Supporting diversity in clinical trials: the equitable breakthroughs in medicine site maturity model.

Background: Among the most powerful barriers to broader inclusion of diverse participants in clinical trials are social determinants of health, trustworthiness of health care providers and research institutions, and competing pressures on potential participants. Nevertheless, current tools to assess organizational capabilities for clinical trial diversity focus primarily on trial infrastructure, rely solely on quantitative self-reported data, and lack meaningful assessment of capabilities related to community engagement.

Methods: The Equitable Breakthroughs in Medicine (EQBMED) initiative developed a holistic, collaborative, site-driven formative model and accompanying assessment to catalog sites' current capabilities and identify opportunities for growth in both conducting industry-sponsored clinical trials and enriching diversity of those trials.

Living Flat: Stories from Women of Color After Mastectomy.

Background: There remain persistent racial and ethnic disparities in the receipt of post-mastectomy breast reconstruction for breast cancer. Yet, patient-reported outcomes and advocacy efforts around living flat overwhelmingly have focused on white women. We sought to characterize the lived experiences among women of color living flat after mastectomy for breast cancer.

Adult Electronic Nicotine Delivery System Use in the USA: a Scoping Review Through a Health Equity Lens.

Purpose Of Review: The objective of this scoping review is to use a health equity lens to understand the extent and type of evidence that exists about the use of electronic nicotine delivery systems (ENDS) based on socioecological understandings of health influences (i.e., the US National Institute of Minority Health and Health Disparities' (NIMHD) Research Framework).

Adaptation of the socioecological model to address disparities in engagement of Black men in prostate cancer genetic testing.

Background: Black men consistently have higher rates of prostate cancer (PCA)- related mortality. Advances in PCA treatment, screening, and hereditary cancer assessment center around germline testing (GT). Of concern is the significant under-engagement of Black males in PCA GT, limiting the benefit of precision therapy and tailored cancer screening despite longstanding awareness of these disparities.

Disparities in COVID-19 vaccine hesitancy among a diverse community-based sample in Connecticut, United States.

Though vaccination is among our strongest tools to prevent COVID-19 infections, its delivery has proven challenging. At a time when COVID-19 cases were rapidly increasing in the Northeast, we examined the role of sociodemographic factors, social determinants of health (SDOH), and health-related beliefs, including conspiracy theories, in influencing COVID-19 vaccine hesitancy among a diverse sample of Connecticut (United States) residents. Between August and December 2020, utilizing community partners and advertisements via social media, we surveyed communities known to be most impacted by COVID-19.

Qualitative exploration of longer versus shorter quit attempts among adults using E-Cigarettes for combustible cigarette cessation.

Empirical evidence about the effectiveness of using e-cigarettes to quit smoking cigarettes remains inconclusive, yet e-cigarettes are commonly used for smoking cessation. Moreover, people who have longer duration quit attempts are likely to have even longer quit attempts in the future. Researchers analyzed 40 qualitative interviews to assess adults' experiences using e-cigarettes during their longest duration quit attempt.

Association of racial discrimination in health care settings and use of electronic cigarettes to quit smoking among Black adults.

Introduction: Black people are disproportionately burdened by tobacco-related diseases and are less successful at cigarette cessation with current treatments. We know little about the effectiveness of e-cigarettes as a smoking cessation method compared to currently approved methods in Black adults who smoke. Many Black adults report experiencing racial discrimination in health care, but if discrimination is related to utilization of smoking cessation aids including e-cigarettes and success with smoking cessation in this population is unclear.

Differences in Cancer Screening Responses to State Medicaid Expansions by Race and Ethnicity, 2011‒2019.

To estimate whether state Medicaid expansions' relationships to breast, cervical, and colorectal cancer screening differ by race/ethnicity. Analyses conducted in 2021 used 2011-2016 and 2018-2019 Behavioral Risk Factor Surveillance System data on adults aged 40 to 64 years with household incomes below 400% of the federal poverty guideline (FPG; n = 537 250). Triple-difference analyses compared cancer screening in Medicaid expansion versus nonexpansion states, before versus after expansion, among people with incomes above versus below the eligibility cutoff (138% FPG).

Examining the potential role of e-cigarettes to reduce health disparities associated with menthol cigarette use: Characterizing e-cigarette use, flavors, and reasons for use among US adults smoking menthol cigarettes.

Introduction: Menthol cigarette use contributes to disproportionate tobacco-related health disparities amongst minoritized race/ethnic groups. E-cigarettes are available in flavors such as menthol and may be a less harmful substitute among adults who smoke. Yet little is known about e-cigarette flavor preference and reasons for use by race/ethnicity among adults who smoke menthol cigarettes.

Qualitative Study of User Experiences with Loop, an Open-Source Automated Insulin Delivery System.

Loop is an open-source automated insulin delivery (AID) system, used by more than 9,000 people with type 1 diabetes. Understanding the pros and cons of Loop use may help improve disease management and support population level innovation. Focus groups revealed 72 new and existing users' perspectives on Loop uptake, use, and persistence.

Discontinued Use of the Loop Insulin Dosing System: A Mixed-Methods Investigation.

Loop is an open-source automated insulin dosing system that allows users unrivaled control over system settings that affect future glucose prediction. Thousands use Loop, but little is known about those who discontinue. In a large observational study, 874 Loop participants completed surveys and provided glycemic data, 46 (5.

Demographic and substance use-related differences among high school adolescents who vape cannabis versus use other cannabis modalities.

Background: Vaping is the second most common modality of using cannabis following smoking. We examined differences in demographics and substance use behaviors between adolescent cannabis vapers and those exclusively using other cannabis modalities.

Methods: In 2019, 4875 students from six Connecticut high schools completed school-wide, online surveys.

Cost considerations for adoption of diabetes technology are pervasive: A qualitative study of persons living with type 1 diabetes and their families.

Background: Cost is a major consideration in the uptake and continued use of diabetes technology. With increasing use of automated insulin delivery systems, it is important to understand the specific cost-related barriers to technology adoption. In this qualitative analysis, we were interested in understanding and examining the decision-making process around cost and diabetes technology use.

What End Users and Stakeholders Want From Automated Insulin Delivery Systems.

Objective: The purpose of this study was to rigorously explore psychosocial factors associated with automated insulin delivery systems among people living with type 1 diabetes.

Research Design And Methods: Across four sites in the U.S.

Trust in hybrid closed loop among people with diabetes: Perspectives of experienced system users.

Automated closed loop systems will greatly change type 1 diabetes management; user trust will be essential for acceptance of this new technology. This qualitative study explored trust in 32 individuals following a hybrid closed loop trial. Participants described how context-, system-, and person-level factors influenced their trust in the system.

Diabetes and cardiometabolic risk factors in Cambodia: Results from two screening studies.

Background: Despite growing attention to diabetes throughout Asia, data from Southeast Asia are limited. This article reports rates of diabetes, hypertension, and obesity in Cambodia.

Methods: Two studies were conducted across different regions of Cambodia: (i) a 2012 screening study across urban, semi-urban, and rural areas that used point-of-care capillary glucose for determination of diabetes (n = 13 997); and (ii) a 2005 epidemiological study with random selection from two main urban areas that used oral glucose tolerance tests for determination of diabetes (n = 1863).

Expectations and Attitudes of Individuals With Type 1 Diabetes After Using a Hybrid Closed Loop System.

Purpose The first hybrid closed loop (HCL) system, which automates insulin delivery but requires user inputs, was approved for treatment of type 1 diabetes (T1D) by the US Food and Drug Administration in September 2016. The purpose of this study was to explore the benefits, expectations, and attitudes of individuals with T1D following a clinical trial of an HCL system. Methods Thirty-two individuals with T1D (17 adults, 15 adolescents) participated in focus groups after 4 to 5 days of system use.