Cell Phone Information Seeking Explains Blood Pressure in African American Women

Although cell phone use and Internet access via cell phone is not marked by racial disparities, little is known about how cell phone use relates to blood pressure and health information seeking behaviors. The purposes of this study were to (a) describe Internet activities, cell phone use, and information seeking; (b) determine differences in blood pressure and information seeking between cell phone information seekers and nonseekers; and (c) examine cell phone information seeking as a predictor of blood pressure in African American women. Participants ( N = 147) completed a survey and had their blood pressure measured. Independent-sample t tests showed a significant difference in systolic blood pressure in cell phone information seekers and nonseekers. Linear regression revealed cell phone information seeking as an independent predictor of systolic blood pressure, despite confounders. It is possible that cell phone information seekers were using health information to make decisions about self-management of blood pressure

Reducing Disparities in Hypertension among African American Women through Understanding Information Seeking and Information Use.

Purpose: The purpose of this dissertation project is to establish a foundation to develop interventions to reduce the health disparity in hypertension that disproportionally affects African American women: (a) explore the evidence on Internet health information seeking; (b) describe Internet behaviors and information behaviors in a sample of African American women; and (c) determine the ability of a conceptual model to explain the variance in information use in a sample of African American women. Methods: The first set of data (literature review) was collected from 15 electronic databases. A total of 9 empirical studies were included in the review. The second set of data was collected from African American women attending a Midwestern church conference (n = 156). Frequencies, descriptives, and means were used to describe blood pressure, hypertension knowledge scores, and information seeking. Pearson r correlations were used to examine the relationships between information seeking and other information behaviors. Logistic regression was used to examine use of information take action to self-mange blood pressure. Results: Manuscript 1 provides seven themes related to Internet health information seeking. Manuscript 2 shows that African American women could use enhanced hypertension education and the Internet could be a facilitator for nurse-patient interactions. Manuscript 3 displays findings that describe the ability conceptual model to explain information used to actively manage blood pressure in African American women. The conceptual model was a good fit to the data as correctly classified women who reported use of information to take action to self-manage blood pressure and those who did not among women at risk for hypertension. The conceptual model was not a good fit for women diagnosed with hypertension. Conclusions: Using the Internet as a tool may be useful for African American women who are interested in self-managing their blood pressure. Women in the sample were using the Internet with frequency and could benefit from enhanced hypertension education. Social aspects of information seeking were identified in this sample; the women reported collaborative information seeking, incidental information acquisition, and information sharing. Information sharing was a significant, independent explanatory variable in the logistic regression models predicting information use.PHDNursingUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/108935/1/lenettew_1.pd

“Take an opportunity whenever you get it”: Information sharing among African‐American women with hypertension

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141773/1/asi23923_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141773/2/asi23923.pd

Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission

Funder: Addenbrooke's Charitable Trust, Cambridge University Hospitals; FundRef: http://dx.doi.org/10.13039/501100002927Significant differences exist in the availability of healthcare worker (HCW) SARS-CoV-2 testing between countries, and existing programmes focus on screening symptomatic rather than asymptomatic staff. Over a 3 week period (April 2020), 1032 asymptomatic HCWs were screened for SARS-CoV-2 in a large UK teaching hospital. Symptomatic staff and symptomatic household contacts were additionally tested. Real-time RT-PCR was used to detect viral RNA from a throat+nose self-swab. 3% of HCWs in the asymptomatic screening group tested positive for SARS-CoV-2. 17/30 (57%) were truly asymptomatic/pauci-symptomatic. 12/30 (40%) had experienced symptoms compatible with coronavirus disease 2019 (COVID-19)>7 days prior to testing, most self-isolating, returning well. Clusters of HCW infection were discovered on two independent wards. Viral genome sequencing showed that the majority of HCWs had the dominant lineage B∙1. Our data demonstrates the utility of comprehensive screening of HCWs with minimal or no symptoms. This approach will be critical for protecting patients and hospital staff

Genomic epidemiology of SARS-CoV-2 in a UK university identifies dynamics of transmission

AbstractUnderstanding SARS-CoV-2 transmission in higher education settings is important to limit spread between students, and into at-risk populations. In this study, we sequenced 482 SARS-CoV-2 isolates from the University of Cambridge from 5 October to 6 December 2020. We perform a detailed phylogenetic comparison with 972 isolates from the surrounding community, complemented with epidemiological and contact tracing data, to determine transmission dynamics. We observe limited viral introductions into the university; the majority of student cases were linked to a single genetic cluster, likely following social gatherings at a venue outside the university. We identify considerable onward transmission associated with student accommodation and courses; this was effectively contained using local infection control measures and following a national lockdown. Transmission clusters were largely segregated within the university or the community. Our study highlights key determinants of SARS-CoV-2 transmission and effective interventions in a higher education setting that will inform public health policy during pandemics.</jats:p

Abstract P281: Examining Allostatic Load Among Marijuana Users In The United States: An Analysis Of The National Health And Nutrition Examination Surveys, 2007-2010

Introduction: Allostatic Load (AL) has been associated with cardiovascular risk and subsequent cardiovascular disease disparities. Recent studies have investigated pharmacological approaches to reduce and/or reverse AL. One particular area of interest lies in the utility of the cannabinoid system in regulating the physiological irregularities associated with AL. The purpose of this study was to describe AL among marijuana users vs. non-marijuana users in a United States sample. Hypothesis: We hypothesized that AL scores and AL prevalence would be lower among marijuana users compared to non-marijuana users. Methods: Data from adults (20-to-65 years) who completed the National Health and Nutrition Examination Surveys between 2007 and 2010 ( N =6,994) were examined. Marijuana use was defined via computer-assisted self-report of lifetime use (had ever smoked marijuana, yes/no) and current use (had used marijuana at least once in the past 30-days). AL scores were calculated using clinical cut-points for BMI, systolic blood pressure, diastolic blood pressure, pulse, C-reactive protein, high-density lipoprotein, total cholesterol, Glycohemoglobin, albumin, and creatinine clearance. An independent samples t-test was conducted to compare AL scores among lifetime and current marijuana users. Pearson Chi-square analysis was employed to determine whether the prevalence of AL (i.e., AL scores 4 or above) significantly differed between low and high frequency marijuana users. Results: Over half of the sample (58%) reported lifetime use of marijuana. Among current users of marijuana (17.0%), participants reported having used marijuana an average of 12 times in the last month. There was a significant difference in mean AL scores, such that means for those who had ever smoked marijuana (M= 1.67, SD= 1.49) were lower than those who had never smoked marijuana (M=1.84, SD= 1.54; p < .001). Current marijuana users with low frequency of marijuana use in the last 30 days (i.e., less than 12 times) had a significantly higher AL score (M= 1.59, SD= 1.51) than those with high frequency of marijuana use (M=1.37, SD= 1.34; p = .01). The prevalence of AL was significantly higher among participants with low frequency of marijuana use (12.4%) versus those with high frequency (7.0%) ( p = .01). Conclusion: The findings of this analysis describe the relationship between marijuana use and allostatic load. Specifically, allostatic load was lower among individuals reporting lifetime marijuana use and those reporting a higher frequency of current marijuana use. Additional research is needed, in particular - longitudinal studies that examine diverse patterns of marijuana use and variations in allostatic load

Abstract P253: Blood Pressure Status Among Current Cigarette, E-cigarette, And Marijuana Users In The United States: An Analysis Of The National Health And Nutrition Examination Surveys, 2013-2016

Introduction: Tobacco and marijuana have been associated with abnormal blood pressure (BP). Yet, little is known about differences in BP status among individuals who smoke cigarettes, e-cigarettes, and marijuana, independently or in combination. The purpose of this study was to provide prevalence estimates of elevated BP, stage 1 hypertension, and stage 2 hypertension among smokers of varied substances and route of administration. Hypothesis: We hypothesized that cigarette users would have higher BP levels compared to e-cigarette or marijuana users. Methods: Data from adults (20-to-59 years) who completed the National Health and Nutrition Examination Surveys between 2013 and 2016 (N=6,282) were examined. Smoking status was ascertained by self-report of use in the last 30-days via computer assisted questionnaires as: cigarette only, cigarette + marijuana, cigarette + e-cigarette, e-cigarette only, e-cigarette + marijuana, marijuana only, and non-smokers of any product. BP was ascertained by the average of three systolic and diastolic readings. Following the latest BP guidelines, BP was categorized as elevated, hypertension stage 1 (HTN1), or hypertension stage 2 (HTN2). Survey method-appropriate chi-squared analyses were conducted to provide weighted prevalence estimates. Results: Over half (60.6%) of the adults in the sample were current smokers [cigarette only (31.9%); e-cigarette only (1.4%); marijuana only (7.3%); cigarette + marijuana (16.1%), cigarette + e-cigarette (3.1%), e-cigarette + marijuana (0.7%)]. A quarter (25.5%) of the sample had elevated BP; 43.9% had HTN1; and 12.7% had HTN2. Among smokers, cigarette only users had the highest prevalence of elevated BP (7.7%), HTN1 (14.7%), and HTN2 (4.3%); followed by the combined use of cigarettes and marijuana (4.8%, 6.0%, 1.2%, respectively). Marijuana and e-cigarette combination users had the lowest prevalence of HTN1 (0.16%) and HTN2 (0.0%) followed by marijuana only users (2.8%, 0.9%, respectively; p=0.04). Conclusions: This analysis is among the first to leverage population-based data to assess BP status among independent and combination users of cigarettes, e-cigarettes, and marijuana. The majority of the sample had at least elevated BP, which is documented to increase cardiovascular disease risk. Additional studies are needed to evaluate the impact of frequency and duration of use on cardiovascular disease risk after considering other lifestyle behaviors (i.e., diet and physical activity)

Designing a Cocreated Intervention with African American Older Adults for Hypertension Self-Management

Hypertension is a lifelong disease that requires self-management. Additionally, there are disparities in hypertension self-management that disproportionately affect African Americans. Interventions designed in collaboration with older adults have the potential to improve hypertension self-management. The purpose of this design paper is to describe the process in which African American older adults and nurse researchers cocreated an intervention to address stress in the self-management of hypertension. A semistructured interview guide was used to elicit feedback on self-management behaviors to cocreate an intervention with the participants. Participants provided constant iterative feedback on the design used for the intervention. Participants prioritized the content and mode of delivery. African American older adults with hypertension (N=31; 87% women) participated in two focus group sessions. The primary stressors identified by the group that influenced their blood pressure self-management were as follows: (a) measuring blood pressure and using home blood pressure monitors; (b) difficulty communicating with family and friends; (c) sleep management and pain at night; and (d) healthy eating. Based on the participants’ feedback, we created four biweekly (2-hour) group sessions that incorporated their suggestions and addressed their concerns. Health care providers can use this technique to engage African American older adults in participant-centered hypertension self-management