Recent Submissions

  • Disparities in Knowledge and Awareness of Human Papillomavirus and Human Papillomavirus-Related Cancers Among Sexual Minorities in the United States, 2017-2020

    Williams, Janille (2024-05)
    Introduction: Human Papillomavirus (HPV) is a prevalent STI linked to penile, anal, oral, and cervical cancers. It is a vaccine-preventable infection, but vaccination uptake rates remain low Sexual minorities (LGBTQ+) are less likely to be screened and have a higher risk of contracting HPV and HPV-related cancers; however, they are often overlooked in interventions and research. Knowledge and awareness of HPV and its vaccines can reduce and prevent HPV-related cancers. Methods: A retrospective analysis of HINTS-5 (2017-2020) data assessed the knowledge and awareness of HPV and HPV vaccination among sexual minorities. Poisson regression models estimated the incidence rate ratio (IRR) of HPV awareness, HPV vaccine awareness, and knowledge of HPV- related cancers. Weighted analysis was performed. Results: Awareness of HPV and the HPV vaccine has generally increased over the years, although there was a slight decline in 2020. Men (aIRR=1.15, p<0.001), individuals with less than a high school education (aIRR=1.24, p<0.001), Midwest residents (aIRR=1.06, p=0.002), and those without regular healthcare providers (aIRR=1.05, p=0.005) were more likely to be aware of HPV. Non- Hispanic Blacks (aIRR=1.04, p=0.007) and those with lower education levels (aIRR=1.10, p<0.001) were more knowledgeable about HPV-related oral cancer, while men (aIRR=1.10, p<0.001), Non-Hispanic Blacks (aIRR=1.07, p=0.008), low-income individuals (aIRR=1.09, p=0.001), and those with lower education levels (aIRR=1.25, p<0.001) were more likely to be knowledgeable about HPV-related cervical cancer. Lower rates of HPV awareness were observed among adults aged 18-34 years old, p<0.001. Conclusion: Despite variations in awareness, sexual minorities demonstrated insufficient knowledge regarding HPV-related cancers. Comprehensive education initiatives are warranted to ensure equitable access to information, addressing disparities across populations. Efforts should leverage existing community strengths to enhance HPV prevention and education strategies, fostering inclusivity and effectiveness.
  • A Pilot Evaluation of a Virtual 21-Day Whole-Food Plant-Based Dietary Intervention In New York City Residents

    Elizabeth Helzner, Rose Calixte, Liza Fuentes; Besson, Ayanna (2024-05)
    Background: Chronic diseases have a substantial impact on global health. Plant-based diets, which are abundant in fiber and antioxidants, consistently demonstrate advantages in mitigating cardiovascular risks, controlling diabetes, decreasing cancer rates, and facilitating healthy weight maintenance. Methods: This study evaluated the feasibility, acceptability, and initial efficacy of a 21-day virtual whole-food plant-based (WFPB) dietary intervention, implemented by the non-profit organization Plant Powered Metro New York, among 139 participants. The intervention consisted of weekly educational and mentorship sessions. A mixed-methods study design was used to evaluate the program. Feasibility was assessed based on program attendance. Acceptability was assessed based on self-reported program satisfaction on survey and key informant focus group responses. Pre- and post-program surveys measured changes in perceptions and knowledge of WFPB nutrition, self-efficacy in cooking, adherence to the diet, health-related quality-of-life metrics, and mental health (Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7). Changes in anthropometric measures, including BMI, waist circumference, HbA1c, LDL, total cholesterol, and blood pressure, were measured in a subsample of participants. Pre- to post-program changes were assessed using Wilcoxon signed- rank, McNemar, or McNemar-Bowkers tests. Inductive content analysis was used to assess qualitative data obtained from the focus group participants. Results: Participants attended an average of 73% of the educational sessions, and 89.9% of participants found the program to be satisfactory, describing the experience as “Excellent” or “Good.” Statistically significant improvements were found in self-reported WFPB nutrition knowledge and perceptions regarding challenge, cost, and the ability to adopt and cook a WFPB diet. Participants from the focus group identified program benefits, such as education and improved health, and challenges, such as scheduling issues and misconceptions about WFPB diets. Recommendations include addressing cost misconceptions and providing culturally relevant recipes to enhance program acceptance. There were also statistically significant self- reported improvements in health-related QoL metrics, including pain (other than headaches), headaches, mobility, breathing, skin, gastrointestinal symptoms, hormonal symptoms, sleep, energy, moodiness, mental clarity, and cravings for unhealthy food. There were median decreases of 2.85 points on the PHQ-9 and 1.82 points on the GAD-7, 1.16 kg/m2 in BMI, and 1.65 inches in waist circumference (all p=<0.0001). No significant changes were observed in HbA1c, LDL cholesterol, total cholesterol, or blood pressure levels. Conclusion: The 21-day program was associated with improvements in participants' perceptions of knowledge and self-efficacy regarding WFPB nutrition, self-reported quality-of-life, mental health, and anthropometric measures, including BMI and waist circumference. Future research is needed to assess the long-term results of the program, and to assess the program in patient populations with specific chronic diseases.
  • Trends in Exposure to Polyfluoroalkyl Substances and Association with Metabolic Syndrome

    Nurse, Claire (2023-12)
    The per-and polyfluoroalkyl substances (PFAS) are a unique group of synthetic compounds found in myriad commercial applications, including non-stick cook ware, food packaging and firefighting foam. The primary pathway for PFAS exposure in humans is via diet, with fish being the primary dietary source. Laboratory and epidemiologic studies have shown positive associations between human PFAS exposure and several metabolic disturbances. Using data from the National Health and Nutrition Examination Survey (NHANES) from 2003-2018, we: 1) conducted a trend analysis to assess mean PFAS concentration, and 2) examined associations between seafood consumption, serum PFAS levels, and metabolic syndrome. The data show a decline in serum PFAS concentrations by 8%, 14%, 11%, 11% and 20% for PFHxS, PFNA, PFDA, PFUnA and MePFOSA, respectively, per survey cycle. Significant associations between increased fish consumption and serum PFAS levels were also observed. Greater consumption of scallops was associated with 15%, 18% and 5% higher serum concentrations of PFNA, PFDA and PFUnA, respectively. For PFDA, increased consumption of cod and salmon were associated with 37% and 16% higher serum PFAS levels, respectively. For PFUnA, higher tuna consumption was associated with an 18% increase, a 64% increase for cod, a 70% increase for flatfish, and a 20% increase for salmon respectively. Increasing serum levels of PFDA and PFUnA were associated with 30% (PR= 0.70, 95% CI (0.54, 0.91), and 51% (PR= 0.49, 95% CI (0.29, 0.81) decreased prevalence of metabolic syndrome, respectively. Despite decreasing serum PFAS levels, significant differences in PFAS concentrations by non-modifiable factors such as race/ethnicity and gender persist. Further exploration of exposure pathways is required to determine risk profiles of PFAS exposure by demographic group for population-based risk reduction.