Community recruitment of underrepresented populations to the AHEAD 3-45 preclinical AD trial using novel partnerships with nursing and community-based organizations: Lessons and outcomes.

INTRODUCTION: Alzheimer's disease (AD) disproportionately affects minoritized populations who remain underrepresented in AD trials. METHODS: We partnered with local nursing community-based organizations to implement a culturally tailored educational intervention and recruit Hispanic/Latino American, Filipino American, and Korean American adults aged 55 to 80 for the AHEAD study, a preclinical AD trial, at the University of California, Irvine. RESULTS: We engaged 654 individuals across 21 events, leading to 71 prescreenings: 21.1% Filipino, 11.2% Hispanic/Latino, and 67.6% Korean adults. Ineligibility due to age and language barriers was common among Hispanic/Latino and Korean adults, respectively. Filipino adults often withdrew interest or were lost to follow-up. Ultimately, 25 participants enrolled: eight Filipino, two Hispanic/Latino, and 15 Korean adults. Tailored, culturally relevant content significantly contributed to the engagement success. DISCUSSION: This study demonstrates the value and impact of novel partnerships with health-related provider organizations that provide trusted care and access to underrepresented communities. HIGHLIGHTS: Six hundred and fifty four underrepresented individuals were reached, and 25 enrolled in the AHEAD 3-45 trial. Twenty-one community events were held via partnerships with nursing and community organizations. The study engaged 21% Filipino, 11% Hispanic/Latino, 68% Korean adults. Community-Based Participatory Research (CBPR) principles enhanced the recruitment process. Transparent communication and joint planning were key.

Ethical Perspectives in Sharing Digital Data for Public Health Surveillance Before and Shortly After the Onset of the COVID-19 Pandemic.

Data from digital technologies are increasingly integrated in public health research. In April of 2020, we interviewed a subset of participants (N=25) who completed a survey approximately one month earlier (just prior to the declaration of the COVID-19 pandemic in the United States). Using the survey, we contacted and interviewed participants who had expressed their willingness or unwillingness to share digital data (e.g., from contact tracing apps) for use in public health. We followed a directed content analysis approach for the analysis of the interview data. Among participants who had reported being unwilling to share data, concerns about privacy, confidentiality, and the purpose of the research were cited. During the interviews, 76.9% of the participants who had previously indicated that they were unwilling to share their data, expressed willingness to share data in order to assist with COVID-19 prevention. Our results contribute to our understanding of people's perspectives on sharing personal data and of the way their perspectives can vary as a function of potential uses of their personal information (e.g., prevention of COVID-19).

Adolescents and opioid-related outcomes amidst the COVID-19 pandemic.

Morbidity and mortality attributable to opioid use and misuse among adolescents and young adults are evident. Although recent trend data suggest a decrease in both opioid misuse and opioid use disorder among adolescents and young adults in the last few years, overdose cases continue to rise. The opioid epidemic among this population is complex and has a different profile compared to adults, with family facilitating exposure to opioids more often than other sources. Additionally, despite recommendations by experts to initiate medications for opioid use disorder, few initiate treatment. The recent COVID-19 pandemic has impacted many facets of daily life and its effects on the opioid crisis are largely unknown. Stay-at-home mandates resulting in online schooling and limited social interaction has had deleterious consequences for adolescents, especially their mental health. This viewpoint attempts to explore the effects of the pandemic on the opioid crisis in this vulnerable population.

Technology-Delivered Intervention Strategies to Bolster HIV Testing.

Since the beginning of the HIV epidemic, there have been more than 75 million cases. Currently, there about 1.2 million living with HIV in the USA. Despite current testing recommendations, test rates continue to be suboptimal. Investigators have studied the use of digital technology to promote HIV testing, especially among high-risk populations. PURPOSE OF REVIEW: This non-systematic review provides an overview of the scientific research between 2015 and 2020 focused on the use of digital technology to bolster HIV testing and suggests novel technologies for exploration. RECENT FINDINGS: A total of 40 studies were included in the review that span a wide range of available technology. Studies effectively increased HIV testing among study participants. Generally, participants in the intervention/exposure groups had significantly higher rates of HIV test uptake compared to participants in the comparison groups at study follow-up. For a variety of reasons (e.g., differences in ways the technologies were used and study design), no digital tool clearly performed better than others, but each have the capacity to increase outreach and self-testing. An exploration of the potential use of nascent technologies is also discussed, as well as the authors' experiences using a number of these technologies in our research.

Towards smoke-free rental cars: an evaluation of voluntary smoking restrictions in California.

INTRODUCTION: Some car rental companies in California and other states in the USA have established non-smoking policies for their vehicles. This study examined the effectiveness of these policies in maintaining smoke-free rental cars. METHODS: A stratified random sample of 250 cars (non-smoker, smoker and unknown designation) was examined in San Diego County, California, USA. Dust, surfaces and the air of each vehicle cabin were sampled and analysed for residual tobacco smoke pollutants (also known as thirdhand smoke (THS)), and each car was inspected for visual and olfactory signs of tobacco use. Customer service representatives were informally interviewed about smoking policies. FINDINGS: A majority of putative non-smoker cars had nicotine in dust, on surfaces, in air and other signs of tobacco use. Independent of a car's smoking status, older and higher mileage cars had higher levels of THS pollution in dust and on surfaces (p<0.05), indicating that pollutants accumulated over time. Compared with smoker cars, non-smoker cars had lower levels of nicotine on surfaces (p<0.01) and in dust (p<0.05) and lower levels of nicotine (p<0.05) and 3-ethynylpyridine (p<0.05) in the air. Non-smoking signage in cars was associated with lower levels of THS pollutants in dust and air (p<0.05). CONCLUSIONS: Existing policies and practices were successful in lowering THS pollution levels in non-smoker cars compared with smoker cars. However, policies failed in providing smoke-free rental cars; THS levels were not as low as those found in private cars of non-smokers with in-car smoking bans. Major obstacles include inconsistent communication with customers and the lack of routine monitoring and enforcement strategies. Strengthening policies and their implementation would allow car rental companies to reduce costs, better serve their customers and make a constructive contribution to tobacco control efforts.

Assessment of dietary intakes of Filipino-Americans: implications for food frequency questionnaire design.

OBJECTIVE: The purpose of this study was to describe food consumption practices of Filipino-American adults, to describe how they respond to a food frequency questionnaire (FFQ) as a function of acculturation and sex, and to suggest modifications to the FFQ to improve dietary assessment among Filipino-Americans. METHODS: Twenty-one Filipino-American women and 14 Filipino-American men (aged 30-60 years) who varied on acculturation level were recruited from the general community of San Diego, California. Participants completed a focus group and rated the Fred Hutchinson Food Frequency Questionnaire. RESULTS: The most commonly eaten food items among Filipino-Americans were white rice, fish or meat, vegetables, and fruit. Most (76%) participants reported that the Fred Hutchinson Food Frequency Questionnaire lacked commonly eaten Filipino-American food. CONCLUSIONS AND IMPLICATIONS: Commonly consumed food, such as adobo, lumpia, and pansit, might be added to a revised FFQ; doing so may improve recall and face validity among Filipino-Americans.

Residual tobacco smoke in used cars: futile efforts and persistent pollutants.

INTRODUCTION: Smoking cigarettes in the enclosed environment of a car leads to the contamination of a car's microenvironment with residual tobacco smoke pollution (TSP). METHODS: Surface wipe, air, and dust samples were collected in used cars sold by nonsmokers (n = 40) and smokers (n = 87) and analyzed for nicotine. Primary drivers were interviewed about smoking behavior and restrictions, and car interiors were inspected to investigate (a) differences in car dustiness, signs of past smoking, ventilation use, mileage, and passenger cabin volume among nonsmokers and smokers with and without in-car smoking bans and (b) factors that contribute to the contamination of cars with residual TSP, such as ventilation use, cleaning behaviors, signs of past smoking, and holding the cigarette near/outside the car window while smoking. RESULTS: Smokers reported using air conditioning less (p < .05) and driving with windows down more often than nonsmokers (p = .05); their cars were also dustier (p < .01) and exhibited more ash and burn marks than nonsmokers' cars (p < .001). Number of cigarettes smoked by the primary driver was the strongest predictor of residual TSP indicators (R(2) = .10 - .16, p = .001). This relationship was neither mediated by ash or burn marks nor moderated by efforts to remove residual TSP from the vehicle (i.e., cleaning, ventilation) or attempts to prevent tobacco smoke pollutants from adsorbing while smoking (e.g., holding the cigarette near/outside window). DISCUSSION: Findings suggest that smokers can prevent their cars from becoming contaminated with residual TSP by reducing or ceasing smoking; however, commonly used cleaning and ventilation methods did not successfully decrease contamination levels. Disclosure requirements and smoke-free certifications could help protect buyers of used cars and empower them to request nonsmoking environments or a discount on cars that have been smoked in previously.

Correlates of smoking cessation among Filipino immigrant men.

A survey on tobacco use among 318 Filipino immigrant men aged 40-75 years was conducted in Los Angeles, California. Those who reported more English language use with their family, friends and neighbors (OR = 1.31) and who lived in households with complete smoking prohibition (OR = 3.82) were more likely to be successful in quitting smoking. Those who endorsed more positive beliefs on physical and social consequences of smoking (OR = 0.69) and who had mostly smoking friends (OR = 0.37) were less likely to be successful in quitting smoking. Our findings suggest that prohibiting smoking in households, creating social networks of non-smokers, and education or counseling are important components of a smoking cessation intervention for Filipino immigrant men.

Smoking trends among Filipino adults in California, 1990-2002.

OBJECTIVES: Filipinos comprise about 18% of the Asian/Pacific Islander American (APIA) population and are increasing. Few studies have examined Filipino current smoking prevalence rates (CSPR) and none have described trends over time. METHODS: Trends in CSPR were estimated for Filipinos and non-Hispanic whites (NHW) from 1990-2002 from the California Tobacco Surveys (N>42,000/year). RESULTS: CSPR for Filipino males declined: 23.7% (95% CI: 18.7, 28.7) in 1990 to 18.7% (15.3, 22.1) in 2002 (p<0.05). The decline in CSPR for Filipino women was non-significant (p=0.24), 9.8% (5.5, 14.1) in 1990 and 7.7% (5.3, 10.1) in 2002. During the same period, CSPR among NHW males declined: 24.4% (23.8, 25.0) in 1990 to 18.8% (18.1, 19.4) in 2002 (p<0.01). For female NHW, CSPR were 21.3% (20.5, 22.0) in 1990 and 15.0% (14.4, 15.6) in 2002 (p<0.01). Adjusted logistic regression for Filipinos suggest that English language use is associated with current smoking among females (p<0.01) and that, overall, 18-29 year-olds were more likely to be current smokers than those 45+ years old (p<0.01). CONCLUSION: Trends for male Filipino current smokers declined similarly to male NHW from 1990-2002; female rates were lower but did not decline. Future smoking prevention and cessation programs would benefit by taking into account important differences in smoking rates between genders and age groups.

Adolescent receptivity to tobacco marketing by racial/ethnic groups in California.

BACKGROUND: Previous research has examined tobacco marketing receptivity across racial/ethnic groups but none has done so across the various levels of the smoking uptake continuum. Identifying adolescent groups that may be more or less receptive to industry marketing, particularly across the levels of smoking uptake, provides important information that may be useful in focusing efforts to eliminate smoking disparities. METHODS: Data came from 5857 adolescents (66.6% response rate) from the 2002 California Tobacco Survey and were analyzed in 2006. An index measure of receptivity to tobacco marketing was based on advertisement recall and willingness to use/own a tobacco promotional item. Respondents were classified along a smoking uptake continuum as committed never smokers, susceptible never smokers, or any smoking. Logistic regression models controlling for possible confounding variables were fit to test for the association between receptivity and race/ethnicity across levels of smoking uptake. RESULTS: African Americans (odds ratio [OR]=0.77; 95% confidence interval [CI]=0.61-0.96) and Asian/Pacific Islanders (OR=0.80; 95% CI=0.66-0.97) were less likely than non-Hispanic white adolescents to be receptive to tobacco marketing after controlling for possible confounders. For susceptible never smokers, African Americans (OR =0.67; 95% CI=0.47-0.93) and Asian/Pacific Islanders (OR=0.72; 95% CI=0.54-0.95) were less likely than non-Hispanic white adolescents to be receptive. CONCLUSIONS: There may be features of the African-American and Asian/Pacific Islander cultures that are protective against receptivity to tobacco marketing, even among those who are susceptible never smokers. Prevention strategies emphasizing such features for adolescents of other races/ethnicities may be beneficial in reducing smoking disparities.

Longitudinal analysis of the group A Streptococcus transcriptome in experimental pharyngitis in cynomolgus macaques.

Identification of the genetic events that contribute to host-pathogen interactions is important for understanding the natural history of infectious diseases and developing therapeutics. Transcriptome studies conducted on pathogens have been central to this goal in recent years. However, most of these investigations have focused on specific end points or disease phases, rather than analysis of the entire time course of infection. To gain a more complete understanding of how bacterial gene expression changes over time in a primate host, the transcriptome of group A Streptococcus (GAS) was analyzed during an 86-day infection protocol in 20 cynomolgus macaques with experimental pharyngitis. The study used 260 custom Affymetrix (Santa Clara, CA) chips, and data were confirmed by TaqMan analysis. Colonization, acute, and asymptomatic phases of disease were identified. Successful colonization and severe inflammation were significantly correlated with an early onset of superantigen gene expression. The differential expression of two-component regulators covR and spy0680 (M1_spy0874) was significantly associated with GAS colony-forming units, inflammation, and phases of disease. Prophage virulence gene expression and prophage induction occurred predominantly during high pathogen cell densities and acute inflammation. We discovered that temporal changes in the GAS transcriptome were integrally linked to the phase of clinical disease and host-defense response. Knowledge of the gene expression patterns characterizing each phase of pathogen-host interaction provides avenues for targeted investigation of proven and putative virulence factors and genes of unknown function and will assist vaccine research.