How do Hispanics/Latinos Perceive and Value the Return of Research Results?

Introduction: Interest in the return of research results has been increasing; however, little is known about how Hispanics/Latinos perceive and value receiving results. This study examined differences among Hispanics/Latinos by education and income in the experience and expectations about the return of research results, perceived value of specific types of information, and the least and most valuable specific information. Method: Retrospective observational design using a cross-sectional national survey sample of Hispanics/Latinos (n = 327). Results: Higher educational attainment was positively associated with the expectation to receive research results, likelihood to participate in research if given study findings, and likelihood to trust researchers if given results. Higher income was positively associated with the perceived value of getting results. Respondents with higher education specifically perceived greater value in information about how lifestyle and genetics affect their risk of disease, how genetics affect how they respond to medications, their ancestry, available clinical trials near them, and how to connect with other study participants. Respondents with higher income perceived greater value in information about how genetics affect their risk of disease and how they respond to medications. Conclusion: The findings offer important insights for planning research initiatives and for developing culturally targeted educational materials for Hispanics/Latinos.

Genetically Predicted Higher Educational Attainment Decreases the Risk of COVID-19 Susceptibility and Severity: A Mendelian Randomization Study

Background: Prior observational studies indicated that lower educational attainment (EA) is associated with higher COVID-19 risk, while these findings were vulnerable to bias from confounding factors. We aimed to clarify the causal effect of EA on COVID-19 susceptibility, hospitalization, and severity using Mendelian randomization (MR).Methods: We identified genetic instruments for EA from a large genome-wide association study (GWAS) (n = 1,131,881). Summary statistics for COVID-19 susceptibility (112,612 cases and 2,474,079 controls), hospitalization (24,274 cases and 2,061,529 controls), and severity (8,779 cases and 1,001,875 controls) were obtained from the COVID-19 Host Genetics Initiative. We used the single-variable MR (SVMR) and the multivariable MR (MVMR) controlling intelligence, income, body mass index, vigorous physical activity, sedentary behavior, smoking, and alcohol consumption to estimate the total and direct effects of EA on COVID-19 outcomes. Inverse variance weighted was the primary analysis method. All the statistical analyses were performed using R software.Results: Results from the SVMR showed that genetically predicted higher EA was correlated with a lower risk of COVID-19 susceptibility [odds ratio (OR) 0.86, 95% CI 0.84–0.89], hospitalization (OR 0.67, 95% CI 0.62–0.73), and severity (OR 0.67, 95% CI 0.58–0.79). EA still maintained its effects in most of the MVMR.Conclusion: Educational attainment is a predictor for susceptibility, hospitalization, and severity of COVID-19 disease. Population with lower EA should be provided with a higher prioritization to public health resources to decrease the morbidity and mortality of COVID-19.

Difference in predictors and barriers to arts and cultural engagement with age in the United States: A cross-sectional analysis using the Health and Retirement Study

Introduction Arts and cultural engagement are associated with a range of mental and physical health benefits, including promoting heathy aging and lower incidence of age-related disabilities such as slower cognitive decline and slower progression of frailty. This suggests arts engagement constitutes health-promoting behaviour in older age. However, there are no large-scale studies examining how the predictors of arts engagement vary with age. Methods Data from the Health and Retirement Study (2014) were used to identify sociodemographic, life satisfaction, social, and arts appreciation predictors of (1) frequency of arts engagement, (2) cultural attendance, (3) difficulty participating in the arts, and (4) being an interested non-attendee of cultural events. Logistic regression models were stratified by age groups [50–59, 60–69, ≥70] for the frequency of arts participation outcome and [50–69 vs ≥70] all other outcomes. Results Findings indicated a number of age-related predictors of frequent arts engagement, including gender, educational attainment, wealth, dissatisfaction with aging, and instrumental activities of daily living (iADL). For cultural event attendance, lower interest in the arts predicted lack of engagement across age groups, whereas higher educational attainment and more frequent religious service attendance became predictors in older age groups (≥ 70). Adults in both age groups were less likely to report difficulties engaging in the arts if they had lower neighbourhood safety, whilst poor self-rated health and low arts appreciation also predicted reduced likelihood of this outcome, but only in the younger (50–69) age group. Adults in the older (≥ 70) age group were more likely to be interested non-attendees of cultural events if they had higher educational attainment and less likely if they lived in neighbourhoods with low levels of safety. Conclusions Our results suggest that certain factors become stronger predictors of arts and cultural engagement and barriers to engagement as people age. Further, there appear to be socioeconomic inequalities in engagement that may increase in older ages, with arts activities overall more accessible as individuals age compared to cultural engagement due to additional financial barriers and transportation barriers. Ensuring that these activities are accessible to people of all ages will allow older adults to benefit from the range of health outcomes gained from arts and cultural engagement.

How Socioeconomic, Health Seeking Behaviours, and Educational Factors Are Affecting the Knowledge and Use of Antibiotics in Four Different Cities in Asia

Antibiotic resistance is occurring widely throughout the world and is affecting people of all ages. Socioeconomic factors, education, use of antibiotics, knowledge of antibiotics, and antibiotic resistance were assessed in four cities in Asia, namely Hong Kong, Shanghai, Hangzhou, and Bangkok. A survey using cluster sampling was used in 2021 to collect data on 642 subjects. Hongkongers used less antibiotics and were knowledgeable about using antibiotics to treat diseases, while Shanghainese were knowledgeable about antibiotic resistance. The multi-linear regression model reported that respondents who lived in Hong Kong (β = 0.744 (95% CI: 0.36–1.128), Shanghai (β = 1.65 (95% CI: 1.267–2.032), and Hangzhou (β = 1.393 (95% CI: 0.011–1.775) (reference group: Bangkok), who had higher scores on antibiotics knowledge (β = 0.161 (95% CI: 0.112–0.21)), higher educational attainment (β = 0.46 (95% CI: 0.296–0.625)), and who were more likely to consult a doctor on using antibiotics (β = 1.102 (95% CI: 0.606–1.598)), were more likely to give correct answers about antibiotic resistance, p < 0.001. Older respondents were less likely to answer the items correctly (β = −0.194 (95% CI: −0.333–−0.055), p < 0.01. When educating the public on the proper use of antibiotics and antibiotic resistance, multiple strategies could be considered for people from all walks of life, as well as target different age groups.

Older Adults’ Worry about COVID-19: Associations with Experiences of COVID-19 Among Social Connections

The COVID-19 pandemic has challenged the physical and mental health of older adults, yet it is unknown how much older adults worry about their own exposure. As older adults are at increased risk for severe complications from COVID-19, understanding patterns of worry may inform public health guidelines and interventions for this age group. We investigated older adults’ worry about COVID-19 in the early months of the pandemic and associations with familial/friend’s diagnosis or disease symptoms. Data comes from the baseline (April/May 2020), one-month, and two-month follow-up surveys from the COVID-19 Coping Study, a national longitudinal cohort study of US adults aged ≥55. We used linear regression models to investigate the association between self-reported familial/friend diagnosis or symptoms with pandemic worry, accounting for demographic factors and individual diagnosis or experience of COVID-19 symptoms. Participants (Baseline=4379, 1 month= 2553, 2 month=2682) were 67 years old on average, 72% were female, 5.7% were non-White, and 80.5% had a college degree. At baseline, 26.6% of participants had friends or family who had been diagnosed or experienced symptoms of COVID-19. Having friends or family diagnosed or with symptoms of COVID-19 (B=0.08, SE=0.04, p&lt;.05), being female (B=0.42, SE=0.03, p&lt;.001), and having higher educational attainment (B=0.06, SE=0.02, p&lt;.001) were significantly associated with greater worry about COVID-19. These associations were consistent over 3 months. Understanding if worry about the pandemic correlates with following public health guidelines is a key next step so intervention strategies can prioritize older adults and their social networks.

Underdiagnosis of Dementia among Indigenous Older Adults with Cognitive Impairment

Early and timely diagnosis of dementia has been recognized as key to improving health outcomes. However, underdiagnosis among the indigenous population has not been adequately investigated. This study examines the association between indigenous ethnic identity and receiving a diagnosis of dementia and identifies factors associated with receiving a diagnosis of dementia. Data were drawn from Ecuador’s Survey of Health, Welfare and Aging (SABE) – 2009, based on a probability sample of households in Ecuador with at least one person 60 years or older. This is a robust data set that allows for understanding ethnic dimensions and disparities, especially because of the successful recruitment of indigenous households. The final sample consisted of 1,437 people who had cognitive impairment. Whether participants had ever been told that he/she had dementia was compared between the groups of people who identified themselves either as indigenous or others. Binary logistic regression analysis was utilized. Indigenous participants had a lower probability than others of receiving a diagnosis of dementia after controlling for health and function related covariates. This association became statistically insignificant after including socioeconomic factors in the model. The final model revealed that people who had higher educational attainment were more likely to receive a diagnosis of dementia. Findings suggest that underdiagnosis among indigenous older adults can be explained by their lower socioeconomic status rather than by health and functional status. This finding implies the possibility of developing strategies to promote timely diagnosis by targeting populations who are especially susceptible to underdiagnosis of dementia.

Willingness and Uptake of the COVID-19 Testing and Vaccination in Urban China: An Online Cross-Sectional Survey at Early 2021

Background: Regular testing and vaccination are effective measures to mitigate the ongoing COVID-19 pandemic. Few studies have focused on COVID-19 testing and vaccination uptake may change as the pandemic continues. This study aims to examine willingness and uptake of COVID-19 testing and vaccination during a low-risk period of the COVID-19 pandemic in urban China.Methods: A cross-sectional online survey was conducted among 2244 adults in urban China. Descriptive analyses were performed to compare the respondents’ willingness and uptake of COVID-19 testing and vaccination. Multivariate logistic regressions were fitted to investigate the factors associated with willingness and uptake of the two measures.Findings: In early 2021, 52.45% of the respondents had received or scheduled a COVID-19 test at least once, and a majority (95.63%) were willing to receive testing. 63.28% of the respondents had received/scheduled or were willing to receive a COVID-19 vaccine. Willingness and uptake of COVID-19 testing were not associated with socio-demographic characteristics, except for occupation. Being of older age, migrants, having higher educational attainment and secure employment were associated with a higher uptake of COVID-19 vaccination among the surveyed respondents, while willingness to vaccinate was consistent across socio-demographic characteristics among those who had not been vaccinated. Interpretation: Chinese adults expressed almost universal willingness of COVID-19 testing and relatively low willingness of COVID-19 vaccination at the low-risk period of the COVID-19 pandemic, independent from their socio-demographic characteristics. Maintaining willingness of COVID-19 vaccination are key especially when the pandemic evolved into a low-risk period.

Knowledge of Fertility and Perception of Fertility Treatment Among Adults with Sickle Cell Disease (KNOW FERTILITY)

Background Adults with sickle cell disease (SCD) face unique fertility risks due to SCD and use of disease modifying therapies (DMTs). Concerns about compromising fertility may inform patients' therapy choices, but little is known about fertility knowledge in adults with SCD. The Cardiff Fertility Knowledge Scale (CFKS) and Fertility Treatment Perception Survey have been studied in international and national cohorts 1,2. The purpose of this study was to administer these surveys to adults with SCD and compare responses to previously studied populations. Methods Our IRB approved this cross-sectional study of adults with SCD (≥18YO) cared for at our Sickle Cell Center for Adults. Due to the COVID-19 pandemic, eligible subjects were recruited during routine telemedicine clinic visits and by invitation via electronic medical record. We collected demographic information (sex, age (≥/&lt; 31YO), educational attainment, and use of DMTs). The CFKS is a 13-question survey that measures knowledge of causes of reduced fertility, common misconceptions about fertility, and infertility facts. Questions are answered True/False/Don't know and equally weighted; the cumulative score is 0-100%. We compared the mean CFKS scores to the scores from two published cohorts 1,2. The fertility treatment perception survey consists of two positive and four negative statements about fertility treatment with responses given on a five-point Likert scale (1= strongly disagree to 5= strongly agree). Responses are calculated by number of respondents with an agreement score of 4 and/or 5 divided by total number of respondents per sub-group; higher scores indicate stronger agreement. Analysis included summary statistics with means and standard deviations and independent student's T-test to compare the mean fertility knowledge scores. Results We contacted 435 subjects; 91 respondents were enrolled (21% response rate). Respondents were 77% female [median age 33 years (IQR 23, 50)]. 51% completed high school or less and 18% used one or more DMTs, with 65% taking hydroxyurea. Table 1 shows the CFKS results. The average CFKS score was 50%, lower than the international cohort (50% vs. 57%, p&lt;0.001) and higher than a cohort of Black women in Atlanta, GA (50% vs. 38%, p&lt;0.001). Respondents with higher educational attainment had a higher score (55% secondary education vs. 44% primary education, p=0.04). The questions most answered correctly addressed the lack of correlation between erectile function and fertility (79%) and smoking's risk to fertility in men (69%) and women (71%). The questions least answered correctly were about classifying infertility (32%) and the impact of age effect (34%), overweight effect (25%), and sexually transmitted infections' effect on fertility (36%). There was no difference in knowledge scores by age, sex, or SCD treatment. Table 2 shows fertility treatment perception survey results. Some respondents (34%) agreed that fertility treatments are safe. Almost half (46%) agreed that fertility treatments are effective. Over 60% of respondents agreed that fertility treatments are scary and/or cause emotional problems, while 48% agreed that fertility treatments may have short-term physical effects. There was no difference in responses by sex, age, or SCD treatment. Conclusion In this study, we identify that higher educational attainment in adults with SCD is associated with better fertility knowledge. All subjects had low knowledge of sexually transmitted infections, weight gain, and older age as infertility risks. Although there is concern that hydroxyurea may compromise fertility, its use was not associated with greater fertility knowledge in this study. Given concerns about fertility in the SCD community, we identify an opportunity to support patients concerned about fertility by contextualizing real or theorized SCD-specific fertility risks within a broader set of established fertility risks. References: 1. Bunting L, Tsibulsky I, Boivin J. Fertility knowledge and beliefs about fertility treatment: findings from the International Fertility Decision-making Study. Hum Reprod. 2013 Feb;28(2):385-97. doi: 10.1093/humrep/des402. Epub 2012 Nov 25. PMID: 23184181. 2. Wiltshire A, Brayboy LM, Phillips K, et al. Infertility knowledge and treatment beliefs among African American women in an urban community. Contracept Reprod Med. 2019 Sep 24;4:16. doi: 10.1186/s40834-019-0097-x. PMCID: PMC6757383. Figure 1 Figure 1. Disclosures Lanzkron: Shire: Research Funding; GBT: Research Funding; Novo Nordisk: Consultancy; CSL Behring: Research Funding; Pfizer: Current holder of individual stocks in a privately-held company; Teva: Current holder of individual stocks in a privately-held company; Novartis: Research Funding; Bluebird Bio: Consultancy; Imara: Research Funding.