Evaluation of Theoretical Frameworks to Detect Correlates of HPV Vaccination in the Midwest, US, Using Structural Equation Modeling.

Knowledge of a valid, well-designed, and targeted theory-based framework helps better characterize reasons for HPV vaccine hesitancy and identify promising approaches to increase vaccination rates for eligible individuals. This study evaluated health theories in explaining factors affecting HPV vaccination and used a theoretical framework to identify direct and indirect predictors and mediators of HPV vaccination. A cross-sectional survey regarding HPV vaccine uptake and related factors was conducted among 1306 teenagers and young adults in the Midwest, US, in March and April 2023. Structural equation modeling confirmed fit of the framework based on the Integrated Health Theory (IHT) to the HPV vaccine data (Comparative Fit Index = 0.93; Tucker-Lewis Index = 0.92; Root Mean Square Error of Approximation = 0.053). While willingness to uptake the HPV vaccine directly predicted increased uptake (p < 0.001), perceived benefits (p < 0.001) and barriers (p < 0.023) about the vaccine indirectly predicted increased and decreased uptake, respectively. In turn, beliefs about susceptibility (p = 0.005) and severity (p < 0.001) of HPV infection and associated cancers and barriers to vaccination in general (p < 0.001) indirectly predicted willingness to uptake the vaccine. In conclusion, IHT can be appropriate in examining predictors of HPV vaccine uptake in teenagers and young adults in the US, particularly in the Midwest.

A review of the toxicology of oil in vertebrates: what we have learned following the Deepwater Horizon oil spill.

In the wake of the Deepwater Horizon (DWH) oil spill, a number of government agencies, academic institutions, consultants, and nonprofit organizations conducted lab- and field-based research to understand the toxic effects of the oil. Lab testing was performed with a variety of fish, birds, turtles, and vertebrate cell lines (as well as invertebrates); field biologists conducted observations on fish, birds, turtles, and marine mammals; and epidemiologists carried out observational studies in humans. Eight years after the spill, scientists and resource managers held a workshop to summarize the similarities and differences in the effects of DWH oil on vertebrate taxa and to identify remaining gaps in our understanding of oil toxicity in wildlife and humans, building upon the cross-taxonomic synthesis initiated during the Natural Resource Damage Assessment. Across the studies, consistency was found in the types of toxic response observed in the different organisms. Impairment of stress responses and adrenal gland function, cardiotoxicity, immune system dysfunction, disruption of blood cells and their function, effects on locomotion, and oxidative damage were observed across taxa. This consistency suggests conservation in the mechanisms of action and disease pathogenesis. From a toxicological perspective, a logical progression of impacts was noted: from molecular and cellular effects that manifest as organ dysfunction, to systemic effects that compromise fitness, growth, reproductive potential, and survival. From a clinical perspective, adverse health effects from DWH oil spill exposure formed a suite of signs/symptomatic responses that at the highest doses/concentrations resulted in multi-organ system failure.

Feasibility and Acceptability of a Mobile Mindfulness Meditation Intervention Among Women: Intervention Study.

BACKGROUND: Traditional mindfulness-based stress reduction programs are resource intensive for providers and time- and cost-intensive for participants, but the use of mobile technologies may be particularly convenient and cost-effective for populations that are busy, less affluent, or geographically distant from skilled providers. Women in southern Louisiana live in a vulnerable, disaster-prone region and are highly stressed, making a mobile program particularly suited to this population. OBJECTIVE: This study aimed to (1) assess the feasibility and acceptability of a mobile mindfulness app in real-world conditions in a pilot study of a community sample of women residing in southern Louisiana, (2) describe predictors of app usage, and (3) assess the effect of the app on secondary health outcomes. METHODS: Women were recruited from an oil spill study on health. A total of 236 women completed a baseline survey, were offered the mobile mindfulness program, and completed a follow-up survey. Subjects were asked to download and use the app for at least 30 days for 10 min. All study procedures were completed on the web. Primary outcomes were feasibility and acceptability of the app and characteristics of app utilization. Secondary outcomes included mindfulness, depression, perceived stress, sleep quality, physical activity, BMI, and healthy eating. RESULTS: Overall, 74.2% (236/318) of subjects completed the follow-up survey, and 13.5% (43/318) used the app. The main barrier to app usage was lack of time, cited by 37% (16/43) of users and 48.7% (94/193) of nonusers of the app. Women who chose to use the app were more highly educated (16/43, 63% had a college education vs 65/193, 33.7% of nonparticipants; P<.001), had higher incomes (23/43, 58% had incomes >US $50,000 per year vs 77/193, 43.0% of nonparticipants), and were employed (34/43, 79% vs 122/193, 63.2% of nonparticipants; P=.047). Those who engaged with the app did so at high levels, with 72% (31/43) of participants self-reporting the completion of some or all sessions and 74% (32/43) reporting high levels of satisfaction with the app. Participation with the app had a beneficial impact on depression (odds ratio [OR] 0.3, 95% CI 0.11-0.81), sleep quality (OR 0.1, 95% CI 0.02-0.96), sleep duration (OR 0.3, 95% CI 0.07-0.86), sleep latency (OR 0.3, 95% CI 0.11-0.81), and physical activity (2.8 95% CI 1.0-7.8), but mindfulness scores did not change from baseline to follow-up. CONCLUSIONS: The Headspace mobile mindfulness app was easy and cost-effective to implement and acceptable to those who participated, but few women elected to try it. The unique characteristics of this southern Louisiana population suggest that more intense promotion of the benefits of mindfulness training is needed, perhaps in conjunction with some therapist or researcher support. Several short-term benefits of the app were identified, particularly for depression and sleep.

Supplemental Selenium May Decrease Ovarian Cancer Risk in African-American Women.

Background: To our knowledge, no previous study has evaluated the associations of antioxidant intake with the risk of ovarian cancer in African-American women, who are known to have high mortality from the disease.Objective: We sought to evaluate these associations among 406 ovarian cancer cases and 632 age- and site-matched controls of African-American descent recruited from AACES (African American Cancer Epidemiology Study), a population-based, case-control study in 11 geographical areas within the United States.Methods: Multivariable logistic regression models were used to estimate ORs and 95% CIs adjusted for a wide range of potentially confounding factors, including age, region, education, parity, oral contraceptive use, menopause, tubal ligation, family history, body mass index (BMI), smoking status, total energy, and physical activity.Results: Women with the highest intakes of supplemental selenium (>20 µg/d) had an ∼30% lower risk of ovarian cancer than those with no supplemental intake (OR: 0.67; 95% CI: 0.46, 0.97; P-trend = 0.035). This inverse association was stronger in current smokers (OR: 0.13; 95% CI: 0.04, 0.46; P-trend = 0.001). There was no association with dietary selenium. The associations with carotenoid intakes were weak and nonsignificant (P = 0.07-0.60). We observed no association with dietary or supplemental intake of vitamin C or vitamin E. There were no appreciable differences in results between serous and nonserous tumors.Conclusions: These findings provide the first insights, to our knowledge, into the potential association between antioxidants and ovarian cancer in African-American women, indicating potential inverse associations with supplemental selenium.

The Deepwater Horizon Oil Spill and Physical Health among Adult Women in Southern Louisiana: The Women and Their Children's Health (WaTCH) Study.

BACKGROUND: The Deepwater Horizon Oil Spill (DHOS) is the largest oil spill in U.S. history, negatively impacting Gulf Coast residents and the surrounding ecosystem. To date, no studies have been published concerning physical health outcomes associated with the DHOS in the general community. OBJECTIVES: We characterized individual DHOS exposure using survey data and examined the association between DHOS exposure and physical health. METHODS: Baseline data from 2,126 adult women residing in southern Louisiana and enrolled in the Women and Their Children's Health study were analyzed. Exploratory factor analysis was used to characterize DHOS exposure. Odds ratios and 95% confidence intervals for the associations between DHOS exposure and physical health symptoms were estimated using multivariate logistic regression. RESULTS: A two-factor solution was identified as the best fit for DHOS exposure: physical-environmental exposure and economic exposure. High physical-environmental exposure was significantly associated with all of the physical health symptoms, with the strongest associations for burning in nose, throat, or lungs (OR = 4.73; 95% CI: 3.10, 7.22), sore throat (OR = 4.66; 95% CI: 2.89, 7.51), dizziness (OR = 4.21; 95% CI: 2.69, 6.58), and wheezing (OR = 4.20; 95% CI: 2.86, 6.17). Women who had high-economic exposure were significantly more likely to report wheezing (OR = 1.92; 95% CI: 1.32, 2.79); headaches (OR = 1.81; 95% CI: 1.41, 2.58); watery, burning, itchy eyes (OR = 1.61; 95% CI: 1.20, 2.16); and stuffy, itchy, runny nose (OR = 1.56; 95% CI: 1.16, 2.08). CONCLUSIONS: Among southern Louisiana women, both physical-environmental and economic exposure to the DHOS were associated with an increase in self-reported physical health outcomes. Additional longitudinal studies of this unique cohort are needed to elucidate the impact of the DHOS on short- and long-term human health. CITATION: Peres LC, Trapido E, Rung AL, Harrington DJ, Oral E, Fang Z, Fontham E, Peters ES. 2016. The Deepwater Horizon Oil Spill and physical health among adult women in southern Louisiana: the Women and Their Children's Health (WaTCH) study. Environ Health Perspect 124:1208-1213; http://dx.doi.org/10.1289/ehp.1510348.