Perceived Economic Strain, Subjective Social Status, and Colorectal Cancer Screening Utilization in U.S. Men-A Cross-Sectional Analysis.

Although socioeconomic status (SES) is fundamentally related to underutilization of colorectal cancer (CRC) screening, the role of perceived economic strain and subjective social status with CRC screening is understudied. The aim of this study was to investigate whether greater perceived economic strain or lower subjective social status would decrease the odds of CRC screening uptake and being up-to-date with guideline-recommended CRC screening. We also explored interactions with household income and educational attainment. Cross-sectional survey-based data from men aged 45-75 years living in the United States (N = 499) were collected in February 2022. Study outcomes were ever completing a stool- or exam-based CRC screening test and being up-to-date with CRC screening. Perceived economic strain and subjective social status were the predictors. We conducted logistic regression models to estimate odds ratios (OR) and 95% confidence intervals (CI). Greater perceptions of economic strain decreased odds of being up-to-date with CRC screening. Household income modified the association between perceived economic strain and completing a stool-based test; the association was stronger for men from lower-income households. In unadjusted models, higher subjective social status increased odds of completing an exam-based test and being up-to-date with CRC screening. Our findings suggest that experiencing economic strain may interfere with men's CRC screening decisions and may capture additional information about barriers to CRC screening utilization beyond those captured by income or education.

Perceived economic pressure and colorectal cancer-related perceptions among U.S. males (aged 45-75).

PURPOSE: To examine whether a greater perception of economic pressure would be associated with more-negative attitudes, greater perceived barriers, and lower subjective norms regarding colorectal cancer (CRC) and CRC screening among males aged 45-75 years. METHODS: We recruited 492 self-identified males aged 45-75 years living in the United States. We operationalized perceived economic pressure as a latent factor with three subscales: can't make ends meet, unmet material needs, and financial cutbacks. Our dependent variables were attitudes toward CRC and CRC screening, perceived barriers to completing a CRC screening exam, and subjective norms regarding CRC screening (e.g., how others value CRC screening). We tested a hypothesized model using structural equation modeling with maximum-likelihood estimation, adjusting for covariates, and made post-hoc modifications to improve model fit. RESULTS: Greater perceived economic pressure was associated with more-negative attitudes toward CRC and CRC screening (ß = 0.47, 95% CI: 0.37,0.57) and with greater perceived barriers to CRC screening (ß = 0.22, 95% CI: 0.11, 0.34), but was not significantly associated with subjective norms (ß = 0.07, 95% CI: - 0.05, 0.19). Perceived economic pressure was an indirect pathway by which lower-income and younger age were associated with more-negative attitudes and greater perceived barriers. CONCLUSIONS: Our study is one of the first to show that, among males, perceived economic pressure is associated with two social-cognitive mechanisms (i.e., negative attitudes, greater perceived barriers) that are known to influence CRC screening intent and, ultimately, CRC screening completion. Future research on this topic should employ longitudinal study designs.

Factors contributing to the utilization of robotic colorectal surgery: a systematic review and meta-analysis.

BACKGROUND: Some studies have suggested disparities in access to robotic colorectal surgery, however, it is unclear which factors are most meaningful in the determination of approach relative to laparoscopic or open surgery. This study aimed to identify the most influential factors contributing to robotic colorectal surgery utilization. METHODS: We conducted a systematic review and random-effects meta-analysis of published studies that compared the utilization of robotic colorectal surgery versus laparoscopic or open surgery. Eligible studies were identified through PubMed, EMBASE, CINAHL, Cochrane CENTRAL, PsycINFO, and ProQuest Dissertations in September 2021. RESULTS: Twenty-nine studies were included in the analysis. Patients were less likely to undergo robotic versus laparoscopic surgery if they were female (OR = 0.91, 0.84-0.98), older (OR = 1.61, 1.38-1.88), had Medicare (OR = 0.84, 0.71-0.99), or had comorbidities (OR = 0.83, 0.77-0.91). Non-academic hospitals had lower odds of conducting robotic versus laparoscopic surgery (OR = 0.73, 0.62-0.86). Additional disparities were observed when comparing robotic with open surgery for patients who were Black (OR = 0.78, 0.71-0.86), had lower income (OR = 0.67, 0.62-0.74), had Medicaid (OR = 0.58, 0.43-0.80), or were uninsured (OR = 0.29, 0.21-0.39). CONCLUSION: When determining who undergoes robotic surgery, consideration of factors such as age and comorbid conditions may be clinically justified, while other factors seem less justifiable. Black patients and the underinsured were less likely to undergo robotic surgery. This study identifies nonclinical disparities in access to robotics that should be addressed to provide more equitable access to innovations in colorectal surgery.

Family economic pressure and early adolescents' prosocial behavior: The importance of considering the types of prosocial behavior.

BACKGROUND: Prior research findings are mixed regarding whether prosocial behavior is positively or negatively related to socioeconomic status and its correlates, such as economic pressure. This may be due to the lack of considerations for the type of prosocial behavior. AIMS: In this study, we aimed to examine how six types of prosocial behavior (i.e., public, anonymous, compliant, emotional, dire, and altruistic) are related to economic pressure among early adolescents. We hypothesized that family economic pressure would be associated with each type of prosocial behavior in differing ways. MATERIALS & METHODS: Participants were 11-14 years old (N = 143, Mage = 12.2 years, SDage = 0.87, 63 boys, 1 trans-identified boy, 55 girls), early adolescents and their parents. Among them, 54.6% were non-Hispanic/Latinx (NH/L) White, 23.8% were NH/L Black, 11.2% were NH/L Asian, 2.1% were NH/L Multiracial, and 8.4% were Hispanic/Latinx. Parents reported family economic pressure and adolescents' six types of prosocial behavior. RESULTS: Path analysis revealed that economic pressure was negatively associated with emotional and dire prosocial behavior over and above age, gender, and race/ethnicity. Family economic pressure was unrelated to public, anonymous, compliant, and altruistic prosocial behavior. DISCUSSION: These findings show some support for the Family Stress Model, such that economic stress might hinder youth's prosocial development. At the same time, youth may have similar levels of certain types of prosocial behavior regardless of their family's economic pressure. CONCLUSION: This research provided insight into the complex relation between economic pressure and youth's prosocial behavior which varies depending on the type of behavior.

The importance of research about research on culture: A call for meta-research on culture.

OBJECTIVES: It is crucial to examine how research on culture is fueled by assumptions, policies, and practices. The goal of this article is to promote meta-research on culture, the critical study of how investigations on culture are performed and interpreted, how scientific knowledge about culture is produced and transmitted, and the importance of scrutinizing assumptions, policies, and practices in a way that challenge views of minoritized groups as deviant and pathological. METHOD: We define key concepts, such as meta-research, culture, and meta-research on culture. RESULTS: We approach cultural research as a system of people (researchers, participants), places (academic institutions, journals), practices (sampling, comparing groups), and power (legitimizing some groups as normative and others as deviant). We discuss assumptions, policies, and practices, and review landmark studies and methods. CONCLUSIONS: Meta-research on culture is an emerging field that can improve scientific understanding of human culture, guide efforts to elevate the perspectives of people who have historically experienced marginalization, inform institutional support and the creation of nurturing academic spaces, and guide the implementation of better research and training practices. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Chronic stress predicts post-traumatic stress disorder symptoms via executive function deficits among urban American Indian children.

Little is known about how chronic exposure to stress affects mental health among American Indian (AI) children. The current study aimed to fill this gap by exploring if hair cortisol concentration (HCC), an indicator of chronic stress, predicted post-traumatic stress disorder (PTSD) symptoms through deficits in executive function (EF) skills commonly referred to as inhibitory control, working memory, and cognitive flexibility. A total of 163 urban AI children between 8- and 15-years old participated in the study (92 girls, 56.4%; Mage = 11.19, SD = 1.98). Chronic stress was measured as the concentration of cortisol in children's hair. EF deficits and PTSD symptoms were reported by primary caregivers using the Behavior Rating Inventory of Executive Function and the Trauma Symptom Checklist for Young Children. The results demonstrated that higher HCC was indirectly associated with more PTSD symptoms through deficits in EF skills. Specifically, higher levels of HCC were related to more symptoms of PTSD arousal through impaired working memory, and more symptoms of PTSD avoidance and Intrusion through deficits in cognitive flexibility. The findings suggest interventions that reduce or buffer chronic stress, or that focus on improving EF skills, may promote not only cognitive development but also the mental health of AI children.

A systematic review and meta-analysis of the association of neighborhood ethnic-racial concentrations and adolescent behaviour problems in the U.S.

INTRODUCTION: Evidence suggesting a link between neighborhood ethnic-racial concentrations and adolescent behaviour problems in the U.S. is mixed, with some studies documenting negative and others positive associations. This work raises important questions about promoting and inhibiting effects of neighborhood environments characterized by high concentrations of ethnic-racial minority groups, including Asian Americans, Blacks or African Americans, and Latinos. We conducted a meta-analysis to examine 1) the magnitude, direction, and variability of the association between neighborhood ethnic-racial concentrations and adolescent behaviour problems, and 2) whether these associations varied by putative moderators. METHODS: We conducted a systematic search in PsycINFO, Web of Science, and PubMed as well as searching reference lists and relying on expert knowledge (285 initial records). We coded the records for theoretical and design elements. RESULTS: We included 40 effect sizes from 17 records (24% unpublished) with N = 11,858. The average association between neighborhood ethnic-racial concentrations and adolescent behaviour problems was not significantly different from zero (r = -0.001, 95% CI -0.048, 0.046, p = .964, τ2= 0.006); there was a large percentage of systematic heterogeneity (I2 = 77.1%), which was not explained by putative moderators. CONCLUSIONS: There is substantial unexplained systematic heterogeneity in the association between neighborhood ethnic-racial concentrations and adolescents' behaviour problems. There is heavy reliance on a small number of parent datasets in research on this topic, alongside critical reporting omissions. We offer recommendations to guide future work, in hopes of supporting culturally and developmentally informed policies and programs capable of addressing residential segregation.

Gender differences across multiple types of prosocial behavior in adolescence: A meta-analysis of the prosocial tendency measure-revised (PTM-R).

INTRODUCTION: Literature on adolescent prosocial behavior (PB) has grown tremendously since the development of The Prosocial Tendency Measure-Revised (PTM-R), which includes subscales assessing different types of PB. However, findings of gender differences are inconsistent across studies. Thus, we computed meta-analyses to examine gender differences in adolescents' PB. Further, we examined the moderating roles of type of PB, and various sample (i.e., mean age, gender composition, ethnic composition) and study (i.e., reporter type, measurement form, reliability) characteristics in gender differences in PB. METHODS: Using online databases (e.g., ProQuest), journal article references, and conference programs, we identified a total of 46 records from 32 studies (215 effect sizes, N = 12,024) across the globe that had measured adolescents' (age 10-18; 51% male) PB using the PTM-R or the PTM. RESULTS: Gender differences in the PB were small to medium in magnitude (ds ranged from 0 to 0.35) for absolute gender differences (i.e., overall magnitude of gender differences regardless of which gender was higher). There were larger gender differences for gender-typed prosocial behaviors (e.g., altruistic, d = 0.35) than gender-neutral behaviors (e.g., anonymous, d = 0.03). The type of PB (i.e., altruistic, compliant, public, emotional, dire, anonymous) and region (i.e., European, U.S., traditional cultures, Asian) and were significant moderators. CONCLUSIONS: Although males and females generally are more similar than different in their prosociality, it is important to consider the type of PB when examining gender differences.

Are Whites and minorities more similar than different? Testing the cultural similarities hypothesis on psychopathology with a second-order meta-analysis.

The cultural differences hypothesis is the assertion that there are large differences between Whites and racial/ethnic minorities in the United States, while there are small differences between- (e.g., African Americans and Latinos) and within- (e.g., Latinos: Mexican Americans and Cuban Americans) minority groups. Conversely, the cultural similarities hypothesis argues that there are small differences between Whites and minorities, and these differences are equal or smaller in magnitude than differences between and within minorities. In this study, we conducted a second-order meta-analysis focused on psychopathology, to (a) test these hypotheses by estimating the absolute average difference between Whites and minorities, as well as between and within minorities, on levels of psychopathology, and (b) determine if general and meta-analytic method moderators account for these differences. A systematic search in PsycINFO, Web of Science, and ProQuest Dissertations identified 16 meta-analyses (13% unpublished) on 493 primary studies (N = 3,036,749). Differences between Whites and minorities (d+ = 0.23, 95% confidence interval [0.18, 0.28]), and between minorities (d+ = 0.30, 95% confidence interval [0.12, 0.48]) were small in magnitude. White-minority differences remained small across moderators. These findings support the cultural similarities hypothesis. We discuss their implications and future research directions.

Unpacking the link between socioeconomic status and behavior problems: A second-order meta-analysis.

Substantial evidence links socioeconomic status to internalizing and externalizing behavior problems. However, it is unclear how these two categories of behavior problems relate to specific components of socioeconomic status (e.g., income, educational attainment, and occupational prestige) or overall social status. In this study, we conducted a second-order meta-analysis to estimate the average associations of income, education, occupation, and overall socioeconomic status with internalizing and externalizing behavior problems, and to examine if age, sex, and race/ethnicity moderated these associations. Our systematic search in PsycINFO, PubMed, Google Scholar, Web of Science, and ProQuest Dissertations and Theses Global identified 12 meta-analyses (17% unpublished), including approximately 474 primary studies and 327,617 participants. In relation to internalizing, we found small average associations with income, r+ = -.18, 95% confidence interval (CI) [-.31, -.04], and education, r+ = -.12, 95% CI [-.15, -.09]. In relation to externalizing, we found smaller associations with income, r+ = -.02, 95% CI [-.15, .10], education, r+ = -.03, 95% CI [-.16, .10], and overall socioeconomic status, r+ = -.05, 95% CI [-.11, .01], but these CIs included zero. Only sex composition of the samples moderated the latter association. We provide recommendations for best practices and future research directions.

Parental education and epigenetic aging in middle-aged and older adults in the United States: A life course perspective.

Epigenetic aging is one plausible mechanism by which socioeconomic status (SES) contributes to disparities in morbidity and mortality. Although the association between SES and epigenetic aging is well documented, the role of parental education into adulthood remains understudied. We examined (1) if parental education was independently associated with epigenetic aging, (2) whether upward educational mobility buffered this association, and (3) if the benefit of parental education was differentiated by race/ethnicity. Secondary data analysis of a subsample (n = 3875) of Non-Hispanic [NH] Black, Hispanic, NH White, and NH other race participants from the Venous Blood Study within Health and Retirement Study were examined. Thirteen clocks based on DNA methylation of cytosine-phosphate-guanine sites were used to calculate epigenetic aging. Participants' education (personal) and their report of their respective parent's education (parental; mother's and/or father's) were included as independent variables; several potential confounders were also included. Direct associations and interactions between parental and personal education were estimated via survey-weighted generalized linear models; marginal means for epigenetic aging were estimated and contrasts were made between the education subcategories. Analyses were also stratified by race/ethnicity. Our results showed that higher parental education was independently associated with slower epigenetic aging among four clocks, whereas higher personal education magnified this association among four different epigenetic clocks. Participants with the lowest parental and personal education had higher marginal means (i.e., accelerated aging) compared to participants with the highest parental and personal education, and there was little evidence of upward mobility. These associations were more frequently observed among NH White participants, whereas fewer were observed for Hispanic and NH Black participants. Overall, our findings support that early-life circumstances may be biologically embedded through epigenetic aging, which may also limit the biological benefits associated with one's own education.

"It's Probably Just Hemorrhoids": A Qualitative Exploration of the Lived Experiences and Perceptions of Long-term Survivors of Early-Onset Colorectal Cancer.

BACKGROUND: Colorectal cancer among adults aged <50 years [early-onset colorectal cancer (EOCRC)] is projected to be the leading cause of cancer-related death by 2030. Although evidence-based guidelines for colorectal cancer screening now recommend beginning screening at age 45, the needs of many at-risk young adults are potentially being overlooked. Unanswered questions also remain regarding the effects of EOCRC on quality-of-life and psychosocial outcomes. This qualitative study explored the lived experiences and perceptions of a sample of adult EOCRC survivors in the United States through one-on-one interviews. METHODS: An EOCRC advocate survivor team member led 27 structured virtual interviews using a 10-question interview guide. Data were analyzed using a 9-step inductive approach. RESULTS: Participants were geographically diverse. Most were women (66.6%) who self-identified as non-Hispanic White (85.2%). The mean age at interview was 40.19 ± 5.99; at diagnosis, 33.93 ± 5.90. Six overarching themes emerged: signs and symptoms, risk factors, system-level factors, quality of life, social support, and reflection. CONCLUSIONS: The specific needs of individuals in this younger population of patients with colorectal cancer should be considered during treatment and future interventions and throughout survivorship. IMPACT: While the reasons for the increasing incidence of EOCRC are currently unknown, the lived experiences and perceptions of EOCRC survivors noted in this study highlight specific needs of this population that can inform educational materials, comprehensive care, future research, and policy change.

"More is better" or "better near the middle"? A U.S.-based individual participant data meta-analysis of socioeconomic status and depressive symptoms.

Socioeconomic status (SES) is a widely researched construct in developmental science, yet less is known concerning relations between SES and adaptive behavior. Specifically, is the relation linear, with higher SES associated with better outcomes, or does the direction of association change at different levels of SES? Our aim was to examine linear ("more is better") and quadratic ("better near the middle") associations between components of SES (i.e., income, years of education, occupational status/prestige) and depressive symptoms (Center for Epidemiologic Studies-Depression Scale), and to explore moderation by developmental period (adolescence, young, middle, and older adulthood), gender/sex (female, male), and race/ethnicity (Asian American, Black, Latinx, multiracial, Native American, White). We hypothesized that there would be more support for a model containing quadratic associations. We conducted a two-stage meta-analytic structural equation model of 60 data sets (27,242 correlations, 498,179 participants) within the United States, accounting for dependencies between correlations, which were identified via the Interuniversity Consortium for Political and Social Research and handled using a two-step approach. Income was quadratically associated with depressive symptoms, but the quadratic model did not explain more variance in depressive symptoms than the linear model. Developmental period and race/ethnicity moderated the associations: Income was quadratically associated with depressive symptoms among middle-aged adults, and years of education were quadratically associated with depressive symptoms among White samples. Our findings suggest that researchers and clinical practitioners should consider the elevated risk of depressive symptoms for individuals from low and high-income backgrounds in the United States. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Systematic Overview of Meta-Analyses on Socioeconomic Status, Cognitive Ability, and Achievement: The Need to Focus on Specific Pathways.

Meta-analyses on the relation between socioeconomic status (SES) and performance on measures of cognitive ability and achievement arrive at the same general conclusion of a small to medium association. Advancements in methods make possible for meta-analyses to examine specific pathways linking SES to cognitive ability and achievement, as well as the moderators of these pathways. In this study, we conducted a systematic overview of meta-analyses on SES to address three research questions: 1) what is the direction and overall strength of association between SES and performance on measures of cognitive ability and achievement, and how precise are the effect sizes reported? 2) to what extent have meta-analyses examined moderation by components of SES, age, sex, and race/ethnicity? and 3) to what extent have meta-analyses examined mechanisms linking SES to cognitive ability and achievement? We conducted a systematic search using online archives (i.e., PsycINFO, ERIC, PubMed, Sociological Abstracts, and Web of Science), searching issues in Psychological Bulletin and Review of Educational Research, and examining references and citations. We identified 14 meta-analyses published between 1982 and 2019. These meta-analyses consistently reported positive associations of small to medium magnitude, indicating that SES is a meaningful contributor to the development of cognitive ability and achievement. Fewer meta-analyses reported evidence of moderation by age, sex, and race/ethnicity. None of the meta-analyses directly examined mechanisms, but provided evidence of possible mechanisms for future research. We suggest that meta-analyses can increase their contribution to future research, interventions, and policy by narrowing their focus on specific pathways.

Examining the relationship between household wealth and colorectal cancer screening behaviors among U.S. men aged 45-75.

Colorectal cancer (CRC) is the third leading cause of cancer-related death among men in the United States (U.S.), particularly among men aged 45 years and older. Early-detection screening remains a key method of decreasing CRC-related deaths, yet socioeconomic barriers exist to planning and completing CRC screening. While accumulating evidence shows income disparities in CRC screening prevalence, a dearth of research has investigated wealth disparities. This study aimed to determine whether household wealth was associated with CRC screening uptake and future screening intent. In February 2022, we sent an online survey to potential participants; U.S. men aged 45-75 years were eligible to participate. We examined four CRC screening behaviors as outcomes: ever completing a stool-based or exam-based screening test, current screening status, and future screening intent. Household net wealth, determined by self-reported household wealth and debt, was the primary predictor. We used logistic regression to estimate odds ratios (ORs) and their 95% confidence interval (CI). Of the study participants (N = 499), most self-identified as Non-Hispanic White, were aged 50-64 years, and had previously completed a CRC screening test. Results revealed that, among men aged 45-49 years, higher net wealth decreased the odds of ever completing a stool- or exam-based test (OR = 0.58, 95% CI: 0.33, 0.98; OR = 0.55, 95% CI: 0.31, 0.94, respectively). By contrast, among men aged 50-75 years, higher net wealth increased the odds of being current with CRC screening (OR = 1.40, 95% CI: 1.03, 1.92). Net wealth was unassociated with CRC screening intent. These findings suggest that household net wealth, rather than income, is an important socioeconomic factor to consider in relation to uptake of CRC early-detection screening. The financial and social cognitive mechanisms linking household wealth to CRC screening behaviors merit future research and intervention.

Economic Pressure and Intention to Complete Colorectal Cancer Screening: A Cross-Sectional Analysis Among U.S. Men.

Although men's lives can be saved by colorectal cancer (CRC) screening, its utilization remains below national averages among men from low-income households. However, income has not been consistently linked to men's CRC screening intent. This study tested the hypothesis that men who perceive more economic pressure would have lower CRC screening intent. Cross-sectional data were collected via an online survey in February 2022. Men (aged 45-75 years) living in the U.S. (N = 499) reported their CRC screening intent (outcome) and their perception of their economic circumstances (predictors). Adjusted binary and ordinal logistic analyses were conducted. All analyses were conducted in March 2022. Men who perceived greater difficulty paying bills or affording the type of clothing or medical care they needed (i.e., economic strain) were less likely to have CRC screening intent (OR = 0.67, 95% CI: 0.49, 0.93). This association was no longer significant when prior screening behavior was accounted for (OR = 0.75, 95% CI: 0.52, 1.10). Contrary to our hypothesis, men who reported more financial cutbacks were more likely to report wanting to be screened for CRC within the next year (OR = 1.06, 95% CI: 1.01, 1.11). This is one of the first studies to demonstrate that men's perceptions of their economic circumstances play a role in their intent to complete early-detection screening for CRC. Future research should consider men's perceptions of their economic situation in addition to their annual income when aiming to close the gap between intent and CRC screening uptake.

Socioeconomic status and depressive symptoms: An individual-participant data meta-analysis on range restriction and measurement in the United States.

INTRODUCTION: The association between socioeconomic status (SES) and depressive symptoms is well documented, yet less attention has been paid to the methodological factors contributing to between-study variability. We examined the moderating role of range restriction and the depressive-symptom measurement instrument used in estimating the correlation between components of SES and depressive symptoms. METHODS: We conducted an individual participant data meta-analysis of nationally-representative, public-access datasets in the United States. We identified 123 individual datasets with a total of 1,655,991 participants (56.8 % female, mean age = 40.33). RESULTS: The presence of range restriction was associated with larger correlations between income and depressive symptoms and with smaller correlations between years of education and depressive symptoms. The measurement instrument of depressive symptoms moderated the association for income, years of education, and occupational status/prestige. The Center for Epidemiological Studies-Depression scale consistently produced larger correlations. Higher measurement reliability was also associated with larger correlations. LIMITATIONS: This study was not a comprehensive review of all measurement instruments of depressive symptoms, focused on datasets from the United States, and did not examine the moderating role of sample characteristics. DISCUSSION: Methodological characteristics, including range restriction of SES and instrument of depressive symptoms, meaningfully influence the observed magnitude of association between SES and depressive symptoms. Clinicians and researchers designing future studies should consider which instrument of depressive symptoms is suitable for their purpose and population.

Early-Onset Colorectal Cancer Survival Differences and Potential Geographic Determinants Among Men and Women in Utah.

By 2030, early-onset colorectal cancer (EOCRC) is expected to become the leading cancer-related cause of death for people age 20 to 49. To improve understanding of this phenomenon, we analyzed the geographic determinants of EOCRC in Utah by examining county-level incidence and mortality. We linked data from the Utah Population Database to the Utah Cancer Registry to identify residents (age 18-49) diagnosed with EOCRC between 2000 and 2020, and we used spatial empirical Bayes smoothing to determine county-level hotspots. We identified 1,867 EOCRC diagnoses (52.7% in male patients, 69.2% in non-Hispanic White patients). Ten counties (34%) were classified as hotspots, with high EOCRC incidence or mortality. Hotspot status was unrelated to incidence rates, but non-Hispanic ethnic-minority men (incidence rate ratio, 1.49; 95% CI, 1.15-1.91), Hispanic White men and women (incidence rate ratio, 2.24; 95% CI, 2.00-2.51), and Hispanic ethnic-minority men and women (incidence rate ratio, 4.59; 95% CI, 3.50-5.91) were more likely to be diagnosed with EOCRC. After adjustment for income and obesity, adults living in hotspots had a 31% higher hazard for death (HR, 1.31; 95% CI, 1.02-1.69). Survival was poorest for adults with a late-stage diagnosis living in hotspots (chi square (1) = 4.0; p = .045). Adults who were married or who had a life partner had a lower hazard for death than single adults (HR, 0.73; 95% CI, 0.58-0.92). The risk for EOCRC is elevated in 34% of Utah counties, warranting future research and interventions aimed at increasing screening and survival in the population age 18 to 49.

Masculinity Barriers to Ever Completing Colorectal Cancer Screening among American Indian/Alaska Native, Black, and White Men (Ages 45-75).

Disparities in colorectal cancer (CRC) mortality among White, Black, and American Indian/Alaska Native (AIAN) men are attributable to differences in early detection screening. Determining how masculinity barriers influence CRC screening completion is critical for cancer prevention and control. To determine whether masculinity barriers to medical care are associated with lower rates of ever completing CRC screening, a survey-based study was employed from December 2020-January 2021 among 435 White, Black, and AIAN men (aged 45-75) who resided in the US. Logistic regression models were fit to four Masculinity Barriers to Medical Care subscales predicting ever completing CRC screening. For all men, being strong was associated with 54% decreased odds of CRC screening completion (OR 0.46, 95% CI 0.23 to 0.94); each unit increase in negative attitudes toward medical professionals and exams decreased the odds of ever completing CRC screening by 57% (OR 0.43, 95% CI 0.21 to 0.86). Black men who scored higher on negativity toward medical professionals and exams had decreased odds of ever screening. Consideration of masculinity in future population-based and intervention research is critical for increasing men's participation in CRC screening, with more salience for Black men.

A systematic review and meta-analysis of racial/ethnic differences and similarities in executive function performance in the United States.

OBJECTIVE: The extent that executive function performance varies between racial/ethnic groups in the United States is unclear, limiting future studies on the problems underlying these differences. The aim of this meta-analysis was to test two competing hypotheses: The cultural differences hypothesis asserts large differences between Whites and racial/ethnic minorities in the U.S., and small differences between- (e.g., African Americans, Latinos) and within- (e.g., Latinos: Mexican Americans, Cuban Americans) minority groups. The cultural similarities hypothesis posits small differences between Whites and minorities, and these differences are equal or smaller in magnitude than differences between- and within-minorities on executive function performance. We also tested moderators of these differences. METHOD: We focused on overall executive functioning performance and its three core components: inhibitory control, working memory, and cognitive flexibility.. A systematic search on PsycINFO, Web of Science, ERIC, PubMed, and ProQuest Dissertations and Theses Global identified 46 records (17% unpublished; 38 independent samples) with 56,067 total participants (Mage = 44.48 years; range = 3.05-80.45; 52% female; 39.5% racial/ethnic minority). RESULTS: Absolute differences between Whites and minorities (d = 0.85, 95% CI [0.65, 1.05]) were larger in magnitude compared to between-minorities (d = 0.44, 95% CI [0.28, 0.60]) and within-minorities (d = 0.09, 95% CI [0.03, 0.15]). White-minority differences were moderated by type of executive function measure and year of data collection. Post hoc analyses revealed large relative differences between some groups but not others. CONCLUSIONS: Findings support the cultural differences hypothesis for executive function performance. This meta-analysis underscores the need to address social inequalities in the U.S. that drive performance differences. (PsycInfo Database Record (c) 2021 APA, all rights reserved).