Faculty Bibliography

OBJECTIVE:To explore how Sesame Workshop resources are perceived by Latino families with economic hardship and to highlight approaches for early heart healthy routine promotion. METHODS:We performed a purposive sampling of Latina mothers (n = 40) with young children experiencing economic hardship. Using an interview guide informed by the Consolidated Framework for Implementation Research, we recorded Spanish and English semistructured interviews, which were translated and transcribed verbatim. Partnering with Sesame Workshop, we iteratively incorporated Sesame Resources into interviews to query for acceptability. Using reflexive thematic analysis, we coded transcripts through textual analysis until saturation, prioritizing in vivo coding to capture participant voices. RESULTS:We constructed 3 themes. Parents connected with resources that 1) Reflect lived and multicultural experiences containing recognizable family scenes that can serve as tools to transfer a parent's own early routines or cultural rituals to their child. They appreciated resources that 2) Engage caregivers and children together, featuring elements for both children and adult caregivers with activities to highlight important caregivers and encourage shared play. Participants also reflected on how 3) Routines amplify family strengths and foster resilient reactions with feelings of decreased stress when daily practices become routines, promoting resilient reactions and supporting long-term goals when facing setbacks. CONCLUSIONS:An interdisciplinary partnership leveraged strengths of pediatric practitioners and Sesame Workshop to align future initiatives with the values and priorities of mothers of young children at risk for early obesity. Resultant themes inform strategies to promote heart healthy routines and relational health in young children with economic hardship.

OBJECTIVE/UNASSIGNED:To investigate the number of safety net hospitals (SNHs) that have American College of Surgeons (ACS) accreditation for surgical programs. BACKGROUND/UNASSIGNED:SNHs provide healthcare to a substantial proportion of uninsured and underserved patient populations and rely heavily on public funding to sustain their operations. ACS accreditation emphasizes evidence-based care and standardization to improve patient outcomes. However, SNHs face financial and administrative barriers to ACS accreditation. METHODS/UNASSIGNED:We investigated the number of SNHs with ACS accreditation for specific programs by utilizing the publicly available listing of ACS-accredited programs and the listing of SNHs from the America's Essential Hospitals membership. We then performed a descriptive analysis of the number and geographic distribution of SNHs within the United States and the number of SNHs with ACS-accredited programs. RESULTS/UNASSIGNED:SNHs vary by regional disparities and demographic characteristics of respective states. Almost 20% of states are without access to SNHs. Most SNHs do not pursue ACS accreditation. Of 322 SNHs, 36% were accredited for cancer care (Commission on Cancer), 31% for trauma (Trauma Quality Improvement Program), 21% for bariatrics (Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program), 13% for breast care (National Accreditation Program for Breast Centers), and 5% for rectal cancer (National Accreditation Program for Rectal Cancer). CONCLUSIONS/UNASSIGNED:ACS accreditation can benefit SNHs in improving guideline-concordant care for medically underserved patients and SNHs should be encouraged to attain ACS accreditation to improve access to and quality of care for vulnerable patient populations.

BACKGROUND/UNASSIGNED:Digital health technologies have been proposed as a potential solution to improving maternal cardiovascular (CV) health in the postpartum (PP) period. In this context we performed a systematic scoping review of digital health interventions designed to improve PP CV health. METHODS/UNASSIGNED:We conducted a systematic review of PubMed/MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Library. We included studies of PP women, with an intervention involving digital or mobile health (wearable devices, telemedicine, or remote monitoring). We included studies that measured an outcome related to CV health. RESULTS/UNASSIGNED:= 27 studies) showed no significant benefit in terms of lowered caloric intake and/or weight loss up to 1 year PP. 6 studies examined improvements in cardiometabolic markers such as lipids and glucose levels, of which the majority showed no benefit. CONCLUSION/UNASSIGNED:The majority of studies we reviewed found that digital health interventions such as mobile health, telemonitoring and wearable devices were feasible and had mixed effectiveness in improving postpartum CV health in the postpartum period.

BACKGROUND AND OBJECTIVE/OBJECTIVE:As most Prostate Imaging Reporting and Data System (PI-RADS) 5 lesions on MRI harbor Gleason grade (GG) group ≥2 disease on biopsy, optimal management of patients with imaging-biopsy discordance remains unclear. To estimate grade misclassification, we evaluated the incidence of Gleason upgrading among patients with GG1 disease in the setting of a PI-RADS 5 lesion. METHODS:We conducted a single-institution retrospective analysis to identify patients with GG1 prostate cancer on fusion biopsy with MRI demonstrating ≥1 PI-RADS 5 lesion. Primary study outcome was identification of ≥GG2 disease on subsequent active surveillance (AS) biopsy or radical prostatectomy (RP). We used multivariable models to examine factors associated with reclassification. RESULTS:We identified 110 patients with GG1 disease on initial biopsy and ≥1 PI-RADS 5 lesion. There were 104 patients (94.6%) initially managed with AS and 6 (5.5%) received treatment. Sixty-one patients (58.7%) on AS underwent additional biopsies. Of these, 43 (70.5%) patients had tumor upgrading, with 32 (74.4%) upgraded on first surveillance biopsy. Forty-four (40%) patients ultimately received treatment, including prostatectomy in 15 (13.6%) and radiation in 25 (22.7%). Two patients (1.8%) developed metastases. In multivariable models, genomic classifier score was associated with upgrading. Limitations include a lack of multi-institutional data and long-term outcomes data. CONCLUSIONS:Most patients diagnosed with GG1 prostate cancer on MRI-Ultrasound fusion biopsy in the setting of a PI-RADS 5 lesion were found to have ≥GG2 disease on subsequent tissue sampling, suggesting substantial initial misclassification and reinforcing the need for confirmatory testing.

OBJECTIVE:This cross-sectional study investigated the associations of neighborhood-level factors with immune activation, systemic inflammation, and leukocyte telomere length in 110 sexual minority men with human immunodeficiency virus. METHOD/METHODS:From 2013 to 2017, sexual minority men with human immunodeficiency virus who used stimulants were recruited in San Francisco, California and provided blood samples to measure the markers of immune activation, systemic inflammation, and leukocyte telomere length. To measure neighborhood-level indices, the home address for each participant was geocoded and linked to data from the Centers for Disease Control and Prevention. Hierarchical linear modeling was employed to investigate the associations of neighborhood-level factors with systemic inflammation and leukocyte telomere length. RESULTS:After adjusting for age, stimulant use, self-reported income, level of education, and race and ethnicity, residing in neighborhoods with greater percentages of poverty (β = .33, p < .001) and a higher proportion of racial/ethnic minority residents (β = .26, p < .05) were independently associated with higher levels of interleukin-6. Additionally, residing in neighborhoods with higher percentage of uninsured individuals was independently associated with higher tumor necrosis factor-alpha (β = .24, p < .05). Indices of neighborhood-level adversity were additionally associated with providing a urine sample that was reactive for stimulants (OR = 1.31, p = .002), which was, in turn, associated with shorter leukocyte telomere length (β = -.31, p < .05). CONCLUSIONS:Future longitudinal research should examine the biobehavioral pathways linking neighborhood-level factors and stimulant use with systemic inflammation and cellular aging. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

We read with interest the paper "Meta-analysis: The Effectiveness of Youth Psychotherapy Interventions in Low- and Middle-Income Countries" by Venturo-Conerly et al. (2023).¹ The paper presents results on the effectiveness of youth psychotherapies in low- and middle-income countries (LMICs) from a systematic review and meta-analysis using rigorous, highly regarded methods. The authors should be commended for taking on this important subject. However, we feel that the paper needs to be situated in the backdrop of a few concerns that we believe are important for LMIC geographies. In our reply, we mainly focus on the finding that interventions developed in high-income countries (HIC) were more effective if not adapted to local conditions, suggesting that non-culturally adapted interventions had better outcomes than culturally adapted ones. This, as the authors note, seems counterintuitive.

INTRODUCTION/BACKGROUND:Many U.S. states expanded the generosity of Medicaid insurance coverage of tobacco dependence treatment over the last fifteen years, but little is known about how coverage impacts cigarette smoking, especially for individuals with substance use disorder. METHODS:Data are from the 2009 to 2018 National Survey on Drug Use and Health and include Medicaid beneficiaries 18-64 years old with past year substance use disorder who smoked at least 100 cigarettes in their lifetime. Outcomes were smoking cessation, nicotine dependence, and number of cigarettes smoked per month. Difference-in-differences models were estimated for smoking behavior by state and year of comprehensive tobacco dependence treatment coverage, estimating multivariable linear probability models, adjusted for sociodemographic characteristics, co-occurring mental illness, and area-level provider supply. All data were analyzed in 2023 and 2024. RESULTS:Rates of nicotine dependence among individuals with past-year SUD increased slightly between 2009 and 2018 among individuals living in states with comprehensive tobacco dependence treatment coverage (55.6% to 58.6%) and changed little among individuals living in states with no or partial TDT coverage (60.0% to 59.5%). Quit rates increased for individuals with substance use disorder during this time, with no differences by comprehensive tobacco dependence treatment coverage. In adjusted models, no significant association between comprehensive Medicaid tobacco dependence treatment coverage and smoking behaviors was identified (e.g., cessation: β= -0.02, CI=-0.08, 0.04). One-year lagged outcomes and sensitivity analyses accounting for the differential time of initiation of state policies demonstrated similar results. CONCLUSIONS:Comprehensive tobacco dependence treatment coverage had no differential effect on smoking cessation among ever smokers with or without substance use disorder, and its expansion was not associated with changes in smoking behaviors for Medicaid beneficiaries with substance use disorder. Other multilevel interventions may be needed to impact smoking cessation rates, such as awareness and education campaigns of expanded tobacco dependence treatment coverage benefits, and interventions that reduce social and structural barriers to treatment.

BACKGROUND:Tobacco use continues to take the lives of many, and targeted interventions can counter this health burden. One possible target population is patients who have had a smoking-related diagnosis, as they may have a greater drive to quit. OBJECTIVE:To assess whether patients with previous cardiac or pulmonary conditions directly attributable to smoking have greater rates of abstinence post-discharge from hospitalization in the CHART-NY trial. DESIGN/METHODS:CHART-NY was a randomized comparative effectiveness trial comparing a more intensive versus a less intensive smoking cessation intervention after hospital discharge. We divided the 1618 CHART-NY participants into a smoking-related history group of 597 and a nonsmoking-related history group of 1021 based on cardiac or pulmonary conditions in a retrospective chart review. We conducted chi-squared analyses on baseline characteristics. Using follow-up survey data, we conducted chi-squared analyses on abstinence outcomes and made logistic regression models for the predictive value of smoking-related conditions on abstinence. PARTICIPANTS/METHODS:A total of 1059 and 1084 participants in CHART-NY who completed both 2- and 6-month follow-up surveys respectively. MAIN MEASURES/METHODS:Self-reported 30-day abstinence at 2- and 6-month follow-up and survey data for baseline characteristics. KEY RESULTS/RESULTS:Those abstinent at 6-month follow-up were more likely to have a smoking-attributable history (OR = 1.40, 95% CI 1.09-1.81). When stratified based on intervention, only the intensive counseling group was significant (OR = 1.53, 95% CI 1.08-2.17). The regression model using a smoking-related comorbidity score was significant at 6 months (OR = 1.29, p = 0.03), and the multivariate logistic regression model analyzing each smoking-related condition separately demonstrated significance for myocardial infarction at 6 months (OR = 1.66, p = 0.03). CONCLUSIONS:People who smoke who have experienced smoking-related conditions may be more likely to benefit from smoking cessation interventions, especially intensive telephone-based counseling. Multiple conditions had an additive effect in predicting long-term abstinence after intervention, and myocardial infarction had the greatest predictive value.