Adverse Childhood Experiences and Chronic Disease Risk in the Southern Community Cohort Study.

We used the Southern Community Cohort Study of people residing in 12 states in the southeastern United States (n=38,200 participants) to examine associations between adverse childhood experiences (ACEs) and chronic disease risk. After adjustment for confounding, there were statistically significant positive associations for people reporting four or more ACEs relative to those reporting no ACEs, and this was true for all chronic diseases except hypertension. The most elevated risk was seen for depression when measured as a yes/no variable (odds ratio (OR) 2.

Developing an Infrastructure to Cultivate Equitable and Sustainable Community-Academic Research Partnerships: Meharry Community Engagement Core.

Objectives: Achieving health equity and reducing racial and ethnic health disparities require intentional community engagement efforts by academicians. Primary among these efforts is the acknowledgement of research-related mistrust. Efforts to build trust must begin with recognition of the invaluable knowledge and experience community stakeholders possess.

Adverse Childhood Experiences and Health Care Utilization in a Low-Income Population.

Objective: To determine associations of adverse childhood experiences (ACE) with adult health care utilization in an underserved, low-income population.

Methods: Questionnaires on ACE were completed by 38,200 adults (mean age 54), two-thirds African American, recruited from community health centers (CHCs) across 12 Southeastern states. Odds ratios (ORs) and accompanying 95% confidence intervals (CIs) were computed.

Diabetes, obesity, and subsequent risk of postmenopausal breast cancer among white and black women in the Southern Community Cohort Study.

Purpose: Meta-analyses have reported a small but positive association between diabetes and postmenopausal breast cancer risk, with summary relative risks of approximately 1.15. We analyzed data from the Southern Community Cohort Study (SCCS) following an underserved population with high diabetes prevalence to prospectively examine whether diabetes was associated with subsequent postmenopausal breast cancer risk and whether obesity modified this effect.

Food intake of folate, folic acid and other B vitamins with lung cancer risk in a low-income population in the Southeastern United States.

Purpose: We prospectively examined associations of lung cancer risk with food intake of B vitamins involved in one-carbon metabolism and the use of folic acid-containing supplements among a low-income population of black and white adults in the Southeastern US.

Methods: Within the Southern Community Cohort Study, we included 1064 incident lung cancer cases among 68,236 participants aged 40-79 years at study enrollment. Food intake and the use of folic acid-containing supplements were assessed using a validated food frequency questionnaire at study enrollment.

Physical Activity Levels and Cardiometabolic Risks in Obese African American Adults: A Pilot Intervention Study.

Limited information is available regarding the effects of physical activity on risks of cardiometabolic diseases among obese African American adults. We conducted a church-based 12-week weight control and cardiometabolic risk reduction intervention (n=30, 22 females, 56.7±11.

The obesity epidemic and rising diabetes incidence in a low-income racially diverse southern US cohort.

Background: Obesity is known to be a major risk factor for diabetes, but the magnitude of risk and variation between blacks and whites are less well documented in populations heavily affected by obesity. Herein we assess rates and risks of incident diabetes in a diverse southern population where obesity is common.

Methods: A total of 24,000 black and 14,064 white adults aged 40-79 in the Southern Community Cohort Study with no self-reported diabetes at study enrollment during 2002-2009 was followed for up to 10 (median 4.

Associations Between Neighborhood Environment, Health Behaviors, and Mortality.

Introduction: Considering the joint association of neighborhood socioeconomic environment and individual-level health behaviors with health outcomes may help officials design effective disease prevention strategies. This study evaluates the joint influences of neighborhood socioeconomic environment and individual health behaviors on mortality in a cohort primarily comprising people with low individual-level SES.

Methods: The prospective Southern Community Cohort Study includes 77,896 white and African American participants recruited in the years 2002-2009; 55% of participants had a household income <$15,000 at baseline interview.

Processes in Increasing Participation of African American Women in Cancer Prevention Trials: Development and Pretesting of an Audio-Card.

The enrollment of African American women into cancer prevention trials (CPTs) continues to be low despite their higher cancer mortality rates. Clinical trials are vital to the discovery of new prevention, diagnostic, and treatment methods that improve cancer outcomes. This study addressed attitudes and beliefs associated with the sub optimal participation of African American women in CPTs through the development and pretesting of an educational tool.

Refining a Church-Based Lifestyle Intervention Targeting African-American Adults at Risk for Cardiometabolic Diseases: A Pilot Study.

Objective: The pilot study was intended to test the feasibility of a multiple-component lifestyle intervention targeting African American adults in a weight control and cardiometabolic risk reduction program on diet, activity, and stress, using community-engagement principles.

Methods: Applying mixed qualitative and quantitative measures, the intervention had a two-part sequential study design consisting of 12 weekly small group sessions that provided individual and group counseling in nutrition, exercise, and mindfulness, while incorporating focus group and interactive techniques to learn about barriers and acceptable practices for this population. The program was implemented at an African-American church in Nashville, Tennessee.

Pragmatic trial of an intervention to increase human papillomavirus vaccination in safety-net clinics.

Background: Human papillomavirus (HPV) infection has been causally linked to six cancers, and many disproportionately affect minorties. This study reports on the development and effectiveness of an intervention aimed at increasing HPV vaccine uptake among African American and Hispanic pediatric patients in safety-net clinics.

Methods: Formative research, community engagement, and theory guided development of the intervention.

Plasma Lycopene Is Associated with Pizza and Pasta Consumption in Middle-Aged and Older African American and White Adults in the Southeastern USA in a Cross-Sectional Study.

Background: The role of dietary lycopene in chronic disease prevention is not well known.

Methods: This study examined intake of lycopene and other antioxidants from lycopene-rich foods (e.g.

Combined Impact of Health Behaviors on Mortality in Low-Income Americans.

Introduction: African Americans and low-income whites have higher mortality than the U.S. general population.

Adult Cancer Risk Behaviors Associated with Adverse Childhood Experiences in a Low Income Population in the Southeastern United States.

Objectives: Adverse childhood experiences (ACE) can affect health in adulthood. We investigate the relationship between childhood experiences and adult cancer risk and screening behaviors in a racially diverse, low income population.

Methods: Nearly 22,000 adults 40 years and older in the Southern Community Cohort Study were administered the ACE questionnaire.

Adherence to Cancer Prevention Guidelines and Cancer Risk in Low-Income and African American Populations.

Background: The American Cancer Society (ACS) publishes behavioral guidelines for cancer prevention, including standards on body weight, physical activity, nutrition, alcohol, and tobacco use. The impact of these guidelines has been rarely studied in low-income and African American populations.

Methods: The study included 61,098 racially diverse, mainly low-income adults who participated in the Southern Community Cohort Study and were followed for a median of 6 years.

The Effect of Changes in Health Beliefs Among African-American and Rural White Church Congregants Enrolled in an Obesity Intervention: A Qualitative Evaluation.

Church interventions can reduce obesity disparities by empowering participants with knowledge and skills within an established community. The purpose of this study was to evaluate the Biomedical/Obesity Reduction Trial (BMORe) and investigate changes in health beliefs among obese adult participants. Ten pre-/post-intervention focus groups applying the Health Belief Model conducted in two African-American churches in Tennessee (n = 20) and South Carolina (n = 20), and one rural Appalachian church in Kentucky (n = 21).

Healthy Eating and Risks of Total and Cause-Specific Death among Low-Income Populations of African-Americans and Other Adults in the Southeastern United States: A Prospective Cohort Study.

Background: A healthy diet, as defined by the US Dietary Guidelines for Americans (DGA), has been associated with lower morbidity and mortality from major chronic diseases in studies conducted in predominantly non-Hispanic white individuals. It is unknown whether this association can be extrapolated to African-Americans and low-income populations.

Methods And Findings: We examined the associations of adherence to the DGA with total and cause-specific mortality in the Southern Community Cohort Study, a prospective study that recruited 84,735 American adults, aged 40-79 y, from 12 southeastern US states during 2002-2009, mostly through community health centers that serve low-income populations.

Prospective evaluation of the association of nut/peanut consumption with total and cause-specific mortality.

Importance: High intake of nuts has been linked to a reduced risk of mortality. Previous studies, however, were primarily conducted among people of European descent, particularly those of high socioeconomic status.

Objective: To examine the association of nut consumption with total and cause-specific mortality in Americans of African and European descent who were predominantly of low socioeconomic status (SES) and in Chinese individuals in Shanghai, China.

Socioeconomic status, race, and mortality: a prospective cohort study.

Objectives: We evaluated the independent and joint effects of race, individual socioeconomic status (SES), and neighborhood SES on mortality risk.

Methods: We conducted a prospective analysis involving 52 965 non-Hispanic Black and 23 592 non-Hispanic White adults taking part in the Southern Community Cohort Study. Cox proportional hazards modeling was used to determine associations of race and SES with all-cause and cause-specific mortality.

Mammography use among women with and without diabetes: results from the Southern Community Cohort Study.

Studies have shown an increased risk of breast cancer associated with diabetes which may be due to differences in mammography use among women who have diabetes compared with women who do not have diabetes. Baseline data was used from the Southern Community Cohort Study - a prospective cohort study conducted primarily among low-income persons in the southeastern United States - to examine the association between diabetes and mammography use. In-person interviews collected information on diabetes and mammography use from 14,665 white and 30,846 black women aged 40-79years between 2002 and 2009.

Physical activity, sedentary behavior, and cause-specific mortality in black and white adults in the Southern Community Cohort Study.

There is limited evidence demonstrating the benefits of physical activity with regard to mortality risk or the harms associated with sedentary behavior in black adults, so we examined the relationships between these health behaviors and cause-specific mortality in a prospective study that had a large proportion of black adults. Participants (40-79 years of age) enrolled in the Southern Community Cohort Study between 2002 and 2009 (n = 63,308) were prospectively followed over 6.4 years, and 3,613 and 1,394 deaths occurred in blacks and whites, respectively.

A prospective study of plasma Selenoprotein P and lung cancer risk among low-income adults.

Background: Epidemiologic studies have shown increased risks of lung cancer among adults with low blood levels of selenium, although evidence is inconsistent. In the United States, the incidence of lung cancer is higher and mean serum selenium levels lower among Blacks than Whites, but prior studies have not assessed the selenium-lung cancer association among Blacks.

Methods: From the prospective Southern Community Cohort Study, we identified 372 participants who provided blood samples and subsequently developed lung cancer.

Plasma selenium biomarkers in low income black and white americans from the southeastern United States.

Biomarkers of selenium are necessary for assessing selenium status in humans, since soil variation hinders estimation of selenium intake from foods. In this study, we measured the concentration of plasma selenium, selenoprotein P (SEPP1), and glutathione peroxidase (GPX3) activity and their interindividual differences in 383 low-income blacks and whites selected from a stratified random sample of adults aged 40-79 years, who were participating in a long-term cohort study in the southeastern United States (US). We assessed the utility of these biomarkers to determine differences in selenium status and their association with demographic, socio-economic, dietary, and other indicators.

Diabetes and prostate cancer screening in black and white men.

Purpose: Prior studies conducted primarily among white men find a reduced risk of prostate cancer associated with time since developing diabetes. While biologic explanations are plausible, the association may in part arise from more frequent prostate cancer screening among those with a diabetes diagnosis. The purpose of the present study was to investigate the association between diabetes and prostate cancer screening.