Trends in the Utilization of Metabolic and Bariatric Surgery (MBS) Procedures by Race and Ethnicity in Florida (2006-2017)

Abstract Metabolic and bariatric surgery (MBS) is an increasingly common treatment option for individuals with severe obesity, but utilization disparities remain with race and ethnic minority groups completing the procedure less frequently than non-Hispanic Whites. We examined the trends in MBS procedure types and prevalence of utilization by race and ethnicity among Florida inpatients. Discharge records with any MBS using the International Classification of Diseases 9th or 10th edition Procedure Coding System (ICD-PCS), were extracted from the Florida Agency for Health Care Administration (AHCA) inpatients’ data (2006 to 2017). Those who completed either Laparoscopic Roux-en-Y Gastric Bypass (RYGB), Sleeve Gastrectomy (SG), Laparoscopic Adjustable Gastric Banding (LAGB), LAGB Revision and Repair (LAGBREV), or LAGB Removal (LAGBREM) were included in the analysis. Cochran-Mantel-Haenszel tests evaluated the trend over time for MBS procedure by race and ethnicity. The sample (n = 90,845) was predominantly non-Hispanic White (NHW, 61.7%), female (75.5%), had a commercial insurance carrier (50.0%), and severe obesity (92.3%). Significant trends (p \u3c 0.05) in three MBS procedures were observed: decreasing trends for LAGB (36.2% in 2008 to 0.3% in 2017) and for RYGB (52.2% in 2009 to 20.3% in 2017) and an increasing trend for SG (18.7% in 2010 to 75.3% in 2017). Regardless of procedure type, NHW had the highest proportion of MBS in all years. More non-Hispanic Blacks received LAGB compared to Hispanics in 2006 through 2016. From 2009 to 2017, more Hispanics received RYGB compared to the NHB inpatients. RYGB was the prevalent procedure from 2006 to 2012 but was later (2013-2017) replaced by SG in Florida hospitals. The diversity in MBS procedures among race-ethnic groups in Florida may indicate social-cultural drivers and should be further investigated

Assessing the current and desired levels of training and applied experiences in chronic disease prevention of students during medical school

Introduction Chronic diseases account for approximately 70% of deaths in the U.S. annually. Though physicians are uniquely positioned to provide behavior change counseling for chronic disease prevention, they often lack the necessary training and self-efficacy. This study examined medical student interest in receiving chronic disease prevention training as a formal part of their education as part of an effort to enhance their ability to provide guidance to patients in the future. Methods A 23-question, online survey was sent to all undergraduate medical students enrolled in a large medical education program. The survey assessed medical student interest in receiving training related to chronic disease prevention. Survey topics included student awareness of primary prevention programs, perceived importance of receiving training and applied experience in chronic disease prevention, and preferences for how and when to receive this training. Results Of 793 eligible medical students, 432 completed the survey (54.5%). Overall, 92.4% of students reported receiving formal training in physical activity, public health, nutrition, obesity, smoking cessation, and chronic diseases was of “very high” or “high” importance. Despite this level of importance, students most frequently reported receiving no or 1–5 h of formal training in a number of topics, including physical activity (35.4% and 47.0%, respectively) and nutrition (16.9% and 56.3%, respectively). The level of importance given to public health training was significantly greater across degree type (p = 0.0001) and future specialty (p = 0.03) for MD/MPH students and those interested in primary care, respectively. Conclusions While medical students perceive chronic disease prevention as an important topic, most reported receiving little to no formal training. To address the growing prevalence of chronic disease across our society, programs schools should place greater emphasis on integrating training in physical activity, nutrition, and obesity-related content into the medical education curriculum

At risk alcohol consumption with smoking by national background: Results from the Hispanic community health study/study of Latinos

Introduction: Tobacco smoking and binge or excess drinking are unhealthy behaviors that frequently co-occur. Studies of Hispanics/Latinos have mostly been of Mexican Americans although there are substantial differences in smoking and drinking by heritage background. Associated with co-use by 5 subpopulations. Methods: Cross-sectional data of 16,412 Hispanics/Latinos from Miami, the Bronx, Chicago and San Diego collected between 2008 and 2011 as part of the HCHS/SOL were analyzed. Smoking and alcohol consumption and demographic data were measured by self-report. Prevalence of smoking and alcohol consumption and co-use were reported. Logistic regression models examined the odds of co-use of smoking and binge or excess alcohol use by Hispanic/Latino background group. Results: Men of Cuban (10.3%), Puerto Rican (8.9%), and Mexican (8.9%) background had the highest prevalence of co-use of smoking and binge drinking compared to men of Central American (6.1%) and Dominican (6.6%) background. Women of Dominican (16.4%) and Puerto Rican (19.7%) background had the highest prevalence of binge drinking compared to women of Central American (10%) and Cuban (8%) background and Puerto Rican (34.1%) and Cuban (21.8%) women were the most likely to report current smoking compared to women of Central American (8.3%) and Mexican (10.4%) background. Acculturation was not associated with couse among men and women. Elevated depressive symptoms were positively associated with smoking and binge drinking among men, OR=1.5 [1.2–2.0], and women, OR=1.5 [1.1–2.2]. Puerto Rican women had increased odds of co-use of smoking and binge or excess drinking compared to Mexican American women, OR=3.2 [1.5–6.6]. Conclusions: Puerto Rican and Dominican Latinas and Central American and South American men have a higher prevalence of co-use

Alcohol Consumption and Metabolic Syndrome Among Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos

Background: The association between alcohol consumption and metabolic syndrome (MetS) among Hispanic/Latino populations has not been studied in great detail. Our study examined the relationship between alcohol consumption and MetS among U.S. Hispanics/Latinos and explored whether this relationship varied by age, body mass index, gender, and Hispanic/Latino backgrounds

Youth and Caregiver Physical Activity and Sedentary Time: HCHS/SOL Youth

We examined associations between youth and caregiver moderate/vigorous physical activity (MVPA) and sedentary (SED) time, using accelerometery, in the Hispanic Community Health Study/Study of Latino Youth (HCHS/SOL) Youth

Perceptions, prevalence, and patterns of cannabis use among cancer patients treated at 12 NCI-Designated Cancer Centers

BackgroundThe legal climate for cannabis use has dramatically changed with an increasing number of states passing legislation legalizing access for medical and recreational use. Among cancer patients, cannabis is often used to ameliorate adverse effects of cancer treatment. Data are limited on the extent and type of use among cancer patients during treatment and the perceived benefits and harms. This multicenter survey was conducted to assess the use of cannabis among cancer patients residing in states with varied legal access to cannabis.MethodsA total of 12 NCI-Designated Cancer Centers, across states with varied cannabis-access legal status, conducted surveys with a core questionnaire to assess cannabis use among recently diagnosed cancer patients. Data were collected between September 2021 and August 2023 and pooled across 12 cancer centers. Frequencies and 95% confidence intervals for core survey measures were calculated, and weighted estimates are presented for the 10 sites that drew probability samples.ResultsOverall reported cannabis use since cancer diagnosis among survey respondents was 32.9% (weighted), which varied slightly by state legalization status. The most common perceived benefits of use were for pain, sleep, stress and anxiety, and treatment side effects. Reported perceived risks were less common and included inability to drive, difficulty concentrating, lung damage, addiction, and impact on employment. A majority reported feeling comfortable speaking to health-care providers though, overall, only 21.5% reported having done so. Among those who used cannabis since diagnosis, the most common modes were eating in food, smoking, and pills or tinctures, and the most common reasons were for sleep disturbance, followed by pain and stress and anxiety with 60%-68% reporting improved symptoms with use.ConclusionThis geographically diverse survey demonstrates that patients use cannabis regardless of its legal status. Addressing knowledge gaps concerning benefits and harms of cannabis use during cancer treatment is critical to enhance patient-provider communication

Cannabis Use, Medication Management and Adherence Among Persons Living with HIV

Cannabis is used to relieve nausea, trigger weight gain, and reduce pain among adults living with HIV; however, the relationship between its use and medication adherence and management is unclear. Participants (N = 107) were from an ongoing cohort study of community-dwelling HIV+ adults, stratified by cannabis (CB) use: HIV+/CB+ (n = 41) and HIV+/CB- (n = 66). CB+ participants either tested positive in a urine toxicology screen for THC or had a self-reported history of regular and recent use. HIV-status was provided by physician results and/or biomarker assessment. Adherence was measured via the Morisky scale and medication management was assessed via the Medication Management Test-Revised. After adjusting for gender, we found no association between cannabis use group and adherence nor medication management. The amount of cannabis used was also not associated with measures of adherence and management. Preliminary findings suggest that cannabis use may not adversely influence medication adherence/management among adults living with HIV

Abstract S07-01: Examining COVID-19 preventive behaviors among cancer survivors in the United States: An analysis of the COVID-19 Impact Survey

Abstract Background: Cancer survivors are at high risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the infection that leads to COVID-19, as they are generally older and cancer therapies frequently lead to immunosuppression. Recently, to mitigate exposure the CDC recommended avoiding nonessential doctor appointments, which may lead to barriers in effective continuity of care and surveillance of cancer survivors during the COVID-19 pandemic. The patterns of COVID-19 preventive behaviors practiced by cancer survivors are unknown, including practices related to canceling doctors’ appointments. Objective: Our objective was to evaluate COVID-19-related preventive behaviors among cancer survivors in the United States (US). We further examined behaviors related to canceling or postponing activities, specifically doctors’ appointments. Methods: We utilized nationally representative weighted data from a sample of 4,428 US adults from the COVID-19 Impact Survey collected during Week 1 (April 20-26, 2020) and Week (May 4-10, 2020). We defined cancer survivors as those with a self-reported prior diagnosis of cancer. We presented frequencies and used χ2 tests to compare COVID-19-related preventive behaviors among cancer survivors to other adults. We calculated prevalence ratios with 95% confidence intervals using Poisson regression and robust estimation of standard errors to estimate determinants of canceling doctors’ appointments among cancer survivors. Results: Cancer survivors were mostly over the age of 60 years (62%), female (53%), non-Hispanic White (62%), and resided in urban areas (72%). Cancer survivors adhered to most recommended COVID-19-related preventive behaviors and were more likely to maintain social distancing (92%, χ2 p-value=0.005), wear a face mask (89%, χ2 p-value=0.001), and avoid crowded areas (84%, χ2 p-value=0.048) compared to other adults. Additionally, we found that cancer survivors are more likely to cancel their doctors’ appointments (44%, χ2 p-value=0.001) whereas they were less likely to cancel other social activities such as work (20%, χ2 p-value=0.001) and school-related (12%, χ2 p-value=0.002) activities, even among those below the age of 60. However, cancer survivors were more likely to report symptoms in the last 7 days, including muscle or body aches (χ2 p-value=0.003). The proportion of cancer patients who have canceled doctors’ appointments due to COVID-19 rose from the month of April (35%) to May (52%). Younger adults aged 18-29 years, females, and rural cancer survivors were more likely to cancel their doctors’ appointments, whereas NH-Blacks are less likely to cancel a doctor's appointment when compared to NH-Whites. Conclusion: Cancer survivors are adhering to recommended preventive behaviors. Cancer survivors’ continuity of care may be impacted by COVID-19, specifically young adults, females, and rural residents. Citation Format: Jessica Y. Islam, Marlene Camacho-Rivera, Denise C. Vidot. Examining COVID-19 preventive behaviors among cancer survivors in the United States: An analysis of the COVID-19 Impact Survey [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S07-01