bluuebunny/crossref_metadata_2025_split huggingface dataset:
National PReCePT Programme: a before-and-after evaluation of the implementation of a national quality improvement programme to increase the uptake of magnesium sulfate in preterm deliveries
Authors: Edwards Hannah B , Redaniel Maria Theresa , Sillero-Rejon Carlos , Margelyte Ruta , Peters Tim J , Tilling Kate , Hollingworth William , McLeod Hugh , Craggs Pippa , Hill Elizabeth , Redwood Sabi , Donovan Jenny , Treloar Emma , Wetz Ellie , Swinscoe Natasha , Ford Gary A , Macleod John , Luyt Karen 
Published: January 2023

ObjectiveTo evaluate the effectiveness and cost-effectiveness of the National PReCePT Programme (NPP) in increasing use of magnesium sulfate (MgSO4) in preterm births.DesignBefore-and-after study.SettingMaternity units (N=137) within NHS England and the Academic Health Science Network (AHSN) in 2018.ParticipantsBabies born ≤30 weeks’ gestation admitted to neonatal units in England.InterventionsThe NPP was a quality improvement (QI) intervention including the PReCePT (Preventing Cerebral Palsy in Pre Term labour) QI toolkit and materials (preterm labour proforma, staff training presentations, parent leaflet, posters for the unit and learning log), regional AHSN-level support, and up to 90 hours funded backfill for a midwife ‘champion’ to lead implementation.Main outcome measuresMgSO4uptake post implementation was compared with pre-NPP implementation uptake. Implementation and lifetime costs were estimated.ResultsCompared with pre-implementation estimates, the average MgSO4uptake for babies born ≤30 weeks’ gestation, in 137 maternity units in England, increased by 6.3 percentage points (95% CI 2.6 to 10.0 percentage points) to 83.1% post implementation, accounting for unit size, maternal, baby and maternity unit factors, time trends, and AHSN. Further adjustment for early/late initiation of NPP activities increased the estimate to 9.5 percentage points (95% CI 4.3 to 14.7 percentage points). From a societal and lifetime perspective, the health gains and cost savings associated with the NPP effectiveness generated a net monetary benefit of £866 per preterm baby and the probability of the NPP being cost-effective was greater than 95%.ConclusionThis national QI programme was effective and cost-effective. National programmes delivered via coordinated regional clinical networks can accelerate uptake of evidence-based therapies in perinatal care.
Abstract A013: Patterns of heterolocalism among Chinese immigrants in Philadelphia
Authors: Batterson Ella , Tseng Marilyn , Walton Emily C. , Egleston Brian , Zhong Julia , Li Minzi , Fang Carolyn 
Published: January 2023

Abstract
Residence in an immigrant enclave has been linked to lower risk for some cancers but higher risk of late-stage diagnosis. In part, these patterns may be explained by the cultural, institutional, and social resources in immigrant enclaves that protect against ill health. Modern communication and transportation can facilitate “exposure” to immigrant enclaves as resource hubs, while individuals may reside in more racially integrated neighborhoods. This process of heterolocalism is underexplored in its relationship to cancer risk. The current study compares residents and non-residents of Chinese immigrant enclaves in Philadelphia with respect to distances traveled for various activities. Participants were 520 Chinese immigrant men and women aged 35-65 y. Interviews conducted 9/18-01/20 included questions on residence and usual locations of five types of activities: employment, grocery shopping, religious services, healthcare, and leisure. Participants were categorized as residing in a traditional (n=167), emerging (n=202), or non-enclave (n=151) neighborhood depending on the co-ethnic density of their census tract and adjacent tracts. We used ArcGIS to geocode participants’ residences and activity locations and conducted spatial analyses to examine distances traveled to these activities. Results indicated that residents of traditional enclaves stayed within or near their residential neighborhoods for grocery shopping, religious services, and leisure activities (median distances all &lt;1 mi), although they traveled further for employment (median 2.5 mi) and healthcare (median 1.9 mi). Based on non-parametric Kruskal-Wallis tests, traditional enclave residents traveled the shortest median distances to all activities (all p&lt;0.001). In contrast, non-enclave residents traveled the furthest for groceries (median 2.9 mi), religious services (median 8.2 mi), and leisure (median 3.2 mi) (all p&lt;0.001). Mapped travel patterns indicate that many non-enclave residents travelled to enclave areas for these activities. Our findings suggest that heterolocalism is a means by which immigrants maintain co-ethnic connections. They also suggest the importance of understanding enclave ‘exposure’ beyond place of residence to clarify the relationships between immigrant enclaves and cancer outcomes.
Citation Format: Ella Batterson, Marilyn Tseng, Emily C. Walton, Brian Egleston, Julia Zhong, Minzi Li, Carolyn Fang. Patterns of heterolocalism among Chinese immigrants in Philadelphia [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A013.
Abstract A039: Factors associated with reconstruction rates in breast cancer patients after mastectomy: Investigating disparities at a private versus safety net hospital
Authors: Norman Thomas , Hwang Lindsay , Ye Jason 
Published: January 2023

Abstract
Purpose: Despite post-mastectomy reconstruction being associated with improved body image, self-confidence, and quality of life, some evidence suggests that race, income, and insurance are associated with decreased rates of reconstruction. The purpose of this study was to evaluate the rates and factors associated with reconstruction after mastectomy at our institution’s private hospital (PH) and government safety net hospital (SNH). Methods: This retrospective study included 158 women (95 PH, 63 SNH) with unilateral, invasive, node-positive breast cancer who underwent surgery (mastectomy), chemotherapy, and radiotherapy in 2008–2019. We recorded age, race, preferred language, hospital, type of insurance, tumor features, and cancer treatment. Results: The median patient age was 52 (range, 27–83) years. Of the 158 patients, 60 underwent reconstruction: 52 (54.7%) at PH and 8 (12.7%) at SNH. Chi-squared tests identified age, race, language, insurance, and hospital as factors associated with reconstruction. In univariable regression analysis, these factors were associated with a higher odds of reconstruction: PPO insurance (OR 2.71, 95% CI 1.15–6.35) and treatment at PH (OR 10.48, 95% CI 4.71–23.32). Lower odds of reconstruction were associated with older age (age &gt; 52 years: OR 0.47, 95% CI 0.25–0.87), Hispanic ethnicity (OR 0.22, 95% CI 0.10–0.50), Spanish as preferred language (OR 0.27, 95% CI 0.13–0.56), Medi-Cal HMO (OR 0.07, 95% CI 0.01–0.60), and being uninsured (OR 0.27, 95% CI 0.08–0.92). In multivariable analysis, only age remained significant: the odds of reconstruction were decreased in patients older than 52 years (OR 0.38, 95% CI 0.17–0.87). Conclusion: In women with unilateral, invasive, node-positive breast cancer, reconstruction after mastectomy was more frequent at our institution’s PH than at our SNH. Age, race, language, insurance, and hospital were associated with reconstruction after breast cancer resection in univariable analysis, but only age remained significantly associated with reconstruction in multivariable analysis. These results suggest that while demographic or socioeconomic factors may limit access to reconstruction after mastectomy, these factors are not as important as patient age.
Citation Format: Thomas Norman, Lindsay Hwang, Jason Ye. Factors associated with reconstruction rates in breast cancer patients after mastectomy: Investigating disparities at a private versus safety net hospital [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A039.
Abstract B034: Cancer Health Awareness through Screening and Education (CHANGE): Community health engagement
Authors: Vernon Marlo M. , Jones Samantha , Coughlin Steven , Moore Justin X. , Heboyan Vahe , Tingen Martha 
Published: January 2023

Abstract
Purpose The goal of the CHANGE project is to provide a sustainable model of evidence-based cancer awareness through education – with an emphasis on prevention and early detection behaviors. Methods: Residents of a public housing community were invited to participate in a 4-week education program on breast, prostate, and colorectal cancer, including modifiable risk factors of obesity and tobacco use, screening eligibility, and participation in clinical trials. Each session was led by trained research staff, and lasted approximately one hour. A community site survey was also conducted among 20% of the residents to evaluate community cancer knowledge and screening behaviors. A community advisory board was established to support program implementation and advise on choosing a cancer risk-reducing environmental change. Results: 14 adult participants (7 men and 7 women, 86% African American) completed baseline measurements. 10 participants received a relevant health history notification, which means they were positive for one of the following which put them in the "higher risk" category: Due for one of the following screenings Breast, Colorectal or Prostate; Had family history of cancer; Tobacco use; Overweight/obese - 1 male was referred to the GCC Tobacco Cessation Program. All eligible participants were navigated to local cancer screening providers and will be followed up at 3 months.Community site survey results indicated a need for improved access to fresh fruits and vegetable access. Community advisory board participants and community resources collaborated to provide locally grown fresh fruits and vegetables to the public housing community's internal market. 1 Discussion: This sample represents those most at risk for cancer in the Augusta, GA area. This project will impact health equity by emphasizing a comprehensive approach to care through community environmental change and individual changes in knowledge and risk-reducing behaviors. Additional sites will be enrolled in the program through the end of 2022.
Citation Format: Marlo M. Vernon, Samantha Jones, Steven Coughlin, Justin X. Moore, Vahe Heboyan, Martha Tingen. Cancer Health Awareness through Screening and Education (CHANGE): Community health engagement [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B034.
Abstract B037: Effective recruitment strategies utilized in the midst of a COVID-19 pandemic to examine dietary practices and colorectal cancer screening practices of Blacks in New York City
Authors: Johnson Cicely K. , Ma Grace X. , Leung May May , Ogunwobi Olorunseun O. 
Published: January 2023

Abstract
African Americans have the highest colorectal cancer incidence and mortality rates of all racial groups in the U.S. Factors that may be contributing to these high rates, however, remain poorly understood. Specifically, this study assessed the relationship between dietary habits and colorectal cancer screening behavior and intent among individuals who identify as Black, with their ethnicity as African-American, Caribbean, and African. There are many factors that influence dietary habits, and a salient factor is culture. Many studies have experienced challenges recruiting in communities of color for various reasons. The purpose of this presentation is to describe recruitment methods utilized for this study in the midst of the COVID-19 pandemic, and to discuss challenges, strategies that were implemented and lessons learned that can inform and improve future recruitment efforts. Effective recruitment strategies included partnership, consistent engagement, and meeting people in places where they frequent and felt comfortable. Utilizing faith-based locations, barbershops, hair salons, and pivotal community locations allowed individuals to trust the researchers, and also eliminated the need to retain study subjects over a period of time, due to on-site data collection. Though our findings are limited to Black families in predominantly minority neighborhoods, we have identified successful strategies for this specific high-risk population and potentially similar others.
Citation Format: Cicely K. Johnson, Grace X. Ma, May May Leung, Olorunseun O. Ogunwobi. Effective recruitment strategies utilized in the midst of a COVID-19 pandemic to examine dietary practices and colorectal cancer screening practices of Blacks in New York City [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B037.
Abstract B074: Evaluating nursing knowledge and readiness in providing care for post-9/11 veterans in civilian healthcare settings: A quality improvement project
Authors: Simoni Chelsey , Ratliff Jack 
Published: January 2023

Abstract
Over three-million military service members deployed overseas in support of the post-9/11 Global War on Terror since 2001. Of those, 7,057 have been killed in action, 30,177 have committed suicide, 279,652 died from ill-defined and unknown medical causes, and 520,966 have been diagnosed with cancer. Post-9/11 veterans are 192.75% more likely to be diagnosed with cancer when compared to their civilian counterparts and are more likely to utilize civilian providers (75%) than the Department of Veterans Affairs for health care concerns. The purpose of this quality improvement project is to investigate the level of nurse knowledge, beliefs, and perceptions related to providing health care to post-9/11 veterans in civilian care settings. A descriptive project design with a 15-question survey was implemented. The survey was sent to registered nurses practicing in civilian care settings. A sample of 537 registered nurses practicing in civilian care settings responded. Findings included that 93% incorrectly chose mental health conditions as the most likely occurring condition in post-9/11 veterans, while 7% correctly chose medical illnesses as most prevalent. Nurse respondents reported a perceived prevalence of post-traumatic stress occurring more often than cancer and malignancies at a ratio of 19:1. These findings highlight the high potential for cognitive biases which may lead to misdiagnoses and delayed diagnoses in post-9/11 veterans presenting for care with medical symptoms, furthering the need for education. This quality improvement project revealed significant gaps in civilian nurses’ clinical knowledge in screening, assessing, identifying, treating, and recommending resources for post-9/11 veterans and medical-related conditions.
Citation Format: Chelsey Simoni, Jack Ratliff. Evaluating nursing knowledge and readiness in providing care for post-9/11 veterans in civilian healthcare settings: A quality improvement project [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B074.
Abstract B082: Collaboration strategies to involve Black women’s perspectives in community engaged breast cancer research
Authors: Edmonds Megan C. 
Published: January 2023

Abstract
Purpose: While advancements in treatment and genomic research in breast cancer are on the rise, breast cancer (BC) disparities continue to widen. Black women disproportionately have the worst prognosis and survival rates from BC compared to all racial/ethnic groups of women. Community engagement and dissemination of disparities focused research may help mitigate poor outcomes among Black women. The goal of this study was to build sustainable research-partnerships with community-based organizations to promote guideline concordant breast cancer surveillance behaviors among Black breast cancer survivors. Methods: Several partnerships were formed to conduct breast cancer research among Black women. Community building and communication tools were developed and evaluated to help shape and sustain meaningful research working relationships with breast cancer focused community organizations. Results: Partnerships were commonly established from shared goals and missions. Frequent communication and strength-based activities were key tenants in developing impactful partnerships and research initiatives. From these partnerships a breast cancer campaign, web-based communication platform and rich secondary and qualitative data were collected from a community cohort of Black and White breast cancer survivors (N=266). Conclusion: Communication tools, iterative goal settings and community engaged approaches were essential in launching several research initiatives and outreach to Black women. To date our collaboration practices have resulted in novel and increased recruitment efforts that provide implications for research participation from Black women.
Citation Format: Megan C. Edmonds. Collaboration strategies to involve Black women’s perspectives in community engaged breast cancer research [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B082.
Abstract B109: Depression is a risk factor for noncompliance with antiviral medication treatment among Asian Americans with chronic hepatitis B
Authors: Zhu Di , Bracy Danny , Lu Wenyue , Zhu Lin , Handorf Elizabeth , Tan Yin , Yeh Ming-chin , Nguyen Minhhuyen T. , Ma Grace X. 
Published: January 2023

Abstract
Introduction: Asian Americans is a Hepatitis B (HBV) disparity population who only account for 6% of the US population but experience a 60% burden of having HBV, which is associated with 75% of hepatocellular carcinoma (HCC). Adherence to HBV medication is a practical approach to prevent liver cancer. However, limited studies have been conducted on the impacts of depression on HBV medication adherence among underserved Asian American HBV patients. Methods: This study utilized 12-m follow up data from a randomized controlled clinical trial aimed at improving long-term adherence to HBV medication adherence. Eligible Asian American HBV patients were recruited from the Greater Philadelphia Area and New York City. HBV medication adherence was assessed using the 8-Item Morisky Medication Adherence Scale (MMAS-8), and depression was measured with Patient Health Questionnaire-9 (PHQ-9). We conducted OLS regression to examine the association between depression and medication adherence among participants who reported that they were taking antiviral medication for their chronic hepatitis B condition. Results: Among 154 participants (118 Chinese and 36 Vietnamese), 43.57% were female, and 56.49% were male. Nearly all the participants reported having health insurance (92.21%) and having a physician to visit regularly (95.21%). Bivariate analysis showed that depression was negatively significantly associated with medication adherence score (r=-0.55, p&lt;0.001). Multivariable analysis revealed that a higher level of depressive symptoms at baseline significantly predicted poor medication adherence (log odds: -0.16, 95% CI: 4.02-6.89), with other covariates controlled for. In addition, study arm and ethnicity were significant predictors of medical adherence as well. Conclusion: The findings suggest that depression level has significant impacts on medication adherence. This indicates the need for mental health monitoring for CHB patients on antiviral. There are needs for culturally sensitive clinical and community interventions to improve mental health status and medication adherence among this vulnerable population. In addition, we will discuss the successes and challenges in the participant recruitment and intervention implementation process of this study.
Citation Format: Di Zhu, Danny Bracy, Wenyue Lu, Lin Zhu, Elizabeth Handorf, Yin Tan, Ming-chin Yeh, Minhhuyen T. Nguyen, Grace X. Ma. Depression is a risk factor for noncompliance with antiviral medication treatment among Asian Americans with chronic hepatitis B [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B109.
Abstract C005: Social determinants and environmental exposures and their localized contribution to risk of cancer mortality
Authors: McCormack Kara 
Published: January 2023

Abstract
When considering environmental exposures and/or social determinants of health (SDOH), data are typically available by counties, zip codes or census tracts. We consider two quantitative challenges in this setting when modeling cancer outcomes. The first is that multiple, potentially highly correlated exposures may contribute to risk. The second is that the spatial correlation of such features may not follow the original models designed for disease risk mapping. While several conditional autoregressive (CAR) models are typically utilized (Besag et al. (1991), Leroux et al. (1999), Stern and Cressie (1999)), a critical drawback is that they impose a global level of autocorrelation across the study area, presuming areas nearest each other are most similar. Spatial data may actually include step changes in the risk surface, indicative of more complex patterns either due to physical barriers and/or social isolation. Thus, identifying these step changes is of interest, as they may reflect the underlying complexity of the relationship between environmental exposures, SDOH and cancer mortality. We consider a two-step model to explore how clusters of environmental exposures and SDOH may be able to identify boundaries in the risk surface of cancer outcomes. In the first step, we estimate clusters of exposures using Bayesian profile regression, a nonparametric approach based on Dirichlet process mixture methods. In the second step, we model cancer mortality using locally adaptive spatial smoothing with the clusters as dissimilarity metrics (Lee and Mitchell, 2012). Several diagnostic tools are used to assess convergence in each step. With this work, we bridge the gap between incorporating mixtures of correlated exposures with the identification of localized areas with elevated risk of cancer mortality. We apply this approach to a nationwide database of county-level breast cancer mortality, utilize environmental exposure data from the National Air Toxics Assessment and assess SDOH from the American Community Survey.
Citation Format: Kara McCormack. Social determinants and environmental exposures and their localized contribution to risk of cancer mortality [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C005.