Alzheimer’s Prevention Lifestyle Risk Coaching in Low-income Older Adults

Prevention, with widespread lifestyle risk reduction at the community-level, is currently considered an effective method to decrease Alzheimer’s disease (AD). As part of the Virginia Commonwealth University iCubed Health and Wellness in Aging Core, diverse older adults (60+) living in Richmond, VA, with incomes below $12,000/year and managing either diabetes/cardiovascular symptoms, were offered weekly lifestyle telephone-health coaching for 12-weeks, providing education, motivations, self-efficacy, and referral services for AD lifestyle risk. The study sample (n=40, mean age 68 years (range: 60-77 years) was 88% African American/Black (n=35), 100% Non-Hispanic, and 45% males (n=18)). Thirty-nine (95%) of subjects successfully participated in coaching sessions; on average 91.9% (11) sessions/subject were completed. On a scale of 0-100 (higher scores more positivity), rated their experience 93.3. On a scale of 0-10 (higher scores more improvement), rated their health improved 8.36. Pre/post-test analyses indicated lifestyle improvement trends over 4-months for total lifestyle risk (F=4.69;p=.037;effect=.12), social activity (F=4.63;p=.063;effect =.09), and improvement in certain psychological domains: AD knowledge (F=4.49;p=.041;effect=.11); cognitive functioning (short-term memory (F=4.99;p=.038;effect= .21); delayed memory (F=2.26;p=.154;effect=.11); Trails A (F=5.60;p=.0294;effect=.24); and Trails B (F=2.22;p=.154;effect=.11). Participants provided positive anecdotal feedback and the need for continued health coaching. In conclusion, this preliminary work creates the impetus for future large-scale lifestyle AD prevention investigations to improve the lives of AD-risk, low-income, diverse older adults. These findings demonstrate that telephone-based health coaching is feasible, based on participant engagement, and effective, based on positive trends in reducing AD risk factors.

Virginia’s Response to the Nursing Home COVID Action Network

The Virginia Geriatric Education Center’s GWEP recruited 195 of Virginia's 273 eligible nursing homes, using two Project ECHO Nursing Home Training Centers located at George Mason University and Virginia Commonwealth University. These sessions promoted collaboration, allowed for sharing of successes and challenges, and nurtured quality improvement projects. Our next steps are to survey Virginia’s nursing homes to see if they are interested in future ECHO sessions with other topics. We plan to share these results with the Institute for Healthcare Improvement so that we may be able to continue to enhance this national network of Training Centers with faculty and staffing dedicated to quality assurance and performance improvement. The program has initiated new collaborations with nursing homes across many healthcare disciplines, strengthened connections between nursing homes and research institutions, and will help foster innovative ways to collaborate in this post-pandemic virtually connected world.

Implementing a Hybrid Summer Transition Program

The mission of the Virginia Commonwealth University Louis Stokes Alliance for Minority Participation (VCU LSAMP) program is to increase the retention and graduation rates of students from underrepresented racial and ethnic groups in science, technology, engineering, and mathematics (STEM) majors and those who matriculate into graduate programs. VCU LSAMP offers a hybrid summer transition program (HSTP) focused on facilitating the high school to college and two-year to four-year college transition process for students majoring in STEM disciplines. The goals of the program are to 1) build community among a cohort of students, 2) orient students to VCU, 3) prepare students for the academic rigors of their first year in a STEM discipline at VCU, 4) expose students to opportunities and careers in STEM, 5) engage them in the VCU LSAMP program, and 6) provide financial support. Five distinct components of the VCU HSTP are 1) a six-week online summer component, 2) a 1 week on-campus orientation, 3) a Design Project Challenge, 4) a transfer student track, and 5) an academic year component. Evaluation data reveals that the HSTP assisted participants with adjustment to the college schedule and setting, facilitated the formation of study groups, and increased overall motivation to graduate. The online courses helped familiarize students with both the academic topics in their chemistry and mathematics classes and the behaviors and norms of STEM majors. On average, participants in the HSTP had higher retention (85%) and graduation (73%) rates when compared with their peers (81% and 64%, respectively). Furthermore, those students who complete the online classes’ requirements had a higher probability of receiving a grade of B or better in their first mathematics or chemistry class.

Effect of Electronic Nicotine Delivery Systems on Cigarette Abstinence in Smokers with no Plans to Quit: Exploratory Analysis of a Randomized Placebo-Controlled Trial

Introduction: The extent to which use of electronic nicotine delivery systems (ENDS) for smoking reduction leads to cigarette abstinence in smokers with no plans to quit smoking is unclear. This exploratory analysis examined the effects of ENDS delivering different amounts of nicotine on cigarette abstinence up to 24-week follow-up, in comparison to placebo or a behavioral substitute. Methods: This four-arm parallel-group, randomized placebo-controlled trial took place at two academic medical centers in USA (Penn State Hershey and Virginia Commonwealth University). Participants were current adult smokers (N=520) interested in reducing but not planning to quit. They received brief advice and were randomized to one of four 24-week conditions, receiving either an eGo-style ENDS paired with 0, 8 or 36 mg/ml nicotine liquid (double-blind) or a cigarette-shaped tube, as a cigarette substitute (CS). Self-reported daily cigarette consumption and exhaled carbon monoxide (CO) were measured at all study visits. Outcomes included intent-to-treat, self-reported 7-day cigarette abstinence, biochemically confirmed by exhaled CO at 24 weeks after randomization. Results: At 24 weeks, significantly more participants in the 36 mg/ml condition (14/130, 10.8%) than in the 0 mg/ml condition (1/130, 0.8%) and the CS condition (4/130, 3.1%) were abstinent (relative risk = 14 [95% CI=1.9-104.9] and 3.5 [95% CI=1.2-10.4], respectively). The abstinence rate in the 8 mg/ml condition was 4.6% (6/130). Conclusions: When smokers seeking to reduce smoking tried ENDS, few quit smoking in the short term. However, if smokers continued to use an ENDS with cigarette-like nicotine delivery, a greater proportion completely switched to ENDS, as compared with placebo or a cigarette substitute.

Multi-View Data Integration Methods for Radiotherapy Structure Name Standardization

Standardization of radiotherapy structure names is essential for developing data-driven personalized radiotherapy treatment plans. Different types of data are associated with radiotherapy structures, such as the physician-given text labels, geometric (image) data, and Dose-Volume Histograms (DVH). Prior work on structure name standardization used just one type of data. We present novel approaches to integrate complementary types (views) of structure data to build better-performing machine learning models. We present two methods, namely (a) intermediate integration and (b) late integration, to combine physician-given textual structure name features and geometric information of structures. The dataset consisted of 709 prostate cancer and 752 lung cancer patients across 40 radiotherapy centers administered by the U.S. Veterans Health Administration (VA) and the Department of Radiation Oncology, Virginia Commonwealth University (VCU). We used randomly selected data from 30 centers for training and ten centers for testing. We also used the VCU data for testing. We observed that the intermediate integration approach outperformed the models with a single view of the dataset, while late integration showed comparable performance with single-view results. Thus, we demonstrate that combining different views (types of data) helps build better models for structure name standardization to enable big data analytics in radiation oncology.

Characterization of Electronic Cigarette Warning Statements Portrayed in YouTube Videos

Introduction In 2018, the United States Food and Drug Administration (FDA) required that manufacturers, packagers, importers, distributors, and retailers display an addictive or alternate warning statement on electronic cigarette (e-cigarette) visual advertisements. Few studies have investigated the FDA-mandated and other warnings on social media. This study examined the prevalence and content of warning statements in e-cigarette-related YouTube videos. Methods In 2019, The Virginia Commonwealth University Center for the Study of Tobacco Products conducted bi-monthly (February-June) YouTube searches by relevance and view count to identify e-cigarette-related videos. Overall, 178 videos met the inclusion criteria. Staff coded each video for the presence of a visual/verbal warning statement, warning statement type (e.g., FDA-mandated, addiction/tobacco, safety/toxic exposure, health effects), sponsorship, and tobacco product characteristics. A data extraction tool collected the video URL, title, upload date, and number of views, likes/dislikes, and comments. Results Only 5.1% of videos contained FDA-mandated warnings and 21.9% contained non-mandated warnings. All videos with FDA-mandated and 46.2% of non-mandated warnings were represented visually. Only 13.1% of industry-sponsored videos uploaded after the mandate effective date had a FDA-mandated warning statement and videos with FDA-mandated and non-mandated warnings had significantly fewer views, likes, dislikes, and comments. Among all non-mandated warnings, 31.3% featured an addiction/tobacco, 18.8% a safety/toxic exposure, and 37.5% a health effects warning. Conclusions The prevalence of FDA-mandated warning statements in e-cigarette related YouTube videos was low. FDA enforcement of the warning statement mandate on YouTube could increase the public’s understanding of the addictive nature of nicotine in e-cigarettes.

Using Social Media to Enhance Information Literacy

Academic librarians have long been committed to developing their students' abilities to assess the quality and credibility of various types of information. A combination of increasing public discourse about evaluating every day information and librarians' commitment to empowering students to be responsible consumers of information led Virginia Commonwealth University (VCU) librarians to develop the #VetYourSources campaign, focused on enhancing undergraduate students' skills for evaluating information in academic and day-to-day contexts through social media. This chapter details the design, planning, and execution of the campaign, as well as future directions.

Potential Concussive Event Narratives of Post-9/11 Combat Veterans: Chronic Effects of Neurotrauma Consortium Study

ABSTRACT Introduction Deployment-related mild traumatic brain injury (mTBI) affects a significant proportion of those who served in Post-9/11 combat operations. The prevalence of head injuries, including those that lead to mTBI, is often reported quantitatively. However, service member (SM) and Veteran firsthand accounts of their potential concussive events (PCEs) and mTBIs can serve as a rich resource for better understanding the nuances and context of these exposures. Materials and Methods Post-9/11 SMs and Veterans with a history of combat deployment were recruited through the Chronic Effects of Neurotrauma Consortium’s observational study of deployment-related mTBI. During a comprehensive assessment, participants completed the Virginia Commonwealth University retrospective Concussion Diagnostic Interview, a specialized validated interview measure which obtains detailed narratives of deployment-incurred blast and non-blast-related PCEs. Qualitative thematic analysis was used to identify and code recurring themes within the narratives. Results Among the sample of 106 SMs and Veterans, deployment-related mTBI was highly prevalent (67.0%). Over half (50.9%) of the participants identified a blast as the cause of their worst PCE, frequently with accompanying themes of self-reported acute neurological symptoms, intense physical blast forces, and tertiary head impact. Exposure to blast at close range, such as driving directly over an improvised explosive device, occurred in 24.7% of all blast-related narratives and in 59.3% of narratives where blast was identified as causing the worst PCE. Themes of potentially preventable head impacts experienced during noncombat circumstances were also frequent, accounting for 35% of all non-blast-related head injuries in the sample. Conclusions Prevalence of deployment-related close-range blast exposure, non-blast impact PCEs, and mTBIs among this Post-9/11 combatant sample was substantial, and in many cases potentially preventable. The use of detailed semi-structured interviews may help health care providers and policymakers to better understand the context and circumstances of deployment-related PCEs and mTBIs.