RSS 1.0Upstate College of Medicine Scholarly Publications
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Research on Health Topics Communicated through TikTok: A Systematic Review of the LiteratureTikTok has more than 1.5 billion users globally. Health and wellness content on the application increased by more than 600% in 2021. This systematic review seeks to summarize which fields within medicine have embraced researching health communication on the TikTok platform and the most common measures reported within this literature. Research questions include what categories of health topics on TikTok are investigated in the literature, trends in topics by year, and types of outcomes reported. Embase, CINAHL, Scopus, and Ovid MEDLINE databases were searched in March 2024. Eligible studies met four criteria: (1) investigated human health topics on TikTok; (2) conducted in the United States; (3) published in English; and (4) published in a peer-reviewed journal. Of the 101 included studies, 50.5% (N = 51) discussed non-surgical specialties, 9.9% (N = 10) discussed topics within surgery, and 11.9% (N = 12) discussed COVID-19. The number of papers referencing non-surgical topics spiked in 2023, and no increase was seen in the number of COVID-19 papers over time. Most papers reported a number of interactions, and papers about mental health were least likely to report accuracy. Our findings highlight several health topics with a wide breadth of research dedicated to them, such as dermatology and COVID-19, and highlight areas for future research, such as the intersection of cancer and TikTok. Findings may be influential in the fields of medicine and healthcare research by informing health policy and targeted prevention efforts. This review reveals the need for future policies that focus on the role and expectations of the healthcare worker in health communication on social media. Implications for clinical practice include the need for providers to consider an individual's perception of health and illness, given the wide variety of information available on social media applications such as TikTok. This review was pre-registered on PROSPERO (CRD42024529182).
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Role of Cytoreductive Nephrectomy in Metastatic Clear Cell Renal cell Carcinoma in the Era of immunotherapy: An Analysis of the National Cancer DatabaseBackground: The effectiveness of the clinical outcome of CN (Cytoreductive Nephrectomy) in cases of mccRCC (Metastatic Clear Cell Renal cell Carcinoma) is still uncertain despite two trials, SURTIME and CARMENA. These trials, conducted with Sunitinib as the standard treatment, did not provide evidence supporting the use of CN. Methods: We queried the NCDB for stage IV mccRCC patients between the years of 2004 to 2020, who received (immunotherapy) IO with or without nephrectomy. Overall survival (OS) was calculated among three groups of IO alone, IO followed by CN (IOCN), CN followed by IO (CNIO). Cox models compared OS by treatment group after adjusting for sociodemographic, health, and facility variables. Results: From 1,549,101 renal cancer cases, 7983 clear and nonclear cell renal cell carcinoma cases were identified. After adjusting for sociodemographic and health covariates, patients who received IO followed by CN or CN followed by IO had a respective 64% (adjusted Hazard Ratio [aHR] = 0.36, 95% CI = 0.30-0.43, P = .006] and 47% (aHR = 0.53, 95% CI = 0.49-0.56, P = .001) mortality risk reduction respectively compared to patients who received IO alone. Compared to White adults, individuals who identified as Black exhibited 17% higher risk mortality (aHR = 1.17, 95% CI = 1.06-1.30, P = .002). Patients who received CN prior to IO had a 59% associated mortality risk compared to patients who received IO followed by CN who had a lower risk, 35.7% (P < .001). Conclusions: Patients receiving CN regardless of sequence with IO did better than IO alone in this national registry-based adjusted analysis for mccRCC. Presently available data indicates that the combination of CN and IO holds promise for enhancing clinical results in patients with mRCC.
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Imbalanced specialty representation of USMLE and NBME test writersPurpose: The United States Medical Licensing Examination (USMLE) is an examination series required for allopathic physician licensure in the United States (US). USMLE content is created and maintained by the National Board of Medical Examinations (NBME). The specialty composition of the USMLE and NBME taskforce members involved in the creation of examination content is currently unknown. Methods: Using the 2021 USMLE and 2021 NBME Committees and Task Forces documents, we determined each member's board-certified primary specialty and involvement in test material development committees who we dubbed "test writers". Total active physicians by primary specialty were recorded from the 2020 Physician Specialty Data Report published by the Association of American Medical Colleges (AAMC). Descriptive statistics and chi-square analysis were used to analyze the cohorts. Results: The USMLE and NBME test writer primary specialty composition was found to be significantly different compared to the US active physician population (USMLE χ2 [32]=172, p<.001 and NBME χ2 [32]=200, p<.001). Only nineteen specialties were represented within USMLE test writers, with three specialties being proportionally represented. Two specialties were represented within NBME test writers. Obstetrics and Gynecology physicians were proportionally represented in USMLE but not within NBME test writers. Internal Medicine (IM) accounts for the largest percentage of all USMLE test writers (60/197, 30%) with an excess representation of 31 individuals. Conclusions: There is an imbalance in the specialty representation of USMLE and NBME test writers compared to the US active physician population. These findings may have implications for the unbiased and accurate portrayal of topics in such national examinations; thus, future investigation is warranted.
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Effectiveness of Artificial Intelligence Technologies in Cancer Treatment for Older Adults: A Systematic ReviewBackground: Aging is a multifaceted process that may lead to an increased risk of developing cancer. Artificial intelligence (AI) applications in clinical cancer research may optimize cancer treatments, improve patient care, and minimize risks, prompting AI to receive high levels of attention in clinical medicine. This systematic review aims to synthesize current articles about the effectiveness of artificial intelligence in cancer treatments for older adults. Methods: We conducted a systematic review by searching CINAHL, PsycINFO, and MEDLINE via EBSCO. We also conducted forward and backward hand searching for a comprehensive search. Eligible studies included a study population of older adults (60 and older) with cancer, used AI technology to treat cancer, and were published in a peer-reviewed journal in English. This study was registered on PROSPERO (CRD42024529270). Results: This systematic review identified seven articles focusing on lung, breast, and gastrointestinal cancers. They were predominantly conducted in the USA (42.9%), with others from India, China, and Germany. The measures of overall and progression-free survival, local control, and treatment plan concordance suggested that AI interventions were equally or less effective than standard care in treating older adult cancer patients. Conclusions: Despite promising initial findings, the utility of AI technologies in cancer treatment for older adults remains in its early stages, as further developments are necessary to enhance accuracy, consistency, and reliability for broader clinical use.
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Healthcare staff perceptions of an electronic hand hygiene monitoring system within a large university systemObjective: The acceptability of an electronic HH monitoring system (EHHMS) was evaluated among hospital staff members. Design: An electronic HH monitoring system was implemented in June 2020 at a large, academic medical center. An interdisciplinary team developed a cross-sectional survey to gather staff perceptions of the EHHMS. Setting: The survey was conducted at a public, tertiary acute care hospital. Participants: The survey included current employees and staff. 1,273 participants responded. The mean age was 44.9 years (SD = 13.5). Most of the samples were female (71%) and non-Hispanic white (83%). Methods: A survey was conducted between June and July 2021. Responses were analyzed using Stata statistical software. Multiple logistic regression models were constructed to examine factors associated with negative perceptions of the EHHMS and its radiofrequency identification (RFID) badge. Supporting qualitative analyses were performed using Atlas.ti version 9. Results: Three-quarters (75%) of respondents reported neutral to negative perceptions of the EHHMS and its associated badge. Respondents reported limited influence on HH practices. Age, campus location, length of employment, job role, and opinion on data sharing were associated with negative perceptions of the EHHMS and RFID badge. Position in a direct patient care role was associated with negative perceptions of the RFID badge. Conclusions: Perceptions of the EHHMS aligned with previous research. Identified associations provide opportunities for targeted education, outreach, and intervention to increase acceptability and uptake. Lack of acceptance is explained by poorly perceived ease of use and usefulness, as well as challenges in implementation.
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Pulse Pressure as a Hemodynamic Parameter in Preeclampsia with Severe Features Accompanied by Fetal Growth RestrictionBackground: Modern management of preeclampsia can be optimized by tailoring the targeted treatment of hypertension to an individual's hemodynamic profile. Growing evidence suggests different phenotypes of preeclampsia, including those with a hyperdynamic profile and those complicated by uteroplacental insufficiency. Fetal growth restriction (FGR) is believed to be a result of uteroplacental insufficiency. There is a paucity of research examining the characteristics of patients with severe preeclampsia who do and who do not develop FGR.We aimed to elucidate which hemodynamic parameters differed between these two groups. Methods: All patients admitted to a single referral center with severe preeclampsia were identified. Patients were included if they had a live birth at 23 weeks of gestation or higher. Multiple gestations and pregnancies complicated by fetal congenital anomalies and/or HELLP syndrome were excluded. FGR was defined as a sonographic estimation of fetal weight (EFW) < 10th percentile or abdominal circumference (AC) < 10th percentile. Results: There were 76% significantly lower odds of overall pulse pressure upon admission for those with severe preeclampsia comorbid with FGR (aOR = 0.24, 95% CI = 0.07-0.83). Advanced gestational age on admission was associated with lower odds of severely abnormal labs and severely elevated diastolic blood pressure in preeclampsia also complicated by FGR. Conclusions: Subtypes of preeclampsia with and without FGR may be hemodynamically evaluated by assessing pulse pressure on admission.
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Correlates of Loneliness and Social Isolation among Older Adults during the COVID-19 Outbreak: A Comprehensive Assessment from a National United States SampleThis study examined the correlates of loneliness and social isolation among older adults in the United States (U.S.) during the COVID-19 outbreak. We analyzed data from the 2020 National Health and Aging Trends Study, a nationally representative sample of 3257 U.S. older adults aged 65 years and older. We analyzed and identified the sociodemographic, health, social support, and community correlates of loneliness, higher loneliness during versus before the COVID-19 outbreak, and social isolation using weighted multiple logistic regression models. About 35.2% of U.S. older adults reported loneliness during the COVID-19 outbreak, 21.9% reported higher loneliness compared to before the COVID-19 outbreak, and 32.8% were socially isolated during the outbreak. Correlates for increased odds of loneliness included female gender, higher education, physical activity, depression, anxiety, functional limitations, and virtual communication access (only for higher loneliness during COVID-19 outbreak). Correlates for increased odds of social isolation included higher age, non- Hispanic Black, Hispanic, higher number of household children, and metropolitan residence. Our findings provide insights into evidence-based approaches to address social disconnection among U.S. older adults. The wide range of sociodemographic, health, social support, and community correlates identified in this study warrants multifaceted interventions that traverse individual, community, and societal levels to address the loneliness and social isolation epidemic.
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Association Between Cannabis Use and Subjective Cognitive Decline: Findings from the Behavioral Risk Factor Surveillance System (BRFSS)Background: Cannabis consumption has rapidly increased in the United States due to more states legalizing non-medical and medical use. There is limited research, however, investigating whether cannabis may be associated with cognitive function, particularly across multiple dimensions of cannabis use. Objective: The objective of this study was to examine whether cannabis consumption reason, frequency, and method are associated with subjective cognitive decline (SCD). Methods: Data were obtained from 4,744 U.S. adults aged 45 and older in the 2021 Behavioral Risk Factor Surveillance System (BRFSS). SCD was a self-reported increase in confusion or memory loss in the past year. Odds of SCD by cannabis use reason, frequency, and methods (e.g., smoke, eat, vaporize) were examined using multiple logistic regression after imputing missing data, applying sampling weights, and adjusting for sociodemographic, health, and substance use covariates. Results: Compared to non-users, non-medical cannabis use was significantly associated with 96% decreased odds of SCD (aOR=0.04, 95% CI=0.01-0.44, p<.01). Medical (aOR=0.46, 95% CI=0.06-3.61, p=.46) and dual medical and non-medical use (aOR=0.30, 95% CI=0.03-2.92, p=.30) were also associated with decreased odds of SCD, although not significant. Cannabis consumption frequency and method were not significantly associated with SCD. Conclusion: The reason for cannabis use, but not frequency and method, is associated with SCD. Further research is needed to investigate the mechanisms that may contribute to the observed associations between non-medical cannabis use and decreased odds of SCD.
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Interaction effect of race-ethnicity and dementia on COVID-19 diagnosis among a national US older adult sampleOlder racial and ethnic minorities and older adults with dementia have an elevated COVID-19 risk, warranting research into the intersection between these two high-risk groups. We examined whether race-ethnicity moderates the association between dementia and COVID-19 diagnosis. Data were retrieved for 3189 respondents from a nationally representative prospective cohort sample of US older adults aged 65+ years. We analysed the effects of the interaction between race-ethnicity and dementia on COVID-19 diagnosis, after adjusting for sociodemographic factors, health and COVID-19 mitigation behaviours. The odds of COVID-19 diagnosis were significantly lower for Black older adults with dementia (adjusted odds ratio [aOR] = 0.07, 95% CI = 0.01-0.78, = 0.03). In addition, dementia increased the odds of COVID-19 diagnosis among Hispanic older adults (aOR = 1.59, 95% CI = 0.12-21.29, = 0.72), although this increase was not statistically significant. The interaction between race-ethnicity and dementia should be considered when assessing COVID-19 risk among older adults. Future research is needed to examine pathways through which dementia may interact with race and ethnicity to influence COVID-19 risk.
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Disparities in neighbourhood characteristics and 10-year dementia risk by nativity status.Prior research indicates that neighbourhood disadvantage increases dementia risk. There is, however, inconclusive evidence on the relationship between nativity and cognitive impairment. To our knowledge, our study is the first to analyse how nativity and neighbourhood interact to influence dementia risk.
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Multi-sectoral collaborations to increase recruitment and retention of diverse older adults in biomedical researchBackground Older adults, especially minoritized racial-ethnic groups, are historically underrepresented in biomedical research. This study summarizes the development and assesses the impact of a review board involving a multi-sectoral group of stakeholders with the goal of increasing the diversity of older adults in biomedical research. Methods A 25-member board of community members, caregivers, researchers, and clinicians from Upstate New York reviewed three projects presented by researchers, clinician-scientists, and a pharmaceutical company between January and December 2022. For each biomedical research project, the reviews provided guidance to increase the recruitment and retention of diverse older adults engaged in the study. Review board members and presenters completed surveys to provide feedback on their experience in this collaboration. Results There was consistent positive feedback from all members and presenters. From member surveys, feedback trended positive in meetings throughout the year. Community members and caregivers initially indicated discomfort in expressing their views, however, these concerns subsided over time. Presenters had a very positive experience in the review board’s impact on their recruitment strategy and study design, and therefore very likely to use this service again. Recommendations were made to adjust membership criteria, presentation format, and funding to sustain this effort. Conclusions Lack of diversity for older adults represented in biomedical research contributes to ethical and generalizability ramifications. The positive feedback from all stakeholders in our multi-sectoral board of community members, caregivers, researchers, and clinicians offers a promising structure for developing similar strategies to increase diversity within and beyond biomedical aging research in other communities.
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Racial and Ethnic Disparities in COVID-19 Diagnosis and Adherence to Mitigation Behaviors in a National U.S. Older Adult SampleOlder adults and people of colour are vulnerable to the COVID-19 pandemic, and mitigation behaviours reduce COVID-19 infection. We examined racial and ethnic differences in COVID- 19 diagnosis and adherence to COVID-19 mitigation behaviours among U.S. older adults. Data were retrieved from the National Health and Aging Trends Study, a nationally representative prospective cohort with 3257 U.S. Medicare beneficiaries aged 65+. COVID-19 variables were collected in 2020; all other data in 2019. Odds of COVID-19 diagnosis and adherence to mitigation behaviours (handwashing, masking, social distancing) were analysed using logistic regression. Compared to White older adults, only Hispanic respondents had 2.7 times significantly higher odds of COVID-19 after adjusting for sociodemographics, health, and mitigation behaviours (aOR = 2.71, 95% CI = 1.20-6.12). Black older adults had 7.9 times significantly higher odds of masking (aOR = 7.94, 95% CI = 2.33-27.04) and 2.3 times higher odds of social distancing (aOR = 2.33, 95% CI = 1.28-4.24), after adjusting for sociodemographics and health. Among all racial and ethnic groups, only Hispanic older adults had a significantly elevated COVID-19 diagnosis. Despite higher adherence to COVID-19 mitigation behaviours among racial and ethnic minorities, especially Black older adults, odds of COVID-19 remained elevated. Research is needed to explore potential mechanisms for higher odds of COVID-19 among minority older adults.
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Enhancing response of a protein conformational switch by using two disordered ligand binding domains.Protein conformational switches are often constructed by fusing an input domain, which recognizes a target ligand, to an output domain that establishes a biological response. Prior designs have employed binding-induced folding of the input domain to drive a conformational change in the output domain. Adding a second input domain can in principle harvest additional binding energy for performing useful work. It is not obvious, however, how to fuse two binding domains to a single output domain such that folding of both binding domains combine to effect conformational change in the output domain. Here, we converted the ribonuclease barnase (Bn) to a switchable enzyme by duplicating a C-terminal portion of its sequence and appending it to its N-terminus, thereby establishing a native fold (OFF state) and a circularly permuted fold (ON state) that competed for the shared core in a mutually exclusive fashion. Two copies of FK506 binding protein (FKBP), both made unstable by the V24A mutation and one that had been circularly permuted, were inserted into the engineered barnase at the junctions between the shared and duplicated sequences. Rapamycin-induced folding of FK506 binding protein stretched and unfolded the native fold of barnase the mutually exclusive folding effect, and rapamycin-induced folding of permuted FK506 binding protein stabilized the permuted fold of barnase by the loop-closure entropy principle. These folding events complemented each other to turn on RNase function. The cytotoxic switching mechanism was validated in yeast and human cells, and with purified protein. Thermodynamic modeling and experimental results revealed that the dual action of loop-closure entropy and mutually exclusive folding is analogous to an engine transmission in which loop-closure entropy acts as the low gear, providing efficient switching at low ligand concentrations, and mutually exclusive folding acts as the high gear to allow the switch to reach its maximum response at high ligand concentrations.
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Do the Rules Always Apply? An Analysis of Exceptions to a COVID-19-Era Pediatric Visitation PolicyBackground The COVID-19 pandemic abruptly reversed the long-standing practice of open visitation in children’s hospitals, due to the concern that hospital visitors might contribute to the spread of disease. However, little is known about the unintended consequences of such policies, including the potential that they may disproportionately impact children and families of color and those from low-income communities. Methods We reviewed requests for an exception to a pediatric visitation policy made between August and November 2020 at a midsize American children’s hospital and collected data regarding details of the requests, demographics, family characteristics, and the patients’ medical histories. We compared the sample to the general patient population using bivariate tests and developed a logistic regression model to explore factors associated with the receipt of requests for an exception to a visitation policy. Results Regression models indicated that Black families were less likely to have their request for an exception to the visitation policy granted, compared to White families (odds ratio, OR = 0.06; 95 percent confidence interval, CI 0.01-0.84; p < .05). The families of children who were admitted to critical care were more likely to have their request for an exception granted (OR = 28.35; 95 percent CI 1.43-562.37, p < .05). Two of the three reviewers of requests for exceptions were found to be less likely to grant a request for an exception (OR = 0.05; 95 percent CI 0.00-0.84; p < .05; OR = 0.03; 95 percent CI 0.00-0.67; p < .05). Conclusions Our findings highlight the need to reconsider the risks and benefits of highly restrictive visitation policies that disproportionately impact vulnerable and marginalized children and their families. This study also provides a model for the broader, prospective analysis of the potential for disparities in the impact of any institutional policy.
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Local Health Departments Tweeting About Ebola: Characteristics and MessagingContext: The first imported U.S. Ebola Hemorrhagic Fever case during the 2014 West Africa Ebola outbreak triggered an increase in online activity through various social media platforms, including Twitter. Objectives: The purpose of our study was to examine characteristics of local health departments (LHDs) tweeting about Ebola, in addition to how and when LHDs were communicating Ebola-related messages. Design: All tweets sent by 287 LHDs known to be using Twitter were collected from September 3 to November 2, 2014. Twitter data were merged with the 2013 National Association of County and City Health Officials (NACCHO) Profile study to assess LHD characteristics associated with sending Ebola-related tweets. To examine the content of Ebola tweets, we reviewed all such tweets and developed a codebook including four major message categories: information-giving, news update, event promotion, and preparedness. A timeline tracking the trends in Ebola tweets was created by aligning daily tweets with major Ebola news events posted on the Centers for Disease Control and Prevention (CDC) Ebola website. Results: Approximately 60% (n=174) of all LHDs using Twitter sent a total of 1 648 Ebola-related tweets during the study period. Sending more tweets in general (OR: 2.42; 95% CI: 1.00-5.84) and employing at least one Public Information Specialist (OR: 2.61; 95% CI: 1.14-5.95) significantly increased the odds that an LHD tweeted about Ebola. Of all the Ebola tweets collected, 78.6% were information-giving, 22.5% were on preparedness, 20.8% were news updates, and 10.3% were event promotion tweets. A temporal analysis of Ebola tweets indicated five distinct waves, each corresponding with major Ebola news events. Conclusions: Twitter has become a communication tool frequently used by many LHDs to respond to novel outbreaks, but messaging strategies vary widely across LHDs. We present several recommendations for LHDs using this novel communication channel during outbreaks and other emergent events.
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Role of Neighborhood Physical Disorder and Social Cohesion on Racial and Ethnic Disparities in Dementia RiskObjectives: To analyze how neighborhood physical disorder and social cohesion are associated with racial and ethnic disparities in dementia risk. Methods: Nine years of data (2011-2019) were retrieved from the National Health and Aging Trends Study, a nationally-representative U.S. older adult (age 65+) sample. Cox regression analyzed time to dementia diagnosis using composite scores for neighborhood physical disorder and social cohesion. Results: Higher baseline neighborhood physical disorder (Adjusted Hazard Ratio [aHR]=1.11, 95% Confidence Interval [CI]=1.01-1.23) and increased disorder at follow-up (aHR=1.10, 95% CI=1.01-1.19) significantly increased dementia risk. Hispanic older adults with higher physical disorder at baseline (aHR=0.62, 95% CI=0.49-0.79) and follow-up (aHR=0.81, 95% CI=0.67-0.98) had a significantly decreased dementia risk. There were no significant associations for social cohesion. Discussion: Physical but not social neighborhood characteristics are associated with dementia risk. Future research is needed to understand protective mechanisms for dementia among Hispanic older adults in neighborhoods with high physical disorder.
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Relationship between dementia, COVID‐19 risk, and adherence to COVID‐19 mitigation behaviors among older adults in the United StatesObjectives: To examine how dementia is associated with COVID-19 risk and adherence to COVID-19 mitigation behaviors, and whether mitigation behaviors mediate the relationship between dementia and COVID-19 risk. Methods/Design: We analyzed 2019 and 2020 data from the National Health and Aging Trends Study, a national prospective cohort study of United States older adults age 65+. Outcomes were COVID-19 diagnosis and adherence to COVID-19 mitigation behaviors (handwashing, mask-wearing, and social distancing). Results: Among the 3257 older adults in this study, 485 (14.9%) had dementia in 2019 and 98 (3.1%) were COVID-19 positive in 2020. Dementia significantly increased the odds of COVID-19 by 129% (odds ratio [OR] = 2.29, 95% confidence interval [CI] 1.32 to 3.97), and remained elevated after adjusting for sociodemographics and health (OR = 1.67, 95% CI 0.90 to 3.11). Dementia significantly decreased the odds of handwashing by 72% (OR = 0.28, 95% CI 0.17 to 0.44), which remained lower after adjusting for sociodemographics and health (OR = 0.53, 95% CI 0.23 to 1.21). Dementia was not significantly associated with mask-wearing and social distancing. The relationship between dementia and COVID-19 was primarily mediated by functional impairment, income, and residential setting. Conclusions: Dementia was associated with an increased COVID-19 risk and lower adherence to handwashing among U.S. older adults. Adherence to COVID-19 mitigation behaviors did not mediate COVID-19 risk by dementia status. For older adults with dementia, COVID-19 risk could be decreased by prioritizing health interventions.
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COVID-19 risk factors and predictors for handwashing, masking, and social distancing among a national prospective cohort of US older adultsObjectives: Older adults have a disproportionately higher COVID-19 risk, however, there is limited research investigating adherence to the major COVID-19 mitigation behaviors (handwashing, masking, social distancing) for older populations. We examined COVID-19 risk factors and predictors for adherence to COVID-19 mitigation behaviors among a national sample of U.S. older adults. Study Design: Data were retrieved for 3,257 respondents from the National Health and Aging Trends Study, a nationally representative prospective sample of U.S. Medicare beneficiaries age 65 or older. COVID-19 variables were collected in 2020, while all other data were collected in 2019. Methods: We utilized multiple logistic regression to analyze COVID-19 risk factors and predictors for handwashing, masking, and social distancing to minimize COVID-19 spread. Missing data were imputed, and all models applied survey sampling weights. Results: Factors significantly associated with increased odds of COVID-19 diagnosis among U.S. older adults were Hispanic ethnicity, low-income household, residential care or nursing home, and generalized anxiety disorder. We identified multiple factors significantly associated with adherence to handwashing, masking, and social distancing. Most notably, older males had a significantly lower odds of practicing all three COVID-19 mitigation behaviors, and Black older adults had a significantly higher odds of masking and handwashing. Conclusions: When prioritizing COVID-19 prevention efforts for older adults, risk factors that should be considered are race and ethnicity, income, residential setting, and anxiety. To effectively mitigate COVID-19 disease spread, public health professionals must also recognize sociodemographic and health factors may influence whether older adults adhere to handwashing, masking, and social distancing.
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Geospatial Distribution of Local Health Department Tweets and Online Searches About Ebola During the 2014 Ebola OutbreakObjective This study compared the geospatial distribution of Ebola tweets from local health departments (LHDs) to online searches about Ebola across the United States during the 2014 Ebola outbreak. Methods Between September and November 2014, we collected all tweets sent by 287 LHDs known to be using Twitter. Coordinates for each Ebola tweet were imported into ArcGIS 10.2.2 to display the distribution of tweets. Online searches with the search term “Ebola” were obtained from Google Trends. A Pearson correlation was conducted to access the relationship between online search activity and per capita number of LHD Ebola tweets by state. Results Ebola tweets from LHDs were concentrated in cities across the northeast states, including Philadelphia and New York City. In contrast, states with the highest online search queries for Ebola were primarily in the south, particularly Oklahoma and Texas. A weak, negative, non-significant correlation (r=-.03, p=.83, 95% CI -.30-.25) was observed between online search activity and per capita number of LHD Ebola tweets by state. Conclusions We recommend LHDs consider using social media to communicate possible disease outbreaks in a timely manner, and consider using online search data to tailor their messages to align with the public health interests of their constituents.
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Food Insecurity and COVID-19 Diagnosis: Findings from a National United States SampleThis study explores the association between experiencing food insecurity and COVID-19 diagnosis in the United States, and what sociodemographic characteristics moderate this relationship. We analyzed a national sample of adults in the United States (n=6,475). Multiple logistic regression results revealed respondents experiencing food insecurity had approximately 3.0 times significantly higher odds of a positive COVID-19 diagnosis (Odds Ratio [OR]=2.95, 95% Confidence Interval [CI]=1.38-6.32, p<.01), which remained significant after adjusting for sociodemographics and COVID-19 mitigation behaviors (OR=2.59, 95% CI=1.09-6.18, p<.05). Age group had a significant moderating effect (OR=42.55, 95% CI=3.13-579.15, p<.01). Results indicate experiencing food insecurity is associated with contracting COVID-19.
