Influence of Cancer Worry on Four Cancer Related Health Protective Behaviors among a Nationally Representative Sample: Implications for Health Promotion Efforts

The aims of this study were to assess what sociodemographic characteristics are associated with cancer worry and what the influence of cancer worry is on four cancer-related protective health behaviors. Data from the Health Information National Trends Survey (HINTS) (4th cycle of the 4th iteration) were used. Multiple regression models were used for all analyses. Behaviors analyzed were as follows: physical activity, diets, smoking, and routine medical screening. Demographics controls included participant age, income, body mass index (BMI), race/ethnicity, and education. N?=?2630, Older participants (OR?=?.99, p?<?.001), participants with higher BMI (OR?=?1.01, p?=?.017), females (OR?=?1.39, p?<?.001), and highly educated participants were more likely to worry about cancer. Cancer worry was not a significant predictor of exercise, healthy eating, or cancer screening behaviors. However, participants who worried about cancer were more likely to be current smokers (RRR?=?1.20, p?<?.001) compared to participants who never smoked. Although, worry is only an emotional influence on health behavior and may be short-lived, the influence of worry on health-related decision making is likely to be lasting even when the emotions are no longer present.     

Do patients at high risk for Hepatitis C receive recommended testing? A retrospective cohort study of statewide Medicaid claims linked with OneFlorida clinical data

Hepatitis C virus (HCV) infection is a leading risk factor for hepatocellular carcinoma.We employed a retrospective cohort study design and analyzed 2012–2018 Medicaid claims linked with electronic health records data from the OneFlorida Data Trust, a statewide data repository containing electronic health records data for 15.07 million Floridians from 11 health care systems. Only adult patients at high-risk for HCV (n = 30,113), defined by diagnosis of: HIV/AIDS (20%), substance use disorder (64%), or sexually transmitted infections (22%) were included. Logistic regression examined factors associated with meeting the recommended sequence of HCV testing.Overall, 44.1% received an HCV test. The odds of receiving an initial test were significantly higher for pregnant females (odds ratio [OR]1.99; 95% confidence interval [CI] 1.86–2.12; P < .001) and increased with age (OR 1.01; 95% CI 1.00–1.01; P < .001).Among patients with low Charlson comorbidity index (CCI = 1), non-Hispanic (NH) black patients (OR 0.86; 95% CI 0.81–0.9; P < .001) had lower odds of getting an HCV test; however, NH black patients with CCI = 10 had higher odds (OR 1.41; 95% CI 1.21–1.66; P < .001) of receiving a test. Of those who tested negative during initial testing, 17% received a second recommended test after 6 to 24 months. Medicaid-Medicare dual eligible patients, those with high CCI (OR 1.14; 95% CI 1.11–1.17; P < .001), NH blacks (OR 1.93; 95% CI 1.61–2.32; P < .001), and Hispanics (OR 1.49; 95% CI 1.08–2.06; P = .02) were significantly more likely to have received a second HCV test, while pregnant females (OR 0.71; 95% CI 0.57–0.89; P = .003), had lower odds of receiving it. The majority of patients who tested positive during the initial test (97%) received subsequent testing.We observed suboptimal adherence to the recommended HCV testing among high-risk patients underscoring the need for tailored interventions aimed at successfully navigating high-risk individuals through the HCV screening process. Future interventional studies targeting multilevel factors, including patients, clinicians and health systems are needed to increase HCV screening rates for high-risk populations.     

Until I get off parole … then I can swim in it if I want to: Facilitators of and barriers to drug use among formerly incarcerated Black drug offenders

Black Americans are overrepresented among those incarcerated for drug-related offenses. Drug use, postincarceration, is associated with high risk of recidivism and overdose deaths. We explored factors influencing drug use among former Black drug offenders. Qualitative interviews with 30 Black Americans released from prison within the past year explored drug behavior as well as institutional, environmental, and social factors that influence drug use. Findings show participants reentered drug-enticing environments and social networks. Being on parole, drug programs, and social support influenced abating drug use. Drug interventions postincarceration should consider the environment and social networks as leverage points for behavior change.