Nutritional and Metabolic Diseases Commons^™

Assessing Healthcare Access Among Overweight And Obese Individuals In Türkiye Using Latent Variable Modeling, Banu Beyaz Sipahi

Makara Journal of Health Research

Background: Overweight and obesity are critical determinants of healthcare access, yet evidence on how the COVID-19 pandemic reshaped these dynamics in Türkiye remains limited. This study investigates whether the early post-pandemic recovery period altered healthcare access patterns for individuals with excess weight.

Methods: Using nationally representative microdata from the 2014, 2016, 2019, and 2022 Turkish Health Surveys, we constructed a latent Healthcare Access Index based on six indicators of unmet care needs. Probit models were estimated to assess associations between BMI categories and healthcare access, controlling for socioeconomic and demographic factors. The 2022 wave serves as the early …

Obesity Paradox In Post-Cholecystectomy Outcomes: A Bmi Class–Based Trinetx Analysis At 6 Months And 1 Year, Jashanveer S. Johal, Mahmoud Al-Bataineh, Bianca Patel, Archana Salek, Om Patel, Jason Hyman, Yecheskel Schneider, Abdallah Hussein

Rowan-Virtua Research Day

Background: Obesity is traditionally associated with higher perioperative risk, yet observational data suggest an "obesity paradox" in which obese patients experience comparable or better outcomes than non-obese peers. We evaluated the impact of obesity (BMI ≥30 kg/m²) and obesity class on post-cholecystectomy outcomes.

Methods: A retrospective cohort study was conducted using the TriNetX global federated network. Adults undergoing cholecystectomy with BMI < 30 kg/m² were propensity score–matched 1:1 to those with BMI ≥30 kg/m², yielding 81,048 patients per group. Primary outcomes included choledocholithiasis, procedural complications, need for ERCP, and ED/inpatient utilization; secondary outcomes included mortality, respiratory and cardiovascular complications, and upgrade of care. Outcomes were assessed at 6 months and 1 year. A prespecified subgroup analysis compared BMI 30–39 versus BMI ≥40 kg/m² (40,238 per cohort).

Results: Obese patients consistently demonstrated lower rates of major outcomes at both timepoints. At 1 year, BMI < 30 had higher risks of choledocholithiasis (9.1% vs. 8.0%; RR 1.13), procedural complications (3.8% vs. 3.1%; RR 1.22), ERCP (5.4% vs. 4.6%; RR 1.19), and ED/inpatient visits (30.3% vs. 28.8%; RR 1.05; all p< 0.001). Mortality was also higher in non-obese patients at 1 year (1.4% vs. 1.2%; RR 1.20). Within the obese subgroup, BMI 30–39 and BMI ≥40 had broadly similar complication and utilization rates, though 1-year mortality was lowest in class I–II obesity (0.8% vs. 1.0%; RR 0.85).

Conclusions: Obesity was associated with better post-cholecystectomy outcomes compared with BMI < 30 kg/m², supporting an obesity paradox in biliary surgery. BMI alone should not deter cholecystectomy, and perioperative risk stratification should incorporate factors beyond weight class.

The Relationship Between Consumption Frequency And Energy Intake Of Ultra-Processed Food And Obesity Based On Body Fat Percentage Among Fph Ui Students In 2025, Sarah Keisya Budiargo, Triyanti Triyanti, Asih Setiarini, Dieta Nurrika

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is the accumulation of excessive body fat and increases the risk of various non-communicable diseases. Obesity prevalence among FPH UI students based on health examination data in 2022-2024 has reached 13.6%, exceeding the public health concern threshold and requiring more accurate measurement than Body Mass Index. This study aimed to determine the relationship between ultra-processed food (UPF) consumption frequency and energy intake with obesity incidence based on body fat percentage among 147 FPH UI students in 2025. This cross-sectional study utilized the Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) based on NOVA classification to assess UPF intake. Body fat percentage was …

The Relationship Between Obesity Among Children And Adolescents With Dietary Intake And Physical Activity: A Scoping Review, Devi Dwi Yolani, Tania Okta Wardhani, Rani Aqilah Ni’Matul Maula, Almira Sitasari, Tri Siswati

Indonesian Journal of Public Health Nutrition (IJPHN)

Childhood and adolescent obesity remain a significant public health issue worldwide. This review summarizes research on the relationship among obesity, physical activity, and diet. This study aims to investigate the relationship between children's and adolescents' obesity, their physical activity levels, and diet. A scoping review was conducted by assessing 81 research journal articles from 2014 to 2023 from electronic databases such as Google Scholar and PubMed. The search strategy used Boolean operators as follows: (“child*” OR “adolescent”) AND (“obesity”) AND (“diet” OR “food intake”) AND (“physical activity”), selected based on the inclusion criteria of children and adolescents aged 1-18 years …

Efficacy Of Glp-1 And Gip/Glp-1 Receptor Agonists On The Body Weight Management Of Obesity, Paige D. Timbrook

Seaver College Research And Scholarly Achievement Symposium

Obesity is a major epidemic across the United States, and weight loss through diet and physical activity alone is not sustainable. Treatment with tirzepatide and semaglutide have proven to be effective for obesity management in the short-term, but more research is needed to understand how certain types of medications impact weight loss over time. In this study, we recruited 42 adult participants with or without Type II diabetes who were 21 years and older, taking only one GLP-1 or GIP/GLP-1 receptor agonist at a time, had a beginning body mass index of 30 or greater or a beginning body mass …

Drug-Induced Sleep Endoscopy Findings In Obese Adolescents With Sleep Apnea, Timothy Kearney, Turaj Vazifedan, Cristina M. Baldassari

Department of Otolaryngology (ENT) Faculty Publications

Objective

Data regarding drug-induced sleep endoscopy (DISE) findings in obese adolescents with obstructive sleep apnea (OSA) are lacking; such information could be used to direct and improve management as there is controversy whether adenotonsillectomy (AT) or positive airway pressure is standard therapy for this population. Our primary objective is to describe DISE findings in obese adolescents.

Study Design

Case-control.

Setting

Tertiary care children's hospital.

Methods

A 10-year retrospective review was conducted of obese adolescents 12 to 21 years old with OSA (apnea-hypopnea index [AHI] ≥ 1) that underwent DISE prior to AT. All DISE procedures were scored utilizing a modified …

The Connection Between Medicaid And Obesity In Northeast Ohio, Emmie Kelley, Sophie Kheder

Williams Honors College, Honors Research Projects

Obesity is a major public health concern in the United States that is projected to increase exponentially over the next few years. Obesity is commonly associated with a lower socioeconomic status. Lower-income individuals tend to be supported by Medicaid, a federal insurance program for low-income Americans. Prior studies have shown a positive correlation between income status and obesity prevalence. Our goal was to find if there was a correlation between Medicaid patients and obesity in Northeast Ohio, to provide physicians with a set of characteristics to better combat obesity, since preventative and treatment guidelines are tailored to national trends. We …

Bariatric Surgery Impacts Immune Cell Metabolism And Function Dependent On Metabolic Status, Samantha N. Hart

University of Kentucky Doctoral Dissertations

Type 2 Diabetes (T2D), one of the top ten causes of death worldwide, is fueled by chronic inflammation. T2D is considered a metabolic disease, and there is a great push to target metabolic and associated inflammatory pathways to ameliorate the disease & its comorbidities i.e., obesity and cardiovascular disease. Thus far, clinical trials of anti-inflammatory drugs have had modest impacts on T2D and have not led to changes in clinical practice. This may in part be due to a gap in knowledge in the mechanism(s) driving obesity-associated chronic inflammation. I posit that metabolic abnormalities in immune cells in those with …

The Connection Between Medicaid And Obesity In Northeast Ohio, Sophie Kheder, Emmie Kelley

Williams Honors College, Honors Research Projects

Obesity is a major public health concern in the United States that is projected to increase exponentially over the next few years. Obesity is commonly associated with a lower socioeconomic status. Lower-income individuals tend to be supported by Medicaid, a federal insurance program for low-income Americans. Prior studies have shown a positive correlation between income status and obesity prevalence. Our goal was to find if there was a correlation between Medicaid patients and obesity in Northeast Ohio, to provide physicians with a set of characteristics to better combat obesity, since preventative and treatment guidelines are tailored to national trends. We …

Dietary Counseling For Obese And Overweight Bmi Range, Samuel Milam, Diane Olski, Manishea Veggal, Anthony Shadiack

South Atlantic Division GME Research Days 2026

No abstract provided.

Achieving A Healthy Lifestyle Through Dietary Improvement, Rena Phillips, Michael Lee Phillips, Avery Kanemasu, Claudia Ludden, Mary Mckennon Stubblefield, Lora Denton

South Atlantic Division GME Research Days 2026

No abstract provided.

Association Of Sarcopenic Obesity With Dementia Risk In A Cohort Of Older Women, Zhongyang Guan, Blossom C.M. Stephan, Lorenzo M. Donini, Joshua R. Lewis, Carla M. Prado, Richard L. Prince, David Scott, Kun Zhu, Marc Sim, Mario Siervo

Research outputs 2022 to 2026

Background and aims: Longitudinal studies have explored the association between sarcopenic obesity (SO) and the risk of cognitive impairment, yet findings remain mixed. This study aimed to investigate the associations of SO with risk of incident dementia in older women, using two diagnostic models: the Sarcopenic Obesity Global Leadership Initiative (SOGLI) and the load-capacity model. Methods: We analysed data from 900 community-dwelling women (aged ≥70 years). SO was defined using two models: (1) the SOGLI criteria, based on low handgrip strength (HGS), low appendicular lean soft tissue to body weight (ALST/W) ratio, and high fat mass percentage (%FM); and (2) …

Association Of Obesity Severity With Cardiometabolic And Renal Disease Burden In The United States, Florina Corpodean, Michael Kachmar, Shengping Yang, Steven B. Heymsfield, Peter T. Katzmarzyk, Philip R. Schauer, Michael W. Cook, Vance L. Albaugh

School of Medicine Faculty Publications

Objective This study examined the association between obesity severity and cardiometabolic and renal disease, using BMI as a surrogate for obesity severity. Methods This is a cross-sectional study using data from the United States Behavioral Risk Factor Surveillance System (BRFSS), 2011–2023. Survey-weighted logistic regression estimated odds ratios (OR) for the diagnosis of diabetes, hypertension, hyperlipidemia, kidney disease, myocardial infarction, stroke, and coronary artery disease among increasing BMI categories. Results Higher BMI was associated with increased odds of all conditions. For BMI ≥ 50 kg/m2, odds were notably elevated for diabetes (OR 8.32; 95% CI: 7.78–8.91), hypertension (OR 6.07; 95% CI: …

Perceived Benefits And Side Effect Of High-Fiber, High-Protein Meal Replacements In Weight Loss Programs, Esti Nurwanti, Harry Fl Muhammad, Naufal M. Nurdin

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is a major risk factor for chronic diseases and early mortality. Although dietary counseling is essential in managing obesity, maintaining a calorie deficit and preventing weight regain remain difficult. Functional foods like high-protein, high-fiber meal replacements may enhance adherence and support weight loss. This randomized controlled trial evaluated the subjective outcomes of a weight loss program incorporating a protein- and fiber-enriched meal replacement among 73 overweight women aged 20–30 years. Participants were randomized to an intervention group (n=38), receiving dietary counseling plus one daily meal replacement, or a control group (n=35), receiving counseling alone. Both groups followed an 8-week …

Sociodemographic, Neighborhood-Level, And Health-Related Factors Associated With Progression To Bariatric Surgery: A Retrospective Chart Review., Angela Godwin

Electronic Theses and Dissertations

Background: Bariatric surgery is the most effective treatment for patients with Class 3 obesity. However, of individuals who start the bariatric surgical process, only about half undergo surgery. Factors associated with completion, including race, have been described; however, consistent evidence on obstacles remains to be identified.

Objectives: To explore variables based on the Social Ecological Model (SEM) that may be related to bariatric surgery completion.

Setting: A large, private hospital with a Bariatric Center of Excellence in New York City

Methods: This retrospective chart review utilized data from adults who established an initial bariatric surgery visit from April 1, 2012, …

Clinical Outcomes After Hospitalization For Acute Coronary Syndrome In Patients Treated With Semaglutide Versus Bariatric Surgery: A Retrospective Multicenter Analysis, Nameer Ascandar, Charles Boadu, Gauthier Stepman, George Skaf, Olugbenga Oyesanmi, Sabry Omar, Rias Ali, Michael Schandorf-Lartey

HCA Healthcare Journal of Medicine

Background

Obesity is a chronic medical condition with a rising prevalence in the United States. A wide range of morbidity and mortality is associated with obesity, with coronary artery disease being among the most common. Ischemic heart disease continues to be the primary cause of death in the United States. Taken together, interventions to minimize the detrimental effects of obesity on patients at risk of heart disease will not only benefit the patient, but the health care system as well.

Methods

In this retrospective study, we used the HCA Healthcare enterprise data warehouse to identify all adult patients who were …

Physiologically Based And Population Pharmacokinetic Modeling Of Midazolam In Children With Obesity Using Real-World Data, Sean Mccann, Victória E. Helfer, Stephen J. Balevic, William J. Muller, John N. Van Den Anker, Amira Al-Uzri, Marisa L. Meyer, Sarah G. Anderson, Sitora Turdalieva, Andrea N. Edginton, Daniel Gonzalez, Best Pharmaceuticals For Children Act Pediatric Trials Network Steering Committee

Department of Pediatrics Faculty Papers

Children represent a highly complex and variable population for treatment, including interindividual differences in drug dose-exposure. Midazolam has been used as a sedative for hospitalized children on- and off-label; however, factors affecting interindividual variability (IIV) in observed clearance for this population are not fully understood and can result in extreme under- or overexposure. Obesity has been described as a significant influence on midazolam in adolescents, which could potentially alter drug exposure. The goal of this study was to use two modeling strategies to evaluate dose-exposure of midazolam in children with and without obesity. Population pharmacokinetic modeling assessed whether measures of …

The Use Of Glp-1 Agonists In Alcohol Use Disorder And Reducing Alcohol Consumption: A Scoping Review, Alec Birnbaum, Yashas Sattur, Akash Patel

Rowan-Virtua Research Day

Alcohol use disorder (AUD) reigns as one of the most pressing issues in the United States with high rates of complications, morbidity, and mortality. Recent studies have exhibited the potential for Glucagon-Like Peptide-1 (GLP-1) agonists to decrease alcohol cravings or alcohol-related adverse events through human and animal studies via reward and satiety signaling pathways. To investigate the ability of GLP-1 agonists to decrease alcohol use, alcohol cravings, and alcohol-related adverse events, this study conducted a scoping review of the current literature to uncover the potential benefit of GLP-1 agonists in patients with AUD. A systematic search across 6 databases was …

How Does Exposure To Early-Life Stressors Shape Eating Behaviors In Adulthood?, Surabhi Panda

Rowan-Virtua Research Day

The objective of this literature review is to explore the relationship between early-life stress and the development of disordered or dysregulated eating in adulthood. A search was conducted across PubMed, CINAHL, Embase, and PsycINFO databases. Results from each study were compared and synthesized. Twelve studies were analyzed including case reports, systematic reviews, cohort studies, and cross-sectional studies. Research indicates that childhood emotional abuse, often more prevalent than other forms of maltreatment, is a significant risk factor for eating pathology, with studies investigating psychological mediators such as anger, anxiety, and dissociation in this relationship. Adverse Childhood Experiences (ACEs) and early life …

Maternal Health And Nutrition: Combating Maternal Mortality Through Proper Nutrition, Archna Mahendru, Yeisanai Cardona Torres, Maya Blayne Partee, Katarina Rusinak

Rowan-Virtua Research Day

Maternal mortality is an increasing concern in the United States. According to the WHO, from 2018-2022 the Maternal Mortality Rate (MMR) was 23.3 deaths per every 100,000 live births. New Jersey's MMR exceeded this average at 26 per 100,000 during the same period, with 91% of cases deemed preventable. While medical care plays a crucial role, research shows that non-medical determinants such as food insecurity, lack of nutritional education, limited access to transportation, and systemic barriers to health care contribute significantly to maternal health outcomes. Among these factors, proper nutrition plays a critical role before and during pregnancy, particularly in …

Understanding Obesity Risk In Intellectual And Developmental Disabilities: Key Diagnoses And Factors, Elizabeth Kolaski, Wendy Aita, Jennifer Lecomte, Andrea Iannuzzelli

Rowan-Virtua Research Day

Background:

Individuals with intellectual and developmental disabilities (IDD) have obesity rates nearly twice those of the general population, leading to higher rates of diabetes, hypertension, sleep apnea, and reduced quality of life.¹ Genetic syndromes such as Prader-Willi syndrome (PWS) and conditions like autism spectrum disorder (ASD) and Down syndrome (DS) feature distinct mechanisms driving weight gain.² The burden of obesity in IDD exacerbates health disparities and strains caregivers and healthcare systems.³ Yet, comparative obesity prevalence and its drivers across specific IDD diagnoses remain poorly characterized.⁴

Hypothesis:

Obesity prevalence and underlying risk factors differ among IDD diagnoses …

Cardiovascular Effects Of Glp-1 Receptor Agonists In Non-Diabetic Adults With Obesity: A Systematic Literature Review, Mariam Abdeen

Rowan-Virtua Research Day

Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in individuals with obesity. GLP-1 receptor agonists, initially developed for glycemic control in diabetes, are now approved for weight loss in non-diabetic populations. Recent clinical trials suggest these agents may also offer direct cardiovascular benefits.

Objective: This literature review aims to evaluate the cardiovascular effects of GLP-1 receptor agonists, specifically semaglutide, liraglutide, and tirzepatide, in non-diabetic adults with overweight or obesity.

Methods: A systematic search was conducted in January 2025 using PubMed as the primary database, supplemented by Google Scholar and Embase. Clinical trials were selected based on …

Examining The Relationship Between Nutritional Access And Childhood Obesity In Low-Resource South Jersey Communities, Anastasiya Matveyenko, Saul Madrid-Flores, Arleen Fortuna, Kirsten Marie Carlberg

Rowan-Virtua Research Day

BACKGROUND: Childhood obesity is defined as a child considered to have obesity when their body mass index falls in the top 5% compared to other children of the same age and gender. Unhealthy eating habits formed during childhood have been associated with diseases such as obesity and diabetes. We aim to examine the relationship between childhood obesity and barriers to optimal nutrition in our local South Jersey community.

METHODS: We conducted a literature review through Google, Google Scholar, and PubMed utilizing the key terms, “low socioeconomic status (SES),” “Childhood obesity in NJ,” “Nutritional Intervention,” and “Health Risks.”

RESULTS: Our study …

Scoping Literature Review: The Role Of Leptin In Autism Spectrum Disorder (Asd) And Associated Obesity, Diana B. Riestra, Andrea Iannuzzelli

Rowan-Virtua Research Day

Overweight and obesity (OW/OB) are significant concerns among individuals with Autism Spectrum Disorder (ASD), yet the underlying causes remain unclear. Emerging evidence points to metabolic and hormonal factors—particularly leptin, a hormone involved in appetite regulation—as potential contributors. This scoping review examined five key studies from 2003 to 2024 that investigated the relationship between leptin and ASD in overweight populations. Across studies, individuals with ASD consistently exhibited elevated leptin levels compared to controls. While some findings also noted changes in other adipokines, such as lower resistin or progranulin, leptin was the most consistently dysregulated. These patterns suggest systemic alterations in energy …

Intermittent Fasting And Cardiometabolic Health In Adults With Obesity: A Scoping Review, Tri Siswati, Lathifa Zahra Putri Nugroho, Natasya Nurul Gina, Almira Sitasari, Agus Wijanarka

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is a significant global health challenge, with adverse impacts on cardiometabolic health such as hypertension, dyslipidemia, and insulin resistance. One promising intervention in obesity management is intermittent fasting (PI). However, scientific evidence on the impact of IF on cardiometabolic health is still limited. This study used a scoping review design to evaluate the association between IF and cardiometabolic health in obese adults. Reference sources are available in English at least abstract between 2015–2023 as well as from PubMed and Google Scholar web sources. The search keywords on PubMed are "Adult AND intermittent fasting AND cardiometabolic" and on Google Scholar …

Exploring The Non-Communicable Disease Burden In Indonesia – Findings From The 2023 Health Survey, Akifa Laila Rusyda

Indonesian Journal of Public Health Nutrition (IJPHN)

The present study rigorously examines the correlation between obesity, high-risk dietary consumption, and unhealthy lifestyles with the prevalence of non-communicable diseases (NCDs) in Indonesia. The study employed a cross-sectional study design using secondary data from the 2023 Indonesian Health Survey, analyzing 38 units (n) representing Indonesia's provinces in 2023. The correlation analysis, conducted using Pearson's test with a significance level of 95% (α<0.05), revealed significant regional disparities in the prevalence of NCDs, dietary consumption, and lifestyle factors across Indonesia. Moreover, the findings reveal a statistically significant positive correlation between obesity, high-risk food consumption, and lifestyle risk factors with the prevalence of several NCDs, including diabetes mellitus, heart disease, hypertension, and chronic kidney disease. These results underscore the potential impact of our research on public health in Indonesia. The results highlight also the urgent need for targeted public health initiatives, such as policies promoting healthier food choices, controlling the food environment, encouraging physical activity, and supporting smoking cessation to mitigate the growing burden of NCDs in Indonesia.

Implementing Intermittent Fasting Education For Improved A1c Control In Type 2 Diabetes Patients, Dakota Dalton, Elizabeth White, Malinda Hansen, Tasaduq Mir

North Texas Research Forum 2025

Background: Management of Type 2 Diabetes Mellitus (T2DM) in the UNTHSC Family Medicine clinic varies among residents, with some advocating robust lifestyle counseling and others relying more on medical management. This leads to inconsistencies in patient education and treatment strategies. Lifestyle interventions such as dietary modifications, are unfortunately too often underutilized in the clinic and in primary care in general, despite strong evidence supporting their efficacy in control of both A1C measurements and random fasting blood sugar, and improved prognosis of diabetes. To address this, we have designed and introduced an intermittent fasting (IF) handout as a supplemental standardized educational …

Sex-Specific Roles Of The Adipocyte Mineralocorticoid Receptor In Obesity And Early Life Stress, Meghan B. Turner

Theses and Dissertations--Pharmacology and Nutritional Sciences

Obesity is a burgeoning health epidemic caused by chronic overnutrition and exacerbated by genetic, environmental and developmental factors. The adipocyte mineralocorticoid receptor (MR), a transcriptionally active nuclear receptor, is speculated to contribute to metabolic dysfunction in the obese state. MR expression is increased in obese adipose tissue, and MR modulates the expression of fat-derived hormones such as leptin and adiponectin. In women, obesity can be exacerbated by early life stress, such as adverse childhood experiences (ACEs). Studies show that women display a positive association between cumulative ACE exposures and increased body mass index. Previously, we demonstrated that maternal separation and …

Exploring The Association Between Sarcopenic Obesity And Cardiovascular Risk: A Summary Of Findings From Longitudinal Studies And Potential Mechanisms, Zhongyang Guan, Blossom C.M. Stephan, Lorenzo Maria Donini, Carla M. Prado, Marc Sim, Mario Siervo

Research outputs 2022 to 2026

It is estimated that more than one-tenth of adults aged ≥60 years are now classified as having sarcopenic obesity (SO), a clinical condition characterized by the concurrent presence of sarcopenia (low muscle mass and weakness) and obesity (excessive fat mass). Independently, sarcopenia and obesity are associated with a high risk of numerous adverse health outcomes including cardiovascular diseases (CVDs) and neurological conditions (e.g. dementia), but SO may confer a greater risk, exceeding either condition alone. This imposes a substantial burden on individuals, healthcare systems and society. In recent years, an increasing number of observational studies have explored the association between …

From Surviving To Thriving: Key Considerations For Weight Control Across Diverse Cancer Survivorship Populations, Justin C. Brown, Marlyn Allicock, Carmina G. Valle, Tanya Agurs-Collins

School of Medicine Faculty Publications

BACKGROUND: Obesity is a chronic, relapsing, progressive disease of excess adiposity that increases the risk of dying from at least 16 types of cancer. The prevalence of obesity has increased more rapidly in cancer survivors compared with the general population. Tailored weight management strategies are needed to improve prognosis and health outcomes in the growing population of cancer survivors. However, certain cancer survivor population subgroups require unique consideration when developing weight management strategies. METHODS: In a symposium convened by The Obesity Society during ObesityWeek 2023 titled "From Surviving to Thriving: Key Considerations for Weight Control Across Diverse Cancer Survivorship Populations," …