Awareness of the causal association between human papillomavirus and anal cancer among US adults.

PURPOSE: The incidence of anal cancer is on the rise in the US, especially among high-risk groups. This study examined the prevalence and determinants of awareness of the causal relationship between HPV and anal cancer among US adults. METHODS: Study data was obtained from the 2017 to 2020 iterations of the Health Information National Trends Survey. The prevalence of awareness that HPV causes anal cancer was estimated among HINTS respondents who were aware of HPV in general. Survey weights were used to provide estimates representative of the adult US population. Multivariable logistic regressions were used to examine the associations between awareness that HPV causes anal cancer and cancer-related behaviors/perceptions and sociodemographic characteristics of respondents. RESULTS: Two thousand six hundred and eighty four (27.2%) of the study population were aware that HPV caused anal cancer. Those of gay sexual orientation were more aware than heterosexuals [OR 2.27; 95% CI (1.24, 4.14)]. Compared to respondents with a high school diploma or less, individuals with some college education [OR 1.38; 95% CI (1.03, 1.85)] and those with at least a college degree [OR 1.52; 95% CI (1.17, 1.98)] were more likely to be aware. Participants who had positive cancer information seeking behavior were more aware of the HPV-anal cancer link compared to those who did not [OR 1.57; 95% CI (1.30, 1.89)]. CONCLUSION: Population-level awareness that HPV causes anal cancer remains critically low in the US. Sexual orientation, level of education and cancer information seeking behavior are associated with increased awareness of the causal relationship between HPV and anal cancer. Efforts should be directed toward addressing the awareness gap among individuals with lower education levels and promoting curiosity-driven information seeking behaviors.

Social media use and health promotion among cancer survivors.

OBJECTIVE: Social media is becoming recognized as an effective platform for cancer health promotion, education, care, and support. However, its utility as a health promotion tool remains relatively unexplored. METHODS: Using cross-sectional data from the 2017-2020 Health Information National Trends Survey, we evaluated health-related usage of social media among cancer survivors and individuals without a history of cancer. We also examined the participant characteristics associated with social media usage and evaluated the relationship between social media use and positive health behaviors among the cancer survivors. RESULTS: Overall, cancer survivors (n = 2579) were as likely as individuals without a history of cancer to use social media for health promotion. Males [OR 0.65; 95% CI (0.45, 0.93)] and older adults (>60 years old) [OR 0.27; 95% CI(0.10, 0.77)] were less likely to use social media, while higher income [OR 2.27; 95% CI (1.05, 4.92) middle income; OR 1.90; 95% CI (1.17, 3.09) high income] and educational levels [OR 3.29; 95% CI (1.85, 5.84) some college; OR 2.36; 95% CI (1.30, 4.28) college graduate or more] were associated with more health-related social media use among survivors. Cancer survivors used social media for online support groups more than other individuals, and those who used at least one form of social media for health-related purposes increasingly meet national recommendations for strength training compared to non-users [OR 2.15; 95% CI (1.48, 3.13)]. CONCLUSIONS: Our findings demonstrate the potential utility of social media to promote positive health behaviors among cancer survivors. Further research is needed to describe the efficacy of social media-based interventions for improving health behaviors in diverse cancer populations.

Gratitude, optimism, and satisfaction with life and patient-reported outcomes in patients undergoing hematopoietic stem cell transplantation.

OBJECTIVE: Associations between positive psychological well-being (PPWB) and patient-reported outcomes (PROs, e.g., quality of life [QOL]) have yet to be studied extensively in patients with hematologic malignancies who are allogeneic hematopoietic stem cell transplant (HSCT) survivors, despite substantial evidence that PPWB impacts PROs of other medical populations. METHODS: We conducted a secondary analysis of cross-sectional data examining the association of PPWB and PROs at day 100 post-transplant among 158 allogeneic HSCT recipients. Optimism, gratitude, life satisfaction, and PROs (i.e., QOL, anxiety, depression, and PTSD symptoms) were assessed using the Life Orientation Test-Revised, Gratitude Questionnaire, Satisfaction with Life Scale, Functional Assessment of Cancer Therapy-Bone Marrow Transplant, Hospital Anxiety and Depression Scale, and Post-Traumatic Stress Disorder (PTSD) Checklist-Civilian Version, respectively. We used linear and multivariate regressions for all analyses and controlled for patient factors. RESULTS: Optimism was associated with better QOL (ß = 1.46; p < 0.001) and lower levels of anxiety (ß = -0.28; p < 0.001), depression (ß = -0.31; p < 0.001), and PTSD (ß = -0.58; p < 0.001). Gratitude was associated with better QOL (ß = 1.11; p < 0.001) and lower levels of anxiety (ß = -0.21; p = 0.001), depression (ß = -0.14; p = 0.021), and PTSD (ß = -0.32; p = 0.032). Finally, satisfaction with life was associated with better QOL (ß = 1.26; p < 0.001) and lower levels of anxiety (ß = -0.18; p < 0.001), depression (ß = -0.21; p < 0.001), and PTSD (ß = -0.49; p < 0.001). CONCLUSION: Optimism, gratitude, and satisfaction with life were all associated with better QOL and lower levels of psychological distress in allogeneic HSCT survivors. These data support studies to harness PPWB as a therapeutic intervention for this population throughout HSCT recovery.

Perceptions of the Addictiveness of Low-Nicotine Cigarettes Versus Typical Cigarettes and Exposure to Tobacco Industry-Sponsored Corrective Campaign.

BACKGROUND: In 2017, the U.S. Food and Drug Administration (FDA) announced a regulatory plan to reduce the nicotine content of cigarettes. This study examines the association of exposure to industry-sponsored corrective statements on perceptions of the addictiveness of low-nicotine cigarettes relative to typical cigarettes within the general US population. METHODS: The study comprised 4975 US adult respondents of the 2019 Health Information National Trends Survey (HINTS 5, Cycle 3). Multinomial logistic regression models were used to examine associations between exposure to tobacco industry corrective messages and perceptions of the addictiveness of low-nicotine cigarettes relative to typical cigarettes. RESULTS: In the overall population, 4.1% reported that low-nicotine cigarettes were much more addictive than typical cigarettes, 67.5% said they were equally addictive, while 28.4% reported they were slightly/much less addictive. Adults exposed to industry-sponsored corrective messages had higher odds of perceiving low-nicotine cigarettes as equally addictive as typical cigarettes (aOR 1.57; 95% CI, 1.13-2.19) than those who saw no corrective messages. Those exposed to the corrective messages specifically about the addictiveness of smoking and nicotine had higher odds of perceiving low-nicotine cigarettes as equally addictive as typical cigarettes (aOR, 1.73; 95% CI, 1.07-2.81) compared to those who saw no corrective message. CONCLUSIONS: Our findings suggest that exposure to court-ordered tobacco industry corrective statements may have reinforced perceptions on the addictive potential of nicotine. However, study findings indicate a need for campaigns specifically tailored to address misperceptions observed in this study.

67.5% of US adults perceived low-nicotine cigarettes and typical cigarettes as being equally addictiveExposure to court-ordered corrective statements increased the odds of equal addictiveness perceptionExposure to corrective statements specifically tailored to addiction increased the odds of equal addictiveness perception.

Associations between Health-Related Use of Social Media and Positive Lifestyle Behaviors: Findings from a Representative Sample of US Adult Smokers.

Background: Cigarette smokers have elevated cardiovascular risk factors, which contributes significantly to mortality. Although social media is a potential avenue to deliver smoking interventions, its role in health promotion among smokers remains relatively unexplored.Objective: To examine the uptake and impact of health-related social media use in cigarette smokers.Methods: Using data from the 2017-2020 Health Information National Trends Survey, we evaluated differences in health-related social media use between smokers and nonsmokers. Multivariable logistic regression was performed to examine the association between social media use and positive health behaviors.Results: We included 1863 current smokers and 13,560 nonsmokers; Most participants were women (51.0%), White (64.6%), and 49.2% were aged ≥50 years. Smokers who used ≥1 social media site for health-related purposes in the past year were significantly more likely to meet the guideline recommendations for: (i) weekly physical activity (AOR 2.00, 95% CI 1.23-3.24), (ii) daily vegetable intake (AOR 2.48, 95% CI 1.10-5.59), and (iii) weekly strength training (AOR 1.80, 95% CI 1.10-2.94). However, the odds of reporting intentions to quit smoking (AOR 1.81, 95% CI 0.98-3.34) and attempts at smoking cessation (AOR 1.68, 95% CI 0.90-3.12) did not differ by health-related social media use.Conclusion: Smokers use social media for health-related purposes at comparable rates to nonsmokers. While our findings indicate that these platforms present a novel opportunity for health promotion among smokers, future research exploring the utility of social media in smoking cessation is crucial.

The Role of Health Information Technology on Colorectal Cancer Screening Participation Among Smokers In The United States.

Background: Despite advances in its prevention and early detection, colorectal cancer (CRC) remains a leading cause of morbidity and mortality in the United States and smokers are at an increased risk. Health information technology (HIT) has shown promise in the uptake of preventive health services, including CRC, and may prove useful among smokers. Methods: We obtained data from 7,419 adults who completed the 2018-2020 Health Information National Trends Survey. Using multivariable logistic regression models, we examined the relationship between HIT use and CRC screening participation. Results: Over 20% of current smokers had no access to HIT tools, and those with access were less likely than never smokers to use HIT in checking test results (odds ratio [OR] 0.58; 95% confidence interval [CI] [0.42-0.80]). Among former smokers, using HIT to check test results (OR 3.41; 95% CI [1.86-6.25]), look up health information online (OR 2.20; 95% CI [1.15-4.22]), and make health appointments (OR 2.86; 95% CI [1.39-5.89]) was associated with increased participation in CRC screening. Among current smokers, the use of HIT was not associated with a change in CRC screening participation. Conclusion: HIT use is associated with higher levels of CRC screening among former smokers, which is reassuring given their increased risk of CRC. The low ownership and use of HIT among current smokers of CRC screening age presents a challenge that may limit the integration of HIT into routine CRC screening services.

Primary Care Telehealth Visits and Its Association with Provider Discussion on Colorectal Cancer Screening in the United States.

Background: Provider discussions about colorectal cancer (CRC) screening are the single most important predictor for CRC screening uptake. Methods: Using cross-sectional data from the 2022 Health Information National Trends Survey, we evaluated the relationship between telehealth use and provider discussion about CRC screening with a multivariable logistic regression model. Results: Of adults aged 45-75 years, 20.3% used telehealth services in the past year of which 69.5% had discussed CRC screening with their providers. There was no difference in provider discussion about CRC screening between telehealth users and nonusers (OR 1.26; 95% confidence interval 0.83-1.90). Conclusion: Telehealth is an important adjunct in health care delivery, enhancing patient-provider discussions about CRC screening.

Digital Phenotyping in Adults with Schizophrenia: A Narrative Review.

PURPOSE OF REVIEW: As care for older adult patients with schizophrenia lacks innovation, technology can help advance the field. Specifically, digital phenotyping, the real-time monitoring of patients' behaviors through smartphone sensors and symptoms through surveys, holds promise as the method can capture the dynamicity and environmental correlates of disease. RECENT FINDINGS: Few studies have used digital phenotyping to elucidate adult patients' experiences with schizophrenia. In this narrative review, we summarized the literature using digital phenotyping on adults with schizophrenia. No study focused solely on older adult patients. Studies including all adult patients were heterogeneous in measures used, duration, and outcomes. Despite limited research, digital phenotyping shows potential for monitoring outcomes such as negative, positive, and functional symptoms, as well as predicting relapse. Future research should work to target the symptomology persistent in chronic schizophrenia and ensure all patients have the digital literacy required to benefit from digital interventions and homogenize datasets to allow for more robust conclusions.

The influence of political ideology on clinical trial knowledge, invitation, and participation among adults in the United States.

BACKGROUND: Clinical trials remain a critical component of medical innovation. Evidence suggests that individuals' political ideologies may impact their health behaviors. However, there is a paucity of literature examining the relationship between political ideologies and clinical trial knowledge and participation. METHODS: Study data were derived from Health Information National Trends Survey 5 Cycle 4 (n = 3300), which was conducted from February to June 2020. We used participants' characteristics to estimate the prevalence of clinical trial knowledge and participation. We used multivariable logistic regressions to investigate whether political ideology had a significant impact on clinical trial knowledge and participation. Jack-knife replicate weights were applied for population-level estimates. RESULTS: Most participants were White (64.2%), earned above US$50,000 (62.4%), and lived in urban areas (88.0%). About 59.2% reported having some knowledge of clinical trials, and only 8.9% had ever been invited to participate in clinical trials. A total of 37.0%, 29.5%, and 33.5% of the population endorsed moderate, liberal, and conservative political viewpoints respectively. In the adjusted logistic regression analysis, compared to conservatives, liberals (adjusted odds ratio, 1.92; 95% confidence interval, 1.31-2.80) and moderates (adjusted odds ratio, 1.43; 95% confidence interval, 1.09-1.88) had significantly greater odds of having knowledge of clinical trials. Also, liberals had higher odds of receiving invitations to participate in clinical trials (odds ratio, 1.76; 95% confidence interval, 1.08-2.85; p = 0.023) and greater odds of trial participation (odds ratio, 3.90; 95% confidence interval, 1.47-10.33; p = 0.007) compared to moderates. CONCLUSIONS: The mechanism underlying the higher rates of clinical trial invitations to liberals is unclear and requires further comprehensive investigation. Similarly, further qualitative studies are needed to understand the attributes that promote knowledge and increased likelihood of clinical trial participation among liberals. This will provide crucial insight to help design interventions that further involve conservatives and moderates in clinical trials and scientific enterprise.

Association between Sexual Violence Victimization and Electronic Vaping Product Use among Adolescents: Findings from a Population-based Study.

BACKGROUND: Although studies have investigated the association between sexual violence (SV) victimization and substance use, few studies have examined the association between SV victimization and electronic vaping product (EVP) use among adolescents in the United States. The objective of this study was to examine the cross-sectional association between SV victimization and EVP use among adolescents. METHODS: Data were pooled from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 28,135 adolescents (51.2% female) was analyzed using binary logistic regression. The outcome variable investigated was EVP use, and the main explanatory variable was SV victimization. RESULTS: Of the 28,135 adolescents, the prevalence of past 30-day EVP use and SV victimization was 22.7% and 10.8%, respectively. Controlling for other factors, adolescents who experienced SV had 1.52 times higher odds of being EVP users when compared to their counterparts who did not experience SV (AOR = 1.52, p < .001, 95% CI = 1.27-1.82). Other factors associated with EVP use included cyberbullying victimization, symptoms of depression, and current use of cigarettes, alcohol, and marijuana. CONCLUSIONS: Experiencing SV was associated with EVP use. Future studies that employ longitudinal designs may offer more insight into the mechanisms underlying the association between SV victimization and EVP use. In addition, school-based interventions that focus on sexual violence prevention and reducing substance use among adolescents are warranted.

The Role of Health Information Technology in Improving Awareness of Human Papillomavirus and Human Papillomavirus Vaccine Among U.S. Adults.

Objective: Although human papillomavirus (HPV) vaccines prevent cancer-causing HPV infections and cervical precancers, there is suboptimal awareness and limited global accessibility of HPV and HPV vaccine. Emerging evidence suggests that health information technology (HIT) may influence HPV-related awareness and improve vaccine adoption. The objective of this study was to evaluate the link between HIT and HPV-related awareness Methods: Data were obtained from 1,866 U.S. adults aged 18-45 years who completed the 2017 and 2018 Health Information National Trends Survey. We conducted multivariable logistic regression to analyze the association between HIT utilization and HPV-related awareness. Results: Awareness of HPV and HPV vaccine were 72.7% and 67.5%, respectively. Participants who used electronic means to look up health information (adjusted odds ratio [aOR] = 3.05; p = 0.001), communicate with health care provider (aOR = 1.68; p = 0.026), look up test results (aOR = 1.94; p = 0.005), and track health costs (aOR = 1.65; p = 0.04) were more likely to report HPV awareness than those who did not. Participants who used an electronic device to look up health information (aOR = 3.10; p = 0.003), communicate with clinicians (aOR = 1.72; p = 0.008), look up test results (aOR = 1.63; p = 0.021), and track health care charges (aOR = 1.90; p = 0.006) were more likely to report HPV vaccine awareness than those who did not. Discussion and Conclusion: Our findings suggest a positive association between HIT utilization and HPV-related awareness. Given the rapid and exponential increase in mobile technology access globally, these results are encouraging and offer a potential opportunity to leverage digital technology in primary cancer prevention for HPV-related cancers, especially in low- and middle-income countries with unsophisticated health infrastructures.

Self-reported injuries and correlates among school-going adolescents in three countries in Western sub-Saharan Africa.

BACKGROUND: Unintentional injuries among adolescents constitute a significant public health problem globally. Injured adolescents may face negative outcomes ranging from poor academic performance to short- and long-term physical and psychosocial health struggles, and even death. The aim of this study was to estimate the prevalence and describe the correlates and most frequent causes of injuries among school-going adolescents in three West African countries - Benin, Ghana, and Liberia. METHODS: We analysed self-reported data provided by 8,912 school-going adolescents who participated in the Global School-based Student Health Survey in Ghana (2012), Benin (2016), and Liberia (2017). Students responded to questions on sociodemographic factors, family involvement factors, mental health factors, school environment factors and injury behaviours. RESULTS: The overall 12-month prevalence estimate of serious injuries in adolescents was 40.9% (Benin = 27.3%; Ghana = 46.1%; Liberia = 49.2%). The most frequently reported injury type was a broken bone or dislocated joint (33% in Benin), cuts or stab wounds (31.7% in Ghana), and non-specified injuries (35.2% in Liberia). Prevalence of serious injuries was higher among males and increased with age. In the multivariable logistic regression analysis, interpersonal aggression outside the family context (bullying victimisation, engaging in physical fights, and having been physically attacked) emerged as key correlates of increased odds of serious injuries. CONCLUSION: The relatively higher prevalence estimates of serious injury reported in this study underscore the need for the included countries to develop interventions aimed at reducing and preventing physical injuries among adolescents.

Association of adverse childhood experiences with subjective cognitive decline in adulthood: Findings from a population-based study.

OBJECTIVE: Adverse childhood experiences have been found to be associated with negative outcomes during adulthood. Emerging research indicates that adverse childhood experiences may elevate the risk for Alzheimer's disease. Yet, few studies have investigated the association between adverse childhood experiences and subjective cognitive decline among middle-aged and older adults in the United States. The objective of this study was to investigate the association between adverse childhood experiences and subjective cognitive decline among middle-aged and older adults in the United States. METHODS: Data for this study were obtained from the 2019 Behavioral Risk Factor Surveillance Survey. An analytic sample of 50,277 adults aged 45 to 79 years (53.3% female) from 15 states was analyzed using binary logistic regression. The outcome variable investigated in this study was subjective cognitive decline, and the main explanatory variable was adverse childhood experiences. RESULTS: Of the 50,277 respondents, 10.3% reported experiencing subjective cognitive decline during the past year, and 14.5% had four or more adverse childhood experiences. We found a dose-response association between adverse childhood experiences and subjective cognitive decline. Respondents who had four or more adverse childhood experiences had 2.98 times higher odds of having subjective cognitive decline when compared to respondents with no adverse childhood experiences (aOR = 2.98, 95% CI = 2.56-3.48). Other factors associated with subjective cognitive decline have been identified and discussed. CONCLUSION: The findings of this study provide evidence indicating that early life factors may be linked with cognitive decline in later adulthood. The findings of this study are discussed with implications for practice and research.

An Association of Adverse Childhood Experiences with Binge Drinking in Adulthood: Findings from a Population-Based Study.

Background: Adverse childhood experiences (ACEs) are a major public health issue linked to negative health outcomes. Yet, few recent studies drawing on national data have examined the association between ACEs and binge drinking. Objective: The objective of this study was to examine the association between ACEs and binge drinking among adults in the United States and whether this association is dependent on sex. Methods: Data for this study were obtained from the 2019 Behavioral Risk Factor Surveillance System survey. An analytic sample of 41,322 adults aged 18-64 years (50.7% male) from 17 states was analyzed using binary logistic regression. The outcome variable was binge drinking, and the main explanatory variable was ACEs. Results: Of the 41,322 respondents, 21.3% engaged in binge drinking. About 30% of the respondents had no ACEs and 23.9% had four or more ACEs. In the multivariable logistic regression, we observed that sex moderated the association between ACEs and binge drinking. Odds were 1.36 times higher for females who experienced two ACEs (aOR = 1.36 p < .05, 95% CI = 1.04-1.77) and 1.58 times higher for females who experienced three ACEs (aOR = 1.58 p < .01, 95% CI = 1.17-2.12) to engage in binge drinking. Other factors associated with binge drinking include younger age, non-Hispanic White, higher income level, higher education, not being married, being overweight, and history of cigarette smoking. Conclusion: The findings of this study underscore the importance of developing sex-appropriate screening and intervention strategies to support individuals exposed to ACEs and potentially mitigate negative health outcomes later in life.

The mediating role of social support in the relationship between stigma and emotional distress among homeless adolescents in Ghana.

Research on youth homelessness has showed a link between emotional distress and social stigma. However, the mechanisms underlying this relationship have received little empirical attention. This study was conducted to examine the mediating effect of social support that accounts for the link. Standard questionnaires that assessed emotional distress, stigma and social support were interviewer-administered to 193 homeless adolescents (50.4% male; Mean = 13.21 (SD = 2.06). The Pearson product-moment correlation coefficient and mediation analyses were used to analyse the data. The study revealed that both self-blame and general stigma were positively related to emotional distress; but negatively related to social support. In the mediation analysis, general stigma significantly predicted decreased perceived social support and had a direct positive influence on emotional problems. However, the levels of self-blame was neither significantly associated with perceived social support nor had a significant indirect influence on the level of emotional problems. Both self-blame and general stigma also did not have a significant indirect influence on the level of emotional problems through perceived social support. These findings call for further research to examine the complex mechanism underlying stigma and mental health outcomes.

Use of digital health tools for health promotion in cancer survivors.

OBJECTIVE: Although digital health tools (DHTs) are a promising alternative and effective strategy to deliver cancer care and support, their role in health promotion among cancer survivors remains relatively unexplored. We aimed to investigate the acceptability and impact of DHT for health promotion in cancer survivors. METHODS: Data was pooled from cycle three of the fifth edition of the Health Information National Trends Survey. Logistic regressions were conducted to evaluate differences between cancer survivors and the general population regarding ownership, usage, and perceived usefulness of DHT for health management. Regression models were used to identify sociodemographic predictors of DHT usage among cancer survivors. RESULTS: Overall, cancer survivors were as likely as the general population to own and use DHT (e.g., health apps, wearable devices) for their care and they were likely to find these tools beneficial in tracking their health and communicating with healthcare providers. Cancer survivors who had health applications installed on their mobile device were more likely to meet national recommendations for diet (fruit and vegetable consumption) and strength training than those without health apps. Age, income, and education level were significant sociodemographic predictors of DHT ownership and usage. CONCLUSION: Cancer survivors own and use DHT at similarly high rates to the general population, highlighting the potential for utilizing DHT to expand access and continuity of care in the growing and vulnerable oncology population. With increasing use of DHT in healthcare, future research that targets digital access disparities in cancer survivors from low SES is essential.

Suicidal behaviours among adolescents in Liberia.

BACKGROUND: Whereas suicide remains in the top 12 leading causes of death among young people aged 10-24 in sub-Saharan Africa, little is known about suicidal behaviours among adolescents in Liberia. We aimed to estimate the 12-month prevalence and describe some of the correlates of suicide behaviours (ideation, planning, and attempt) among school-going adolescents in Liberia. METHODS: We analysed data from the 2017 Liberia Global School-based Student Health Survey conducted nationwide among secondary school students. We performed bivariate and multivariable analyses to assess the correlates of suicidal ideation, planning, and attempt in the previous 12 months. RESULTS: Of the 2744 students, 26.8% reported suicidal ideation, 36.5% made a specific plan to attempt suicide and 33.7% attempted suicide during the 12 months preceding the survey. In the final adjusted logistic models, bullying victimisation and food insecurity were associated with increased odds of ideation, planning, and attempt. Whereas no factor was uniquely associated with suicidal ideation, having many close friends, and parental monitoring were associated with the increased odds of suicidal planning only. Leisure-time sedentary behaviour was associated with increased odds of suicidal planning and attempt. Cannabis use, alcohol drunkenness, being physically attacked, and parental supervision were uniquely associated with increased odds of suicidal attempt, while parental understanding and having a smaller number of close friends were uniquely associated with reduced odds of suicidal attempt. CONCLUSIONS: The relatively high prevalence estimates of suicide behaviours and the multi-contextual nature of the associated factors warrant the need for the design and implementation of universal and multi-level, collaborative targeted intervention efforts towards the prevention of the onset of ideation, planning, and attempt, and the possible transition to deaths by suicide among school-going adolescents in Liberia.

Impact of Depression in Sickle Cell Disease Hospitalization-Related Outcomes: An Analysis of the National Inpatient Sample (NIS).

OBJECTIVES: This study aimed to analyze and discern the differences in demographics and inpatient outcomes (length of stay (LOS), total charges, disease severity, and mortality) between depressed versus non-depressed sickle cell disease (SCD) patients. Materials and Methods: A retrospective analysis was conducted using the Nationwide Inpatient Sample (2010-2014). We identified 73,225 SCD hospitalizations and comorbid depression (6317, 8.6%) as the primary and the other diagnosis, respectively, using International Classification of Diseases (ICD)-9 codes. We used linear and logistic regression model to evaluate the changes in inpatient outcomes. RESULTS: Comorbid depression was more prevalent among middle-aged adults (11.5%), females (10.63%), and whites (12.43%). We did not find any association between income and comorbid depression among SCD patients. After adjusting for the demographic covariates, comorbid depression remained a significant risk factor for longer LOS (mean difference -1.16 days, 95% CI -1.30 to -1.03) and higher total charges (mean difference -USD5058, 95% CI -6261 to -3855) during hospitalization. SCD with comorbid depression was also significantly associated with a higher number of chronic conditions (mean difference -2.08, 95% CI -2.13 to -2.03) and 1.5 times (95% CI 1.39 to 1.63) higher odds of major severity of illness. CONCLUSION: Comorbid depression was significantly associated with longer LOS, more severity of illness, and higher hospital charges. Healthcare providers caring for adults with SCD should consider screening for and treating comorbid depression to improve the health-related quality of life.

Barriers to the assessment and recommendation of HPV vaccination among healthcare providers in Texas.

Background: Healthcare providers (HCPs) recommendations for HPV vaccination plays a critical role in increasing vaccination uptake. This study assesses the prevalence of reported barriers to HPV vaccination assessment and recommendation among HCPs in Texas. Methods: Study data were obtained from a population-based survey of HCPs currently practicing in Texas. Participants were asked about their HPV vaccination assessment and recommendation practices and the reasons for not assessing or recommending the vaccine. Barriers were stratified by HCP characteristics including age, sex, race/ethnicity, location of practice, provider type, and type of facility. Results: Among the 826 HCPs included in this study, 47.3 % never, 49.6 % sometimes, and 3.0 % often/always assessed a patient's HPV vaccination status. Similarly, 36.0 % never, 36.2 % sometimes, and 27.9 % often/always recommended HPV vaccination. The most frequently reported barriers to assessment and recommendation of HPV vaccination were time constraints (22.9 %), delegating the task to others (15.0 %), lack of effective tools and information to give patients (12.0 %), and requiring additional training (9.2 %). HCPs who were female, less than 35 years old, non-Hispanic black, and nonphysician HCPs (Physician Assistant, Nurse Practitioner) most frequently reported lacking effective tools and information and a need for additional training. Conclusion: The assessment and recommendation for HPV vaccination among HCPs in Texas is suboptimal. Barriers reported varied based on the provider's characteristics. Addressing these barriers, such as by providing more effective tools and information and offering additional training to HCPs, could potentially increase HPV vaccination rates in Texas. The findings also suggest that interventions should be tailored to specific demographic groups.

Ethnoracial disparities in care on a consultation-liaison service at an academic hospital.

BACKGROUND: There is currently an increasing recognition of and focus on structural and institutional racism and its impacts on health disparities. In psychiatry and mental health, research has focused on racial and ethnic disparities in the availability and utilization of mental health services, care in emergency departments, and inpatient psychiatric services. Little is known about disparities in care on general hospital psychiatry consultation-liaison (CL) services. METHODS: In this exploratory study, we conducted a retrospective chart review using electronic health record (EHR) data of all adults (≥ 18 years of age) admitted to inpatient medical or surgical floors at an urban academic medical center for whom a psychiatric consultation was requested during the study period. We examined differences by race and ethnicity in: rates of consultation requests; use of legal holds, constant observation, restraints; follow-up by the CL service; and ultimate disposition. RESULTS: The service received 310 unique consults during the study period. Compared to hospital-wide numbers, Black-identifying patients were over-represented in our sample (11.9% vs 6.6%), while Latinx patients were underrepresented (6.1% vs 9.8%). Of the clinical and outcome variables collected, there were higher odds of being placed on a legal hold both prior to (OR 2.6) and after the consult question (OR 2.98) and in the odds of having a one-to-one observer prior to (OR 2.47) and after (OR 2.9) the initial consult visit for Black-identifying patients, when adjusting for confounders. There were no other measurable differences in care or outcomes by racial or ethnic categories. CONCLUSION: Black-identifying patients may be more likely to receive psychiatric consultation and be placed on legal holds because of a combination of chronic adverse social determinants of health and race-based bias. Conversely, Latinx patients may be less likely to receive psychiatric consultation because of language barriers among other factors. The lack of disparities identified in other domains may be encouraging, but larger studies are needed. Further research is also needed to identify causality and interventions that could help close the gap in care and outcomes for racial and ethnic minorities.