultural relevance and effectiveness, especially with increased smartphone use during the coronavirus disease 2019 pandemic. We aimed to refine an existing mobile health intervention via a virtual focus group series. Methods African-American community members (n = 15) from churches in Minneapolis-St. Paul and Rochester, Minnesota were enrolled in a virtual (via videoconferencing), three-session focus group series over five months to refine a cardiovascular health-focused mobile health application (FAITH! [Fostering African-American Improvement in Total Health!] App). Participants accessed the app via their smartphones and received a Fitbit synced to the app. Participants engaged with multimedia cardiovascular health-focused education modules, a sharing board for social networking, and diet/physical activity self-monitoring. Participant feedback on app features prompted iterative revisions to the FAITH! App. Primary outcomes were app usability (assessed via Health Information Technology Usability Evaluation Scale range: 0–5) and user satisfaction. Results Participants (mean age [SD]: 56.9 [12.3] years, 86.7% female) attended a mean 2.8 focus groups (80% attended all sessions). The revised FAITH! App exceeded the goal Health Information Technology Usability Evaluation Scale score threshold of ≥4 (mean: 4.39, range: 3.20–4.95). Participants positively rated updated app content, visual appeal, and use of social incentives to maintain engagement. Increasing user control and refinement of the moderated sharing board were identified as areas for future improvement. Conclusions Community-partnered, virtual focus groups can optimize usability and increase participant satisfaction of mobile health lifestyle interventions that aim to promote cardiovascular health in African-Americans.
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Affiliation(s)
- LaPrincess C. Brewer
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
- Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, USA
| | - Jissy Cyriac
- Department of Internal Medicine, Mayo Clinic Graduate School of Medical Education, Rochester, MN, USA
| | - Ashok Kumbamu
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Lora E. Burke
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sarah Jenkins
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Sharonne N. Hayes
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | | | - Lisa A. Cooper
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christi A. Patten
- Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA
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Van't Hof JR, Duval S, Luepker RV, Jones C, Hayes SN, Cooper LA, Patten CA, Brewer LC. Association of Cardiovascular Disease Risk Factors With Sociodemographic Characteristics and Health Beliefs Among a Community-Based Sample of African American Adults in Minnesota. Mayo Clin Proc 2022; 97:46-56. [PMID: 34996565 PMCID: PMC8765600 DOI: 10.1016/j.mayocp.2021.08.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/23/2021] [Accepted: 08/18/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To assess cardiovascular disease (CVD) and CVD risk factors and their association with sociodemographic characteristics and health beliefs among African American (AA) adults in Minnesota. METHODS A cross-sectional analysis was conducted of a community-based sample of AA adults enrolled in the Minnesota Heart Health Program Ask About Aspirin study from May 2019 to September 2019. Sociodemographic characteristics, health beliefs, and self-reported CVD and CVD risk factors were collected. Prevalence ratio (PR) estimates were calculated using Poisson regression modeling to assess the association between participants' characteristics and age- and sex-adjusted CVD risk factors. RESULTS The sample included 644 individuals (64% [412] women) with a mean age of 61 years. Risk factors for CVD were common: hypertension (67% [434]), hyperlipidemia (47% [301]), diabetes (34% [219]), and current cigarette smoking (25% [163]); 19% (119) had CVD. Those with greater perceived CVD risk had a higher likelihood of prevalent hyperlipidemia (PR, 1.34; 95% CI, 1.14 to 1.57), diabetes (PR, 1.61; 95% CI, 1.30 to 1.98), and CVD (PR 1.61; 95% CI, 1.16 to 2.23) compared with those with lower perceived risk. Trust in health care provider was high (83% [535]) but was not associated with CVD or CVD risk factors. CONCLUSION In this community sample of AAs in Minnesota, CVD risk factors were high, as was trust in health care providers. Those with greater CVD risk perceptions had higher CVD prevalence. Consideration of sociodemographic and psychosocial influences on CVD and CVD risk factors could inform development of effective cardiovascular health promotion interventions in the AA Minnesota community.
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Affiliation(s)
- Jeremy R Van't Hof
- Cardiovascular Division, University of Minnesota Medical School, Minneapolis, MN
| | - Sue Duval
- Cardiovascular Division, University of Minnesota Medical School, Minneapolis, MN
| | - Russell V Luepker
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | | | - Sharonne N Hayes
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Lisa A Cooper
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - LaPrincess C Brewer
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN; Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN.
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Buis L, Jenkins S, Patten CA, Hayes SN, Jones C, Cooper LA, Brewer LC. Improvements in Diet and Physical Activity-Related Psychosocial Factors Among African Americans Using a Mobile Health Lifestyle Intervention to Promote Cardiovascular Health: The FAITH! (Fostering African American Improvement in Total Health) App Pilot Study. JMIR Mhealth Uhealth 2021; 9:e28024. [PMID: 34766917 PMCID: PMC8663698 DOI: 10.2196/28024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/27/2021] [Accepted: 09/01/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND African Americans continue to have suboptimal cardiovascular health (CVH) related to diet and physical activity (PA) behaviors compared with White people. Mobile health (mHealth) interventions are innovative platforms to improve diet and PA and have the potential to mitigate these disparities. However, these are understudied among African Americans. OBJECTIVE This study aims to examine whether an mHealth lifestyle intervention is associated with improved diet and PA-related psychosocial factors in African Americans and whether these changes correlate with diet and PA behavioral change. METHODS This study is a retrospective analysis evaluating changes in diet and PA-related self-regulation, social support, perceived barriers, and CVH behaviors (daily fruit and vegetable intake and moderate-intensity PA [MPA] per week) in 45 African American adults (mean age 48.7 years, SD 12.9 years; 33/45, 73% women) enrolled in the FAITH! (Fostering African American Improvement in Total Health) app pilot study. The intervention is a 10-week, behavioral theory-informed, community-based mHealth lifestyle intervention delivered through a mobile app platform. Participants engaged with 3 core FAITH! app features: multimedia education modules focused on CVH with self-assessments of CVH knowledge, self-monitoring of daily fruit and vegetable intake and PA, and a sharing board for social networking. Changes in self-reported diet and PA-related self-regulation, social support, perceived barriers, and CVH behaviors were assessed by electronic surveys collected at baseline and 28 weeks postintervention. Changes in diet and PA-related psychosocial factors from pre- to postintervention were assessed using paired 2-tailed t tests. The association of changes in diet and PA-related psychosocial variables with daily fruit and vegetable intake and MPA per week was assessed using Spearman correlation. Associations between baseline and 28-week postintervention changes in diet and PA-related psychosocial measures and CVH behaviors with covariates were assessed by multivariable linear regression. RESULTS Participants reported improvements in 2 subscales of diet self-regulation (decrease fat and calorie intake, P=.01 and nutrition tracking, P<.001), one subscale of social support for healthy diet (friend discouragement, P=.001), perceived barriers to healthy diet (P<.001), and daily fruit and vegetable intake (P<.001). Improvements in diet self-regulation (increase fruit, vegetable, and grain intake, and nutrition tracking) and social support for healthy diet (friend encouragement) had moderate positive correlations with daily fruit and vegetable intake (r=0.46, r=0.34, and r=0.43, respectively). A moderate negative correlation was observed between perceived barriers to healthy diet and daily fruit and vegetable intake (r=-0.25). Participants reported increases in PA self-regulation (P<.001). Increase in social support subscales for PA (family and friend participation) had a moderate positive correlation with MPA per week (r=0.51 and r=0.61, respectively). CONCLUSIONS Our findings highlight key diet and PA-related psychosocial factors to target in future mHealth lifestyle interventions aimed at promoting CVH in African Americans.
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Affiliation(s)
| | - Sarah Jenkins
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, United States
| | - Sharonne N Hayes
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, United States
| | | | - Lisa A Cooper
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - LaPrincess C Brewer
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, United States.,Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, United States
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Manjunath C, Jenkins SM, Phelan S, Breitkopf CR, Hayes SN, Cooper LA, Patten CA, Brewer LC. Association of body image dissatisfaction, behavioral responses for healthy eating, and cardiovascular health in African-American women with overweight or obesity: A preliminary study. Am J Prev Cardiol 2021; 8:100254. [PMID: 34632436 PMCID: PMC8487888 DOI: 10.1016/j.ajpc.2021.100254] [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] [Received: 06/24/2021] [Revised: 09/01/2021] [Accepted: 09/16/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND African-American (AA) women have the lowest prevalence of ideal categorizations of diet and body mass index (BMI), as defined by the American Heart Association (AHA) Life's Simple 7 (LS7) cardiovascular health (CVH) components compared to other racial/ethnic groups, regardless of sex/gender. There is limited research exploring the interplay of unique psychosocial influences on CVH such as body image dissatisfaction (BID) and behavioral responses for healthy eating among AA women with overweight or obesity. OBJECTIVE This study aimed to assess the association of BID with behavioral responses for healthy eating and LS7 components. METHODS A cross-sectional analysis of baseline data was conducted among 32 AA women with overweight or obesity from a larger, community-based participatory research study. Self-reported measures were used to assess BID and behavioral responses to healthy eating (diet self-regulation to reduce fat or caloric intake and motivation for healthy eating [intrinsic motivation and integrated regulation]) using previously validated instruments. The LS7 components (e.g., BMI, diet, etc.) and composite score were evaluated using the AHA LS7 metrics rubric. RESULTS Women with no or lower BID had greater diet self-regulation to reduce fat or caloric intake (mean, 3.5 vs 3.0; P=.05), intrinsic motivation for healthy eating (mean, 5.3 vs 4.2; P=.01), and integrated regulation for healthy eating (mean, 5.3 vs 3.7; P=.002) than those with higher BID. These significant differences remained after adjustment for BMI. Women with higher BID had a higher proportion of BMI within the obesity range compared with those with no or lower BID (94.4% vs 57.1%, P=.03). BID was not significantly associated with other LS7 components or composite score. CONCLUSION BID and other psychosocial influences for healthy eating are potential targets for culturally tailored lifestyle interventions among AA women.
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Key Words
- AA, African-American
- AHA, American Heart Association
- African-American women
- BID, body image dissatisfaction;, BMI, body mass index
- Body image dissatisfaction
- CVD, cardiovascular disease
- CVH, cardiovascular health;, FAITH!, Fostering African-American Improvement in Total Health
- Cardiovascular health
- Healthy eating
- LS7, Life's simple 7
- Obesity
- SCT, Social Cognitive Theory
- SDT, Self-Determination Theory
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Affiliation(s)
- Chandrika Manjunath
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Sarah M. Jenkins
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | - Sean Phelan
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | | | - Sharonne N. Hayes
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Lisa A. Cooper
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Christi A. Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - LaPrincess C. Brewer
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States,Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, United States,Corresponding author at: Department of Cardiovascular Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, United States.
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Sinicrope PS, Maciejko LA, Fox JM, Steffens MT, Decker PA, Wheeler P, Juhn YJ, Wi CI, Gorfine M, Patten CA. Factors associated with willingness to wear a mask to prevent the spread of COVID-19 in a Midwestern Community. Prev Med Rep 2021; 24:101543. [PMID: 34493965 PMCID: PMC8411589 DOI: 10.1016/j.pmedr.2021.101543] [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] [Received: 02/17/2021] [Revised: 07/02/2021] [Accepted: 08/30/2021] [Indexed: 12/14/2022] Open
Abstract
Behavioral science methods can help promote masking to prevent COVID-19. We assessed willingness to wear a mask and theory-based factors in Southeastern MN. Urban residence, being democrat, and trust in CDC were linked with mask wearing. Improving trust in the CDC and positive outcomes for wearing masks is needed.
Objective To identify motivators and barriers to wearing a mask to prevent COVID-19. Participants and methods An anonymous, online survey of adults from Southeastern Minnesota conducted August 2020. We assessed willingness to wear a mask and its associations with socio-demographics, COVID-19-related factors and prevention behaviors using multivariable ordinal logistic regression. Results Of 7,786 respondents (78% women, 51% rural), 9% reported ‘not at all willing’, 27% ‘willing’, and 64% ‘very willing’ to wear a mask. Factors independently associated with willingness to wear a mask were: urban residence (OR = 1.23, 95% CI 1.05–1.44, p = 0.009); college degree or greater (OR 1.42, CI 1.05–1.93, p = 0.025); age (18–29 years OR 1.29, CI 01.02–1.64, p = 0.038; 30–39 OR = 1.37, CI 1.12–1.69, p = 0.003; 60–69 OR = 1.44, CI 1.09–1.91, p = 0.011; 70–89 OR 2.09, CI 1.32–3.37, p = 0.002; 40–49 reference group); and (all p < 0.001) democratic party affiliation (OR 1.79, CI 1.40–2.29), correct COVID-19 knowledge (OR 1.50, CI 1.28–1.75), 5 + COVID-19 prevention behaviors (OR 2.74, CI 1.98–3.81), positive perceived impacts for wearing a mask (OR 1.55, 1.52–1.59), perceived COVID-19 severity (OR 2.1, CI 1.44–3.1), and greater stress (OR 1.03, CI 1.02–1.04), and trust in the Centers for Disease Control (CDC) (OR 1.78, CI 1.45 –2.19). Conclusion Results from this sample of SEMN residents suggest interventions to enhance COVID-19 knowledge, positive expectations for mask wearing, and trust in the CDC are warranted. Research is needed to understand cultural and other barriers and facilitators among sub-populations, e.g., rural residents less willing to wear a mask.
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Affiliation(s)
- Pamela S Sinicrope
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Laura A Maciejko
- Mayo Clinic Alix School of Medicine, Rochester, MN, United States
| | - Jean M Fox
- Department of Gastroenterology, Mayo Clinic, Rochester, MN, United States
| | | | - Paul A Decker
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Philip Wheeler
- Community Pediatric & Adolescent Medicine, Mayo Clinic, Rochester, MN, United States
| | - Young J Juhn
- Community Pediatric & Adolescent Medicine, Mayo Clinic, Rochester, MN, United States
| | - Chung-Il Wi
- Community Pediatric & Adolescent Medicine, Mayo Clinic, Rochester, MN, United States
| | - Mary Gorfine
- Community Engagement Program, Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
| | - Christi A Patten
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.,Community Engagement Program, Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
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Merculieff ZT, Koller KR, Sinicrope PS, Hughes CA, Bock MJ, Decker PA, Resnicow K, Flanagan CA, Meade CD, McConnell CR, Prochaska JJ, Thomas TK, Patten CA. Developing a Social Media Intervention to Connect Alaska Native People Who Smoke with Resources and Support to Quit Smoking: The Connecting Alaska Native Quit Study. Nicotine Tob Res 2021; 23:1002-1009. [PMID: 33674856 PMCID: PMC8248946 DOI: 10.1093/ntr/ntaa253] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/30/2020] [Indexed: 11/12/2022]
Abstract
BACKGROUND Face-to-face tobacco cessation has had limited reach and efficacy in Alaska Native (AN) communities. We describe our two-phased approach to develop content for Connecting Alaska Native People to Quit Smoking, a Facebook group intervention to reduce barriers to evidence-based smoking cessation treatment for AN people in Alaska. METHODS Phase 1 included semi-structured telephone interviews with 30 AN people who smoke and ten stakeholders. They provided feedback on existing content from the Centers for Disease Control and Prevention Tips campaign and AN digital stories. Phase 2 included an online survey with a new group of 40 AN smokers who provided feedback on existing content via a measure of perceived effectiveness and cultural relevance. RESULTS Phase I results revealed participants evaluated content based upon story strength, relevance to AN culture, emotional appeal, relatability to AN people, and favorite video. No single posting was rated highly across all themes. All perceived effectiveness (PE) and cultural relevance median scores fell between 3.5 and 4.4 (range 1-5). PE scores varied across participant demographic groups. CONCLUSIONS Content embodying characteristics perceived to be most appealing, effective, and culturally relevant were selected for the private Facebook group content library with refinements made to incorporate images of AN people engaged in AN activities. PE scores indicate a need for a wide variety of content that moderators could pull from when conducting the intervention. IMPLICATIONS Social media content targeting specific population sectors, such as American Indian/AN people for tobacco cessation needs to be culturally tailored. Our approach provides a model others can follow to determine what is appealing, relevant, and effective messaging. CLINICAL TRIAL REGISTRATION NCT03645941.
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Affiliation(s)
- Zoe T Merculieff
- Clinical & Research Services, Division of Community
Health Services, Alaska Native Tribal Health Consortium,
Anchorage, AK, USA
| | - Kathryn R Koller
- Clinical & Research Services, Division of Community
Health Services, Alaska Native Tribal Health Consortium,
Anchorage, AK, USA
| | - Pamela S Sinicrope
- Department of Psychiatry and Psychology and Behavioral
Health Research Program, Mayo Clinic, Rochester,
MN, USA
| | - Christine A Hughes
- Department of Psychiatry and Psychology and Behavioral
Health Research Program, Mayo Clinic, Rochester,
MN, USA
| | - Martha J Bock
- Department of Psychiatry and Psychology and Behavioral
Health Research Program, Mayo Clinic, Rochester,
MN, USA
| | - Paul A Decker
- Department of Psychiatry and Psychology and Behavioral
Health Research Program, Mayo Clinic, Rochester,
MN, USA
- Department of Health Sciences Research, Mayo Clinic,
Rochester, MN, USA
| | - Kenneth Resnicow
- School of Public Health, University of
Michigan, Ann Arbor, MI, USA
| | - Christie A Flanagan
- Clinical & Research Services, Division of Community
Health Services, Alaska Native Tribal Health Consortium,
Anchorage, AK, USA
| | - Crystal D Meade
- Wellness and Prevention, Division of Community Health
Services, Alaska Native Tribal Health Consortium,
Anchorage, AK, USA
| | - Clara R McConnell
- Wellness and Prevention, Division of Community Health
Services, Alaska Native Tribal Health Consortium,
Anchorage, AK, USA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of
Medicine, Stanford University, Stanford,
CA, USA
| | - Timothy K Thomas
- Clinical & Research Services, Division of Community
Health Services, Alaska Native Tribal Health Consortium,
Anchorage, AK, USA
| | - Christi A Patten
- Department of Psychiatry and Psychology and Behavioral
Health Research Program, Mayo Clinic, Rochester,
MN, USA
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Patten CA, Balls-Berry J(JE, Cohen EL, Brockman TA, Valdez Soto M, West IW, Cha J, Zavala Rocha MG, Eder M(M. Feasibility of a virtual Facebook community platform for engagement on health research. J Clin Transl Sci 2021; 5:e85. [PMID: 34007468 PMCID: PMC8111695 DOI: 10.1017/cts.2021.12] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Community engagement is important for advancing Clinical and Translational Science (CTS), but face-to-face engagement has limited reach and scale. We examined the feasibility of a novel virtual Facebook community platform for public engagement on health research statewide in Minnesota. METHODS The Facebook platform, MN Research Link, was evaluated from June 19, 2019 to June 30, 2020. Facebook advertisements and boosts were used to recruit followers. Content, based on prior formative work, included health research information and interactive postings (e.g., live interviews with researchers). Standard metrics obtained from Facebook analytics included participation (followers), content reach (views), and engagement (likes, shares, comments, clicks). RESULTS During the 12-month period, we acquired 1406 followers (31% rural residents), with a retention of followers of 99.7%. Mean number of views per month was 9379.83 (Mdn = 2791, range 724-41,510). Engagement metrics indicated a mean of 535.2 likes, shares, comments, and/or clicks per month (Mdn = 296.5, range 55-1535). The page continued to acquire new followers, but a slight decrease in engagement was observed in the final months after state COVID-19 mitigation strategies were implemented. CONCLUSION As the complexity of CTS continues to grow, along with social distancing measures resulting from the COVID-19 pandemic, the availability of virtual digital platforms to reach and engage community stakeholders in conversations about health and research has increasing importance. Preliminary findings from this program evaluation indicate that a Facebook community platform is feasible to engage Minnesota residents in conversations around health and research topics. Future work will evaluate its potential for reach, scale, and sustainability.
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Affiliation(s)
- Christi A. Patten
- Department of Psychiatry and Psychology and Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | | | - Elisia L. Cohen
- Hubbard School of Journalism & Mass Communication, University of Minnesota, Minneapolis, MN, USA
| | - Tabetha A. Brockman
- Department of Psychiatry and Psychology and Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | - Miguel Valdez Soto
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | - Ian W. West
- Department of Psychiatry and Psychology and Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | - Jinhee Cha
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Maria G. Zavala Rocha
- Department of Psychiatry and Psychology and Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | - Milton (Mickey) Eder
- Department of Family Medicine and Community Health, Medical School and the Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
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Patten CA, Lando HA, Desnoyers CA, Bock MJ, Alexie L, Decker PA, Hughes CA, Resnicow K, Burhansstipanov L, Boyer R, Klejka J. Healthy Pregnancies Project: Cluster Randomized Controlled Trial of a Community Intervention to Reduce Tobacco Use among Alaska Native Women. Int J Environ Res Public Health 2020; 17:E9302. [PMID: 33322686 PMCID: PMC7764642 DOI: 10.3390/ijerph17249302] [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: 10/27/2020] [Revised: 12/07/2020] [Accepted: 12/11/2020] [Indexed: 11/23/2022]
Abstract
Substantial gaps remain in the evidence base for prenatal tobacco use interventions among Indigenous women. Using a cluster randomized controlled trial (RCT), the Healthy Pregnancies Project evaluated a community-level intervention for Alaska Native (AN) women in rural western Alaska. Sixteen villages were randomly assigned to usual care (control, n = 8 villages) or usual care plus a community-level intervention delivered by local AN "Native Sisters" (n = 8 villages). Outcomes were tobacco use rate at delivery and at 2 and 6 months postpartum, with biochemical confirmation obtained at 6 months. The program had high reach, enrolling 73% of all eligible women screened. Of the 352 participants, 67% used tobacco at baseline. No significant differences emerged between study groups on follow-up in tobacco use rates. More intervention than control participants made a quit attempt at 2 months postpartum (70% vs. 51%, respectively, p = 0.012). Participants in both study groups reported the program helped to raise awareness of healthy pregnancies in the study villages. This trial supports the reach of a community-level intervention, but not its efficacy for reducing tobacco use during pregnancy or postpartum. Efforts to sustain early quit attempts appear warranted. The community involvement, and reported impact on raising awareness of the importance of healthy pregnancies, supports the value of the research program in this community.
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Affiliation(s)
- Christi A. Patten
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA; (M.J.B.); (C.A.H.)
| | - Harry A. Lando
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, 1300 2nd St, Ste 200, Minneapolis, MN 55454, USA;
| | - Chris A. Desnoyers
- Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA; (C.A.D.); (L.A.); (R.B.); (J.K.)
| | - Martha J. Bock
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA; (M.J.B.); (C.A.H.)
| | - Lucinda Alexie
- Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA; (C.A.D.); (L.A.); (R.B.); (J.K.)
| | - Paul A. Decker
- Department of Health Sciences Research, Mayo Clinic, Harwick 7, 200 First Street SW, Rochester, MN 55905, USA;
| | - Christine A. Hughes
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA; (M.J.B.); (C.A.H.)
| | - Kenneth Resnicow
- School of Public Health, University of Michigan, 109 S. Observatory, 3867 SPH1, Ann Arbor, MI 48109, USA;
| | - Linda Burhansstipanov
- Native American Cancer Initiatives, Inc., 3022 South Nova Road, Pine, CO 80470, USA;
| | - Rahnia Boyer
- Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA; (C.A.D.); (L.A.); (R.B.); (J.K.)
| | - Joseph Klejka
- Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA; (C.A.D.); (L.A.); (R.B.); (J.K.)
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Brewer LC, Kumbamu A, Smith C, Jenkins S, Jones C, Hayes SN, Burke L, Cooper LA, Patten CA. A Cardiovascular Health and Wellness Mobile Health Intervention Among Church-Going African Americans: Formative Evaluation of the FAITH! App. JMIR Form Res 2020; 4:e21450. [PMID: 33200999 PMCID: PMC7709003 DOI: 10.2196/21450] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/25/2020] [Accepted: 09/30/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In light of the scarcity of culturally tailored mobile health (mHealth) lifestyle interventions for African Americans, we designed and pilot tested the Fostering African-American Improvement in Total Health (FAITH!) App in a community-based participatory research partnership with African American churches to promote cardiovascular health and wellness in this population. OBJECTIVE This report presents the results of a formative evaluation of the FAITH! App from participants in an intervention pilot study. METHODS We included 2 semistructured focus groups (n=4 and n=5) to explore participants' views on app functionality, utility, and satisfaction as well as its impact on healthy lifestyle change. Sessions were audio-recorded and transcribed verbatim, and qualitative data were analyzed by using general inductive analysis to generate themes. RESULTS In total, 6 overarching themes emerged among the 9 participants: overall impression, content usefulness, formatting, implementation, impact, and suggestions for improvement. Underpinning the themes was a high level of agreement that the intervention facilitated healthy behavioral change through cultural tailoring, multimedia education modules, and social networking. Suggestions for improvement were streamlining the app self-monitoring features, prompts to encourage app use, and personalization based on individuals' cardiovascular risk. CONCLUSIONS This formative evaluation found that the FAITH! App had high reported satisfaction and impact on the health-promoting behaviors of African Americans, thereby improving their overall cardiovascular health. Further development and testing of the app among African Americans is warranted. TRIAL REGISTRATION ClinicalTrials.gov NCT03084822; https://clinicaltrials.gov/ct2/show/NCT03084822.
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Affiliation(s)
- LaPrincess C Brewer
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States.,Center for Healthy Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, United States
| | - Ashok Kumbamu
- Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States
| | - Christina Smith
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, United States
| | - Sarah Jenkins
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, United States
| | | | - Sharonne N Hayes
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Lora Burke
- School of Nursing, Department of Health and Community Systems, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lisa A Cooper
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
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Patten CA, Lando HA, Desnoyers CA, Klejka J, Decker PA, Bock MJ, Hughes CA, Alexie L, Boyer R, Resnicow K, Burhansstipanov L. Association of Tobacco Use During Pregnancy, Perceived Stress, and Depression Among Alaska Native Women Participants in the Healthy Pregnancies Project. Nicotine Tob Res 2020; 22:2104-2108. [PMID: 31566239 PMCID: PMC7593352 DOI: 10.1093/ntr/ntz189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 09/27/2019] [Indexed: 11/13/2022]
Abstract
INTRODUCTION In general population samples, higher levels of stress and depression have been associated with increased prevalence of smoking in pregnancy. Little is known about the association of prenatal tobacco use, stress, and depression among American Indian or Alaska Native (AI/AN) women. METHODS The Healthy Pregnancies Project is a cluster-randomized controlled trial, evaluating a community-level intervention compared with usual care, for reducing tobacco use during pregnancy and postpartum among AN women in 16 villages in western Alaska. This cross-sectional study analyzed baseline data from enrolled pregnant women. Baseline measures included the self-reported, 7-day, point-prevalence current use of any tobacco, Perceived Stress Scale (PSS), and the Center for Epidemiological Studies-Depression (CES-D). Generalized estimating equations (GEE) analyses adjusted for village, participant age, and gestational age. RESULTS Participants (N = 352) were on average (SD) 25.8 (5.0) years of age and at 26.8 (9.8) weeks gestation. 66.5% were current tobacco users, of which 77% used Iqmik, a homemade form of smokeless tobacco. Compared with nonusers, tobacco users reported lower PSS score (p = .020) and less clinical levels of depression (CES-D ≥ 16) (18.1% vs. 9.3%, p = .21). Findings were not accounted for by nicotine dependence severity or self-reported tobacco use before pregnancy. CONCLUSIONS In this sample of pregnant AN women, tobacco users report less stress and clinical levels of depression than nonusers. A potential challenge with tobacco treatment for pregnant AN women is to provide alternative ways of deescalating stress and affect management instead of using tobacco. IMPLICATIONS This study contributes novel information on the association of tobacco use, perceived stress, and depression among Alaska Native women enrolled in a clinical trial to promote healthy pregnancies. Most prior studies addressing this topic were conducted among general population samples of pregnant women who smoked cigarettes. Little is known about these associations with prenatal smokeless tobacco, or among American Indian or Alaska Native women. The results are contrary to findings reported previously, because current tobacco use was associated with less stress and depression than nonuse. The study findings have implications for cessation treatment for this tobacco-use disparity group.
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Affiliation(s)
- Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | | | | | | | - Paul A Decker
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Martha J Bock
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
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Darmawan I, Bakker C, Brockman TA, Patten CA, Eder M. The Role of Social Media in Enhancing Clinical Trial Recruitment: Scoping Review. J Med Internet Res 2020; 22:e22810. [PMID: 33104015 PMCID: PMC7652693 DOI: 10.2196/22810] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/31/2020] [Accepted: 09/15/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Recruiting participants into clinical trials continues to be a challenge, which can result in study delay or termination. Recent studies have used social media to enhance recruitment outcomes. An assessment of the literature on the use of social media for this purpose is required. OBJECTIVE This study aims to answer the following questions: (1) How is the use of social media, in combination with traditional approaches to enhance clinical trial recruitment and enrollment, represented in the literature? and (2) Do the data on recruitment and enrollment outcomes presented in the literature allow for comparison across studies? METHODS We conducted a comprehensive literature search across 7 platforms to identify clinical trials that combined social media and traditional methods to recruit patients. Study and participant characteristics, recruitment methods, and recruitment outcomes were evaluated and compared. RESULTS We identified 2371 titles and abstracts through our systematic search. Of these, we assessed 95 full papers and determined that 33 studies met the inclusion criteria. A total of 17 studies reported enrollment outcomes, of which 9 achieved or exceeded their enrollment target. The proportion of participants enrolled from social media in these studies ranged from 0% to 49%. Across all 33 studies, the proportion of participants recruited and enrolled from social media varied greatly. A total of 9 studies reported higher enrollment rates from social media than any other methods, and 4 studies reported the lowest cost per enrolled participant from social media. CONCLUSIONS While the assessment of the use of social media to improve clinical trial participation is hindered by reporting inconsistencies, preliminary data suggest that social media can increase participation and reduce per-participant cost. The adoption of consistent standards for reporting recruitment and enrollment outcomes is required to advance our understanding and use of social media to support clinical trial success.
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Affiliation(s)
- Ida Darmawan
- Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis, MN, United States
| | - Caitlin Bakker
- Health Sciences Libraries, University of Minnesota, Minneapolis, MN, United States
| | - Tabetha A Brockman
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
| | - Milton Eder
- Department of Family Medicine & Community Health, University of Minnesota, Minneapolis, MN, United States
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, United States
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Patten CA, Wang XQ, Little MA, Ebbert JO, Talcott GW, Hryshko-Mullen AS, Klesges R. Influence of gender on initiation of tobacco and nicotine containing product use among U.S. Air Force trainees. Prev Med Rep 2020; 19:101104. [PMID: 32435579 PMCID: PMC7229489 DOI: 10.1016/j.pmedr.2020.101104] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/15/2020] [Accepted: 04/23/2020] [Indexed: 12/02/2022] Open
Abstract
Military personnel are a subgroup of young adults at risk for tobacco and nicotine containing product (TNCP) use. This study of US Air Force (USAF) trainees who were never users of TNCPs examined gender, peer tobacco use, and tobacco use intentions as predictors of TNCP initiation after Basic Military Training (BMT). We used a longitudinal cohort assessment study design with baseline and 1-year surveys completed (2011-2016) among 2393 USAF trainees: 73% men, 95% aged 18-25 years, 36% racial minorities. Overall, initiation of any TNCP use at 1-year was 23% (20% women, 24% men). From a multivariable multinomial logistic regression model predicting TNCP use at 1-year follow-up, significant 2-way interactions were detected between gender and number of close friends using tobacco before BMT (p = 0.015), and between gender and tobacco use intentions (p < 0.0001). Women reporting almost all or many close friends used tobacco were more likely to report TNCP use compared to women with none (Odds ratio [OR] = 5.8, 95% CI 2.5-13.5, Bonferroni corrected p < 0.0001). Having close friends using tobacco had little influence on TNCP use among men. Men with tobacco use intentions were more likely to report TNCP use compared to men having no intentions (OR = 8.0, 95% CI: 4.7-13.6, Bonferroni corrected p < 0.001), but tobacco use intentions had little influence among women. In this sample of USAF trainees, the study provides novel prospective findings on TNCP initiation, and how men and women are influenced differently by peer tobacco use and tobacco use intentions. Gender-specific prevention efforts focused on uptake of TNCPs appear warranted.
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Affiliation(s)
- Christi A. Patten
- Department of Psychiatry and Psychology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Xin-Qun Wang
- Department of Public Health Sciences, University of Virginia School of Medicine, PO Box 800717, Charlottesville, VA 22908, USA
| | - Melissa A. Little
- Department of Public Health Sciences, University of Virginia School of Medicine, PO Box 800717, Charlottesville, VA 22908, USA
| | - Jon O. Ebbert
- Department of Internal Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Gerald W. Talcott
- Department of Public Health Sciences, University of Virginia School of Medicine, PO Box 800717, Charlottesville, VA 22908, USA
| | - Ann S. Hryshko-Mullen
- Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio-Lackland, TX 78236, USA
| | - Robert Klesges
- Department of Public Health Sciences, University of Virginia School of Medicine, PO Box 800717, Charlottesville, VA 22908, USA
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Biggs BK, Tolleson E, Millerbernd J, Bronars C, Meiers SJ, Slowiak K, Olson M, Lebow J, Ridgeway JL, Patten CA, Clark MM, Sia IG, Wieland ML. Identifying Opportunities to Promote Physical Activity in a Diverse Low-Income Population: A Mixed-Method Study at a Boys & Girls Club Site. Child Youth Care Forum 2020; 49:171-200. [PMID: 33833490 PMCID: PMC8025775 DOI: 10.1007/s10566-019-09521-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prevalence and consequences of obesity and sedentary lifestyle are well-documented public health concerns for youth in the United State of America (U.S.A) that disproportionally affect children from low income and minority families. OBJECTIVE This mixed-method study focused on estimating levels of physical activity and sedentary behavior and prevalence of overweight and obesity among the child members served in one Boys and Girls Club in the Midwest U.S.A. We aimed to better understand opportunities for improving children's engagement in physical activity through focus groups with members, staff, and parents/caregivers of members. METHODS Social cognitive learning theory, the ecological model of health behavior, and community based participatory research principles provided the study framework. Members completed assessments of physical activity, sedentary activity, height, and weight. Focus groups with members, staff, and parents/caregivers identified barriers, facilitators, and opportunities for promoting physical activity. RESULTS: Nearly 50% of members were overweight or obese. Most (87%) participants reported at least 60 minutes physical activity every day across the 3-day recall. Fewer than half (41%) reported 2 hours or less of sedentary screen time every day across the 3 day recall. Focus group themes identified opportunities for addressing needs associated with health disparities in physical activity and pediatric obesity. CONCLUSIONS Findings suggest stakeholder interest in physical activity promotion through afterschool programs. We discuss study implications regarding needs specific to individuals from diverse, low-income households that may not be adequately addressed with existing empirically-supported treatments and opportunities to address health disparities in physical activity and pediatric obesity through afterschool programs.
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Patten CA, Juhn YJ, Ryu E, Wi CI, King KS, Bublitz JT, Pignolo RJ. Rural-urban health disparities for mood disorders and obesity in a midwestern community. J Clin Transl Sci 2020; 4:408-415. [PMID: 33244429 PMCID: PMC7681122 DOI: 10.1017/cts.2020.27] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/26/2020] [Accepted: 03/13/2020] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Prior studies indicate greater disease burden for obesity among rural compared with urban residents but no differences for mood disorder based on geographic location. Recent attention has focused on the need to examine regional rural-urban disparities in disease burden. We focused on mood disorders and obesity prevalence within three southeastern Minnesota counties served by the Mayo Clinic Center for Translational Science Award, in Rochester, Minnesota, as these were top priorities identified in community health needs assessments. METHODS Cross-sectional study to assess the association of rural-urban locality on 5-year (2009-2014) prevalence of mood disorder and obesity obtained using the Rochester Epidemiological Project medical records linkage system, among subjects residing in three mixed rural-urban counties on April 1, 2014. Multivariable analyses adjusted for demographics, socioeconomic status using an individual housing-based measure, and counties. RESULTS The study cohort (percent rural location) included 91,202 (15%) for Olmsted, 10,197 (51%) in Dodge, and 10,184 (57%) in Wabasha counties. On multivariate analysis, 5-year prevalence of mood disorders and obesity was significantly greater for urban compared with rural residents, after adjusting for confounders; odds ratios (95% confidence intervals): 1.21 (1.17-1.26), P < 0.001, and 1.05 (1.01-1.10), P = 0.016, respectively. Observed effects were not modified in additional models adjusted for health care utilization (HCU; ≥1 general medical examination visit and flu vaccination). CONCLUSIONS Rural-urban health disparities for burden of mood disorders and obesity are independent of socioeconomic status and HCU in a Midwestern community. It is important to assess potential regional heterogeneity of rural-urban disparities on health outcomes.
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Affiliation(s)
- Christi A. Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Young J. Juhn
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Euijung Ryu
- Division of Biostatistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Katherine S. King
- Division of Biostatistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Josh T. Bublitz
- Division of Biostatistics and Informatics, Mayo Clinic, Rochester, MN, USA
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Mohamed EA, Giama NH, Shaleh HM, Kerandi L, Oseini AM, Ahmed Mohammed H, Kerandi H, Allotey LK, Waaeys IA, Ali HA, Ali HM, Mohamed SA, Yang JD, Gaga WO, Tamire LL, Windissa A, Patten CA, Balls-Berry JE, Roberts LR. Knowledge, Attitudes, and Behaviors of Viral Hepatitis Among Recent African Immigrants in the United States: A Community Based Participatory Research Qualitative Study. Front Public Health 2020; 8:25. [PMID: 32211358 PMCID: PMC7067746 DOI: 10.3389/fpubh.2020.00025] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 01/27/2020] [Indexed: 12/13/2022] Open
Abstract
Background: In the United States, hepatocellular carcinoma is the ninth leading cause of cancer mortality. Hepatocellular carcinoma disproportionately affects individuals of African ancestry with the rates being higher amongst individuals of foreign-born African ancestry. This study explored knowledge, attitudes, and behaviors toward viral hepatitis transmission, screening, and vaccination among recent African immigrants in Minnesota and identify ways to improve early detection and screening methods. Methods: A community based participatory research (CBPR) team with minority researchers and community members sought to gain insight on persons of African Ancestry knowledge, attitudes, and behaviors related to viral hepatitis by conducting a qualitative research study. The CBPR team developed a focus group moderator's guide with semi-structured questions related to transmission, screening, and vaccination of viral hepatitis. We conducted seven focus groups using bilingual, bicultural moderators with participants from local Ethiopian, Liberian and Kenyan communities from August 10th, 2014 to October 11th, 2014. Focus groups were audio recorded and transcribed. The CBPR team categorized the data into themes and subthemes with consensus using traditional content analysis. Results: Community partners recruited 63 participants with a majority identifying as male (51%). Participants lacked knowledge of viral hepatitis screening, vaccination, and treatment. Participants were aware of some behaviors that increased risk of acquisition of hepatitis. Participants endorsed a strategy of developing and delivering educational materials for African immigrants. Moreover, access to care and cultural awareness were mentioned as pivotal for prevention and treatment of viral hepatitis. Conclusions: Findings from this pilot study provide insight on areas of research focus. Having a research team consisting of members from the community helped to increase trust and foster an understanding of shared community values. Information from this study provides evidence to support the development culturally appropriate strategies to address disparities in viral hepatitis in these communities.
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Affiliation(s)
- Essa A Mohamed
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
| | - Nasra H Giama
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
| | - Hassan M Shaleh
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
| | - Linda Kerandi
- Urgent Care and Clinic, Midpoint Medical Clinic, Brooklyn Park, MN, United States
| | - Abdul M Oseini
- Division of Gastroenterology, Virginia Commonwealth University, Richmond, VA, United States
| | - Hager Ahmed Mohammed
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
| | - Henry Kerandi
- Urgent Care and Clinic, Midpoint Medical Clinic, Brooklyn Park, MN, United States
| | - Loretta K Allotey
- Medical School, University of Minnesota, Rochester, MN, United States
| | | | - Hamdi A Ali
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
| | - Hawa M Ali
- Medical School, University of Minnesota, Rochester, MN, United States
| | | | - Ju Dong Yang
- Transplant Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Wudneh O Gaga
- St. George Ethiopian Tewahido Orthodox Church, Rochester, MN, United States
| | - Lily L Tamire
- St. George Ethiopian Tewahido Orthodox Church, Rochester, MN, United States
| | - Awol Windissa
- Pillsbury United Communities, Minneapolis, MN, United States
| | - Christi A Patten
- Behavioral Health Research Program, Mayo Clinic, Rochester, MN, United States
| | | | - Lewis R Roberts
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States
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Little M, Ebbert JO, Krukowski RA, Halbert J, Kalpinski MR, Patten CA, Talcott GW, Klesges RC. Factors Associated with Cigarette Use During Airmen's First Year of Service in the United States Air Force. Mil Med 2020; 185:e212-e220. [PMID: 31287888 DOI: 10.1093/milmed/usz155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/18/2019] [Accepted: 06/07/2019] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Despite declines of cigarette use in the civilian population, military personnel report alarmingly high rates of cigarette use. Enlisted Air Force recruits are required to remain tobacco-free for the first 12 weeks of training, and the majority express confidence they will not use tobacco after the ban; however, most previous smokers return to smoking and many nonsmokers initiate. Understanding the factors associated with cigarette-smoking initiation among non-users and re-initiation among former users is critical for the development of successful tobacco control efforts. MATERIALS AND METHODS The current study examines predictors of cigarette smoking among a sample of 2,188 USAF personnel after their first year of service. Logistic regression analyses examined associations between baseline predictors and initiation and re-initiation of cigarette smoking at a one-year follow-up. RESULTS Compared to never smokers at both time points, the strongest predictor of smoking initiation over the past 12 months was having owned cigarette-branded merchandise (OR 3.81, 95% CI 1.67, 8.71). Compared to former smokers who remained abstinent, the strongest predictor of re-initiation was intention to use tobacco (OR 2.08, 95% CI 1.53, 2.83). Compared to individuals who initiate, the strongest predictors of re-initiation were prior use of other tobacco products and tobacco use intentions (ORs range 1.85 to 4.63). CONCLUSIONS Multiple risk factors are associated with tobacco use. Given that Airmen are tobacco-free for the first 12 weeks of training, tobacco interventions during this period might be more effective. Our findings can be used to tailor interventions to prevent tobacco use in the U.S. military.
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Affiliation(s)
- Melissa Little
- Center for Addiction and Prevention Research, University of Virginia Medical School, 59 MDW/ 59 SGOWMP, 1100 Wilford Hall Loop, Bldg 4554, Joint Base Lackland AFB, TX 78236
| | - Jon O Ebbert
- Mayo Clinic, 200 First Street SW, Rochester, MN 55905
| | - Rebecca A Krukowski
- University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163-2181
| | - Jennifer Halbert
- Department of Public Health Sciences, Center for Addiction and Prevention Research, University of Virginia, 560 Ray C. Hunt Drive, PO Box 800717, Charlottesville, VA 22908
| | | | | | - Gerald W Talcott
- Department of Public Health Sciences, Center for Addiction and Prevention Research, University of Virginia, 2200 Bergquist Dr Ste 1, Joint Base Lackland AFB, TX 78236
| | - Robert C Klesges
- Department of Public Health Sciences, Center for Addiction and Prevention Research, University of Virginia, 560 Ray C. Hunt Drive, PO Box 800717, Charlottesville, VA 22908
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