Promising Themes for Electronic Cigarette Prevention Campaigns for Youth and Young Adults.

INTRODUCTION: Electronic cigarettes (e-cigarettes) are the most widely used tobacco product by youth and young adults in the United States. Effective prevention campaigns require the identification of appropriate content focus for message construction. AIMS AND METHODS: A sample of 2622 youth and young adults ages 15-24 were recruited through social media advertisements and completed an online survey. Respondents reported current e-cigarette use or intention to use if not currently using. They also indicated agreement or disagreement with 75 e-cigarette-related beliefs representing 16 themes. The relative promise of each theme/belief for campaign messaging was investigated by examining its association with the behavior/intention outcomes and the opportunity for positive change in its distribution (room to move). RESULTS: All themes showed significant associations with the behavior (ORs = 2.49-19.04) and intention (ORs = 2.21-6.11) outcomes. Room to move for themes ranged from 32.9% to 96.3% in behavior analysis and 15.6-93.9% in intention analysis. A normed relative promise index (M = 50, SD = 17) showed flavors (72), comparison to cigarettes (69), and relaxation and mental health (68) as the top ranked themes. Subgroup analyses by demographics revealed few differences. Results on the belief level were largely consistent with those on the theme level. CONCLUSIONS: Data from this study provide timely evidence for the relative value of various themes/beliefs as potential targets for message development in e-cigarette prevention campaigns. The final selection of target themes/beliefs requires consideration of openness to persuasion, which may be informed by additional testing. IMPLICATIONS: Electronic cigarettes (e-cigarettes) are the most widely used tobacco products among youth and young adults in the United States. This study adds new evidence on the relative promise of a wide range of e-cigarette beliefs and belief clusters (themes) as potential targets for message development in educational campaigns. This evidence is important to consider in future campaign efforts directed at the youth and young adult populations in the United States.

Message Fatigue and COVID-19 Vaccine Booster Uptake in the United States.

Dissemination of public health information plays an essential role in communicable disease control and prevention. However, widespread and repeated messaging could become counterproductive if it leads to avoidance and disengagement due to message fatigue. Americans have been inundated with accurate and inaccurate COVID-19 information from myriad sources since the start of the pandemic. Using the health belief model (HBM) as a guiding framework, this study examines COVID-19-related message fatigue among adults in the United States who have gotten at least one dose of a COVID-19 vaccine and the association between message fatigue and COVID-19 booster uptake and intentions. A special survey module of The COVID States Project was fielded between August and September 2022 (n = 16,546). Results showed moderately high levels of message fatigue among vaccinated individuals. Message fatigue was negatively associated with the likelihood of having gotten a COVID-19 booster and intentions to do so among those who had not yet received a booster, above and beyond variance explained by the HBM constructs. These findings underscore the importance of monitoring and mitigating COVID-19-related message fatigue in encouraging the public to stay up to date with COVID-19 vaccination.

Valence of YouTube Comments and College Student Reactions Towards Electronic Nicotine Product Counter-Marketing Messages.

Advertisements promoting and discouraging electronic nicotine products (ENPs) are widespread on social media. User interaction is a hallmark feature of social media sites. This study examined how user-comment valence (i.e. positive versus negative comments) influences attitudes toward counter-marketing ads, and determinants of ENP abstinence according to the theory of planned behavior (TPB). College students were randomly assigned to one of three conditions, a positive comment condition (n = 121), in which they were shown a YouTube comment section with eight positive comments and two negative comments; a negative comment condition (n = 126), in which they were shown a YouTube comment section with eight negative and two positive comments; and a control condition (n = 128). Then, all groups were shown a YouTube video advocating for ENP abstinence and completed measures about their attitudes toward the ad (Aad), attitudes toward ENP abstinence, injunctive and descriptive norms about ENP abstinence, perceived behavioral control (PBC) toward ENP abstinence, and intention to abstain from ENPs. Results indicated that exposure to negative comments yielded significantly less favorable Aad when compared to the positive condition, but no difference in Aad was observed between the negative and control conditions, or between the positive and control conditions. Further, there were no differences for any determinants of ENP abstinence. Additionally, Aad mediated the effects of negative comments on attitudes toward ENP abstinence, injunctive norms and descriptive norms about ENP abstinence, and behavioral intention. Findings indicate that negative user comments depress attitudes toward counter-persuasion ads targeting ENP use.

Achieving Public Health Impact: Health Communication Research to Inform Tobacco Regulatory Science.

Health communication research applies communication science to develop generalizable knowledge capable of improving the health and well-being of individuals and communities. But to what extent does the knowledge generated by the health communication field actually achieve public health impact? To answer this question, we discuss the application of health communication science and research within a tobacco regulatory science framework. We describe three areas in which health communication research funded by the Food and Drug Administration (FDA) Center for Tobacco Products (CTP) contributed to 1) youth tobacco prevention campaigns, 2) cigarette health warnings, and 3) regulation of labeling, advertising, and marketing claims. These examples demonstrate how communication regulatory science achieves public health impact in the real world by informing national policies, regulatory actions, and public health practice.

Disparities in Nicotine Addictiveness and Cancer Harm Perceptions Among U.S. Adults: A Trend Analysis Using the Health Information National Trends Survey.

INTRODUCTION: Recent research has found widespread misperceptions about nicotine. This study tests perceptions among U.S. adults with respect to nicotine addictiveness and cancer harm, while distinguishing between nicotine misperceptions (ie an incorrect response) and "don't know" (DK) responses. AIMS AND METHODS: Data from three cycles of the Health Information National Trends Survey, fielded in 2015, 2017, and 2019 were merged for analysis. Weighted multinominal logistic regression models were conducted where nicotine addictiveness and cancer harm beliefs (DK, incorrect, and correct responses) were regressed on survey year and demographic variables. We also tested for interactions between survey year and demographic variables to assess if previously identified disparities had evolved during these years. RESULTS: Analyses showed lower odds of misperceptions about nicotine addictiveness, but higher odds of misperceptions about nicotine cancer harm in 2019 compared to 2015. There was no change in DK responses during these years. Disparities by sociodemographics and tobacco use status were observed, mostly for cancer harm. Survey year significantly interacted with age in the model for cancer harm, which was driven primarily by increased incorrect responses and decreased DK responses over time among the youngest age group (18-34 years). There were no significant interactions between survey year and race and ethnicity or level of educational attainment. CONCLUSIONS: Disparities in nicotine addictiveness and cancer harm perceptions reflect the uneven distribution of knowledge in the U.S. adult population. Nicotine cancer harm misperceptions are increasing and educational efforts to address this misperception are warranted. IMPLICATIONS: Future educational efforts targeting nicotine addictiveness beliefs may benefit by focusing on DK responders. The growing trend of misperceptions of nicotine's role in cancer harm may negatively impact perceptions about nicotine replacement therapy and low nicotine content cigarettes. Future efforts should focus on correcting nicotine cancer harm misperception, particularly among young adults.

CoMoO4-modified hematite with oxygen vacancies for high-efficiency solar water splitting.

Hematite is a potential photoelectrode for photoelectrochemical (PEC) water splitting. Nevertheless, its water oxidation efficiency is highly limited by its significant photogenerated carrier recombination, poor conductivity and slow water oxidation kinetics. Herein, under low-vacuum (LV) conditions, we fabricated a CoMoO4 layer on oxygen-vacancy-modified hematite (CoMo-Fe2O3 (LV)) for the first time for efficient solar water splitting. The existence of oxygen vacancies can significantly facilitate the electrical conductivity, while the large onset potential along with oxygen vacancies can be lowered by the CoMoO4 with accelerated water oxidation kinetics. Therefore, a high photocurrent density of 3.53 mA cm-2 at 1.23 VRHE was obtained for the CoMo-Fe2O3 (LV) photoanode. Moreover, it can be further coupled with the FeNiOOH co-catalyst to reach a benchmark photocurrent of 4.18 mA cm-2 at 1.23 VRHE, which is increased around 4-fold compared with bare hematite (0.90 mA cm-2). The combination of CoMoO4, FeNiOOH, and oxygen vacancies may be used as a reasonable strategy for developing high-efficiency hematite-based photoelectrodes for solar water oxidation.

Framing Youth Vaping Prevention Messages: The Role of Uncertainty Tolerance.

Vaping is the most prevalent form of tobacco use among youth in the United States. Motivated by the certainty effect in prospect theory, this study investigated the role of uncertainty tolerance as a potential moderator of the effects of gain- vs. loss-framed text messages for youth vaping prevention. Youth susceptible to future vaping (N = 536) were randomized to view a series of eight gain- or loss-framed text messages about the health consequences of vaping. Cognitive and affective responses to the messages as well as beliefs, attitude, and intentions about vaping were assessed post-exposure. Results showed an overall advantage of the loss frame on several outcomes. Additionally, an interaction between framing and uncertainty tolerance was observed for most outcomes such that the loss frame was more effective for those high in uncertainty tolerance, while the gain frame held a slight edge for those low in uncertainty tolerance. Findings from this study have implications for further engaging prospect theory in message framing research. They may also inform audience segmentation and targeted message design for youth vaping prevention efforts.

Social Media Data Mining of Antitobacco Campaign Messages: Machine Learning Analysis of Facebook Posts.

BACKGROUND: Social media platforms provide a valuable source of public health information, as one-third of US adults seek specific health information online. Many antitobacco campaigns have recognized such trends among youth and have shifted their advertising time and effort toward digital platforms. Timely evidence is needed to inform the adaptation of antitobacco campaigns to changing social media platforms. OBJECTIVE: In this study, we conducted a content analysis of major antitobacco campaigns on Facebook using machine learning and natural language processing (NLP) methods, as well as a traditional approach, to investigate the factors that may influence effective antismoking information dissemination and user engagement. METHODS: We collected 3515 posts and 28,125 associated comments from 7 large national and local antitobacco campaigns on Facebook between 2018 and 2021, including the Real Cost, Truth, CDC Tobacco Free (formally known as Tips from Former Smokers, where "CDC" refers to the Centers for Disease Control and Prevention), the Tobacco Prevention Toolkit, Behind the Haze VA, the Campaign for Tobacco-Free Kids, and Smoke Free US campaigns. NLP methods were used for content analysis, including parsimonious rule-based models for sentiment analysis and topic modeling. Logistic regression models were fitted to examine the relationship of antismoking message-framing strategies and viewer responses and engagement. RESULTS: We found that large campaigns from government and nonprofit organizations had more user engagements compared to local and smaller campaigns. Facebook users were more likely to engage in negatively framed campaign posts. Negative posts tended to receive more negative comments (odds ratio [OR] 1.40, 95% CI 1.20-1.65). Positively framed posts generated more negative comments (OR 1.41, 95% CI 1.19-1.66) as well as positive comments (OR 1.29, 95% CI 1.13-1.48). Our content analysis and topic modeling uncovered that the most popular campaign posts tended to be informational (ie, providing new information), where the key phrases included talking about harmful chemicals (n=43, 43%) as well as the risk to pets (n=17, 17%). CONCLUSIONS: Facebook users tend to engage more in antitobacco educational campaigns that are framed negatively. The most popular campaign posts are those providing new information, with key phrases and topics discussing harmful chemicals and risks of secondhand smoke for pets. Educational campaign designers can use such insights to increase the reach of antismoking campaigns and promote behavioral changes.

Chronic inflammatory demyelinating polyneuropathy and psoriasis comorbidity with significantly alleviated in symptoms after secukinumab: case report.

BACKGROUND: Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune disease that involves damage to the peripheral nervous system. The course of the disease can progress for more than 8 weeks, with frequent incidences of relapse-remission courses. This article reported a rare combination of CIDP with fluctuating symptoms, recurrence-remission, and comorbidity with psoriasis. CASE PRESENTATION: A 29-year-old male patient with repeated limb weakness and numbness was admitted to the hospital several times in the past six months. He had a history of psoriasis for 6 years, and the medications (clobetasol propionate ointment and calcipotriol ointment) treated for psoriasis were discontinued 1 year ago. During the hospitalization, repeated intravenous injections of human immunoglobulin G (IVIg), immunoadsorption, and secukinumab were performed. Nerve electrophysiology tests, ganglioside autoantibody spectrum tests, and clinical MRC muscle strength scores were performed on a regular basis to confirm the diagnosis of CIDP. The patient was regularly followed up. RESULTS: After repeated rounds of human IVIg and immunoadsorption, the patient's MRC score was increased by ≥ 6 points. The first ganglioside autoantibody spectrum test showed anti-GQ1b IgG ( +) and anti-GM1 IgM ( +) antibodies, and all were negative after re-examination. Finally, the patient was treated with the IL-17A inhibitor secukinumab for psoriasis. During 7 months of follow-up, the CIDP and psoriasis symptoms are relatively stable. CONCLUSION: Combination of IVIg and immunoadsorption was highly effective in treating CIDP complicated with psoriasis. The clinical manifestations of CIDP are diverse. When relapse-remission occurs in the course of the disease, it is necessary to clarify whether it is combined with other autoimmune diseases and should control the autoimmune diseases as soon as possible.

Visual Attention to the Source Matters: Using Eye Tracking to Understand the FDA's 'Every Try Counts' Campaign Message Effectiveness.

INTRODUCTION: Visual attention is a crucial mechanism in health messaging and campaign persuasiveness. Little is known about how visual attention may translate into cessation-related outcomes in tobacco public education campaigns. METHODS: Using the eye-tracking technology, this study investigated the relationships among visual attention, cognitive and affective message responses, and cessation-related outcomes (readiness to quit, intentions to quit, and intentions to seek cessation information). Four different posters from the Every Try Counts (ETC) campaign were used as message stimuli. A total of 80 adult current smokers participated. The associations between their behavioral eye gaze patterns and self-reported message responses and cessation-related outcomes were examined. RESULTS: Half of the sample (49.4%) were male, and 46.8% were White-with ages ranging from 18 to 36 years old (M = 21.22, SD = 2.86). Roughly 41% were daily smokers, and 78% had attempted quitting in the previous year. When exposed to campaign ads, only fixation on the FDA logo showed consistent positive relationships with cognitive and affective message responses. Mediation analyses revealed significant indirect effects of fixation on the FDA logo on quitting and information-seeking intentions mainly through positive affective message responses. CONCLUSIONS: Visual attention to the FDA logo played an important role in the effects of ETC campaign messages. IMPLICATIONS: This study contributes new evidence on the relationship of visual attention, message responses, and ETC campaign outcomes. The current findings suggest that highlighting FDA as a campaign sponsor in the visual display may enhance the effectiveness of FDA tobacco education messages.

Perceived Message Effectiveness and Campaign-Targeted Beliefs: Evidence of Reciprocal Effects in Youth Tobacco Prevention.

Perceived message effectiveness (PE) has been widely used in campaign formative research and evaluation. The relationship between PE and actual message effectiveness (AE) is often assumed to be causal and unidirectional, but careful conceptualization and empirical testing of this and other causal possibilities are generally lacking. In this study, we investigated the potential reciprocity in the relationship between PE and AE in the context of a national youth tobacco education campaign. In so doing, we also sought to generate much needed evidence on PE's utility to predict campaign-targeted outcomes in youth tobacco prevention. Using five waves of campaign evaluation data (N = 1,128), we found significant lagged associations between PE and campaign-targeted beliefs, and vice versa. These results suggest a dynamic, mutually influencing relationship between PE and AE and call for greater attention to such dynamics in campaign research.

Effects of a National Campaign on Youth Beliefs and Perceptions About Electronic Cigarettes and Smoking.

INTRODUCTION: Our study assesses the relationship between the exposure of youth to the US Food and Drug Administration's national tobacco public education campaign, The Real Cost, and changes in campaign-focused risk perceptions and beliefs. METHODS: A nationally representative cohort study of youth was conducted from June 2018 to July 2019, consisting of a baseline and one follow-up survey. We performed logistic regressions to examine the association between campaign exposure and beliefs. Exposure was measured by self-report as the frequency of exposure to individual campaign advertisements about the health consequences of e-cigarette use and of smoking cigarettes. RESULTS: We found that increased levels of exposure to campaign advertising was associated with a significant increase in the odds of reporting agreement with campaign-specific beliefs. Positive patterns of findings were found across multiple items selected by specific advertisements, whereas unrelated beliefs were not associated with advertisement exposure. CONCLUSION: A sustained national tobacco public education campaign can change beliefs about the harms of e-cigarette use and cigarette smoking among youth. Combined with other findings from The Real Cost evaluation, results indicate that prevention mass media campaigns continue to be an effective and cost-efficient approach to reduce the health and financial cost of tobacco use in the US.

Ring finger sensory latency difference in the diagnosis and treatment of carpal tunnel syndrome.

OBJECTIVE: To explore the sensitivity of median and ulnar nerve sensory latency differences in diagnosing carpal tunnel syndrome (CTS) at different severities. METHODS: CTS patients were divided into three groups based on disease severity (mild, moderate, and severe). Distal latency of sensory nerve action potential (SNAP) for the median and ulnar nerves was recorded. The sensitivity of SNAP distal latency to CTS and its correlation with CTS severity were analyzed. RESULTS: Significant differences were found in the median nerve sensory action potential distal latency (MSDL) and in the median and ulnar sensory latency difference to ring finger (MUD) but not in the ulnar nerve sensory action potential distal latency (USDL) between CTS and control. The sensitivity and specificity were 92.2 and 99.4% with an MSDL cutoff value of 2.40 ms, respectively, and were both 100% with a MUD cutoff value of 0.33 ms. There was no significant difference in USDL among the CTS and control groups. Significant differences were found in MSDL and MUD among the CTS severities and between mild and moderate CTS, but not between mild and severe CTS or between moderate and severe CTS. Correlations with CTS severity were observed for MSDL and MUD but not for USDL. CONCLUSION: The ulnar nerve of the CTS patients was not damaged. A smaller MSDL reflected median nerve damage, which can be used for the early diagnosis of CTS. MUD correlated with CTS severity with a higher sensitivity than MSDL, which can provide therapeutic insight without pain to patients.

"The Real Cost" Smokeless campaign: changes in beliefs about smokeless tobacco among rural boys, a longitudinal randomized controlled field trial.

BACKGROUND: The prevalence of current smokeless tobacco (SLT) use in 2019 among high school students was 4.8%, and the overall rate of SLT use was higher among high school boys (7.5%) than girls (1.8%). The U.S. Food and Drug Administration (FDA) launched "The Real Cost" Smokeless media campaign in April 2016 to educate rural youth about the dangers of SLT use. In this study, we evaluate the effectiveness of "The Real Cost" Smokeless campaign. METHODS: We use a 3-year (Jan 2016 - Dec 2018) randomized controlled longitudinal field trial that consists of a baseline survey of boys and a parent/guardian and four follow-up surveys of the boys. The cohort includes 2200 boys who were 11 to 16 years old at baseline and lived in the rural segments of 30 media markets (15 treatment markets and 15 control). "The Real Cost" Smokeless campaign targets boys who are 12 to 17 years old in 35 media markets. It focuses primarily on graphic depictions of cosmetic and long-term health consequences of SLT use. The key outcome measures include beliefs and attitudes toward SLT that are targeted (explicitly or implicitly) by campaign messages. RESULTS: Using multivariate difference-in-difference analysis (conducted in 2019 and 2020), we found that agreement with 4 of the 11 explicit campaign-targeted belief and attitude measures increased significantly from baseline to post-campaign launch among boys 14 to 16 years old in treatment vs. control markets. Agreement did not increase for boys 11-13 years old in treatment vs. control markets and only increased for one targeted message for the overall sample. CONCLUSIONS: These findings suggest that "The Real Cost" Smokeless campaign influenced beliefs and attitudes among older boys in campaign markets and that a campaign focused on health consequences of tobacco use can be targeted to rural boys, influence beliefs about SLT use, and potentially prevent SLT use.

COVID-19 Risk Perceptions and Intentions to Engage in Familial Advance Care Planning: The Mediating Role of Death Anxiety.

Advance care planning (ACP) is the process of communicating about end-of-life (EOL) care with loved ones. Due to the deadly nature of COVID-19, ACP is vital. Unfortunately, fewer than 30% of American patients engage in ACP. In addition to low motivation, people experiencing death anxiety (DA) similarly avoid ACP.  This finding coincides with predictions from terror management theory (TMT) that people avoid DA-arousing behaviors. Guided by the theory of planned behavior (TPB) and the health belief model (HBM), we posited COVID-19 risk perceptions would be positively associated with determinants of health behavior, including intention to share and ask loved ones about EOL wishes, as well as the associated attitudes, norms, and level of perceived behavioral control regarding ACP. Guided by TMT, we posited that DA negatively mediated relationships between COVID-19 risk perceptions and these behavioral determinants. An MTurk participant sample (N = 522) completed a survey about COVID-19 risk perceptions, DA, and health behavior determinants in the context of ACP. Results indicate COVID-19 risk perceptions were rarely directly related to these determinants. However, results of PROCESS mediation models examining the role of DA in these relationships reveal a different picture. While direct relationships were rarely significant, DA negatively mediated most relationships between COVID-19 risk perceptions and behavioral determinants. Our results indicate DA demotivates EOL communication during the COVID-19 pandemic; a concerning yet important finding due to the increased importance of ACP in the context of a deadly disease like COVID-19.

Healthfulness Assessment of Recipes Shared on Pinterest: Natural Language Processing and Content Analysis.

BACKGROUND: Although Pinterest has become a popular platform for distributing influential information that shapes users' behaviors, the role of recipes pinned on Pinterest in these behaviors is not well understood. OBJECTIVE: This study aims to explore the patterns of food ingredients and the nutritional content of recipes posted on Pinterest and to examine the factors associated with recipes that engage more users. METHODS: Data were collected from Pinterest between June 28 and July 12, 2020 (207 recipes and 2818 comments). All samples were collected via 2 new user accounts with no search history. A codebook was developed with a raw agreement rate of 0.97 across all variables. Content analysis and natural language processing sentiment analysis techniques were employed. RESULTS: Recipes using seafood or vegetables as the main ingredient had, on average, fewer calories and less sodium, sugar, and cholesterol than meat- or poultry-based recipes. For recipes using meat as the main ingredient, more than half of the energy was obtained from fat (277/490, 56.6%). Although the most followed pinners tended to post recipes containing more poultry or seafood and less meat, recipes with higher fat content or providing more calories per serving were more popular, having more shared photos or videos and comments. The natural language processing-based sentiment analysis suggested that Pinterest users weighted taste more heavily than complexity (225/2818, 8.0%) and health (84/2828, 2.9%). CONCLUSIONS: Although popular pinners tended to post recipes with more seafood or poultry or vegetables and less meat, recipes with higher fat and sugar content were more user-engaging, with more photo or video shares and comments. Data on Pinterest behaviors can inform the development and implementation of nutrition health interventions to promote healthy recipe sharing on social media platforms.

Workplace bullying among nurses and organizational response: An online cross-sectional study.

AIMS: To examine prevalence of bullying among nurses and explore associations of organizational betrayal and support with well-being among nurses exposed to bullying. BACKGROUND: Bullying is a problem in many nursing workplaces, and organizations have an obligation to support nurses who are bullied. Support or betrayal after bullying could affect nurse well-being, including burnout. METHODS: In this cross-sectional study among U.S. nurses, data were collected in a survey using the Negative Acts Questionnaire-Revised for Nursing, the Institutional Betrayal Questionnaire for Health, the Well-Being Index, a job satisfaction scale and demographic questions. RESULTS: Prevalence of weekly/daily bullying was 31% (N = 242). Among nurses exposed to any bullying (N = 173), organizational betrayal increased odds of burnout (OR 2.62, p = .02), job dissatisfaction (OR 2.97, p = .04) and absenteeism (OR 6.11, p < .001). Organizational support decreased odds of job dissatisfaction (OR 0.30, p = .001) and absenteeism (OR 0.50, p = .04). CONCLUSION: Analysis of study findings suggests organizational betrayal increases likelihood of burnout, job dissatisfaction and absenteeism, and support decreases likelihood of dissatisfaction and absenteeism. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders should be aware of the issue of organizational betrayal and support in relation to well-being. Future studies can further explore the concepts of betrayal and support to provide additional evidence.

Undiagnosed diabetes among Hispanic and white adults with elevated haemoglobin A1c levels.

AIMS: The aim of this study is to compare the frequency and correlates of undiagnosed diabetes between Hispanic and white American adults ages 20 and older with known diabetes or elevated HbA1c . METHODS: Using 2007 to 2012 National Health and Nutrition Survey data, 1792 white and Hispanic Americans age 20 and older with known diabetes or elevated HbA1c (≥6.5%) were included in the analysis. Undiagnosed diabetes was defined as elevated HbA1c more than or equal to 6.5% without prior diabetes diagnosis. Covariates included demographics, health care access, and survey language. RESULTS: Hispanics were younger (54.92 vs 61.45 y, p < .001) and had a higher rate of undiagnosed diabetes (28.2% vs 18.0%, p < .001) than their white counterparts. For Hispanics, those with undiagnosed diabetes had higher mean HbA1c than those with known diabetes (p = .03), but no significant difference was found between diagnosed and undiagnosed diabetes among whites. Covariates that decreased the odds of undiagnosed diabetes among Hispanic Americans included having a routine place to receive health care. For whites, covariates that decreased the odds of undiagnosed diabetes were a higher ratio of income to poverty level, having health insurance and having a routine place for health care. CONCLUSION: The high proportion of unknown diabetes among Hispanic Americans suggests the need for a culturally competent health campaign to improve community diabetes awareness. Emphasizing the importance of having a routine place of health care for regular health check-ups and expanded community resources for diabetes early detection and prevention among this population could decrease the burden of diabetes.

Using graphic text-messaging to promote smoking cessation among first-generation Chinese and Korean male immigrants.

First-generation Chinese and Korean male immigrants in the United States are at high risk for tobacco use. This study pilot-tested a graphic, native-language text-messaging intervention to promote smoking cessation among these groups. First-generation Chinese and Korean male immigrant smokers (N = 71) were recruited from the Washington DC area. Participants were randomly assigned to one of four conditions based on a between-subjects 2 (graphic plus text or text-only messages) � 2 (quitline information or quitting tips) design. The text-messaging intervention included 30 text messages in total and lasted one month. Participants completed an expired air carbon monoxide (CO) assessment and self-reported measures at both baseline and follow-up. Results show that, from baseline to follow-up, participants' expired air CO levels decreased significantly (P = 0.001). Attitude toward quitting also became more positive (P = 0.028). Compared with text-only messages, graphic text messages produced greater positive changes in quitting attitudes (P = 0.039) and elicited greater fear response (P = 0.005). Compared with quitting tip messages, quitline information resulted in greater regret (P = 0.016) and fear (P = 0.051). These findings suggest that graphic text-messaging can be an effective method to promote smoking cessation among first-generation Chinese and Korean male immigrants.

Sexual and gender minority cigarette smoking disparities: An analysis of 2016 Behavioral Risk Factor Surveillance System data.

We examined the association between lesbian, gay, bisexual, and transgender (LGBT) identity, cigarette and e-cigarette use, and potential risk factors in the United States. Using data from 198,057 adults in 26 states in the 2016 Behavioral Risk Factor Surveillance System (BRFSS), we estimated the prevalence of cigarette use, e-cigarette use, and potential risk factors by gender identity and sexual identity. Overall and sex-stratified bivariate and multivariate logistic regressions examined whether the relationship between sexual and gender identity and cigarette and e-cigarette use persisted after adjusting for demographics, socio-economic status, and other unhealthy behaviors. After adjusting for covariates, gender minority identity was no longer associated with increased likelihood of currently smoking cigarettes and ever use of e-cigarettes. Sexual minority identity continued to be significant after adjusting for covariates, indicating that sexual identity disparities in cigarette and e-cigarette use are not fully explained by these factors. Findings varied by identity. Compared to their straight peers, likelihood of tobacco product use among LGB individuals varied between sexes, by product, and by sexual identity (gay/lesbian versus bisexual). More research is needed to understand the mechanisms that influence diverse patterns of cigarette and e-cigarette use among sexual and gender minority adults.