Abstract
Community perspectives on research with older adults living with HIV
Annie Nguyen, PhD, MPH1 and Brandon Brown, PhD, MPH2
(1)Keck School of Medicine at the University of Southern California, Alhambra, CA, (2)University of California Riverside, Riverside, CA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Approximately 50% all people living with HIV in the US are over age 50, but research has yet to clearly define the role of healthy aging with HIV. The Coachella Valley Community Research Initiative, in Palm Springs, CA, plans to address this question by creating a prospective cohort study of HIV+ older adults, similar to the nationwide MACS study which may soon lose federal funding. The prevalence of HIV in the Coachella Valley is substantially higher than the national rate, in part because of the large older HIV+ population in Palm Springs. Three focus groups (5-7 participants each; N=18) were held with HIV+ men and women in the community to gather input about elements of this research. Transcripts were coded line-by-line and summarized into a thematic codebook. Participants agreed that protecting their data was important and that any violation of privacy is unacceptable. They recognized that HIV-related research is often funded by pharmaceutical companies, and while some referred to this as a “necessary evil”, they shared suggestions to mitigate study bias. Participants called for a “truly representative” community board to have oversight of research and for transparency of study protocols and conflicts of interest. Regarding discouraging results in research, most participants said they were used to getting “bad news” about HIV, and the findings should be disseminated to participants in a direct, timely, and understandable manner. Our findings illustrate how community input into future community participatory research can help identify and address concerns and facilitate inclusion of participant preferences.
Public health or related research
Abstract
Dietary patterns and Cancer mortality among Older Blacks and Whites in the REGARDS cohort
Tomi Akinyemiju, PhD
University of Alabama at Birmingham School of Public Health, Birmingham, AL
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
OBJECTIVE: To determine whether dietary patterns were associated with cancer mortality overall and by race among a large cohort of racially diverse, community-dwelling older adults.
METHODS: We performed a prospective data analysis among 22,041 participants from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Dietary patterns were defined based on factor analysis of dietary items and categorized as : Convenience (Chinese and Mexican foods, pasta, pizza), Plant-based (fruits, vegetables), Southern (added fats, fried foods, organ meats, sugar-sweetened beverages), Sweets/Fats (sugary foods) and Alcohol/Salads (alcohol, green-leafy vegetables, salad dressing). Using Cox regression, we examined the association between adherence and cancer mortality overall among all participants and stratified by race.
RESULTS: There were a total of 873 cancer deaths over the 10-year observation period: 582 (66.7%) in Whites and 291 (33.3%) in Blacks. Greater adherence to the Southern dietary pattern was associated with an increased risk of cancer mortality (4th vs. 1st quartile HR: 1.67; 95% CI: 1.32 – 2.10) overall, especially among Whites (4th vs. 1st quartile HR: 1.59; 95% CI: 1.22 – 2.08). The Convenience (HR: 0.73; 95% CI: 0.56 – 0.94) and Plant-based (HR: 0.72; 95% CI: 0.55 – 0.93) dietary patterns were associated with up to a 28% reduced risk of cancer mortality, but only among Whites.
CONCLUSION: Greater adherence to the Southern dietary pattern was associated with an increased risk of cancer mortality, while greater adherence to the Convenience and Plant-based diets was associated with a reduced risk of cancer mortality among Whites.
Advocacy for health and health education Assessment of individual and community needs for health education Diversity and culture Epidemiology Other professions or practice related to public health Planning of health education strategies, interventions, and programs
Abstract
Addressing Barriers to HIV testing in the Coachella Valley
Brandon Brown, PhD, MPH1 and Jenna LeComte-Hinely, PhD2
(1)University of California, Riverside, Riverside, CA, (2)HARC, Palm Desert, CA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Over one million people are living with HIV in the United States, yet many are unaware of their HIV status. Riverside County is California's fourth largest populated county, and 63% of all residents living with HIV are in the Coachella Valley region. Half of Coachella Valley seniors age 55 and older report being sexually active, but most (88.4%) do not use condoms, and 72.3% have never been tested for HIV. We collected data from 995 participants as part of the Get Tested Coachella Valley Campaign (GTCV). Most participants were female (62.5%), Hispanic (55.8%), over age 50 (51%), and 44% never had an HIV test. Participants who had never been tested reported barriers which included they were not at risk (57.4%), lack of healthcare provider recommendation (26.5%), and lack of sexual activity (23.4%). Among those not tested, 80% said they would get tested if their provider offered them a test. Women and those reporting Hispanic ethnicity were less likely (p<0.001) to have had an HIV test in their lifetime. Women over age 50 were also less likely to have had an HIV test compared to younger women (p<0.001).Few seniors have been tested for HIV. This is especially true for older seniors (28.4% of those 70 to 79, 6.9% of those 80 and older). The US population is aging but few interventions are available for at-risk older adults to get an HIV test. Campaigns like GTCV may be able to reach this population and educate physicians on ways to recommend testing.
Administer health education strategies, interventions and programs Assessment of individual and community needs for health education Protection of the public in relation to communicable diseases including prevention or control Public health or related research
Abstract
Strategies for Enhancing Research in Aging Health Disparities by Mentoring Diverse Academic Investigators
Nina T. Harawa, PhD, MPH1, Carol M. Mangione, MD, PhD2, Spero Manson, PhD3, Louis A. Penner4, Keith Norris, MD5, Charles DeCarli, FAAN6, Isabel Scarinci, PhD, MPH7, Julie Zissimopoulos, PhD8, Dedra S. Buchwald, MD9 and Eliseo Perez-Stable, M.D.10
(1)UNIVERSITY OF CALIFORNIA, LOS ANGELES, LOS ANGELES, CA, (2)UNIVERSITY OF CALIFORNIA, LOS ANGELES, (3)University of Washington, (4)Wayne State University, (5)University of California, Los Angeles, (6)University of California, Davis, (7)University of Alabama at Birmingham, (8)University of Southern California, (9)University of Washington, Seattle, Seattle, WA, (10)National Institute of Minority Health and Health Disparities, NIH, Bethesda, MD
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
The ongoing NIA-funded Resource Centers in Minority Aging Research (RCMAR) program was launched in 1997 to build an infrastructure that would “improve the health and wellbeing of older racial/ethnic minority populations by identifying mechanisms for reducing health disparities.” Primary strategies include mentoring junior faculty whose research focuses on the health of racial/ethnic minority elders and enhancing cultural diversity of the professional workforce that conducts elder health research. Between 1997 and 2014, 12 centers received RCMAR awards and provided pilot funding and mentorship to 373 scholars; 72% of whom were from underrepresented racial/ethnic groups. These scholars, usually junior faculty, receive up to two years of funding to participate in focused mentoring and training, and conduct mentored pilot research to advance their professional development. The program has been highly successful, with 84% of scholars from longstanding Centers continuing on to academic research careers and an additional 6% addressing aging and other health disparities through leadership roles within public health agencies and research industry. This paper describes the specific approaches and activities that have contributed to the success of the RCMAR model, and discusses challenges as well as lessons learned related to promoting a diverse group of researchers who conduct aging and health disparities research.
Administer health education strategies, interventions and programs Conduct evaluation related to programs, research, and other areas of practice Public health or related education Public health or related research