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Hooper MW, Lee DJ, Simmons VN, Brandon KO, Antoni MH, Asfar T, Koru-Sengul T, Brandon TH. Cognitive behavioral therapy versus general health education for smoking cessation: A randomized controlled trial among diverse treatment seekers. Psychol Addict Behav 2024; 38:124-133. [PMID: 37141036 PMCID: PMC10624643 DOI: 10.1037/adb0000928] [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: 05/05/2023]
Abstract
OBJECTIVE Racial and ethnic disparities in smoking cessation persist. This randomized controlled trial compared the efficacy of group cognitive behavioral therapy (CBT) for cessation among African American/Black, Latino/Hispanic, and White adults. METHOD African American/Black (39%), Latino/Hispanic (29%), and White (32%) adults (N = 347) were randomly assigned to eight group sessions of CBT or general health education (GHE), both including nicotine patch therapy. Biochemically confirmed 7-day point prevalence abstinence (7-day ppa) was measured at the end-of-therapy, and at 3-, 6-, and 12-month follow-ups. Generalized linear mixed models and logistic regressions tested abstinence rates by condition, stratified by race and ethnicity, and interaction effects. RESULTS CBT led to greater abstinence than GHE across 12-months of follow-up (AOR = 1.84, 95% CI [1.59, 2.13]) overall [12-month follow-up: CBT = 54% vs. GHE = 38%] and within racial and ethnic groups [12-months: African American/Black (CBT = 52%, GHE = 29%), Latino/Hispanic (CBT = 57%, GHE = 47%), and White (CBT = 54%, GHE = 41%)]. African American participants were less likely than White participants to quit irrespective of condition, as were persons with lower education and income. Socioeconomic status indicators positively predicted abstinence among racial and ethnic minority participants, but not White participants. CONCLUSIONS Group CBT was efficacious compared with GHE. However, cessation patterns suggested that intensive group interventions were less beneficial over the longer term among lower socioeconomic African American and Latino individuals, compared with White participants. Tobacco interventions should target racial and ethnic and socioeconomic differences, via culturally specific approaches and other means. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Monica Webb Hooper
- Case Western Reserve University School of Medicine, Case Comprehensive Cancer Center, 11000 Euclid Ave, 44106, Cleveland, OH, United States
| | - David J. Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St., Miami, FL 33136
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Miami, FL 33136
| | | | | | - Michael H. Antoni
- Department of Psychology, University of Miami College of Arts and Sciences, PO Box 248185, Coral Gables, FL 33124
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Miami, FL 33136
| | - Taghrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St., Miami, FL 33136
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Miami, FL 33136
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St., Miami, FL 33136
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Miami, FL 33136
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Mensah GA, Johnson LE, Zhang X, Stinson N, Carrington K, Malla G, Land SR, Huff E, Freeman N, Stoney C, Ampey B, Paltoo D, Clark D, Rajapakse N, Ilias MR, Haase KP, Punturieri A, Kurilla MG, Archer H, Bolek M, Santos M, Wilson-Frederick S, Devaney S, Marshall V, Farhat T, Hooper MW, Wilson DR, Perez-Stable EJ, Gibbons GH. Community Engagement Alliance (CEAL): A National Institutes of Health Program to Advance Health Equity. Am J Public Health 2024; 114:S12-S17. [PMID: 37944098 PMCID: PMC10785165 DOI: 10.2105/ajph.2023.307476] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 11/12/2023]
Affiliation(s)
- George A Mensah
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Lenora E Johnson
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Xinzhi Zhang
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Nathan Stinson
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Kelli Carrington
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Gargya Malla
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Stephanie R Land
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Erynn Huff
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Naomi Freeman
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Catherine Stoney
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Bryan Ampey
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Dina Paltoo
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Dave Clark
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Nishadi Rajapakse
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Maliha R Ilias
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Karen Plevock Haase
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Antonello Punturieri
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Michael G Kurilla
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Hillary Archer
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Michelle Bolek
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Melanie Santos
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Shondelle Wilson-Frederick
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Stephanie Devaney
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Vanessa Marshall
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Tilda Farhat
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Monica Webb Hooper
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - David R Wilson
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Eliseo J Perez-Stable
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
| | - Gary H Gibbons
- George A. Mensah, Xinzhi Zhang, Maliha R. Ilias, and Karen Plevock Haase are with the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD. Lenora E. Johnson, Hillary Archer, Michelle Bolek, Melanie Santos, and Shondelle Wilson-Frederick are with the Office of Science Policy, Engagement, Education, and Communications, NHLBI. Nathan Stinson Jr, Kelli Carrington, Gargya Malla, Vanessa Marshall, Tilda Farhat, Monica Webb Hooper, and Eliseo J. Perez-Stable are with the National Institute on Minority Health and Health Disparities, NIH. Stephanie R. Land is with the National Cancer Institute, NIH. Erynn Huff and Naomi Freeman are with the Office of Management, Immediate Office of the Director, NHLBI. Catherine Stoney is with Stoney Consulting, Washington, DC. Bryan Ampey and Dina Paltoo are with the Immediate Office of the Director, NHLBI. Dave Clark is with the Eunice Kennedy Schriver National Institute of Child Health and Human Development, NIH. Nishadi Rajapakse is with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Antonello Punturieri is with the Division of Lung Diseases, NHLBI. Michael G. Kurilla is with the National Center for Advancing Translational Sciences, NIH. Stephanie Devaney is with the All of Us Research Program, Office of the Director, NIH. David R. Wilson is with the Office of the Director, NIH
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Walker A, Abnet CC, Shiels MS, Lawrence WR, Funchess T, Rogers DB, Hooper MW, Chen Y. Racial and geographical disparities in oesophageal cancer incidence, mortality and county-level risk factors in the state of Mississippi between 2003 and 2019: a descriptive analysis. BMJ Public Health 2023; 1:e000316. [PMID: 38292243 PMCID: PMC10827340 DOI: 10.1136/bmjph-2023-000316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Background Oesophageal cancer is one of the most aggressive cancers. The aim was to describe the disparities in oesophageal cancer incidence and mortality, and county-level factors in the state of Mississippi from 2003 to 2019 by sex, race, and geolocation. Methods This study used data from the Mississippi Cancer Registry, linked to county-level data from the Behavioral Risk Factor Surveillance System, the American Community Survey, and the Institutes for Health Metrics and Evaluation. We estimated age-standardised incidence (crude ASR) and mortality rates (crude AMR), mortality-incidence rate ratio and average annual percent change (AAPC) in rates by sex, race, and geolocation, using the Joinpoint Software V.5.0. We further calculated relative risks for oesophageal cancer using age-adjusted quasi-Poisson regression for each county-level factor including smoking, obesity, college degree completion, unemployment rate and median household income ranking within the state. Results Between 2003 and 2019, a total of 2737 oesophageal cancer cases and 2259 oesophageal cancer deaths occurred in Mississippi. Black men had the greatest reduction in oesophageal cancer incidence and mortality despite high rates (crude ASR2019=10.5, crude AMR2019=7.3 per 100 000; AAPCincidence=-3.7%, p<0.001 and AAPCmortality=-4.9%, p<0.001). The reduction was largely driven by decreases in the non-Delta region (AAPCincidence=-4.2%, p<0.001), while incidence rate remained high among Black men in the Delta region (crude ASR2019=15.4 per 100 000, AAPCincidence=-1.8%, p=0.3). The rates among White men were relatively stable (crude ASR2019=8.5, crude AMR2019=7.6 per 100 000; AAPCincidence=0.18%, p=0.7, AAPCmortality=-0.4%, p=0.6). County-level smoking prevalence (in quartile, p=0.02) was significantly associated with oesophageal cancer incidence. Discussion This study highlights the importance of targeted interventions to address the persistent high incidence rate of oesophageal cancer among Black men in the Delta region.
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Affiliation(s)
- Angel Walker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
- School of Biology, Environmental and Earth Sciences, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Meredith S Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Wayne R Lawrence
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Tanya Funchess
- College of Nursing and School of Health Professions, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Deirdre B Rogers
- Department of Population Health Science, University of Mississippi, Hattiesburg, Mississippi, USA
- UMMC and Mississippi Cancer Registry, Jackson, Mississippi, USA
| | - Monica Webb Hooper
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Yingxi Chen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
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Pérez-Stable EJ, Webb Hooper M. The Pillars of Health Disparities Science-Race, Ethnicity, and Socioeconomic Status. JAMA Health Forum 2023; 4:e234463. [PMID: 38127587 DOI: 10.1001/jamahealthforum.2023.4463] [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] [Indexed: 12/23/2023] Open
Abstract
This Viewpoint examines the importance of race and ethnicity and socioeconomic status as the pillars of health disparities science.
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Affiliation(s)
- Eliseo J Pérez-Stable
- Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Monica Webb Hooper
- Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
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5
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Bello MS, Zhang Y, Cho J, Kirkpatrick MG, Pang RD, Oliver JA, Webb Hooper M, Barrington-Trimis JL, Ahluwalia JS, Leventhal AM. Nicotine deprivation amplifies attentional bias toward racial discrimination stimuli in African American adults who smoke cigarettes. Exp Clin Psychopharmacol 2023; 31:1023-1031. [PMID: 37535524 PMCID: PMC10837307 DOI: 10.1037/pha0000662] [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: 08/05/2023]
Abstract
High smoking prevalence and low quit smoking rates among African American adults are well-documented, but poorly understood. We tested a transdisciplinary theoretical model of psychopharmacological-social mechanisms underlying smoking among African American adults. This model proposes that nicotine's acute attention-filtering effects may enhance smoking's addictiveness in populations unduly exposed to discrimination, like African American adults, because nicotine reduces the extent to which discrimination-related stimuli capture attention, and in turn, generate distress. During nicotine deprivation, attentional biases toward discrimination may be unmasked and exacerbated, which may induce distress and perpetuate smoking. To test this model, this within-subject laboratory experiment determined whether attentional bias toward racial discrimination stimuli was amplified by nicotine deprivation in African American adults who smoked daily. Participants (N = 344) completed a computerized modified Stroop task assessing attentional interference from racial discrimination-related words during two counterbalanced sessions (nicotine sated vs. overnight nicotine deprived). The task required participants to quickly name the color of discrimination and matched neutral words. Word Type (Discrimination vs. Neutral) × Pharmacological State (Nicotine Deprived vs. Sated) effects on color naming reaction times were examined. Attentional bias toward racial discrimination-related stimuli was amplified in nicotine deprived (reaction time to discrimination minus neutral stimuli: M [95%CI] = 34.69 [29.62, 39.76] ms; d = 0.15) compared to sated (M [95%CI] = 24.88 [19.84, 29.91] ms; d = 0.11) conditions (Word Type × Pharmacological State, p < .0001). The impact of nicotine deprivation on attentional processes in the context of adverse societal conditions merit consideration in future science and intervention addressing smoking in African American adults. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Mariel S Bello
- Department of Behavioral and Social Sciences, School of Public Health, Brown University
| | - Yi Zhang
- Department of Epidemiology and Biostatistics, University of Arizona
| | - Junhan Cho
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | - Matthew G Kirkpatrick
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | - Raina D Pang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | - Jason A Oliver
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center
| | | | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | - Jasjit S Ahluwalia
- Department of Behavioral and Social Sciences, School of Public Health, Brown University
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
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6
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Webb Hooper M, Carpenter KM, Salmon EE, Resnicow K. Enhancing Tobacco Quitline Outcomes for African American Adults: An RCT of a Culturally Specific Intervention. Am J Prev Med 2023; 65:964-972. [PMID: 37302513 DOI: 10.1016/j.amepre.2023.06.005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 06/13/2023]
Abstract
INTRODUCTION This study tested the effectiveness of a culturally specific tobacco cessation video intervention among African American quitline enrollees. STUDY DESIGN This was a 3-arm semipragmatic RCT. SETTING/PARTICIPANTS African American adults (N=1,053) were recruited from the North Carolina tobacco quitline and data were collected between 2017 and 2020. INTERVENTION Participants were randomized to receive (1) quitline services only; (2) quitline services plus a standard, general audience video intervention; or (3) quitline services plus Pathways to Freedom (PTF), a culturally specific video intervention designed to promote cessation among African American persons. MAIN OUTCOME MEASURES The primary outcome was self-reported 7-day point prevalence smoking abstinence at 6 months. Secondary outcomes included 7-day and 24-hour point prevalence abstinence at 3 months, 28-day continuous abstinence, and intervention engagement. Data analyses occurred in 2020 and 2022. RESULTS At 6 months, 7-day point prevalence abstinence was significantly greater in the Pathways to Freedom Video arm compared with quitline-only (OR=1.5, CI=1.11, 2.07). Twenty four-hour point prevalence abstinence was significantly greater in the Pathways to Freedom (than in quitline-only) group at 3 (OR=1.49, 95% CI=1.03, 2.15) and 6 (OR=1.58, 95% CI=1.10, 2.28) months. At 6 months, 28-day continuous abstinence (OR=1.60, 95% CI=1.17, 2.20) was significantly greater in the Pathways to Freedom Video arm than in the quitline-only arm. Views of the Pathways to Freedom Video were 76% higher than views of the standard video. CONCLUSIONS Culturally specific tobacco interventions delivered through state quitlines can increase cessation and thus have the potential to decrease health disparities among African American adults. TRIAL REGISTRATION This study is registered at www. CLINICALTRIALS gov NCT03064971.
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Affiliation(s)
- Monica Webb Hooper
- Case Comprehensive Cancer Center, Department of Oncology, School of Medicine, Case Western Reserve University, Cleveland, Ohio.
| | | | - Erica E Salmon
- Optum Center for Wellbeing Research, Eden Prairie, Minnesota
| | - Ken Resnicow
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
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Griffith DM, Efird CR, Baskin ML, Webb Hooper M, Davis RE, Resnicow K. Cultural Sensitivity and Cultural Tailoring: Lessons Learned and Refinements After Two Decades of Incorporating Culture in Health Communication Research. Annu Rev Public Health 2023; 45. [PMID: 37931182 DOI: 10.1146/annurev-publhealth-060722-031158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
In this article, we examine progress and challenges in designing, implementing, and evaluating culturally sensitive behavioral interventions by tailoring health communication to groups or individuals. After defining common tailoring constructs (i.e., culture, race, and ethnicity), cultural sensitivity, and cultural tailoring, we examine when it is useful to culturally tailor and address cultural sensitivity in health communication by group tailoring or individual tailoring and when tailoring health communication may not be necessary or appropriate for achieving behavior change. After reviewing selected approaches to cultural tailoring, we critique the quality of research in this domain with a focus on the internal validity of empirical findings. Then we explore the ways in which cultural sensitivity, group targeting, and individual tailoring have incorporated culture in health promotion and health communication. We conclude by articulating yet unanswered questions and suggesting future directions to move the field forward. Expected final online publication date for the Annual Review of Public Health, Volume 45 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Derek M Griffith
- Center for Men's Health Equity, Racial Justice Institute, Georgetown University, Washington, DC, USA;
- Racial Justice Institute, Georgetown University, Washington, DC, USA
- Department of Health Management and Policy, School of Health, Georgetown University, Washington, DC, USA
| | - Caroline R Efird
- Racial Justice Institute, Georgetown University, Washington, DC, USA
| | - Monica L Baskin
- Division of Hematology/Oncology, School of Medicine; and Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Monica Webb Hooper
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Rachel E Davis
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Ken Resnicow
- Department of Health Behavior and Health Education, School of Public Health; and Community Outreach and Health Disparities Research, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
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8
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Abstract
Health equity is the aspirational assurance of optimal health for all. Synonymous with fair and just opportunities for physical and mental health, equity work reflects intentional efforts to remove access barriers and allocate high-quality, need-based resources. Health equity is not possible without meaningful reductions in disparities-and evaluating progress goes further to describe, assess, and continuously evaluate fairness and social justice within structures, community contexts, and healthcare. The National Institute on Minority Health and Health Disparities (NIMHD) has a longstanding and deep commitment to advancing health equity. This article describes efforts in two specific areas: workforce diversity, equity, and inclusion (DEI) and scientific initiatives. We also summarize five actionable strategies for health equity promotion in health psychology-relevant research and practice, including increasing workforce DEI, inclusive research participation, cultural competence and humility, applying community-engaged research principles, and going beyond "do no harm." Meaningful equity work often requires major shifts in approaches, dedicated resources, and targeted efforts toward social justice. The current emphasis on addressing health disparities and understanding the structural factors underlying them presents unequivocal opportunities for changes in clinical practice and research. NIMHD seeks to support innovative health psychology and behavioral medicine research with the potential to transform health via effective and equitable interventions/treatments, systems changes, and policies. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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9
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Choi K, Jones JT, Ruybal AL, McNeel TS, Duarte DA, Webb Hooper M. Trends in Education-Related Smoking Disparities Among U.S. Black or African American and White Adults: Intersections of Race, Sex, and Region. Nicotine Tob Res 2023; 25:718-728. [PMID: 36239224 PMCID: PMC10032197 DOI: 10.1093/ntr/ntac238] [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: 12/03/2021] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Despite its overall decline in the United States, trends in cigarette smoking could vary by intersection with demographic characteristics. We explored trends in education-related disparities in current smoking among U.S. adults by race (Black or African American and White), sex, and U.S. census region. AIMS AND METHODS Data were from U.S. civilian non-institutionalized adults (aged ≥18 years) who self-identified as Black or African American and White and participated in the 1995-2019 Tobacco Use Supplement to the Current Population Survey. We estimated average annual percent changes in current cigarette smoking by the intersections of race, sex, census region, and educational attainment. We calculated educated-related prevalence differences in current cigarette smoking by subtracting the prevalence of bachelor's degrees from that of RESULTS Education-related disparities in current cigarette smoking increased over time, especially among Black or African American male (PD1995-1996 = 22.8%; PD2018-2019 = 27.2%) and female adults (PD1995-1996 = 12.1%; PD2018-2019 = 16.5%). By region, Black or African American male adults in the Midwest showed the largest increase in education-related current cigarette smoking disparities, followed by Black or African American male and female adults in the South, and White male and female adults in the Midwest. These findings were because of small to no declines in the prevalence of current cigarette smoking among those with CONCLUSION AND RELEVANCE The gap in the prevalence of current cigarette smoking by education widened over time, especially among Black or African American adults in certain regions. IMPLICATIONS Despite the decline in the prevalence of current cigarette smoking in the U.S. population overall, such public health gain may not benefit all individuals equally. Using the data from a U.S. representative serial cross-sectional survey study during 1995-2019, we found that disparities in current cigarette smoking prevalence between those with
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Affiliation(s)
- Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Jamal T Jones
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, Maryland, USA
| | - Andrea L Ruybal
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, Maryland, USA
| | | | - Danielle A Duarte
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Monica Webb Hooper
- Office of the Director, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
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10
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Webb Hooper M, Compton WM, Walsh ER, Hodes RJ, Pérez-Stable EJ. Harnessing the Power of Community-Engaged Science to Facilitate Access and Uptake of COVID-19 Testing: RADx-UP. Am J Public Health 2022; 112:S854-S857. [PMID: 36446064 PMCID: PMC9707707 DOI: 10.2105/ajph.2022.307105] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Monica Webb Hooper
- Monica Webb Hooper and Eliseo J. Pérez-Stable are with the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD. Wilson M. Compton is with the National Institute on Drug Abuse, NIH. Elizabeth R. Walsh is with the Office of the Director, NIH. Richard J. Hodes is with the National Institute on Aging, NIH
| | - Wilson M Compton
- Monica Webb Hooper and Eliseo J. Pérez-Stable are with the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD. Wilson M. Compton is with the National Institute on Drug Abuse, NIH. Elizabeth R. Walsh is with the Office of the Director, NIH. Richard J. Hodes is with the National Institute on Aging, NIH
| | - Elizabeth R Walsh
- Monica Webb Hooper and Eliseo J. Pérez-Stable are with the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD. Wilson M. Compton is with the National Institute on Drug Abuse, NIH. Elizabeth R. Walsh is with the Office of the Director, NIH. Richard J. Hodes is with the National Institute on Aging, NIH
| | - Richard J Hodes
- Monica Webb Hooper and Eliseo J. Pérez-Stable are with the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD. Wilson M. Compton is with the National Institute on Drug Abuse, NIH. Elizabeth R. Walsh is with the Office of the Director, NIH. Richard J. Hodes is with the National Institute on Aging, NIH
| | - Eliseo J Pérez-Stable
- Monica Webb Hooper and Eliseo J. Pérez-Stable are with the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD. Wilson M. Compton is with the National Institute on Drug Abuse, NIH. Elizabeth R. Walsh is with the Office of the Director, NIH. Richard J. Hodes is with the National Institute on Aging, NIH
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11
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Jaworski BK, Webb Hooper M, Aklin WM, Jean-Francois B, Elwood WN, Belis D, Riley WT, Hunter CM. Advancing digital health Equity: Directions for behavioral and social science research. Transl Behav Med 2022; 13:132-139. [PMID: 36318232 DOI: 10.1093/tbm/ibac088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Abstract
The field of digital health is evolving rapidly and encompasses a wide range of complex and changing technologies used to support individual and population health. The COVID-19 pandemic has augmented digital health expansion and significantly changed how digital health technologies are used. To ensure that these technologies do not create or exacerbate existing health disparities, a multi-pronged and comprehensive research approach is needed. In this commentary, we outline five recommendations for behavioral and social science researchers that are critical to promoting digital health equity. These recommendations include: (i) centering equity in research teams and theoretical approaches, (ii) focusing on issues of digital health literacy and engagement, (iii) using methods that elevate perspectives and needs of underserved populations, (iv) ensuring ethical approaches for collecting and using digital health data, and (v) developing strategies for integrating digital health tools within and across systems and settings. Taken together, these recommendations can help advance the science of digital health equity and justice.
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Affiliation(s)
- Beth K Jaworski
- Office of Behavioral and Social Sciences Research, National Institutes of Health , Bethesda, MD , USA
| | - Monica Webb Hooper
- National Institute on Minority Health and Health Disparities, National Institutes of Health , Bethesda, MD , USA
| | - Will M Aklin
- National Institute on Drug Abuse, National Institutes of Health , Bethesda, MD , USA
| | - Beda Jean-Francois
- National Center for Complementary and Integrative Health, National Institutes of Health , Bethesda, MD , USA
| | - William N Elwood
- Office of Behavioral and Social Sciences Research, National Institutes of Health , Bethesda, MD , USA
| | - Deshirée Belis
- Office of Behavioral and Social Sciences Research, National Institutes of Health , Bethesda, MD , USA
| | - William T Riley
- Office of Behavioral and Social Sciences Research, National Institutes of Health , Bethesda, MD , USA
| | - Christine M Hunter
- Office of Behavioral and Social Sciences Research, National Institutes of Health , Bethesda, MD , USA
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12
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Morgan BL, Stern MC, Pérez-Stable EJ, Hooper MW, Fejerman L. Adding a One Health approach to a research framework for minority health and health disparities. eLife 2022; 11:76461. [PMID: 35796544 PMCID: PMC9262385 DOI: 10.7554/elife.76461] [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: 12/17/2021] [Accepted: 06/28/2022] [Indexed: 11/24/2022] Open
Abstract
The National Institute on Minority Health and Health Disparities (NIMHD) has developed a framework to guide and orient research into health disparities and minority health. The framework depicts different domains of influence (such as biological and behavioral) and different levels of influence (such as individual and interpersonal). Here, influenced by the “One Health” approach, we propose adding two new levels of influence – interspecies and planetary – to this framework to reflect the interconnected nature of human, animal, and environmental health. Extending the framework in this way will help researchers to create new avenues of inquiry and encourage multidisciplinary collaborations. We then use the One Health approach to discuss how the COVID-19 pandemic has exacerbated health disparities, and show how the expanded framework can be applied to research into health disparities related to antimicrobial resistance and obesity.
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Affiliation(s)
- Brittany L Morgan
- Department of Public Health Sciences, University of California, Davis, Davis, United States.,Center for Animal Disease Modeling and Surveillance (CADMS), Department of Veterinary Medicine, University of California, Davis, Davis, United States
| | - Mariana C Stern
- Departments of Preventive Medicine and Urology, Keck School of Medicine of USC, Los Angeles, United States.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, United States
| | - Eliseo J Pérez-Stable
- Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, United States
| | - Monica Webb Hooper
- Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, United States
| | - Laura Fejerman
- Department of Public Health Sciences, University of California, Davis, Davis, United States.,Comprehensive Cancer Center, University of California, Davis, Davis, United States
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13
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Abstract
Racial and ethnic disparities in healthcare and health outcomes are longstanding. The real-time emergence of COVID-19 disparities has heightened the public and scientific discourse about structural inequities contributing to the greater risk of morbidity and mortality among racial and ethnic minority populations and other underserved groups. A key aspect of assuring health equity is addressing social determinants that lead to adverse health outcomes among minoritized groups. This article presents an exploratory social determinants of health (SDOH) conceptual framework for understanding racial and ethnic COVID-19 disparities, including factors related to health and healthcare, socioeconomics, and environmental determinants. The model also illustrates the backdrop of structural racism and discrimination, which directly affect health and COVID-19 exposure risk, and thus transmission, infection, and death. We also describe a special SDOH collection in the PhenX Toolkit (consensus measures for Phenotypes and eXposures), which includes established measures to promote standardization of assessment and the use of common data elements in research contexts. The use of common constructs, measures, and data elements are important for data integration, understanding the causes of health disparities, and evaluating interventions to reduce them. Substandard SDOH are among the primary drivers of health disparities-and scientific approaches to address these key concerns require identification and leveled alignment with the root causes. The overarching goal of this discussion is to broaden the consideration of mechanisms by which populations with health disparities face additional SARS-CoV-2 exposure risks, and to encourage research to develop interventions to reduce SDOH-associated disparities in COVID-19 and other conditions and behaviors.
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Affiliation(s)
- Monica Webb Hooper
- Office of the Director, National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health (NIH)
| | - Vanessa Marshall
- Office of the Director, National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health (NIH)
| | - Eliseo J Pérez-Stable
- Office of the Director, National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health (NIH)
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14
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Owusu C, Margevicius S, Nock NL, Austin K, Bennet E, Cerne S, Hergenroeder P, Moore HCF, Petkac J, Schluchter M, Schmitz KH, Webb Hooper M, Wimbley L, Berger NA. A randomized controlled trial of the effect of supervised exercise on functional outcomes in older African American and non-Hispanic White breast cancer survivors: Are there racial differences in the effects of exercise on functional outcomes? Cancer 2022; 128:2320-2338. [PMID: 35289926 DOI: 10.1002/cncr.34184] [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: 11/29/2021] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND The objective of this study was to test the hypothesis that exercise would be more effective than a support group plus Fitbit (SG+Fitbit) program in improving functional outcomes in older breast cancer survivors (BCSs) and that race would moderate the exercise effect on outcomes. METHODS Older African American (AA) and non-Hispanic White (NHW) BCSs were purposively recruited and enrolled into the 52-week randomized controlled trial. The interventions included 20 weeks of supervised moderate-intensity aerobic and resistance training followed by 32 weeks of unsupervised exercise called IMPROVE (n = 108) and a 20-week SG+Fitbit program followed by 32 weeks of unsupervised activity (n = 105). Study outcomes were assessed at 20 and 52 weeks. The primary outcome was the change in Short Physical Performance Battery (SPPB) scores 20 weeks from the baseline between arms. Secondary outcomes included change in the 6-Minute Walk Test (6MWT) in meters 20 weeks from the baseline between arms. General linear regression and multivariable logistic regression analyses were used. RESULTS The mean age was 71.9 years (SD, 5.9 years), and 44% were AA. SPPB scores did not differ between arms (adjusted difference in mean change, 0.13; 95% CI, -0.28 to 0.55; P = .53). However, the exercise arm (vs the SG+Fitbit arm) improved on the 6MWT (21.6 m; 95% CI, 2.5-40.6 m; P = .03). Race moderated the exercise effect on the 6MWT (adjusted interaction effect, 43.3 m; 95% CI, 6.3-80.2 m; P = .02); this implied that the change in the adjusted mean for the 6MWT at 20 weeks from the baseline was 43.3 m higher in AA exercise participants versus NHW exercise participants. CONCLUSIONS Combined aerobic and resistance exercise appears to improve physical performance in older BCSs, and the exercise effect might be moderated by race, with AAs appearing to derive larger benefits in comparison with NHWs. Larger studies are warranted to confirm the study findings.
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Affiliation(s)
- Cynthia Owusu
- Division of Hematology/Oncology, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Seunghee Margevicius
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio.,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Nora L Nock
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio.,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Kristina Austin
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | | | | | | | - Halle C F Moore
- Department of Hematology/Oncology, Cleveland Clinic, Cleveland, Ohio
| | - Jean Petkac
- University Hospitals of Cleveland, Cleveland, Ohio
| | - Mark Schluchter
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio.,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | | | - Monica Webb Hooper
- National Institute on Minority Health and Disparities, National Institutes of Health, Bethesda, Maryland
| | - Leonard Wimbley
- Division of Hematology/Oncology, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Nathan A Berger
- Division of Hematology/Oncology, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
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15
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Huang LF, Hong A, Cioffi G, Alahmadi A, Tang TY, Ocuin LM, Patil N, Bajor DL, Saltzman JN, Mohamed A, Selfridge E, Webb Hooper M, Barnholtz-Sloan J, Lee RT. Associations of Racial and Ethnic Category, Age, Comorbidities, and Socioeconomic Factors on Concordance to NCCN Guidelines for Patients With High-Risk Biliary Tract Cancers After Surgery. Front Oncol 2022; 12:771688. [PMID: 35273909 PMCID: PMC8901570 DOI: 10.3389/fonc.2022.771688] [Citation(s) in RCA: 2] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/03/2022] [Indexed: 12/11/2022] Open
Abstract
Background Biliary tract cancers (BTC) have a limited prognosis even for localized cancers, emphasizing the importance of multidisciplinary management. NCCN guidelines recommend adjuvant chemotherapy (CT) +/- radiotherapy (RT) for high-risk disease. We analyzed the association between racial and ethnic category along with other demographic factors and concordance to NCCN guidelines among patients following surgery for high-risk BTC. Methods Subjects were identified from the National Cancer Database (NCDB) for BTC patients who underwent surgery and found to have metastatic lymph nodes (LN+) or positive surgical margins (M+) from 2004 to 2015. We defined concordance to NCCN guidelines as receiving surgery + CT +/- RT and non-concordance to the guidelines as surgery +/- RT. Descriptive studies and multivariate logistic regression analysis was performed. Results A total of 3,792 patients were identified with approximately half being female (55.4%) and between the ages of 50-69 (52.8%). Most were White (76.3%) followed by Black (10.6%), Hispanic (8.5%), and Asian (5.3%). The BTC included extrahepatic cholangiocarcinoma (CCA) (48.6%), gallbladder cancer (43.5%), and intrahepatic CCA (7.9%). Most patients had an M- resection (71.9%) but also had LN+ disease (88.0%). There were no significant differences between racial groups in disease presentation (histological grade, tumor stage) and surgical outcomes (LN+, M+, hospital readmission, and 90 day post-surgery mortality). Hispanic patients as compared to White patients were less likely to be insured (85.7% vs 96.3%, p<0.001) and less likely to be treated at an academic facility (42.1% vs 52.1%, p=0.008). Overall, almost one-third (29.7%) of patients received non-concordant NCCN guideline care with Hispanic patients having the highest proportion of non-concordance as compared to Whites patients (36.1% vs 28.7%, p=0.029). On multivariate analysis, Hispanic ethnicity (HR=1.51, 95% CI: 1.15-1.99) remained significantly associated with non-concordance to NCCN guidelines. Conclusion This study indicates that Hispanic patients with high-risk BTC are significantly less likely to receive NCCN-concordant treatment in comparison to White patients. More research is needed to confirm and understand the observed disparities and guide targeted interventions at the system-level.
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Affiliation(s)
- Lauren F Huang
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Augustine Hong
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Gino Cioffi
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Asrar Alahmadi
- Department of Internal Medicine, Ohio State University James Thoracic Oncology Center, Comprehensive Cancer Center, Columbus, OH, United States
| | - Tin-Yun Tang
- Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Lee M Ocuin
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Nirav Patil
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - David L Bajor
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Joel N Saltzman
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Amr Mohamed
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Eva Selfridge
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Monica Webb Hooper
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, United States.,Department of Psychology, Case Comprehensive Cancer Center, Cleveland, OH, United States
| | - Jill Barnholtz-Sloan
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Richard T Lee
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, United States.,Department of Medicine, Case Western Reserve University Comprehensive Cancer Center, Cleveland, OH, United States
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16
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Rodgers-Melnick SN, Zanotti K, Lee RT, Webb Hooper M. Demographic and Clinical Predictors of Engaging in Tobacco Cessation Counseling at a Comprehensive Cancer Center. JCO Oncol Pract 2022; 18:e721-e730. [PMID: 34995104 DOI: 10.1200/op.21.00458] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To address challenges promoting tobacco cessation in oncology settings, it is important to understand characteristics associated with patient engagement in tobacco cessation treatment. This analysis examined predictors of participating in at least one tobacco cessation counseling session among patients referred to a comprehensive cancer center's Tobacco Intervention and Psychosocial Support (TIPS) service. METHODS Patients with cancer who reported current smoking or recently quitting and referred to TIPS between June 2017 and February 2020 were included in the analysis. Independent variables included sex, race and ethnicity, insurance type, cancer diagnosis (tobacco-related or not), age, nicotine dependence, and cigarettes smoked per day at baseline. The outcome variable was completion of at least one tobacco cessation counseling session among those assessed by the TIPS program. Unadjusted and adjusted analyses tested associations between the independent variables and tobacco cessation counseling engagement. RESULTS Of 360 oncology patients referred to the TIPS program, 224 (62.2%) were assessed and 120 (33%) engaged in at least one counseling session. After controlling for sociodemographics and tobacco use, the results demonstrated that patients diagnosed with tobacco-related cancers were 45.3% less likely to engage in the tobacco cessation program compared with those with non-tobacco-related cancers (P = .041). CONCLUSION Patients diagnosed with tobacco-related cancers were less likely to engage in TIPS. Additional therapeutic resources may be needed to engage these patients to address potential explanatory factors, such as stigma, guilt, and fatalism. More research is needed to explore the impact of a tobacco-related cancer diagnosis on treatment engagement.
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Affiliation(s)
- Samuel N Rodgers-Melnick
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH.,University Hospitals Connor Whole Health, Cleveland, OH
| | - Kristine Zanotti
- University Hospitals Cleveland Medical Center, Cleveland, OH.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Richard T Lee
- University Hospitals Cleveland Medical Center, Cleveland, OH.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
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Webb Hooper M, Mitchell C, Marshall VJ, Cheatham C, Austin K, Sanders K, Grafton LL. Responding to healthcare distrust among underserved communities: Phase II. Psychooncology 2022; 31:3-8. [PMID: 34985177 DOI: 10.1002/pon.5841] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Medical distrust is both a psychosocial construct and an underappreciated individual social determinant of health with the potential to affect oncology care and clinical trial participation. A community-based participatory research effort, called the Forward Movement Project (FMP), identified multilevel factors affecting trust for healthcare and research in an underserved urban community. In FMP Phase II, we implemented a community-responsive approach to provide lay-oriented education and address misinformation, with the goal of beginning to remediate distrust for healthcare systems and biomedical research. METHODS Community residents (N = 154 adults, 64% male, M = 61.5 years old, 53% annual income <$10,000, 83% African American/Black) engaged in participant-driven dialogues with oncology clinicians/clinical researchers and support services professionals. A program evaluation focused on trust for healthcare and biomedical research. RESULTS Participants reported positive evaluations of both the program and the cancer center clinicians and staff, who were rated as trustworthy (80% strong agreement). However, trust for healthcare systems ("Strongly agree" = 58%) and medical researchers ("Strongly agree" = 50%) following the program was moderate. Over half of the sample (52%) strongly agreed they would participate in a clinical trial compared to before joining this study. CONCLUSION Findings supported the user-generated program approach. The FMP is an example of a model for true community engaged research and has implications for rebuilding trust in healthcare and research.
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Affiliation(s)
- Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Charlene Mitchell
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Vanessa J Marshall
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
- University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, Ohio, USA
| | - Chesley Cheatham
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
- University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, Ohio, USA
| | | | - Kimberly Sanders
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
- Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA
| | - Lena L Grafton
- NEOMED-CSU Partnership for Urban Health, Cleveland State University, Cleveland, Ohio, USA
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Asfar T, Koru-Sengul T, Antoni MA, Dorsey A, Ruano Herreria EC, Lee DJ, Webb Hooper M. Recruiting racially and ethnically diverse smokers seeking treatment: Lessons learned from a smoking cessation randomized clinical trial. Addict Behav 2022; 124:107112. [PMID: 34530210 PMCID: PMC8511330 DOI: 10.1016/j.addbeh.2021.107112] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Recruiting racial/ethnic minorities in smoking cessation trials is a priority. This study described lessons learned from recruiting a diverse sample of African American, White, and Hispanic/Latinx smokers in a smoking cessation trial. METHODS We implemented a 42-month recruitment campaign utilizing reactive (e.g., word-of-mouth, newspaper, radio, online ads, flyers, community partnerships) and proactive (e.g., direct invitations) strategies. We included 821 participants in the analysis. We described our recruitment strategies' implementation, their enrollment yield and rate (number enrolled/number screened) by race/ethnicity, and direct cost-per-participant (CPP: total cost/number of enrolled) for paid strategies. RESULTS Enrollment yields were higher using reactive strategies than proactive strategies (94.3% vs. 5.7%). The top source of enrollment was word-of-mouth among African Americans (36%) and Whites (44%), and flyers among Hispanics/Latinxs (34%). Proactive recruitment, word-of-mouth, and flyers were more successful among African Americans than other groups. Newspaper and online ads were more successful among Hispanics/Latinxs than other groups (P < .05). Word-of-mouth was cost-free and yielded 23.1% of enrollment. The most economic method among paid strategies was flyer distribution (CPP = $47.6; yield 17.5%), followed by newspaper ($194.7; 23.7%) and online advertisements ($264.6; 24.0%). Radio and television ads were the most expensive and produced the least participant yield ($4,755.6; 0.8%). CONCLUSION Recruiting racially/ethnically diverse samples into smoking cessation clinical trials requires implementing multiple strategies and adjusting these strategies based on their enrollment yield and cost. Word-of-mouth, flyers, and newspaper and online ads were more successful among racial/ethnic minorities. Flyers and newspaper ads were the most economic methods for recruitment.
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Affiliation(s)
- Taghrid Asfar
- Department of Public Health Science, University of Miami Miller School of Medicine, United States; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, United States.
| | - Tulay Koru-Sengul
- Department of Public Health Science, University of Miami Miller School of Medicine, United States; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, United States
| | - Michael A Antoni
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, United States
| | - Asha Dorsey
- Department of Public Health Science, University of Miami Miller School of Medicine, United States
| | | | - David J Lee
- Department of Public Health Science, University of Miami Miller School of Medicine, United States; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, United States
| | - Monica Webb Hooper
- The National Institute on Minority Health and Health Disparities, United States
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19
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Webb Hooper M, Miller DB, Saldivar E, Mitchell C, Johnson L, Burns M, Huang MC. Randomized controlled trial testing a video-text tobacco cessation intervention among economically disadvantaged African American adults. Psychol Addict Behav 2021; 35:769-777. [PMID: 34647777 DOI: 10.1037/adb0000691] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This pilot study tested the acceptability and short-term outcomes of a culturally specific mobile health (mHealth) intervention (Path2Quit) in a sample of economically disadvantaged African American adults. We hypothesized that Path2Quit would demonstrate greater acceptability, biochemically verified abstinence, and promote nicotine replacement therapy (NRT) use compared with a standard text-messaging program. METHOD In a 2-arm pilot randomized trial, adults who sought to quit smoking (N = 119) received either Path2Quit or the National Cancer Institute's (NCI) SmokefreeTXT, both combined with a brief behavioral counseling session plus 2 weeks of NRT. Outcomes included acceptability (intervention evaluation and use), NRT utilization, 24-hr quit attempts, self-reported 7-day point prevalence abstinence (ppa), and biochemically verified smoking abstinence at the 6-week follow-up. RESULTS Participants were 52% female/48% male, mostly single (60%), completed ≥ 12 years of education (83%), middle-aged, and 63% reported a household income < $10K/year. Participants smoked 11 (SD = 8.2) cigarettes/day for 25 (SD = 16) years, and reported low nicotine dependence. There were no differences in intervention evaluations or use (ps > .05), yet Path2Quit led to significantly greater NRT utilization at follow-up (p < .05). There was no difference in quit attempts between conditions or 7-day ppa (p > .05). However, Path2Quit resulted in significantly greater carbon monoxide confirmed ppa (adjusted odds ratio [AOR] = 3.55; 95% CI [1.32, 9.54]) at the 6-week follow-up. CONCLUSIONS A culturally specific mHealth intervention demonstrated positive effects on NRT use and short-term abstinence. Additional research in a larger sample and with long-term follow-up is warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - David B Miller
- Jack, Joseph and Morton Mandel School of Applied Social Sciences
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20
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Hunter CM, Chou WYS, Webb Hooper M. Behavioral and social science in support of SARS-CoV-2 vaccination: National Institutes of Health initiatives. Transl Behav Med 2021; 11:1354-1358. [PMID: 34080616 PMCID: PMC8195039 DOI: 10.1093/tbm/ibab067] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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] [Indexed: 12/02/2022] Open
Abstract
Control of the COVID-19 pandemic relies heavily on behavioral mitigation strategies such as physical distancing, hand washing and mask wearing. Even with the availability of SARS-CoV-2 vaccines, the extraordinary effort to distribute the vaccines must be paired with continued adherence to behavioral recommendations as well as vaccine confidence. To facilitate rapid and equitable uptake of the vaccines, there is a need for responsive, trustworthy, and evidence-informed communication about vaccination, enhanced trust in science, and engaging populations disproportionately affected by the pandemic. Efforts to address vaccine hesitancy and increase vaccine confidence will address the emerging gaps between vaccine availability and actual vaccination. Although these gaps are attributable, in part, to challenges with logistics and access, social and behavioral drivers of vaccination decision making also have a significant role in vaccination uptake. As federal, state, and local health and public health agencies coordinate vaccine dissemination, there will be a continuous need to adapt to an evolving landscape of SARS-CoV-2 vaccines, new scientific information, and the spread of COVID-19- and vaccine-related misinformation. Facilitating widespread vaccination and maintaining a focus on equity requires thoughtful and compassionate approaches to reach and address the needs of those who are disproportionately affected by the pandemic such as underserved, vulnerable, and racial/ethnic minority populations. This commentary focuses on several National Institutes of Health initiatives that are supporting behavioral and social science research to address SARS-CoV-2 vaccine communication and increase the uptake of vaccination. We conclude with implications for future research.
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Affiliation(s)
- Christine M Hunter
- Office of Behavioral and Social Science Research, National Institutes of Health (NIH), Bethesda, MD, USA
| | | | - Monica Webb Hooper
- National Institute on Minority Health and Health Disparities, NIH, Bethesda, MD, USA
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21
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Cavallo DN, Martinez R, Webb Hooper M, Flocke S. Feasibility of a social media-based weight loss intervention designed for low-SES adults. Transl Behav Med 2021; 11:981-992. [PMID: 32716040 DOI: 10.1093/tbm/ibaa070] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Low-socioeconomic status (SES) individuals have higher rates of obesity. Social media platforms are used frequently by low-SES individuals and facilitate important weight loss program components including social support. Very few social media-based weight loss interventions, however, have enrolled or been tailored to low-SES participants. The purpose of this article is to examine the feasibility of a social media-based weight loss intervention among low-SES adults. We conducted a one-group pretest post-test pilot intervention study with two groups (group 1, n = 39, group 2, n = 16) of low-SES overweight/obese adults who were enrolled in a 12-week social media-based weight loss intervention including self-monitoring via Fitbits and participation in a private Facebook group. A moderator provided educational content and encouraged social support via Facebook. Descriptive statistics were used to assess intervention acceptability and engagement. Exploratory analyses were conducted to examine changes in study outcomes and engagement patterns. The study had good retention (86%). Among 55 total participants enrolled, there were 9,175 participant interactions within the Facebook group. Among completers (n = 47), 96% indicated they would recommend the intervention to a friend. Mean weight loss was 1.07 kg (SD = 3.96, p = .0498), and participants reported increases in positive dietary social support (mean = 2.47, SD = 5.09, p = .0007). Engagement in this social media-based pilot intervention was high and exceeded results from previous studies using similar formats. Participants evaluated the intervention favorably. Changes in weight loss and several theoretical mediators were in the desired direction. Overall, our results indicate social media groups as a platform for weight loss intervention delivery among low-SES adults are feasible and should be studied in larger randomized trials.
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Affiliation(s)
- David N Cavallo
- Department of Nutrition, Case Western Reserve University, Cleveland, OH, USA
| | - Rogelio Martinez
- University of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX, USA
| | - Monica Webb Hooper
- Office of Cancer Disparities Research, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Susan Flocke
- Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA
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22
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Webb Hooper M, Nápoles AM, Pérez-Stable EJ. No Populations Left Behind: Vaccine Hesitancy and Equitable Diffusion of Effective COVID-19 Vaccines. J Gen Intern Med 2021; 36:2130-2133. [PMID: 33754319 PMCID: PMC7985226 DOI: 10.1007/s11606-021-06698-5] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/03/2021] [Indexed: 11/03/2022]
Abstract
Racial/ethnic minority communities are experiencing an undue burden from coronavirus disease 2019 (COVID-19), and the availability of Food and Drug Administration (FDA) authorized vaccines is critical for improving population health. National surveys assessing vaccination willingness and reports of vaccination administration by race/ethnicity indicate at least two areas that warrant attention: elevated vaccine hesitancy among African American and Latino adults, and the need to ensure equitable access to vaccination. COVID-19 vaccine hesitancy is not uniform within racial/ethnic minority populations; yet, given the disproportionate impact, understandable distrust, and widespread misinformation, there is an imperative to overcome challenges associated with vaccination willingness and uptake, as well as implementation and access. This Perspective discusses the complexity of drivers for each of these areas, which include individual, community, and structural factors. It also highlights two initiatives at the National Institutes of Health. One is focused on addressing misinformation and distrust through academic-community partnerships, and the other on community-engaged behavioral interventions to address the population-specific reasons for COVID-19 vaccine hesitancy, support informed decision-making, and promote equitable access among populations with health disparities. For the foreseeable future, proactive and persistent efforts around COVID-19 mitigation strategies, including vaccination, will remain of paramount importance for health equity.
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Affiliation(s)
- Monica Webb Hooper
- Office of the Director, National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health (NIH), Bethesda, MD, USA.
| | - Anna María Nápoles
- Office of the Scientific Director, National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Eliseo J Pérez-Stable
- Office of the Director, National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health (NIH), Bethesda, MD, USA
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23
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D'Angelo H, Webb Hooper M, Burris JL, Rolland B, Adsit R, Pauk D, Rosenblum M, Fiore MC, Baker TB. Achieving Equity in the Reach of Smoking Cessation Services Within the NCI Cancer Moonshot-Funded Cancer Center Cessation Initiative. Health Equity 2021; 5:424-430. [PMID: 34235367 PMCID: PMC8237098 DOI: 10.1089/heq.2020.0157] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Ensuring equitable access to smoking cessation services for cancer patients is necessary to avoid increasing disparities in tobacco use and cancer outcomes. In 2017, the Cancer Center Cessation Initiative (C3I) funded National Cancer Institute (NCI)-designated Cancer Centers to integrate evidence-based smoking cessation programs into cancer care. We describe the progress of C3I Cancer Centers in expanding the reach of cessation services across cancer populations. Methods: Cancer centers (n=17) reported on program characteristics and reach (the proportion of smokers receiving evidence-based cessation treatment) for two 6-month periods. Reach was calculated overall and by patient gender, race, ethnicity, and age. Results: Average reach increased from 18.5% to 25.6% over 1 year. Reach increased for all racial/ethnic groups, and in particular for American Indian/Alaska Native (6.6–24.7%), Asian/Native Hawaiian/Pacific Islander (7.3–19.4%), and black (18.8–25.9%) smokers. Smaller gains in reach were observed among Hispanic smokers (19.0–22.8%), but these were similar to gains among non-Hispanic smokers (18.9–23.9%). By age group, smokers aged 18–24 years (6.6–14.5%) and >65 years (16.1–24.5%) saw the greatest increases in reach. Conclusion: C3I Cancer Centers achieved gains in providing smoking cessation services to cancer patients who smoke, thereby reducing disparities that had existed across important subgroups. Taking a population-based approach to integrating tobacco treatment into cancer care has potential to increase reach equity. Implementation strategies including targeted and proactive outreach to patients and interventions to increase providers' adoption of evidence-based smoking cessation treatment may advance reach even further.
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Affiliation(s)
- Heather D'Angelo
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jessica L Burris
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA.,Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Betsy Rolland
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Institute for Clinical and Translational Research, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Rob Adsit
- Center for Tobacco Research and Intervention, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Danielle Pauk
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Marika Rosenblum
- Center for Tobacco Research and Intervention, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Michael C Fiore
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Center for Tobacco Research and Intervention, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Timothy B Baker
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Center for Tobacco Research and Intervention, University of Wisconsin-Madison, Madison, Wisconsin, USA
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24
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Collins FS, Adams AB, Aklin C, Archer TK, Bernard MA, Boone E, Burklow J, Evans MK, Jackson S, Johnson AC, Lorsch J, Lowden MR, Nápoles AM, Ordóñez AE, Rivers R, Rucker V, Schwetz T, Segre JA, Tabak LA, Hooper MW, Wolinetz C. Affirming NIH's commitment to addressing structural racism in the biomedical research enterprise. Cell 2021; 184:3075-3079. [PMID: 34115967 DOI: 10.1016/j.cell.2021.05.014] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
NIH has acknowledged and committed to ending structural racism. The framework for NIH's approach, summarized here, includes understanding barriers; developing robust health disparities/equity research; improving its internal culture; being transparent and accountable; and changing the extramural ecosystem so that diversity, equity, and inclusion are reflected in funded research and the biomedical workforce.
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Affiliation(s)
- Francis S Collins
- Office of the Director (OD), National Institutes of Health (NIH), Bethesda, MD 20892, USA.
| | - Amy Bany Adams
- National Institute of Neurological Disorders and Stroke (NINDS), NIH, Bethesda, MD 20892, USA
| | - Courtney Aklin
- Immediate Office of the Director (IMOD)/OD, NIH, Bethesda, MD 20892, USA
| | - Trevor K Archer
- National Institute of Environmental Health Sciences (NIEHS), NIH, Bethesda, MD 20892, USA
| | - Marie A Bernard
- Office of Scientific Workforce Diversity (OSWD)/OD, NIH, Bethesda, MD 20892, USA; National Institute on Aging (NIA), NIH, Bethesda, MD 20892, USA
| | - Ericka Boone
- Office of Extramural Research (OER)/OD, NIH, Bethesda, MD 20892, USA
| | - John Burklow
- Office of Communications and Public Liaison (OCPL)/OD, NIH, Bethesda, MD 20892, USA
| | - Michele K Evans
- National Institute on Aging (NIA), NIH, Bethesda, MD 20892, USA
| | - Sadhana Jackson
- National Institute of Neurological Disorders and Stroke (NINDS), NIH, Bethesda, MD 20892, USA; National Cancer Institute (NCI), NIH, Bethesda, MD 20892, USA
| | | | - Jon Lorsch
- National Institute of General Medical Sciences (NIGMS), NIH, Bethesda, MD 20892, USA
| | - Mia Rochelle Lowden
- Office of Research Infrastructure Programs (ORIP)/OD, NIH, Bethesda, MD 20892, USA
| | - Anna María Nápoles
- National Institute on Minority Health and Health Disparities (NIMHD), NIH, Bethesda, MD 20892, USA
| | - Anna E Ordóñez
- National Institute of Mental Health (NIMH), NIH, Bethesda, MD 20892, USA
| | - Robert Rivers
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, Bethesda, MD 20892, USA
| | - Victoria Rucker
- Office of Scientific Workforce Diversity (OSWD)/OD, NIH, Bethesda, MD 20892, USA; Center for Information Technology (CIT), NIH, Bethesda, MD 20892, USA
| | - Tara Schwetz
- Immediate Office of the Director (IMOD)/OD, NIH, Bethesda, MD 20892, USA
| | - Julia A Segre
- National Human Genome Research Institute (NHGRI), NIH, Bethesda, MD 20892, USA
| | - Lawrence A Tabak
- Immediate Office of the Director (IMOD)/OD, NIH, Bethesda, MD 20892, USA
| | - Monica Webb Hooper
- National Institute on Minority Health and Health Disparities (NIMHD), NIH, Bethesda, MD 20892, USA
| | - Carrie Wolinetz
- Immediate Office of the Director (IMOD)/OD, NIH, Bethesda, MD 20892, USA
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25
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Pearson JL, Waa A, Siddiqi K, Edwards R, Nez Henderson P, Webb Hooper M. Naming Racism, not Race, as a Determinant of Tobacco-Related Health Disparities. Nicotine Tob Res 2021; 23:885-887. [PMID: 33822185 PMCID: PMC8496138 DOI: 10.1093/ntr/ntab059] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 03/29/2021] [Indexed: 12/14/2022]
Affiliation(s)
- Jennifer L Pearson
- Division of Social and Behavioral Health/Health Administration and
Policy, School of Community Health Sciences, University of Nevada,
Reno, USA
| | - Andrew Waa
- Department of Public Health, University of Otago,
Wellington, New
Zealand
| | - Kamran Siddiqi
- Department of Health Sciences, University of York,
York, UK
| | - Richard Edwards
- Department of Public Health, University of Otago,
Wellington, New
Zealand
| | | | - Monica Webb Hooper
- National Institute on Minority Health and Health Disparities, National
Institutes of Health, Bethesda, MD,
USA
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26
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Abstract
Ethn Dis. 2021;31(Suppl 1):289-292;doi:10.18865/ed.31.S1.289
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Affiliation(s)
- Eliseo J. Pérez-Stable
- Office of the Director, National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health (NIH)
| | - Monica Webb Hooper
- Office of the Director, National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health (NIH)
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27
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Abstract
Cigarette smoking is the primary preventable cause of death and disease worldwide. Studies reveal that smoking is associated with psychiatric symptoms, sociodemographic characteristics, social stressors, and lack of social support. In general, smokers report poorer mental health and benefit from support to be able to quit smoking (Jorm et al., 1999). In this paper, a tailored smoking cessation system has been developed in which the counseling and support is delivered via video-messaging. The system engages users in adaptive motivating video access. Users can interact with the system and the system selects the best matching video for them by processing their messages using Natural Language Processing (NLP). We have tailored 77 videos for interactive contents that encompass important issues users might face during the process of smoking cessation. A novel application-based data driven approach has been taken for categorizing videos to push to participants. The approach is based on analyzing 750 messages of people in the cessation process. We observed that most of the messages' contents were about smoking health effects, cravings, triggers, relapse, positive mood, low cessation self efficacy, medications, and culturally specific targeting inquiries. Considering these categories, videos are categorized to the corresponding groups by an intelligent approach. The information underlying the data driven categories allows for improving and facilitating smoking status assessment. The system has the potential for improving future smoking cessation decision-making adaptive interventions and health monitoring systems. The goal is to tailor the system to meet the needs of the users in real-time and maximize the potential impact.
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Affiliation(s)
- Golnoush Asaeikheybari
- Department of Electrical, Computer, and System Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, Psychological Sciences, Family Medicine & Community Health, Case Western Reserve University, Cleveland, OH, USA
| | - Ming-Chun Huang
- Department of Electrical, Computer, and System Engineering, Case Western Reserve University, Cleveland, OH, USA
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28
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Owusu C, Nock NL, Feuntes V, Margevicius S, Hergenroeder P, Austin K, Bennet E, Cerne S, Moore HCF, Petkac J, Schluchter M, Schmitz KH, Webb Hooper M, Coccia S, Nagy C, Wimbley L, Berger NA. IMPROVE, a community-based exercise intervention versus support group to improve functional and health outcomes among older African American and Non-Hispanic White breast cancer survivors from diverse socioeconomic backgrounds: Recruitment strategies and baseline characteristics. Cancer 2021; 127:1836-1846. [PMID: 33539554 DOI: 10.1002/cncr.33430] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/30/2020] [Accepted: 12/22/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Behavioral intervention studies in older breast cancer survivors, particularly older African American (AA) and socioeconomic status-disadvantaged breast cancer survivors, are lacking. To inform future studies, the authors examined recruitment strategies in older breast cancer survivors who participated in an exercise intervention study. METHODS IMPROVE is a randomized trial designed to evaluate a group-based exercise intervention versus a support group (ClinicalTrials.gov identifier, NCT02763228). Participants were aged ≥65 years who had survived stage I through III breast cancer and were within 5 years of treatment completion. Participants were recruited through multiple approaches, including peripheral, linguistic, and constituent-involving strategies that incorporated the identification of potentially eligible patients from 3 local hospitals and from State of Ohio registries and through direct clinician and community organization referrals. RESULTS Between October 2016 and November 2019, 7487 patients were screened, 4790 were potentially eligible, and 213 were randomized into the study. The eligible:randomization rates were 4.4% overall and 84%, 8%, and 2% for recruitment using direct referrals, hospital registries, and state registries, respectively. The median age of the randomized cohort was 70 years (range, 65-88 years) and included 44% AA and 44% socioeconomic status-disadvantaged breast cancer survivors. Compared with all registry-eligible patients, directly referred-eligible patients were more likely to be AA versus Non-Hispanic White (41% vs 19%; P = .006), to be contacted successfully (100% vs 33%; P < .0001), and to accept study participation (88% vs 16%; P < .0001). CONCLUSIONS Direct referrals appeared to be the most efficient strategy for recruiting AA survivors. Behavioral intervention studies seeking to target older AA and socioeconomic status-disadvantaged breast cancer survivors should include strategies that foster direct referrals to study participation.
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Affiliation(s)
- Cynthia Owusu
- Division of Hematology/Oncology, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Nora L Nock
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio.,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Vanessa Feuntes
- Washington University School of Medicine, St Louis, Missouri
| | - Seunghee Margevicius
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | | | | | | | | | - Halle C F Moore
- Department of Hematology/Oncology, Cleveland Clinic, Cleveland, Ohio
| | - Jean Petkac
- Physical Medicine and Rehabilitation, University Hospitals of Cleveland, Cleveland, Ohio
| | - Mark Schluchter
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio.,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | | | - Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Sarah Coccia
- Division of Hematology/Oncology, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Caitlin Nagy
- Division of Hematology/Oncology, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Leonard Wimbley
- Division of Hematology/Oncology, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Nathan A Berger
- Division of Hematology/Oncology, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
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29
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Robinson CD, Wiseman KP, Webb Hooper M, El-Toukhy S, Grenen E, Vercammen L, Prutzman YM. Engagement and Short-term Abstinence Outcomes Among Blacks and Whites in the National Cancer Institute's SmokefreeTXT Program. Nicotine Tob Res 2021; 22:1622-1626. [PMID: 31535690 DOI: 10.1093/ntr/ntz178] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 09/11/2019] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Text-messaging programs for smoking cessation improve abstinence outcomes in the general population. However, little is known about engagement and abstinence outcomes among African Americans in text-messaging smoking cessation programs. The current study compares engagement and abstinence between Blacks and Whites in the National Cancer Institute's SmokefreeTXT program. METHOD Data were from Blacks (n = 1333) and Whites (n = 7154) who enrolled in the 6-week SmokefreeTXT program between August 2017 and June 2018. We assessed the association between race and program initiation and completion; responses to weekly smoking cessation, mood, and craving assessments; and self-reported abstinence using multivariable logistic regression. RESULTS Blacks and Whites initiated the program at a similar frequency, yet Blacks were more likely to complete the program (adjusted odds ratio [AOR] = 1.71, 95% confidence interval [CI] = 1.43 to 2.06). Blacks were less likely to respond to all seven abstinence, mood, and craving assessments (eg, AOR of quit day responses = 0.63, 95% CI = 0.51 to 0.77; 6-week AOR = 0.50, 95% CI = 0.34 to 0.72). Self-reported abstinence was lower among Blacks for all seven smoking assessments (eg, quit day abstinence AOR = 0.52, 95% CI = 0.41 to 0.68; 6-week abstinence AOR = 0.58, 95% CI = 0.38 to 0.89). CONCLUSION Although Blacks were more likely than Whites to complete the SmokefreeTXT program, they were less likely to engage with the program by responding to assessment questions and had lower abstinence rates. Qualitative research may reveal unique barriers to engagement among Blacks. IMPLICATIONS Black smokers enrolled in a nationwide mobile smoking cessation program at a rate comparable to White smokers. However, they were significantly less likely to engage with the program or quit smoking. This study highlights the need to examine barriers to cessation for Black smokers.
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Affiliation(s)
- Cendrine D Robinson
- Tobacco Control Research Branch, Behavioral Research Program, National Cancer Institute, Bethesda, MD
| | - Kara P Wiseman
- Tobacco Control Research Branch, Behavioral Research Program, National Cancer Institute, Bethesda, MD
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Sherine El-Toukhy
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | | | | | - Yvonne M Prutzman
- Tobacco Control Research Branch, Behavioral Research Program, National Cancer Institute, Bethesda, MD
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30
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Riley WT, Borja SE, Hooper MW, Lei M, Spotts EL, Phillips JRW, Gordon JA, Hodes RJ, Lauer MS, Schwetz TA, Perez-Stable E. National Institutes of Health social and behavioral research in response to the SARS-CoV2 Pandemic. Transl Behav Med 2020; 10:857-861. [PMID: 32716038 PMCID: PMC7529099 DOI: 10.1093/tbm/ibaa075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The COVID-19 pandemic has been mitigated primarily using social and behavioral intervention strategies, and these strategies have social and economic impacts, as well as potential downstream health impacts that require further study. Digital and community-based interventions are being increasingly relied upon to address these health impacts and bridge the gap in health care access despite insufficient research of these interventions as a replacement for, not an adjunct to, in-person clinical care. As SARS-CoV-2 testing expands, research on encouraging uptake and appropriate interpretation of these test results is needed. All of these issues are disproportionately impacting underserved, vulnerable, and health disparities populations. This commentary describes the various initiatives of the National Institutes of Health to address these social, behavioral, economic, and health disparities impacts of the pandemic, the findings from which can improve our response to the current pandemic and prepare us better for future infectious disease outbreaks.
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Affiliation(s)
- William T Riley
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, MD, USA
| | - Susan E Borja
- National Institute of Mental Health, Bethesda, MD, USA
| | - Monica Webb Hooper
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - Ming Lei
- National Institute of General Medical Sciences, Bethesda, MD, USA
| | - Erica L Spotts
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | | | | | - Eliseo Perez-Stable
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
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Webb Hooper M, Calixte-Civil P, Verzijl C, Brandon KO, Asfar T, Koru-Sengul T, Antoni MH, Lee DJ, Simmons VN, Brandon TH. Associations between Perceived Racial Discrimination and Tobacco Cessation among Diverse Treatment Seekers. Ethn Dis 2020; 30:411-420. [PMID: 32742143 PMCID: PMC7360180 DOI: 10.18865/ed.30.3.411] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objectives This study investigated a) racial/ethnic differences in past-year discrimination experiences and b) associations between discrimination and smoking abstinence. Design Prospective, longitudinal analysis of smoking status. Perceived past-year discrimination was assessed at baseline. ANCOVAs and intent-to-treat hierarchical logistic regressions were conducted. Setting Dual-site (Tampa, FL and Miami, FL) randomized controlled trial testing the effects of a group cessation intervention plus pharmacotherapy. Participants Treatment-seeking adult smokers (N=347; non-Hispanic White, non-Hispanic African American/Black, or Hispanic). Main Outcome Measures Biochemically verified 7-day point prevalence abstinence (7-day ppa) was assessed immediately post-intervention and at 6-month follow-up. Results After controlling for covariates, African Americans/Blacks reported greater perceived discrimination compared with non-Hispanic Whites (P=.02), and Hispanics (P=.06). Non-Hispanic Whites and Hispanics did not differ in perceived racial/ethnic discrimination experiences over the past year. Irrespective of race/ethnicity, past-year perceived discrimination was inversely associated with 7-day ppa, both post-intervention (AOR=.97, CI: .95-.99) and at 6-months (AOR=.98, CI: .96-.99). Among African Americans/Blacks, past-year perceived discrimination was inversely associated with 7-day ppa, both post-intervention (AOR=.95, CI: .92-.97) and at 6-months (AOR=.97, CI: .94-.99). Perceived discrimination was unrelated to 7-day ppa among Hispanics. Among non-Hispanic Whites, past-year perceived discrimination was inversely associated with post-intervention 7-day ppa (AOR=.95, CI: .91-.99), but not 6-months. Conclusions Perceived racial/ethnic discrimination was greater among African American/Black smokers compared with non-Hispanic Whites. Perceived discrimination was negatively associated with tobacco cessation in the full sample, and for African Americans at 6-months post-intervention. These data have implications for intervention delivery and health disparities.
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Affiliation(s)
- Monica Webb Hooper
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD (former affiliation when study was conducted: Case Western Reserve University School of Medicine, Case Comprehensive Cancer Center, Cleveland, OH)
| | | | | | | | - Taghrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | | | - David J. Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Vani N. Simmons
- Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
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Affiliation(s)
- Monica Webb Hooper
- National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health, Bethesda, Maryland
| | - Anna María Nápoles
- National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health, Bethesda, Maryland
| | - Eliseo J Pérez-Stable
- National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health, Bethesda, Maryland
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D'Angelo H, Ramsey AT, Rolland B, Chen LS, Bernstein SL, Fucito LM, Webb Hooper M, Adsit R, Pauk D, Rosenblum MS, Cinciripini PM, Joseph A, Ostroff JS, Warren GW, Fiore MC, Baker TB. Pragmatic Application of the RE-AIM Framework to Evaluate the Implementation of Tobacco Cessation Programs Within NCI-Designated Cancer Centers. Front Public Health 2020; 8:221. [PMID: 32596200 PMCID: PMC7304341 DOI: 10.3389/fpubh.2020.00221] [Citation(s) in RCA: 20] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 05/13/2020] [Indexed: 11/13/2022] Open
Abstract
Tobacco cessation after cancer diagnosis leads to better patient outcomes. However, tobacco treatment services are frequently unavailable in cancer care settings, and multilevel implementation challenges can impede uptake of new programs. The National Cancer Institute (NCI) dedicated Cancer Moonshot funding through the Cancer Center Cessation Initiative (C3I) for NCI-Designated Cancer Centers to implement or enhance the implementation of tobacco treatment services. We examined a pragmatic application of the RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance) to evaluate tobacco treatment programs implemented within Cancer Centers funded through C3I. Using three C3I-funded Centers as examples, we describe how each RE-AIM construct was operationalized to evaluate the implementation of a wide range of cessation services (e.g., tobacco use screening, counseling, Quitline referral, pharmacotherapy) in this heterogeneous group of cancer care settings. We discuss the practical challenges encountered in assessing RE-AIM constructs in real world situations, including using the electronic health record (EHR) to aid in assessment. Reach and effectiveness evaluation required that Centers define the setting(s) where cessation services were implemented (to determine the “denominator”), enumerate the patient population, report current patient tobacco use, patient engagement in tobacco treatment, and 6-month cessation outcomes. To reduce site heterogeneity, increase data accuracy, and reduce burden, reach was frequently captured via standardized EHR enhancements that improved the identification of current smokers and tobacco treatment referrals. Effectiveness was determined by cessation outcomes (30-day point prevalence abstinence at 6-months post-engagement) assessed through a variety of data collection approaches. Adoption was measured by the characteristics and proportion of targeted cancer care settings and clinicians engaged in cessation service delivery. Implementation was assessed by examining the delivery of tobacco screening assessments and intervention components across sites, and provider-level implementation consistency. Maintenance assessments identified whether tobacco treatment services continued in the setting after implementation and documented the sustainability plan and organizational commitment to continued delivery. In sum, this paper demonstrates a pragmatic approach to using RE-AIM as an evaluation framework that yields relevant outcomes on common implementation metrics across widely differing tobacco treatment approaches and settings.
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Affiliation(s)
- Heather D'Angelo
- Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Alex T Ramsey
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States.,Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, United States
| | - Betsy Rolland
- Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States.,Institute for Clinical and Translational Research, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States.,Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, United States
| | - Steven L Bernstein
- Yale Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Lisa M Fucito
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Yale Cancer Center, Smilow Cancer Hospital at Yale-New Haven, New Haven, CT, United States
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - Robert Adsit
- Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Danielle Pauk
- Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Marika S Rosenblum
- Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States.,Department of Research, William S. Middleton Memorial Veterans Hospital, Madison, WI, United States
| | - Paul M Cinciripini
- Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Anne Joseph
- Department of Medicine, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
| | - Jamie S Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Graham W Warren
- Department of Radiation Oncology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States.,Department of Cell and Molecular, Pharmacology and Experimental Therapeutics, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States
| | - Michael C Fiore
- Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Timothy B Baker
- Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
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Owusu C, Nock NL, Hergenroeder P, Austin K, Bennet E, Cerne S, Moore H, Petkac J, Schluchter M, Schmitz KH, Webb Hooper M, Atkins L, Asagba O, Wimbley L, Berger NA. IMPROVE, a community-based exercise intervention versus support group to improve functional and health outcomes among older African American and non-Hispanic White breast cancer survivors from diverse socioeconomic backgrounds: Rationale, design and methods. Contemp Clin Trials 2020; 92:106001. [PMID: 32304828 PMCID: PMC7325580 DOI: 10.1016/j.cct.2020.106001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/24/2020] [Accepted: 04/13/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND African Americans (AA) and socioeconomic status (SES) disadvantaged older breast cancer survivors (BCS) are more likely to experience poor functional and health outcomes. However, few studies have evaluated the putative beneficial effects of exercise on these outcomes in older racial minority and SES-disadvantaged BCS. METHODS This is a mixed-methods study that includes a randomized-controlled trial, "IMPROVE", to evaluate a group-based exercise intervention compared to a support group program in older BCS, followed by post-intervention semi-structured interviews to evaluate the intervention. The trial aims to recruit 220 BCS with 55 in each of four strata defined by race (AA versus Non-Hispanic Whites) and SES (disadvantaged vs. non-disadvantaged). Participants are ≥65 years old and within five years of treatment completion for stage I-III breast cancer. Participants are randomized to a 52-week, three sessions/week, one-hour/session, moderate intensity aerobic and resistance group exercise intervention, (n = 110) or a 52-week, one hour/week, support group intervention [attention-control arm], (n = 110). The first 20 weeks of both programs are supervised and the last 32 weeks, unsupervised. The primary outcome is the change in Short Physical Performance Battery (SPPB) Scores at 20 weeks from baseline, between the two arms. Secondary outcomes include change in SPPB scores at 52 weeks, change in body composition and biomarkers, at 20 and 52 weeks from baseline, between arms. DISCUSSION Results of the trial may contribute to a better understanding of factors associated with recruitment, and acceptability, and will inform future exercise programs to optimally improve health outcomes for older BCS.
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Affiliation(s)
- Cynthia Owusu
- Division of Hematology/Oncology, Department of Medicine, Case Western Reserve University (CWRU) School of Medicine, Cleveland, OH, United States of America; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States of America.
| | - Nora L Nock
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States of America; Department of Population and Quantitative Health Sciences, CWRU, Cleveland, OH, United States of America
| | - Paul Hergenroeder
- Department of Medicine, Division of Hematology/Oncology, MetroHealth Medical Center, Cleveland, OH, United States of America
| | - Kristina Austin
- The Gathering Place, Beachwood, OH, United States of America
| | | | - Stephen Cerne
- The Gathering Place, Beachwood, OH, United States of America
| | - Halle Moore
- Cleveland Clinic, Department of Hematology/Oncology, Cleveland, OH, United States of America
| | - Jean Petkac
- University Hospitals of Cleveland, Cleveland, OH, United States of America
| | - Mark Schluchter
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States of America; Department of Population and Quantitative Health Sciences, CWRU, Cleveland, OH, United States of America
| | - Kathryn H Schmitz
- Penn State University College of Medicine, Hershey, PA, United States of America
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States of America
| | - Lindsay Atkins
- California Baptist University, Riverside, CA, United States of America
| | - Oghenerukeme Asagba
- West Virginia University School of Medicine, Morgantown, WV, United States of America
| | - Leonard Wimbley
- Division of Hematology/Oncology, Department of Medicine, Case Western Reserve University (CWRU) School of Medicine, Cleveland, OH, United States of America
| | - Nathan A Berger
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States of America
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Qua K, Papp KK, Junk DJ, Webb Hooper M, Berger NA. Youth Enjoy Science Program at the Case Comprehensive Cancer Center: Increasing Engagement and Opportunity for Underrepresented Minority Students. Ethn Dis 2020; 30:15-24. [PMID: 31969779 DOI: 10.18865/ed.30.1.15] [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] [Indexed: 11/18/2022] Open
Abstract
The Youth Enjoy Science (YES) Program at the Case Comprehensive Cancer Center is a National Cancer Institute (NCI) R25-funded training grant, designed to increase the pipeline of underrepresented minority (URM) students entering college and pursuing biomedical research and health care careers in the Cleveland Metropolitan and surrounding school districts. The three components of the program include: Learn to Beat Cancer, engaging middle school students and their families; Research to Beat Cancer, designed for high school students and college undergraduates; and Teach to Beat Cancer, focused on enhancing science, technology, engineering, and mathematics (STEM) teaching capacity among high school teachers. This study focuses on Research to Beat Cancer, which, in 2018 enrolled 36 URM students as paid summer scholars. Students were assigned to a faculty mentor, were taught laboratory safety, responsible conduct of research and the scientific method, and then immersed in full-time laboratory cancer research during an eight-week period. Twice each week, students participated in Lunch and Learn Seminars where faculty members provided combined motivational and scientific guidance lectures. In a capstone poster session at the end of the program, students presented their research to peers, medical and graduate students, family members, faculty, community members and leaders. Students' perceptions of the program were reported using descriptive statistics and qualitative thematic analyses. Twenty-four of the 2018 YES students (67%) and 19 (53%) mentors completed the online post-program survey. Opportunity was a major qualitative theme from student and mentor responses. Future research will investigate the long-term impacts of YES, including college enrollment.
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Affiliation(s)
- Kelli Qua
- Department of General Medical Sciences, Case Western Reserve University, Cleveland, OH
| | - Klara K Papp
- Department of General Medical Sciences, Case Western Reserve University, Cleveland, OH
| | - Damian J Junk
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH.,Department of Family Medicine, Case Western Reserve University, Cleveland, OH.,Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Nathan A Berger
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH.,Department of Biochemistry, Case Western Reserve University, Cleveland, OH.,Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH.,Department of Medicine, Case Western Reserve University, Cleveland, OH
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Abstract
Introduction: Despite the strong relationship between marijuana and tobacco use, especially among African American individuals and males, very few studies have examined the association between marijuana and menthol cigarette use. This study was designed to identify the prevalence of past month, past year and lifetime marijuana use and marijuana dependence among menthol and non-menthol cigarette smokers, as well as the association between marijuana and menthol cigarette use among African American female and male cigarette smokers. Methods: Data were drawn from 1,173 African American adult cigarette smokers in the 2017 National Survey on Drug Use and Health. Results: Overall, 8.8%, 13.9% and 44.7% of African American menthol and non-menthol cigarette smokers reported past month, past year and lifetime marijuana use, respectively. Weighted multivariable logistic regression models revealed a significant interaction between gender and past month marijuana use on menthol cigarette use (AOR = 1.49, 95% CI: 1.21-2.42, p < .05). Past month marijuana use was associated with an increased odds of past month menthol cigarette use (relative to non-menthol cigarette use) among females, but a decreased odds of past of past month menthol cigarette use among males. Conclusions: When stratified by gender, marijuana use is differentially related to menthol cigarette use among African American adults. Given the prevalence of menthol cigarette use among this population, it is important to examine factors such as marijuana use that could be targeted in prevention and treatment interventions for African Americans, especially females, who are at risk for smoking or are currently smoking menthol cigarettes. Implications: This study found that marijuana use was associated with an increased odds of menthol cigarette use among African American females, while marijuana use was associated with a decreased odds of menthol cigarette use among their male counterparts. The impact of marijuana use on menthol cigarette smoking differs among females and males, highlighting the need for gender-tailored interventions that target marijuana use among African American individuals, especially females, who are at risk for smoking or are currently smoking menthol cigarettes.
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Affiliation(s)
- LaTrice Montgomery
- Department of Psychiatry and Behavioral Neuroscience, Addiction Sciences Division, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Sheffer CE, Webb Hooper M, Ostroff JS. Commentary: Educational and Clinical Training for Addressing Tobacco-Related Cancer Health Disparities. Ethn Dis 2019; 28:187-192. [PMID: 30038480 PMCID: PMC6051502 DOI: 10.18865/ed.28.3.187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In the United States, tobacco use is a leading contributor to inequities in cancer health among individuals for many ethnic, racial, sexual minority, and other minority groups as well as individuals in lower socioeconomic groups and other underserved populations. Despite remarkable decreases in tobacco use prevalence rates in the United States over the past 50 years, the benefits of tobacco control efforts are not equitably distributed. Tobacco-related disparities include higher prevalence rates of smoking, lower rates of quitting, less robust responses to standard evidence-based treatments, substandard tobacco treatment delivery by health care providers, and an increased burden of tobacco-related cancers and other diseases. Among the multiple critical barriers to achieving progress in reducing tobacco treatment-related disparities, there are several educational barriers including a unidimensional or essentialist conceptualizations of the disparities; a tobacco treatment workforce unprepared to address the needs of tobacco users from underserved groups; and known research-to-practice gaps in understanding, assessing, and treating tobacco use among underserved groups. We propose the development of competency-based curricula that: 1) use intersectionality as an organizing framework for relevant knowledge; 2) teach interpersonal skills, such as expressing sociocultural respect, a lack of cultural superiority, and empathy as well as skills for developing other-oriented therapeutic relations; and 3) are grounded in the science of the evidence-based treatments for tobacco dependence. These curricula could be disseminated nationally in multiple venues and would represent significant progress toward addressing tobacco-related disparities.
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Affiliation(s)
- Christine E. Sheffer
- Department of Health Behavior; Roswell Park Cancer Institute; Buffalo, NY, Address correspondence to Christine E. Sheffer, PhD; Associate Member and Associate Professor of Oncology, Department of Health Behavior; Carlton House, Room 402; Roswell Park Cancer Institute; Buffalo, NY 14263; 716.845.1186;
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center; Case Western Reserve University; Cleveland, OH
| | - Jamie S. Ostroff
- Department of Psychiatry & Behavioral Sciences; Memorial Sloan Kettering Cancer Center; New York, NY
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Smiley SL, DeAtley T, Rubin LF, Harvey E, Kierstead EC, Webb Hooper M, Niaura RS, Abrams DB, Pearson JL. Early Subjective Sensory Experiences with "Cigalike" E-cigarettes Among African American Menthol Smokers: A Qualitative Study. Nicotine Tob Res 2019; 20:1069-1075. [PMID: 28549156 DOI: 10.1093/ntr/ntx102] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/09/2017] [Indexed: 12/20/2022]
Abstract
Introduction Despite smoker interest in e-cigarettes as a harm reduction or cessation aid, many smokers prematurely discontinue vaping after trying a product. This study explored the role of early subjective sensory experiences in vaping persistence and desistance. Methods African American menthol cigarette smokers aged ≥18 years (N = 15; M = 54.1 years; SD = 8.2), motivated to quit smoking, and interested in trying e-cigarettes were recruited in Washington, DC. Participants were followed for 3 weeks and provided menthol cigalike e-cigarettes after Week 1. Participants completed three interviews about their vaping experiences. Thematic analysis of responses was designed to understand the sensory aspects of vaping. Results During the first 2 weeks of vaping, four participants reported a positive vaping experience while 11 reported decreased satisfaction. Salient sensory attributes of dissatisfaction included poor taste, insufficient throat hit, difficulty pulling, and a lack of "whole body" satisfaction compared to their preferred cigarette brand. Conclusions The sensory experiences with a specific cigalike e-cigarette were related to vaping persistence and desistence. Although this was a small volunteer sample of African American menthol smokers motivated to quit smoking, 27% (N = 4) of participants with a positive vaping experience continued using the product, while 73% (N = 11) of participants' vaping experience was unsatisfactory across several experiential categories. In future research of e-cigarettes' efficacy as a smoking cessation or reduction aid, both device characteristics and smokers' expectations for these devices should be considered, so vapers do not expect the same taste sensations, throat sensations, and "whole body" satisfaction as they experienced with their menthol cigarettes. Implications The subjective sensory experiences associated with initial e-cigarette product use are associated with use patterns. Subjective sensory experiences may also help understand the differences in the appeal, satisfaction, and harm-reduction potential of the rapidly evolving diverse types of products emerging in the marketplace. How products meet the sensory needs of smokers wanting to switch or quit smoking may influence adherence and success rates.
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Affiliation(s)
- Sabrina L Smiley
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Teresa DeAtley
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Leslie F Rubin
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC.,Department of Psychology, American University, Washington, DC
| | - Emily Harvey
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Elexis C Kierstead
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC.,Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, School of Medicine, Case Western Reserve University, Cleveland, OH
| | - Raymond S Niaura
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
| | - David B Abrams
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
| | - Jennifer L Pearson
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Webb Hooper M, Mitchell C, Marshall VJ, Cheatham C, Austin K, Sanders K, Krishnamurthi S, Grafton LL. Understanding Multilevel Factors Related to Urban Community Trust in Healthcare and Research. Int J Environ Res Public Health 2019; 16:ijerph16183280. [PMID: 31500126 PMCID: PMC6765868 DOI: 10.3390/ijerph16183280] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 08/31/2019] [Accepted: 09/02/2019] [Indexed: 12/19/2022]
Abstract
Background: Community and patient engagement in the healthcare system and biomedical research are prerequisites for eliminating health disparities. We conducted a “listening tour” to enhance our understanding of multilevel factors associated with community trust. Methods: Using community-based participatory research (CBPR) methods, we conducted a phenomenological qualitative study. “Town-hall” style discussions were held at nine sites across an urban, Midwestern city. We recruited adults (N = 130) via community networks, social media, flyers, and word-of-mouth. Demographic assessments were self-administered and listening tour sessions were conducted by trained moderators. Themes were framed within the social ecological model (SEM; intrapersonal, interpersonal, institutional, community, and policy levels). Results: Participants were mostly female (68%), African American (80%), had health coverage (97%) and were diagnosed with a chronic health condition (71%). The overarching theme was sociodemographic differences in distrust, such that African Americans and deaf/hearing impaired participants perceived disparities in healthcare, a lower quality of care, and skepticism about biomedical research, relative to Whites. Conclusions: The depth of distrust for healthcare providers, systems, and researchers in underserved communities remains strong and complex. Findings highlight the need to understand the lived experiences of community members, and how distrust is maintained. Multilevel interventions to increase trust and the accrual of underrepresented populations into clinical trials are needed.
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Affiliation(s)
- Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA.
| | - Charlene Mitchell
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Vanessa J Marshall
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
- University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH 44106, USA
| | - Chesley Cheatham
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
- University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH 44106, USA
| | | | - Kimberly Sanders
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH 44195, USA
| | - Smitha Krishnamurthi
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH 44195, USA
| | - Lena L Grafton
- NEOMED-CSU Partnership for Urban Health, Cleveland State University, Cleveland, OH 44115, USA
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Webb Hooper M. Racial/Ethnic Differences in Physiological Stress and Relapse among Treatment Seeking Tobacco Smokers. Int J Environ Res Public Health 2019; 16:E3090. [PMID: 31450707 PMCID: PMC6747351 DOI: 10.3390/ijerph16173090] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/16/2019] [Accepted: 08/18/2019] [Indexed: 11/16/2022]
Abstract
Stress is robustly associated with tobacco smoking and relapse. African Americans experience greater difficulty quitting compared to whites, yet no studies have examined race differences in physiological stress biomarkers during a quit attempt. This pilot study compared cortisol levels among treatment-seeking African American and white smokers, and relapse rates. Adult smokers (N = 115; n = 72 African American, n = 43 White) received eight sessions of group cognitive behavioral therapy plus transdermal nicotine patches. Assessments included demographics, salivary cortisol (collected at session 1, the end-of-therapy [EOT], and one-month post-therapy), and carbon monoxide-verified smoking relapse. Overall, cortisol levels declined over the course of the day at baseline, the EOT, and the one-month follow-up. African Americans exhibited lower cortisol levels compared to Whites at baseline and the EOT, but not at the one-month follow-up. In addition, African American smokers exhibited flatter slopes compared to Whites at each time point. Relapse rates were greater among African Americans at the EOT and one-month follow-up. The attenuated cortisol pattern observed in African Americans may indicate hypothalamic-pituitary-adrenal axis (HPA) exhaustion and aid our understanding of tobacco-related disparities. There is a need to focus on stress mechanisms and specific intervention approaches in order to eliminate racial/ethnic differences.
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Affiliation(s)
- Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University Cleveland, OH 44106, USA.
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Abstract
Introduction Internet-based tobacco cessation programs have increased in use and popularity in recent years. To examine evidence for racial/ethnic digital inequality in web-only tobacco cessation services offered by US tobacco quitlines, we conducted an analysis of quitline enrollees in five states. We hypothesized that racial/ethnic minorities would demonstrate lower enrollment and utilization of a web-only tobacco cessation program. Methods The sample includes enrollees into five state quitlines whose service options included a web-only program in 2015 (N=32,989). Outcomes included web-entry into the quitline, web-only enrollment, establishment of a web account, and the number of times users logged into the program. Regression models tested associations with race/ethnicity. Results Compared with Whites, African Americans, Hispanics, American Indians/Alaska Natives, and "others" were less likely to enter the quitline via the web (Ps<.01) and enroll in a web-only (vs counseling) program (Ps<.01). Among web-only program enrollees, all racial/ethnic minority groups were significantly less likely than Whites to establish an online account (Ps<.03), and African Americans were less likely than Whites to log in to the web-only service (P<.01). Conclusions This study suggests that digital inequalities exist in web-based tobacco cessation services. Findings have implications for the development and implementation of digital tobacco interventions for racial/ethnic minority communities. The proliferation of digital tobacco interventions could increase disparities, as members of racial/ethnic minority groups may not engage in these interventions. Implications The proliferation of digital interventions has the potential to increase tobacco-related disparities, as members of racial/ethnic minority groups may not enroll in, or engage in, such interventions. As the field moves to digitize tobacco interventions, we must remain cognizant of persistent digital inequalities and the potential for widening racial/ethnic tobacco cessation disparities.
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Affiliation(s)
- Monica Webb Hooper
- Case Western Reserve University School of Medicine, Case Comprehensive Cancer Center, Cleveland, Ohio
| | | | - Erica E Salmon
- Center for Wellbeing Research, Optum, Eden Prairie, Minnesota
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Webb Hooper M. Achieving Health Equity through Science, Policy, and Partnerships. Ethn Dis 2019; 29:317-320. [PMID: 31308598 PMCID: PMC6604775 DOI: 10.18865/ed.29.s2.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Ethn Dis. 2019;29(Suppl 2):317-320; doi:10.18865/ed.29.S2.317.
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Affiliation(s)
- Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine
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Schnall R, Carcamo J, Porras T, Huang MC, Webb Hooper M. Use of the Phase-Based Model of Smoking Treatment to Guide Intervention Development for Persons Living with HIV Who Self-Identify as African American Tobacco Smokers. Int J Environ Res Public Health 2019; 16:E1703. [PMID: 31096577 PMCID: PMC6571600 DOI: 10.3390/ijerph16101703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/10/2019] [Accepted: 05/11/2019] [Indexed: 01/10/2023]
Abstract
Cigarette smoking is highly prevalent among persons living with the human immunodeficiency virus (HIV) (PLWH), with rates as high 50% as compared to 14% in the general U.S. population. Tobacco use causes morbidity and mortality in PLWH, and tobacco-related harm is substantially higher in PLWH than smokers in the general population, providing the scientific premise for developing effective tobacco cessation interventions in this population. To better address this issue, we conducted six focus group sessions with 45 African American smokers who are living with HIV to understand the barriers to smoking cessation and the strategies that would be helpful to overcome these barriers. We organized our findings by the Phase-Based Model of Smoking Treatment to understand the intervention components that are needed at each phase to help PLWH successfully quit smoking. Participants in our focus group sessions articulated key components for incorporation into tobacco cessation intervention for PLWH: a personalized plan for quitting, reminders about that plan, and a support system. Participants thought that their HIV and tobacco use were disassociated. Participants described barriers to the use of pharmacotherapy, including adverse side effects of the gum and patch and concerns about the negative health effects of some oral medications. Substance use was identified as a commonly co-occurring condition as well as a barrier to successfully ceasing to smoke tobacco products. In summary, these findings offer information on the components of a tobacco cessation intervention for PLWH, namely reminders, a support system, substance use treatment, and monitoring to prevent relapse.
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Affiliation(s)
- Rebecca Schnall
- School of Nursing, Columbia University, New York, NY 10032, USA.
| | - Jasmine Carcamo
- School of Nursing, Columbia University, New York, NY 10032, USA.
| | - Tiffany Porras
- School of Nursing, Columbia University, New York, NY 10032, USA.
| | - Ming-Chun Huang
- School of Engineering, Case Western Reserve University, Cleveland, OH 44106, USA.
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA.
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Webb Hooper M, Asfar T, Unrod M, Dorsey A, Correa JB, Brandon KO, Simmons VN, Antoni MA, Koru-Sengul T, Lee DJ, Brandon TH. Reasons for Exclusion from a Smoking Cessation Trial: An Analysis by Race/Ethnicity. Ethn Dis 2019; 29:23-30. [PMID: 30713413 DOI: 10.18865/ed.29.1.23] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective The exclusion criteria of tobacco cessation randomized clinical trials (RCTs) may have unintended consequences on inclusion and cessation disparities. We examined racial/ethnic differences in: a) exclusion from a group-based cessation RCT; and b) reasons for exclusion. Design Quasi-experimental. Inclusion criteria were self-identification as African American/Black, non-Hispanic White, or Hispanic (any race), adults, minimum five cigarettes/day or carbon monoxide reading of ≥ 8 parts per million (ppm), interest in quitting, and spoke/read English. Data were obtained from a parent trial, which is ongoing and will be completed in 2019. Analyses for our present study on participant screening and enrollment were conducted in 2018. Main Outcome Measures Study ineligibility, and reasons for exclusion (contraindications for nicotine patch use, serious mental illness [SMI, eg, bipolar disorder or schizophrenia], alcohol dependence or illicit drug use, current tobacco treatment, attendance barriers [eg, transportation], and other concerns [eg, aggressive, intoxicated, disruptive, visibly ill]). Results Of 1,206 individuals screened, 36% were ineligible. The most frequent reasons were SMI (28%), alcohol dependence or drug use (10%), and attendance barriers (7%). Ineligibility was greater among African Americans (42%) and Hispanics (37%), compared with Whites (24%; P<.001). Compared with African Americans and Hispanics, Whites were more likely to be excluded for single reasons, including attendance barriers, and medical conditions (P<.05). African Americans were more than twice as likely as Whites to be excluded for 3 or more reasons (12% vs 5% respectively, P<.05). Conclusions A notable proportion of smokers were ineligible for this RCT, with SMI as the greatest single cause. Racial/ethnic minorities were more likely to be excluded, with African Americans deemed ineligible for multiple reasons. Findings have implications for RCT generalizability, addressing tobacco disparities and health equity.
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Affiliation(s)
| | - Taghrid Asfar
- University of Miami Miller School of Medicine, Department of Public Health Sciences and Sylvester Comprehensive Cancer Center
| | | | - Asha Dorsey
- University of Miami Miller School of Medicine, Department of Public Health Sciences and Sylvester Comprehensive Cancer Center
| | - John B Correa
- VA San Diego Healthcare System.,University of California, San Diego
| | | | | | - Michael A Antoni
- University of Miami Miller School of Medicine, Department of Public Health Sciences and Sylvester Comprehensive Cancer Center.,University of Miami, Department of Psychology
| | - Tulay Koru-Sengul
- University of Miami Miller School of Medicine, Department of Public Health Sciences and Sylvester Comprehensive Cancer Center
| | - David J Lee
- University of Miami Miller School of Medicine, Department of Public Health Sciences and Sylvester Comprehensive Cancer Center
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Chen T, Zhang X, Jiang H, Asaeikheybari G, Goel N, Hooper MW, Huang MC. Are you smoking? Automatic alert system helping people keep away from cigarettes. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.smhl.2018.07.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Abstract
<em>Ethn Dis.</em> 2018;28(3):129-132; doi:10.18865/ed.28.3.129.
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Affiliation(s)
- Monica Webb Hooper
- Psychological Sciences, Family Medicine & Community Health, Case Comprehensive Cancer Center, Case Western Reserve University
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47
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Abstract
Objective E-cigarette use is increasing among adult cigarette smokers. With the availability and variety of appealing characteristics, including menthol flavor, e-cigarette use patterns may differ among menthol and non-menthol cigarette smokers. This study compared e-cigarette knowledge and use between current menthol and non-menthol smokers aged ≥18 years. Design Current adult cigarette smokers (N=223; M=42.1 years; SD=12.2; 68% menthol smokers) recruited in South Florida completed an interviewer-administered survey via telephone during June to November 2014. Main Outcome Measures E-cigarette use (ever-use, past 30-day use, past 30-day flavored e-cigarette use, and past 30-day mentholated e-cigarette use), consideration of e-cigarette use for quitting/reduction of cigarettes, and knowledge assessments. Bivariate and multivariate analyses tested associations with menthol smoking. Results Menthol smokers were more likely to be African American or Hispanic (P<.001) and report lower income (P=.02) and education (P<.001) than non-menthol smokers. Adjusted analyses found no association between menthol cigarette use and e-cigarette ever-use. However, menthol smokers demonstrated less e-cigarette knowledge (P<.01) and were more likely to consider using e-cigarettes to quit/reduce smoking (AOR=3.89, CI:1.55-9.78). Among ever-users, there was no association between menthol cigarette use and past 30-day e-cigarette use, yet menthol smokers were more likely to use menthol flavored e-cigarettes (AOR=6.65, CI: 1.94-12.78). Conclusions Our findings suggest that, compared with current non-menthol smokers, current menthol smokers are more likely to consider using e-cigarettes to help quit/reduce smoking, and are more likely to use menthol flavored e-cigarettes. Further research is needed to better examine low e-cigarette knowledge among menthol smokers, which may represent an important intervention target.
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Affiliation(s)
- Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Sabrina L Smiley
- Keck School of Medicine, Department of Preventive Medicine, University of Southern California, Health Sciences Campus, Los Angeles, CA
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Tan MM, Okuyemi KS, Resnicow K, Dietz NA, Antoni MH, Webb Hooper M. Association between smoking cessation and weight gain in treatment-seeking African Americans. Addict Behav 2018; 81:84-90. [PMID: 29452980 DOI: 10.1016/j.addbeh.2018.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/31/2018] [Accepted: 02/02/2018] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Research has shown that African Americans gain more than average weight after smoking cessation. However, African Americans have been underrepresented in post-cessation weight gain research. The current study examined 1) the pattern of weight gain and 2) the association between smoking status and weight gain in a sample of African Americans seeking smoking cessation treatment. METHODS Data were drawn from a randomized controlled trial testing the efficacy of a 4-week culturally specific smoking cessation cognitive behavioral therapy (CBT) intervention among African American smokers (N = 342). Weight was measured and self-reported smoking status was biochemically verified at baseline, end of counseling, 3-, 6-, and 12-month follow-ups. Random effects multilevel modeling was used to examine weight gain over twelve months post CBT, and a fully unconditional model tested the pattern of weight gain over time. Smoking status was included as a time-varying factor to examine its effect on weight gain, controlling for potential confounding variables. RESULTS Weight significantly increased among those who remained abstinent over 12 months post CBT [average gain of seven lbs. (three kg)]. Controlling for covariates, abstinence was predictive of the rate of weight gain for those with high weight concern. CONCLUSIONS Weight gain among African American abstainers was comparable to the average post-cessation weight gain observed among the general population. It is possible that exposure to CBT (culturally specific or standard) may have mitigated excessive weight gain. Future research should assess predictors of weight gain in African American smokers to inform future smoking cessation interventions and help elucidate factors that contribute to tobacco- and obesity-related health disparities.
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Webb Hooper M, Lee DJ, Simmons VN, Brandon KO, Antoni MH, Unrod M, Asfar T, Correa JB, Koru-Sengul T, Brandon TH. Reducing racial/ethnic tobacco cessation disparities via cognitive behavioral therapy: Design of a dualsite randomized controlled trial. Contemp Clin Trials 2018; 68:127-132. [PMID: 29617633 DOI: 10.1016/j.cct.2018.03.017] [Citation(s) in RCA: 6] [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: 09/27/2017] [Revised: 03/28/2018] [Accepted: 03/31/2018] [Indexed: 11/27/2022]
Abstract
Racial/ethnic disparities in tobacco cessation are such that U.S. minorities have greater difficulty quitting compared to White non-Hispanics. Group differences in distress (i.e., perceived stress and depressive symptoms) may contribute to cessation disparities. The allostasis model of health suggests that the toll of chronic stress experienced by racial/ethnic minorities may lead to dysregulation of the physiological stress system and drug use. Previous research suggests that group cognitive behavioral therapy (CBT) for tobacco cessation addresses distress as a modifiable mechanism and has the potential to reduce/eliminate disparities. The present study is a dualsite randomized controlled trial aimed at evaluating the efficacy of group CBT in eliminating racial/ethnic differences in smoking cessation and distress. The study utilizes a [2 (intervention: group CBT or group general health education [GHE]) × 3 (race/ethnicity: African American/Black, Hispanic, White)] factorial design by randomizing 225 adult smokers from the community. Both interventions provide eight counseling sessions and eight weeks of nicotine patch therapy. Assessments occur at the end-of-therapy, and at 3-, 6-, and 12-months. Generalized longitudinal mixed modeling will be used to test our primary abstinence outcome, biochemically-confirmed 7-day point prevalence abstinence at 12-months. We hypothesize that group CBT will reduce or eliminate racial/ethnic differences in perceived stress, depressive symptoms, and smoking cessation compared to group GHE. We also hypothesize that reductions in physiological distress, assessed by salivary cortisol, will mediate racial/ethnic group differences in smoking cessation, particularly among racial/ethnic minorities. This study has implications for eliminating disparities in psychosocial factors related to tobacco use and cessation. TRIAL REGISTRATION Clinicaltrials.govNCT02511236. Registered on July 27, 2015.
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Affiliation(s)
- Monica Webb Hooper
- Case Western Reserve University School of Medicine, Case Comprehensive Cancer Center, 10900 Euclid Ave, Cleveland, OH 44106, United States.
| | - David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Miami, FL 33136, United States; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave, Miami, FL 33136, United States
| | - Vani N Simmons
- Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, United States
| | - Karen O Brandon
- Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, United States
| | - Michael H Antoni
- Department of Psychology, University of Miami College of Arts and Sciences, PO Box 248185, Coral Gables, FL 33124, United States; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave, Miami, FL 33136, United States
| | - Marina Unrod
- Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, United States
| | - Taghrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Miami, FL 33136, United States; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave, Miami, FL 33136, United States
| | - John B Correa
- Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, United States
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Miami, FL 33136, United States; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave, Miami, FL 33136, United States
| | - Thomas H Brandon
- Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, United States
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Smiley SL, Collins L, Elmasry H, Moore RA, Hooper MW. The relationship between past-month marijuana, cigarette, and cigar use among older adults in the United States. Tob Prev Cessat 2018; 4:6. [PMID: 32411837 PMCID: PMC7205074 DOI: 10.18332/tpc/84867] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 01/21/2018] [Accepted: 01/28/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Previous research indicates that marijuana use may be interrelated with combustible tobacco use among U.S. adolescents and young adults. However, little is known about this relationship during older adulthood. The purpose of this study was: 1) examine the prevalence of past-month marijuana, cigarette and cigar use, and 2) assess the associations between demographic and tobacco-use variables with past-month marijuana use, among a nationally representative sample of U.S. adults 50 years and older. METHODS Data are from the public-use files of the 2013 National Survey on Drug Use and Health (NSDUH). The sample consisted of 6325 adults aged ≥50 years. RESULTS Overall, 2.98% (N=216) of the sample reported past-month marijuana use; higher prevalence was noted for those who were past-month users of cigarettes (15.62%, N=1162) and lower prevalence was noted for those who were past-month users of cigars (2.68%, N=176). After accounting for covariables, past-month cigarette use was the strongest predictor of past-month marijuana use (adjusted odds ratio [AOR]=5.19, 95% CI, 3.51-7.66). Additionally, past-month cigar use showed a positive association with past-month marijuana use (AOR=2.41, 95% CI, 1.23-4.72). CONCLUSIONS Tobacco prevention, cessation, and control efforts that target older adults should be tailored effectively to address the use of marijuana and other combustible tobacco products.
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Affiliation(s)
- Sabrina L Smiley
- Institute for Health Promotion and Disease Prevention Research, Keck School of Medicine, Department of Preventive Medicine, University of Southern California, California, United States
| | - Lauren Collins
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, United States
| | - Hoda Elmasry
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, United States
| | - Rakiya A Moore
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, United States
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center School of Medicine, Case Western Reserve University, Ohio, United States
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