Correlates of Psychological Distress Among Filipino Americans and Filipinos Living in Urban Areas in the United States and the Philippines.

INTRODUCTION: Many Asian immigrants, including Filipino Americans (FilAms), experience psychological distress (PD) due to the challenges in adjusting to their new country and culture. This descriptive comparative study aimed to compare FilAms and Filipinos concerning their levels of PD, sources of stress, and use of health-promotion strategies. METHODS: Data from 89 FilAms and 95 Filipinos living in urban cities, obtained from the I-HELP-FILIPINOS database, measuring cardiometabolic risks, mental health, and environmental stressors in 2017, including PD, were examined. RESULTS: The mean age of all participants (N = 184) was 44.2 ± 22.8 years old. Both groups rated their health as good to excellent, although Filipinos were significantly more likely to be distressed (p < .001). Filipinos were also more likely to ascribe stress to employment (48.3% vs. 68.2%, p =.006) and finances (28.1% vs. 52.6%, p <.001) than FilAms. DISCUSSION: While both groups shared comparative perspectives on health, FilAms reported lower PD than Filipinos. The most significant source of stress was the country of residence. We recommend tailoring interventions to each local context's unique social and environmental circumstances.

Evidence-based practice strategies for faculty professional development in clinical translational research at Institutional Development Award (IDeA) state institutions in the Mountain West.

The Mountain West Clinical Translational Research - Infrastructure Network (MW CTR-IN), established in 2013, is a research network of 13 university partners located among seven Institutional Development Award (IDeA) states targeting health disparities. This is an enormous undertaking because of the size of the infrastructure network (encompassing a third of the US landmass and spanning four time zones in predominantly rural and underserved areas, with populations that have major health disparities issues). In this paper, we apply the barriers, strategies, and metrics to an adapted educational conceptual model by Fink (2013). Applying this model, we used four tailored approaches across this regional infrastructure network to: (1) assess individual faculty specific needs, (2) reach out and engage with faculty, (3) provide customized services to meet the situational needs of faculty, and (4) utilize a "closed communication feedback loop" between Professional Development (PD) core and MW CTR-IN faculty within the context of their home institutional environment. Summary statement results from participating faculty show that these approaches were positive. Grounded in best educational practice approaches, we have an opportunity to refine and build from this sound foundation with implications for future use in other CTR-IN networks and institutions in the IDeA states.

Spatial variations in family planning demand to limit childbearing and the demand satisfied with modern methods in sub-Saharan Africa.

BACKGROUND: There is an increasing demand for family planning to limit childbearing in sub-Saharan Africa (SSA). However, limited studies have quantified the spatial variations. This study examined: (i) the spatial patterns in the demand for family planning to limit childbearing and satisfied with modern methods, and (ii) the correlates of the demand for family planning to limit childbearing satisfied with modern methods in SSA. METHODS: This study analyzed secondary data on 306,080 married/in-union women obtained from Demographic Health Surveys conducted between 2010 and 2019 in 33 sub-Saharan African countries. We conducted exploratory spatial data analysis, with countries as the unit of analysis. We also performed regression analysis to determine the factors associated with demand for family planning to limit childbearing satisfied with modern methods in SSA. RESULTS: The mean percentage of women who demanded for family planning to limit childbearing by country was 20.5% while the mean prevalence of demand for family planning to limit childbearing satisfied with modern methods by country was 46.5%. There was a significant positive global spatial autocorrelation in the demand for family planning to limit childbearing (global Moran's I = 0.3, p = 0.001). The cluster map showed the concentration of cold spots (low-low clusters) in western and central Africa (WCA), while hot spots (high-high clusters) were concentrated in eastern and southern Africa (ESA). Also, the demand for family planning to limit childbearing satisfied with modern methods showed significant positive global spatial autocorrelation (global Moran's I = 0.2, p = 0.004) and concentration of cold spots in WCA. In the final multivariable regression model the joint family planning decision making (ß = 0.34, p < 0.001), and antenatal care (ß = 13.98, p < 0.001) were the significant factors associated with the demand for family planning to limit childbearing satisfied by modern methods. CONCLUSIONS: There are significant spatial variations in the demand for family planning to limit childbearing and the demand satisfied by modern methods, with cold spots concentrated in WCA. Promoting joint decision making by partners and increasing uptake of antenatal care may improve the demand for family planning to limit childbearing satisfied with modern methods.

In sub-Saharan Africa (SSA), studies have shown that the proportion of married women who want to stop having children has been increasing as well as the proportion using modern contraceptive methods among them. These studies also indicated that this proportion of women are higher in certain regions of Africa than the others. To extend these previous findings, we performed geographical analysis to assess how the proportion of married/in-union women who want to stop having children and the ones using modern methods among them differ geographically. Our findings indicated that neighboring countries where the proportion of married/in-union women who want to stop having children was higher than the overall average were concentrated in eastern and southern Africa (ESA), while neighboring countries in which the proportion of married/in-union women who want to stop having children was lower than the overall average were concentrated in western and central Africa (WCA). Similarly, the results also showed that neighboring countries where the proportion of married/in-union women using modern contraceptive methods among those who want to stop having children was lower than the overall average were concentrated in WCA. Our findings suggest that increasing joint decision making on family planning and uptake of antenatal care in SSA may improve the use of modern contraceptive methods among married/in-union women who want to stop childbearing.

Changes in body mass index among people living with HIV who are new on highly active antiretroviral therapy: a systematic review and meta-analysis.

In the era of highly active antiretroviral therapy (HAART), obesity is increasingly being reported among people living with HIV (PLHIV). In this study, we reviewed published literature on body mass index (BMI) changes among treatment-naïve adult PLHIV who started HAART and remained on treatment for at least six months. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, four databases were searched, and results of included studies were synthesized to describe the BMI trend among PLHIV on treatment. The search generated 4948 studies, of which 30 were included in the qualitative synthesis and 18 were eligible for the meta-analysis. All the studies showed an increase in group BMI. HAART was associated with increase in BMI (pooled effect size [ES] = 1.58 kg/m2; 95% CI: 1.36, 1.81). The heterogeneity among the 18 studies was high (I2 = 85%; p < .01). Subgroup analyses showed pooled ES of 1.54 kg/m2 (95% CI: 1.21, 1.87) and 1.63 kg/m2 (95% CI: 1.34, 1.91) for studies with follow-up ≤1 year and >1 year, respectively. We conclude that the greatest gain in BMI is in the initial 6-12 months on treatment, with minor gains in the second and subsequent years of treatment.

Individual- and country-level correlates of female permanent contraception use in sub-Saharan Africa.

BACKGROUND: Female permanent contraception is a cost-effective contraceptive method that can help clients with the desire to limit childbearing achieve their reproductive intention. However, despite its benefits, the use of FPC remains low in sub-Saharan Africa (SSA), and limited studies have examined the correlates of its uptake. In this study, we assessed the individual- and country-level factors associated with the use of FPC among married or in-union women using modern contraceptive methods to limit childbearing in SSA. METHODS: This study was a secondary data analysis of individual- and country-level data obtained from the Demographic and Health Surveys (DHS) Program and three open data repositories. The study included 29,777 married or in-union women aged 15-49 years using modern contraceptive methods to limit childbearing from DHS conducted in 33 sub-Sahara African countries between 2010 and 2018. We performed descriptive statistics and fitted multilevel logistic regression models to determine the predisposing, enabling, and need factors associated with the use of FPC. RESULTS: Approximately 13% of the women used FPC. About 20% of the variance in the odds of using FPC was attributable to between-country differences. In the full model, the significant individual-level factors associated with the use of FPC compared with other modern contraceptive methods were: age (odds ratio [OR] = 1.10; 95%CI = 1.08-1.12), living children (OR = 1.11, 95%CI = 1.04-1.16), high household wealth (OR = 1.39, 95%CI = 1.18-1.64), rural residence (OR = 0.83, 95% CI = 0.71-0.97), joint contraceptive decision with partner (OR = 1.68, 95% = 1.43-1.99), contraceptive decision by partner and others (OR = 2.46, 95% = 1.97-3.07), and the number of living children less than the ideal number of children (OR = 1.40, 95%CI = 1.21-1.62). The significantly associated country-level factors were births attended by skilled health providers (OR = 1.03, 95%CI = 1.00-1.05) and density of medical doctors (OR = 1.37, 95%CI = 1.01-1.85). CONCLUSIONS: Our results suggest that both individual- and country-level factors affect uptake of FPC in SSA. Increasing geographic, economic, and psychosocial access to FPC may improve its uptake in SSA.

Effectively Confronting the COVID-19 Pandemic: Critical Lessons From HIV Prevention, Care, and Treatment and Innovative Strategies to Conduct Community-Based and Community-Engaged Research Safely.

Coronavirus disease 2019 (COVID-19) is a new infectious disease caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The COVID-19 pandemic has profoundly altered the ways in which members of communities live, learn, work, and play. Similarly, the pandemic has affected the conduct of community-based and community-engaged research, which are essential research approaches to promoting health equity, reducing health disparities, and improving community and population health. In this commentary, we outline nine lessons from HIV prevention, care, and treatment that are particularly relevant to reducing the impact of the COVID-19 pandemic. We also identify ten innovative strategies to reduce exposure to SARS-CoV-2 among teams and community members conducting community-based and community-engaged research. Implementation of these strategies will help to ensure these research approaches can safely continue during the pandemic and that communities and populations continue to benefit from research designed to promote equity, reduce disparities, and improve health.

Low colorectal cancer survival in the Mountain West state of Nevada: A population-based analysis.

Colorectal cancer (CRC) is the third greatest cancer burden in the United States. The remarkably diverse Mountain West state of Nevada has uncharacteristically high CRC mortality compared to other Western states. We aimed to study the determinants of the CRC excess burden by using data from the Nevada Central Cancer Registry from 2003-2013. Five-year cause-specific age-adjusted survival from colorectal cancer was calculated and stratified by sex, race/ethnicity and region of Nevada. Cox Proportional Hazards regression modelling was used to study the impact of demographic, social, and clinical factors on CRC survival in Nevada, assessing follow-up as accurately as possible. The extent to which differences in survival can be explained by receipt of stage-appropriate treatment was also assessed. 12,413 CRC cases from 2003-2013 in Nevada were analyzed. Five-year CRC survival was low: 56.0% (95% CI: 54.6-57.5) among males and 59.5% (95% CI: 58.0-61.1) among females; significantly lower than national 5-year survival of 65.1% and 66.5%, respectively. Low survival was driven by populous Southern Nevada; after adjustment for all covariates, Southern Nevadans were at 17% higher risk of death than their counterparts in Northwestern Nevada (HR:1.17; 95% CI:1.08-1.27). Many patients did not receive stage-appropriate treatment, although this only partly explained the poor survival, uniformly low for every race/ethnicity in Nevada. The observed disparity for this one state within a single nation merits public health attention; regardless of the state or region of residence, all Americans deserve equal opportunity for optimum health outcomes in the face of a cancer diagnosis. The current study provides baseline information critical to clinicians, public health professionals, and all relevant stakeholders as they attempt to discern why Nevada's outcomes are vastly divergent from its neighboring Western states and make plans for remediation.

Decline in telomere length by age and effect modification by gender, allostatic load and comorbidities in National Health and Nutrition Examination Survey (1999-2002).

BACKGROUND: This study aims to assess the decline in telomere length (TL) with age and evaluate effect modification by gender, chronic stress, and comorbidity in a representative sample of the US population. METHODS: Cross-sectional data on 7826 adults with a TL measurement, were included from the National Health and Nutrition Examination Survey, years 1999-2002. The population rate of decline in TL across 10-year age categories was estimated using crude and adjusted regression. RESULTS: In an adjusted model, the population rate of decline in TL with age was consistent and linear for only three age categories: 20-29 (ß = -0.0172, 95% CI: -0.0342, -0.0002), 50-59 (ß = -0.0182, 95% CI: -0.0311, -0.0054) and 70-79 (ß = -0.0170, 95% CI: -0.0329, -0.0011) years. The population rate of decline in TL with age was significantly greater for males and those with high allostatic load and a history of comorbidities. When the population rate of decline in TL was analyzed by gender in 10-year age bins, a fairly consistent yet statistically non-significant decline for males was observed; however, a trough in the rate was observed for females in the age categories 20-29 years (ß = -0.0284, 95% CI: -0.0464, -0.0103) and 50-59 years (ß = -0.0211, 95% CI: -0.0391, -0.0032). To further elucidate the gender difference observed in the primary analyses, secondary analyses were conducted with reproductive and hormonal status; a significant inverse association was found between TL and parity, menopause, and age at menopause. CONCLUSIONS: TL was shorter with increasing age and this decline was modified by gender, chronic stress and comorbidities; individuals with chronic morbidity and/or chronic stress and females in their twenties and fifties experienced greater decline. Female reproductive factors, i.e., parity and menopause, were associated with TL.

Is selenium intake associated with the presence of depressive symptoms among US adults? Findings from National Health and Nutrition Examination Survey (NHANES) 2011-2014.

OBJECTIVES: This study aimed to examine the cross-sectional association between dietary and serum selenium measures and depressive symptoms among a nationally representative sample of US adults. METHODS: Dietary selenium intake and serum selenium concentration were evaluated on 7725 adult participants from National Health and Nutrition Examination Survey (NHANES) 2011-2014. Participants' selenium intake, assessed by 24-h recall, was classified based on the recommended dietary allowance (dietary selenium intake ≥ 55 µg/d) and estimated average requirement (dietary selenium intake ≥ 45 µg/d) criteria. Serum selenium and depressive symptoms were assessed using inductively coupled plasma mass spectrometry and a patient health questionnaire or use of an antidepressant, respectively. Univariate and multivariate logistic regression, accounting for the complex survey design of NHANES, were employed to estimate the cross-sectional association between measures of selenium and the presence of depressive symptoms. RESULTS: The median selenium concentration was 193.9 µg/L (interquartile range = 179.3-209.3). Approximately 8% of the participants met the case definition for depressive symptoms. Based on the recommended dietary allowance of selenium, participants not meeting the recommended dietary intake, compared with those meeting the requirement, had higher odds of depressive symptoms (odds ratio [OR] = 1.57, 95% confidence interval [CI]: 1.03-2.38). When analyzing by quintile of dietary selenium intakes, compared with the first quintile, participants in higher quintiles had significantly lower odds of depressive symptoms. However, based on quintiles of serum selenium and using the first quintile as referent category, except for quintile 3, results indicated a higher but not significant association (quintile 2 [OR = 1.08, 95% CI: 0.73-1.61], quintile 4 [OR = 1.17, 95% CI: 0.89-1.55], and quintile 5 [OR = 1.14, 95% CI: 0.83-1.58]). Power analysis indicated sufficient power. Notably, study participants had a very high serum selenium concentration. The findings, although not significant, between serum selenium concentrations and depressive symptoms had a U-shaped association, supported by the current literature. CONCLUSIONS: Our study supports an inverse association between participants recommended dietary intake of selenium and depressive symptoms. Although results were not statistically significant for the association by quartile of serum selenium concentrations and depressive symptoms, a U-shaped association was identified.

A Health Needs Assessment of the Filipino American Community in the Greater Las Vegas Area.

Purpose: The number of Filipino Americans in Las Vegas, Nevada, is growing considerably, but no research to date has assessed the specific health needs of this burgeoning population. Thus, this study aims to assess health behaviors, perceived community health problems, and self-reported diseases/conditions among Filipino Americans in the Greater Las Vegas area and evaluate any difference by gender. Methods: A cross-sectional survey was conducted among 200 Filipino American adults residing in the Greater Las Vegas area using a prevalidated instrument. Results: The self-reported prevalence of hypertension, high cholesterol, and diabetes was 48%, 46%, and 25%, respectively. Adverse health behaviors, in terms of insufficient exercise and diets lacking in fruits and vegetables, were noted among our participants. Approximately 67% of participants reported exercising less than the recommended 150 min of physical activity per week and <3% of the study population ate the recommended five servings of fruits and vegetables a day. On the contrary, consumption of sweet snacks and salty condiments was high. More than two-thirds of respondents indicated that the Filipino American community should address the identified health conditions. Conclusions: The high self-reported prevalence of hypertension, high cholesterol, and diabetes demonstrates a pressing public health problem among Filipino Americans in Las Vegas. Given that our study population comprised predominantly college-educated, middle-income, and insured individuals, the findings may be underestimated and thus the actual disease prevalence may be even higher. Results of this survey will be used to develop future interventions for the Filipino American community in Las Vegas using the principles of community-based participatory research.

Surveillance on the endemic of Zika virus infection by meteorological factors in Colombia: a population-based spatial and temporal study.

BACKGROUND: Zika virus (ZIKV) infection is a pandemic and a public health emergency. It is transmitted by mosquitoes, primarily the Aedes genus. In light of no treatment currently, it is crucial to develop effective vector control programs to prevent the spread of ZIKV infection earlier when observing possible risk factors, such as weather conditions enhancing mosquito breeding and surviving. METHODS: This study collected daily meteorological measurements and weekly ZIKV infectious cases among 32 departments of Colombia from January 2015-December 2016. This study applied the distributed lag nonlinear model to estimate the association between the number of ZIKA virus infection and meteorological measurements, controlling for spatial and temporal variations. We examined at most three meteorological factors with 20 lags in weeks in the model. RESULTS: Average humidity, total rainfall, and maximum temperature were more predictable of ZIKV infection outbreaks than other meteorological factors. Our models can detect significantly lagged effects of average humidity, total rainfall, and maximum temperature on outbreaks up to 15, 14, and 20 weeks, respectively. The spatial analysis identified 12 departments with a significant threat of ZIKV, and eight of those high-risk departments were located between the Equator and 6°N. The outbreak prediction also performed well in identified high-risk departments. CONCLUSION: Our results demonstrate that meteorological factors could be used for predicting ZIKV epidemics. Building an early warning surveillance system is important for preventing ZIKV infection, particularly in endemic areas.

The science of eliminating health disparities: summary and analysis of the NIH summit recommendations.

In December 2008, the National Institutes of Health (NIH) sponsored the first NIH Summit showcasing its investment and contribution to health disparities research and unveiling a framework for moving this important field forward. The Summit, titled "The Science of Eliminating Health Disparities," drew on extensive experience of experts leading health disparities research transformation in diverse fields. The Summit also provided a historic educational opportunity to contribute to health care reform. The theme, addressing disparities through integration of science, practice, and policy, introduced a paradigm for advancing research through transformational, translational, and transdisciplinary research. Engaging active participation throughout the Summit generated recommendations bridging science, practice, and policy, including action on social determinants of health, community engagement, broad partnerships, capacity-building, and media outreach.

Moving toward paradigm-shifting research in health disparities through translational, transformational, and transdisciplinary approaches.

Translational, transdisciplinary, and transformational research stands to become a paradigm-shifting mantra for research in health disparities. A windfall of research discoveries using these 3 approaches has increased our understanding of the health disparities in racial, ethnic, and low socioeconomic status groups. These distinct but related research spheres possess unique environments, which, when integrated, can lead to innovation in health disparities science. In this article, we review these approaches and propose integrating them to advance health disparities research through a change in philosophical position and an increased emphasis on community engagement. We argue that a balanced combination of these research approaches is needed to inform evidence-based practice, social action, and effective policy change to improve health in disparity communities.

Epidemiology of HIV/AIDS among Asians and Pacific Islanders in the United States.

Although the percentage of overall AIDS diagnoses remains low among Asian and Pacific Islanders (APIs) in the United States compared with other racial/ethnic groups, research on API risk behaviors and health status suggest that the low number of AIDS cases may not provide a full picture of the epidemic and issues faced by this understudied and underserved population. Data from national HIV/AIDS surveillance systems and the Behavioral Risk Factor Surveillance System (BRFSS) were examined to delineate the magnitude and course of the HIV/AIDS epidemic among APIs in the United States. Same-sex sexual activity is the main HIV risk for API men, whereas heterosexual contact is for API women. APIs are significantly less likely to report being tested for HIV despite the fact that a similar proportion of APIs and other racial/ethnic groups reported having HIV risk in the past 12 months. Given the enormous diversity among APIs in the United States it is important to collect detailed demographic information to improve race/ethnicity and HIV risk classification, conduct better behavioral and disease monitoring for informing prevention planning, and addressing cultural, linguistic, economic and legal barriers to HIV prevention among APIs.