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Development and Evaluation of the Clinical Trial HEalth Knowledge and Beliefs Scale (CHEKS)

Chung, Alicia; Donley, Tiffany; Hays, Ron D; Robbins, Rebecca; Seixas, Azizi; Jean-Louis, Girardin
Patient health literacy is vital to clinical trial engagement. Knowledge and beliefs about clinical trials may contribute to patient literacy of clinical trials, influencing engagement, enrollment and retention. We developed and assessed a survey that measures clinical trial health knowledge and beliefs, known as the Clinical trial HEalth Knowledge and belief Scale (CHEKS). The 31 survey items in CHEKS represent knowledge and beliefs about clinical trial research (n = 409) in 2017. We examined item-scale correlations for the 31 items, eliminated items with item-scale correlations less than 0.30, and then estimated internal consistency reliability for the remaining 25 items. We used the comparative fit index (CFI) and the root mean squared error of approximation (RMSEA) to evaluate model fit. The average age of the sample was 34 (SD = 15.7) and 48% female. We identified 6 of the 31 items that had item-scale correlations (corrected for overlap) lower than 0.30. Coefficient alpha for the remaining 25 items was 0.93 A one-factor categorical confirmatory factor analytic model with 16 correlated errors was not statistically significant (chi-square = 10011.994, df = 300, p < 0.001) but fit the data well (CFI = 0.95 and RMSEA = 0.07). CHEKS can assess clinical trial knowledge and beliefs.
PMCID:9315756
PMID: 35886512
ISSN: 1660-4601
CID: 5276482

DOES COPING STRATEGY PROTECT SLEEP QUALITY DURING COVID-19? AN EXAMINATION OF RACIAL, ETHNIC, CULTURAL DIFFERENCES [Meeting Abstract]

Blanc, J; Seixas, A; Small, S; Locklear, C; Dorcent, R; Auguste, E; Buysse, D; Jean-Louis, G
Introduction: Little has been done to examine within/between group predictors and mediators of race/ethnic differences in sleep health outcomes, due to COVID-19 exposure. We evaluated the effect of COVID-19 exposure on sleep quality in a multiracial/ethnic sample of New York residents.
Method(s): We conducted a cross-sectional study among adults exposed to COVID-19 across New York State from September to November of 2020. Comparisons of participant characteristics e.g., mean scores by race/ethnicity status were made using one-way ANOVA for continuous variables, and chi-square tests for categorical variables. Associations between social determinants of health (employment, location), Trauma Coping Self-Efficacy (CES-T), and sleep quality (Pittsburgh Sleep Quality Index-PSQI) were examined using multilinear regression analysis stratified by race/ethnicity.
Result(s): Of the 541 participants, 373 (68.9%) were female; mean age was 40.9 years (SD=15), 198 (36.6%) identified as Whites, 111 (20.5%) as Black, 97 (17.9%) as Hispanics, and 135(25%) identified as either Asians, Native-Americans, Pacific-Islanders. Sex was the strongest predictor [beta = 1.335; p < .05] of sleep quality, but only among Whites. Trauma Coping Self-Efficacy was negatively associated with sleep quality among Asian, Native-American, or Pacific- Islander participants [beta = -.114; p < .05 ]; Black [beta = -.099; p < .05] and White participants [beta = -0.79; p < .05] but not among Latinos/ as [beta = -.058; p = 0.71].
Conclusion(s): Coping Self-Efficacy moderated the effect of COVID-19 on sleep quality among some, but not all, racial/ethnic groups. While CSE-T scores during the first wave of COVID-19 acted as a protective factor for sleep quality among Asians, Native-Americans, and Pacific- Islanders, White and Black participants, this was not the case for Latinos/as/Hispanics residing in New York. Clinical interventions that are tailored for racial/ethnic, community and cultural needs may help to mitigate sleep problems associated with COVID-19 exposure
EMBASE:638375975
ISSN: 1550-9109
CID: 5293332

Targeting versus Tailoring Educational Videos for Encouraging Deceased Organ Donor Registration in Black-Owned Barbershops

Wall, Stephen P; Castillo, Patricio; Shuchat-Shaw, Francine; Norman, Elizabeth; Brown, David; Martinez-López, Natalia; López-Ríos, Mairyn; Seixas, Azizi A; Plass, Jan L; Ravenell, Joseph E
In the U.S., black men are at highest risk for requiring kidney transplants but are among those least likely to register for organ donation. Prior outreach used videos culturally targeted for Black communities, yet registration rates remain insufficient to meet demand. Therefore, we assessed whether generic versus videos culturally targeted or personally tailored based on prior organ donation beliefs differentially increase organ donor registration. In a randomized controlled trial, 1,353 participants in Black-owned barbershops viewed generic, targeted, or tailored videos about organ donation. Logistic regression models assessed the relative impact of videos on: 1) immediate organ donor registration, 2) taking brochures, and 3) change in organ donation willingness stage of change from baseline. Randomization yielded approximately equal groups related to demographics and baseline willingness and beliefs. Neither targeted nor tailored videos differentially affected registration compared with the generic video, but participants in targeted and tailored groups were more likely to take brochures. Targeted (OR = 1.74) and tailored (OR = 1.57) videos were associated with incremental increases in organ donation willingness stage of change compared to the generic video. Distributing culturally targeted and individually tailored videos increased organ donor willingness stage of change among Black men in Black-owned barbershops but was insufficient for encouraging registration.Abbreviations: CI - confidence interval; DMV - Department of Motor Vehicles; BOBs - Black-owned barbershops; ODBI - organ donation belief index; ODWS - organ donation willingness stage of change; OR - odds ratio.
PMID: 35170401
ISSN: 1087-0415
CID: 5171632

Sleep Health among Racial/Ethnic groups and Strategies to achieve Sleep Health Equity

Chapter by: Seixas, Azizi A; Briggs, Anthony Q; Blanc, Judite; Moore, Jesse; Chung, Alicia; Williams, Ellita; Rogers, April; Turner, Arlener; Jean-Louis, Girardin
in: Essentials of Sleep Medicine : A Practical Approach to Patients with Sleep by
[S.l.] : Humana Press, 2022
pp. 47-68
ISBN: 978-3-030-93738-6
CID: 5354512

COVID-19 instructional approaches (in-person, online, hybrid), school start times, and sleep in over 5,000 U.S. adolescents

Meltzer, Lisa J; Saletin, Jared M; Honaker, Sarah M; Owens, Judith A; Seixas, Azizi; Wahlstrom, Kyla L; Wolfson, Amy R; Wong, Patricia; Carskadon, Mary A
STUDY OBJECTIVES:To examine associations among instructional approaches, school start times, and sleep during the COVID-19 pandemic in a large, nationwide sample of U.S. adolescents. METHODS:Cross-sectional, anonymous self-report survey study of a community-dwelling sample of adolescents (grades 6-12), recruited through social media outlets in October/November 2020. Participants reported on instructional approach (in-person, online/synchronous, online/asynchronous) for each weekday (past week), school start times (in-person or online/synchronous days), and bedtimes (BT) and wake times (WT) for each identified school type and weekends/no school days. Sleep opportunity was calculated as BT-to-WT interval. Night-to-night sleep variability was calculated with mean square successive differences. RESULTS:Respondents included 5,245 racially and geographically diverse students (~50% female). BT and WT were earliest for in-person instruction; followed by online/synchronous days. Sleep opportunity was longer on individual nights students did not have scheduled instruction (>1.5 h longer for online/asynchronous than in-person). More students obtained sufficient sleep with later school start times. However, even with the same start times, more students with online/synchronous instruction obtained sufficient sleep than in-person instruction. Significantly greater night-to-night variability in sleep-wake patterns was observed for students with in-person hybrid schedules versus students with online/synchronous + asynchronous schedules. CONCLUSIONS:These findings provide important insights regarding the association between instructional approach and school start times on the timing, amount, and variability of sleep in U.S. adolescents. Given the public health consequences of short and variable sleep in adolescents, results may be useful for education and health policy decision-making for post-pandemic secondary schools.
PMCID:8385997
PMID: 34401922
ISSN: 1550-9109
CID: 5080222

Stress and Depression are Associated with Life's Simple 7 Among African Americans with Hypertension: Findings from the Jackson Heart Study

Langford, Aisha T; Butler, Mark; Booth Iii, John N; Jin, Peng; Bress, Adam P; Tanner, Rikki M; Kalinowski, Jolaade; Blanc, Judite; Seixas, Azizi; Shimbo, Daichi; Sims, Mario; Ogedegbe, Gbenga; Spruill, Tanya M
BACKGROUND:The American Heart Association created the Life's Simple 7 (LS7) metrics to promote cardiovascular health by achieving optimal levels of blood pressure, cholesterol, blood sugar, physical activity, diet, weight, and smoking status. The degree to which psychosocial factors such as stress and depression impact one's ability to achieve optimal cardiovascular health is unclear, particularly among hypertensive African Americans. METHODS:Cross-sectional analyses included 1,819 African Americans with hypertension participating in the Jackson Heart Study (2000-2004). Outcomes were LS7 composite and individual component scores (defined as poor, intermediate, ideal). High perceived chronic stress was defined as the top quartile of Weekly Stress Inventory scores. High depressive symptoms were defined as Center for Epidemiologic Studies Depression scale scores of ≥16. We compared four groups: high stress alone; high depressive symptoms alone; high stress and high depressive symptoms; low stress and low depressive symptoms (reference) using linear regression for total LS7 scores and logistic regression for LS7 components. RESULTS:Participants with both high stress and depressive symptoms had lower composite LS7 scores (B [95% confidence interval-CI]= -0.34 [-0.65 to -0.02]) than those with low stress and depressive symptoms in unadjusted and age/sex-adjusted models. They also had poorer health status for smoking (OR [95% CI]= 0.52 [0.35-0.78]) and physical activity [OR (95% CI)= 0.71 (0.52-0.95)] after full covariate adjustment. CONCLUSIONS:The combination of high stress and high depressive symptoms was associated with poorer LS7 metrics in hypertensive African Americans. Psychosocial interventions may increase the likelihood of engaging in behaviors that promote optimal cardiovascular health.
PMID: 34272853
ISSN: 1941-7225
CID: 4947672

Age-associated differences in sleep duration in the US population: potential effects of disease burden

Jean-Louis, Girardin; Shochat, Tamar; Youngstedt, Shawn D; Briggs, Anthony Q; Williams, Ellita T; Jin, Peng; Bubu, Omonigho Michael; Seixas, Azizi A
OBJECTIVES/OBJECTIVE:We contrasted the relative risks (RR) of short [<7 h] and long [>8 h] sleep experienced by middle-aged (45-64 years) and older (≥65 years) adults, compared with young adults (20-44 years). METHODS:We utilized NHANES data (2005-2016), capturing sociodemographic, socioeconomic, and health-related data among US adults. RESULTS:The Relative Risk (RR) of short sleep between young and middle-aged adults did not differ [RR = 1.02, NS]. However, the RR of short sleep was significantly reduced among older participants [RR = 0.81, p < 0.01]. Middle-aged adults had significantly lower RR of long sleep [RR = 0.80, p < 0.01], whereas older adults had significantly greater RR of long sleep [RR = 1.41, p < 0.01]. Compared with young adults, older adults with or without increased disease burden had significantly lower RR of short sleep [RR = 0.81, p < 0.01 and RR = 0.80, p < 0.01], respectively. However, for middle-aged adults, the RR of short sleep did not differ whether they reported a greater disease burden. Relative to young adults, older adults with or without disease burden had higher RRs of long sleep [RR = 1.39, p < 0.01] and [RR = 1.45, p < 0.01], respectively. For middle-aged adults without disease burden, the RR of long sleep was lower than among young adults [RR = 0.72, p < 0.01]. CONCLUSIONS:Compared with young adults, older adults were not at increased risk for short sleep. Rather, they reported longer sleep time regardless of the presence of disease burden. Future studies should investigate longitudinal effects of aging on objective sleep time, with or without common diseases.
PMID: 34619501
ISSN: 1878-5506
CID: 5037152

Using a Digital Neuro Signature to measure longitudinal individual-level change in Alzheimer's disease: the Altoida large cohort study

Meier, Irene B; Buegler, Max; Harms, Robbert; Seixas, Azizi; Çöltekin, Arzu; Tarnanas, Ioannis
Conventional neuropsychological assessments for Alzheimer's disease are burdensome and inaccurate at detecting mild cognitive impairment and predicting Alzheimer's disease risk. Altoida's Digital Neuro Signature (DNS), a longitudinal cognitive test consisting of two active digital biomarker metrics, alleviates these limitations. By comparison to conventional neuropsychological assessments, DNS results in faster evaluations (10 min vs 45-120 min), and generates higher test-retest in intraindividual assessment, as well as higher accuracy at detecting abnormal cognition. This study comparatively evaluates the performance of Altoida's DNS and conventional neuropsychological assessments in intraindividual assessments of cognition and function by means of two semi-naturalistic observational experiments with 525 participants in laboratory and clinical settings. The results show that DNS is consistently more sensitive than conventional neuropsychological assessments at capturing longitudinal individual-level change, both with respect to intraindividual variability and dispersion (intraindividual variability across multiple tests), across three participant groups: healthy controls, mild cognitive impairment, and Alzheimer's disease. Dispersion differences between DNS and conventional neuropsychological assessments were more pronounced with more advanced disease stages, and DNS-intraindividual variability was able to predict conversion from mild cognitive impairment to Alzheimer's disease. These findings are instrumental for patient monitoring and management, remote clinical trial assessment, and timely interventions, and will hopefully contribute to a better understanding of Alzheimer's disease.
PMCID:8225898
PMID: 34168269
ISSN: 2398-6352
CID: 4932052

Adolescent Peer Influence on Eating Behaviors via Social Media: Scoping Review

Chung, Alicia; Vieira, Dorice; Donley, Tiffany; Tan, Nicholas; Jean-Louis, Girardin; Kiely Gouley, Kathleen; Seixas, Azizi
BACKGROUND:The influence of social media among adolescent peer groups can be a powerful change agent. OBJECTIVE:Our scoping review aimed to elucidate the ways in which social media use among adolescent peers influences eating behaviors. METHODS:A scoping review of the literature of articles published from journal inception to 2019 was performed by searching PubMed (ie, MEDLINE), Embase, CINAHL, PsycINFO, Web of Science, and other databases. The review was conducted in three steps: (1) identification of the research question and clarification of criteria using the population, intervention, comparison, and outcome (PICO) framework; (2) selection of articles from the literature using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines; and (3) charting and summarizing information from selected articles. PubMed's Medical Subject Headings (MeSH) and Embase's Emtree subject headings were reviewed along with specific keywords to construct a comprehensive search strategy. Subject headings and keywords were based on adolescent age groups, social media platforms, and eating behaviors. After screening 1387 peer-reviewed articles, 37 articles were assessed for eligibility. Participant age, gender, study location, social media channels utilized, user volume, and content themes related to findings were extracted from the articles. RESULTS:Six articles met the final inclusion criteria. A final sample size of 1225 adolescents (aged 10 to 19 years) from the United States, the United Kingdom, Sweden, Norway, Denmark, Portugal, Brazil, and Australia were included in controlled and qualitative studies. Instagram and Facebook were among the most popular social media platforms that influenced healthful eating behaviors (ie, fruit and vegetable intake) as well as unhealthful eating behaviors related to fast food advertising. Online forums served as accessible channels for eating disorder relapse prevention among youth. Social media influence converged around four central themes: (1) visual appeal, (2) content dissemination, (3) socialized digital connections, and (4) adolescent marketer influencers. CONCLUSIONS:Adolescent peer influence in social media environments spans the spectrum of healthy eating (ie, pathological) to eating disorders (ie, nonpathological). Strategic network-driven approaches should be considered for engaging adolescents in the promotion of positive dietary behaviors.
PMID: 34081018
ISSN: 1438-8871
CID: 4891762

The development and psychometric evaluation of the Survey of Obstructive Sleep Apnea Functional Health Literacy

Robbins, Rebecca; Hays, Ron D; Calderón, José Luís; Seixas, Azizi; Newsome, Valerie; Chung, Alicia; Jean-Louis, Girardin
Objective and Objective/UNASSIGNED:Obstructive Sleep Apnea (OSA) is a highly prevalent disorder that disparately affects racial/ethnic minorities. OSA functional health literacy can contribute to health disparities. Documenting poor OSA functional health literacy is needed to inform research agendas, policy, and advocacy efforts. The objective of this study is to develop a scale for measuring OSA functional health literacy among diverse audiences and a variety of reading levels and to ascertain its reliability and validity. Methods/UNASSIGNED:Development of the 18-item Survey of OSA Functional Health Literacy (SOFHL) was guided by literature review and input from experts. A convenience sample of persons enrolled in a clinical trial completed the survey (n=194). The psychometric evaluation was conducted using factor analysis to identify the number of dimensions in the SOFHL and their relationship to other domains that are relevant to OSA functional health literacy. Results/UNASSIGNED:Internal consistency reliability (alpha) was estimated for the resulting scale and correlations with educational attainment and income completed. All respondents were Black and 29% reported average household income less than $10,000 USD. Confirmatory factor analysis provided support for two dimensions: OSA general knowledge (alpha=0.81) and self-efficacy for OSA self-management (alpha=0.71). Conclusions/UNASSIGNED:Higher educational attainment and socioeconomic status were associated with better OSA functional health literacy. These results provide preliminary support for the SOFHL, a measure that can be used to assess OSA functional health literacy.
PMCID:8594920
PMID: 34790431
ISSN: 2093-9175
CID: 5049292