Social Determinants of Smoke Exposure During Pregnancy: Findings From Waves 1 & 2 of the Population Assessment of Tobacco and Health (PATH) Study

Maternal smoking during pregnancy (MSDP) and secondhand smoke (SHS) exposure are associated with a myriad of negative health effects for both mother and child. However, less is known regarding social determinants for SHS exposure, which may differ from those of maternal smoking during pregnancy (MSDP). To identify social determinants for SHS exposure only, MSDP only, and MSDP and SHS exposure, data were obtained from all pregnant women (18–54 years; N = 726) in waves 1 and 2 of the Population Assessment of Tobacco and Health Study (2014–2015). Multiple logistic regressions were conducted using SAS 9.4. Smoke exposure during pregnancy was common; 23.0% reported SHS exposure only, 6.1% reported MSDP only, and 11.8% reported both SHS exposure and MSDP. Results demonstrate that relationships between smoke exposure during pregnancy and social determinants vary by type of exposure. Women at risk for any smoke exposure during pregnancy include those who are unmarried and allow the use of combustible tobacco products within the home. Those who are at higher risk for SHS exposure include those who are younger in age, and those who are earlier in their pregnancy. Those who are at higher risk for maternal smoking include those with fair/poor mental health status and those who believe that others\u27 view tobacco use more positively. These results suggest the need for implementing more comprehensive policies that promote smoke-free environments. Implementing these strategies have the potential to improve maternal and fetal health outcomes associated with tobacco smoke exposure

Predictors of Lung Cancer Screening Recommendation in Virginia Using the Community Health Assessment Survey

Purpose: The purpose of this analysis was to determine the factors that may influence the probability of being recommended a lung cancer screening by a health professional in Virginia. Methods: Data were obtained from the Community Health Assessment Survey conducted by the University of Virginia (UVA) Health System and Cancer System in collaboration with Virginia Commonwealth University (VCU) Cancer Center. SAS software was used to conduct a logistic regression with the following variables: age, sex, race, current smoking status, cancer history, education level, income level, insurance, and rurality. Results: Statistically significant positive predictors included being a current smoker (OR: 3.504, CI: 1.576 - 7.794), having previous cancer history (OR: 2.159, CI: 1.090 - 4.278), and living in an urban environment (OR: 1.939, CI: 1.009 - 3.724). Conclusion: Smoking, cancer history, and rurality were considered significant predictors of lung cancer screening recommendations by a health professional in Virginia while age, sex, race, education level, income level, and insurance were not considered significant predictors in this model. This study suggests that key mechanisms underlying lung cancer outcome disparities among racial minorities and socioeconomically disadvantaged groups may lie beyond the level of screening recommendations. Further research investigating when along the disease progression these disparities tend to arise could help in creating more targeted public health interventions and improving health equity

Knowledge of the Human Papillomavirus Vaccine: An Analysis using Together for Health Virginia Population Health Survey

Purpose: The purpose of this analysis was to identify key predictors which impact knowledge of the Human Papillomavirus vaccine in adults aged 21 to 45 in Virginia. Methods: Data was collected from the Together for Health Virginia Population Surveys administered by Virginia Commonwealth University and the University of Virginia. Logistic regression was performed on data using the variables sex, age, rurality, race, education, income, occupation, and type of health insurance coverage. Results: There was a statistically significant positive relationship between knowledge of the HPV vaccine and part-time occupation (OR: 4.288, CI: 1.492-13.325), younger age (OR: 2.31, CI: 1.088-4.905), and higher education (OR: 2.683, CI: 1.227-5.870). There was a statistically significant negative relationship between knowledge of the vaccine and being male (OR: 0.437, CI: 0.248-0.771), living in an urban area (OR: 0.511, CI: 0.267-0.977), and identifying in the lower income category (OR: 0.246, CI: 0.093-0.651). Conclusion: This study identified 6 key predictors in knowledge of the HPV vaccine among adults in Virginia. Future studies should explore, in particular, the category of students and residents of urban areas. Despite these results, knowledge of the HPV vaccine does not translate to intention to receive the vaccine. Therefore, future studies should additionally study attitudes, behaviors, and potential barriers

Racial differences in parenting style typologies and heavy episodic drinking trajectories.

This study examines racial differences between Caucasians and African Americans in the association of parenting style typologies with changes in heavy episodic drinking from adolescence to young adulthood

Attention Deficit Hyperactivity Disorder symptoms and smoking trajectories: Race and gender differences

This study examined the influence of Attention Deficit Hyperactivity Disorder (ADHD) symptoms severity and directionality (hyperactive-impulsive symptoms relative to inattentive symptoms) on trajectories of the probability of current (past month) smoking and the number of cigarettes smoked from age 13 to 32. Racial and gender differences in the relationship of ADHD symptoms and smoking trajectories were also assessed

Individual- and community-level correlates of cigarette-smoking trajectories from age 13 to 32 in a U.S. population-based sample

Characterizing smoking behavior is important for informing etiologic models and targeting prevention efforts. This study explored the effects of both individual- and community-level variables in predicting cigarette use vs. non-use and level of use among adolescents as they transition into adulthood

An epigenome-wide association study of child appetitive traits and DNA methylation

The etiology of childhood appetitive traits is poorly understood. Early-life epigenetic processes may be involved in the developmental programming of appetite regulation in childhood. One such process is DNA methylation (DNAm), whereby a methyl group is added to a specific part of DNA, where a cytosine base is next to a guanine base, a CpG site. We meta-analyzed epigenome-wide association studies (EWASs) of cord blood DNAm and early-childhood appetitive traits. Data were from two independent cohorts: the Generation R Study (n = 1,086, Rotterdam, the Netherlands) and the Healthy Start study (n = 236, Colorado, USA). DNAm at autosomal methylation sites in cord blood was measured using the Illumina Infinium HumanMethylation450 BeadChip. Parents reported on their child's food responsiveness, emotional undereating, satiety responsiveness and food fussiness using the Children's Eating Behaviour Questionnaire at age 4–5 years. Multiple regression models were used to examine the association of DNAm (predictor) at the individual site- and regional-level (using DMRff) with each appetitive trait (outcome), adjusting for covariates. Bonferroni-correction was applied to adjust for multiple testing. There were no associations of DNAm and any appetitive trait when examining individual CpG-sites. However, when examining multiple CpGs jointly in so-called differentially methylated regions, we identified 45 associations of DNAm with food responsiveness, 7 associations of DNAm with emotional undereating, 13 associations of DNAm with satiety responsiveness, and 9 associations of DNAm with food fussiness. This study shows that DNAm in the newborn may partially explain variation in appetitive traits expressed in early childhood and provides preliminary support for early programming of child appetitive traits through DNAm. Investigating differential DNAm associated with appetitive traits could be an important first step in identifying biological pathways underlying the development of these behaviors.</p