Public Health Commons^™

Interventions To Increase Follow-Up Of Abnormal Cervical Cancer Screening Results: A Systematic Literature Review And Meta-Analysis, Melissa Lopez Varon, Yimin Geng, Bryan M Fellman, Catherine Troisi, Maria E Fernandez, Ruosha Li, Belinda Reininger, Kathleen M Schmeler, Emma Allanson

Faculty, Staff and Student Publications

INTRODUCTION: Ensuring timely follow-up of abnormal screening results is essential for eliminating cervical cancer.

OBJECTIVE: The purpose of the study was to review single and multicomponent interventions designed to improve follow-up of women with abnormal cervical cancer screening results. We report on effectiveness across studies, and describe what aspects of these interventions might be more impactful.

METHODS: Publications were searched between January 2000 and December 2022. The search included observational, quasi-experimental (pre-post studies) and randomized controlled studies describing at least one intervention to increase follow-up of women with abnormal cervical cancer screening results. Outcomes of studies included completion of any …

2023-2024 Louisiana Adult Justice, Institute For Public Health And Justice, Data Collecting And Reporting

Policy & Position Papers

No abstract provided.

2023-2024 Louisiana Juvenile Justice, Institute For Public Health And Justice, Data Collecting And Reporting

Policy & Position Papers

No abstract provided.

Social Determinants Of Health Predict Readmission Following Covid-19 Hospitalization: A Health Information Exchange-Based Retrospective Cohort Study, Micaela N Sandoval, Jennifer L Mikhail, Melyssa K Fink, Guillermo A Tortolero, Tru Cao, Ryan Ramphul, Junaid Husain, Eric Boerwinkle

Faculty, Staff and Student Publications

INTRODUCTION: Since February 2020, over 104 million people in the United States have been diagnosed with SARS-CoV-2 infection, or COVID-19, with over 8.5 million reported in the state of Texas. This study analyzed social determinants of health as predictors for readmission among COVID-19 patients in Southeast Texas, United States.

METHODS: A retrospective cohort study was conducted investigating demographic and clinical risk factors for 30, 60, and 90-day readmission outcomes among adult patients with a COVID-19-associated inpatient hospitalization encounter within a regional health information exchange between February 1, 2020, to December 1, 2022.

RESULTS AND DISCUSSION: In this cohort of 91,007 …

Changes In Unhealthy Food Consumption Among Vulnerable Elementary-Aged Children In The United States During The Covid-19 Pandemic: A Serial Cross-Sectional Analysis, Nivedhitha Parthasarathy, Nalini Ranjit, Ru-Jye Chuang, Christine Markham, Mike Pomeroy, Jacqueline Noyola, Deepali K Ernest, Shreela V Sharma

Faculty, Staff and Student Publications

Objective: Several studies suggest that during the early pandemic, amidst socioeconomic instability, children from underserved families were more likely to resort to consuming cheaper, lower-quality foods with longer shelf lives. This study investigated the change in unhealthy food consumption across different phases (pre, early, mid) of the COVID-19 pandemic, and whether the strength of association between unhealthy food consumption and household socioeconomic disadvantage (HSED) varied across phases of the pandemic.

Methods: This study utilized serial cross-sectional data collected from low-income families enrolled in a school-based food co-op, Brighter Bites. Secondary data analysis included 5,384 surveys from families who had complete …

Comparing The Use And Effectiveness Of In-Person And Remote Physical Education Delivery During The Covid-19 Pandemic, Kempson Onadeko, Timothy J Walker, Derek W Craig, Jacob Szeszulski, Andjelka Pavlovic, Laura F Defina, Harold W Kohl

Faculty, Staff and Student Publications

BACKGROUND: Physical Education is a key component to improve youth health, but there is limited information on Physical Education delivery in different formats.

PURPOSE: We compared PE formats (in-person versus remote) across evaluation aspects: weekly minutes; perceived effectiveness; and student-to-teacher ratio.

METHODS: We distributed questionnaires (2020-2021 school year) to school contacts who represented NFL Play 60 FitnessGram

RESULTS: Among 165 schools, 10% (n=17) offered in-person instruction, 31% (n=51) offered remote instruction, and 59% offered both (n=97). Results revealed higher in-person PE minutes (77.2±7.3) compared to remote minutes (67.1±14.6), but results were not significantly different (p=0.19). School contacts reported significantly more …

A Virtual Culinary Medicine Intervention For Ethnically Diverse Individuals With Type 2 Diabetes: Development Of The Nourishing The Community Through Culinary Medicine, Lorena Macias-Navarro, John Wesley Mcwhorter, Diana C Guevara, Sarah S Bentley, Shreela V Sharma, Jennifer H Torres, David Ai, Natalia I Heredia

Faculty, Staff and Student Publications

Virtual culinary medicine education interventions have the potential to improve dietary behaviors, nutrition knowledge, cooking skills, and health outcomes for ethnically diverse individuals with type 2 diabetes. The purpose of this study is to describe the adaptation of the Nourishing the Community through Culinary Medicine (NCCM) program for virtual delivery, and the protocol for pilot testing this intervention. The intervention includes five 90-min virtual NCCM sessions streamed live from a Teaching Kitchen. Feasibility outcomes are recruitment, retention, acceptability, and satisfaction. Short-term effectiveness outcomes are measured through self-administered questionnaires, including perceived health, average daily servings of fruits and vegetables, frequency of …

Exploring Sexual Orientation Disparities Regarding The Interplay Of Childhood Sexual Abuse, Self-Reported Diabetes Status, And Depression Among Adults In The United States, Sumaita Choudhury, Paul G Yeh, Kaitlyn L Zajack-Garcia, Christine M Markham

Faculty, Staff and Student Publications

Previous research has revealed a strong link between the experience of childhood sexual abuse (CSA) and diabetes in adulthood. Moreover, research has shown that sexual minorities (SM) are exposed to adverse childhood experiences (ACEs) (i.e. CSA) and experience depression at higher rates than their heterosexual counterparts. Thus, it is imperative to further investigate the role of depression and the differential associations of exposure to ACEs with diabetes prevalence by sexual orientation. We explored sexual orientation disparities regarding the relationship between CSA and diabetes and examined the moderating role of depression. A total of 29,903 participants from the 2021 Behavioral Risk …

Circulating Sphingolipids In Relation To Cognitive Decline And Incident Dementia: The Cardiovascular Health Study, Kristine F Moseholm, Héléne T Cronjé, Manja Koch, Annette L Fitzpatrick, Oscar L Lopez, Marcia C De Oliveira Otto, W T Longstreth, Andrew N Hoofnagle, Kenneth J Mukamal, Rozenn N Lemaitre, Majken K Jensen

Faculty, Staff and Student Publications

INTRODUCTION: Whether circulating levels of sphingolipids are prospectively associated with cognitive decline and dementia risk is uncertain.

METHODS: We measured 14 sphingolipid species in plasma samples from 4488 participants (mean age 76.2 years; 40% male; and 25% apolipoprotein E (

RESULTS: Higher plasma levels of sphingomyelin-d18:1/16:0 (SM-16) were associated with a faster cognitive decline measured with 3MSE, in contrast, higher levels of sphingomyelin-d18:1/22:0 (SM-22) were associated with slower decline in cognition measured with DSST. In Cox regression, higher levels of SM-16 (hazard ration [HR] = 1.24 [95% confidence interval [CI]: 1.08-1.44]) and ceramide-d18:1/16:0 (Cer-16) (HR = 1.26 [95% CI: 1.10-1.45]) …

Trio Rvemvs: A Bayesian Framework For Rare Variant Association Analysis With Expectation-Maximization Variable Selection Using Family Trio Data, Duo Yu, Matthew Koslovsky, Margaret C Steiner, Kusha Mohammadi, Chenguang Zhang, Michael D Swartz

Faculty, Staff and Student Publications

It is commonly reported that rare variants may be more functionally related to complex diseases than common variants. However, individual rare variant association tests remain challenging due to low minor allele frequency in the available samples. This paper proposes an expectation maximization variable selection (EMVS) method to simultaneously detect common and rare variants at the individual variant level using family trio data. TRIO_RVEMVS was assessed in both large (1500 families) and small (350 families) datasets based on simulation. The performance of TRIO_RVEMVS was compared with gene-level kernel and burden association tests that use pedigree data (PedGene) and rare-variant extensions of …

A Comprehensive Program To Improve Treatment Of Precancerous Cervical Lesions In The Rio Grande Valley Of Texas, Melissa Varon, Mila Pontremoli Salcedo, Bryan Fellman, Catherine Troisi, Rose Gowen, Maria Daheri, Ana M Rodriguez, Paul Toscano, Laura Guerra, Monica Gasca, Blanca Cavazos, Elena Marin, Susan Fisher-Hoch, Maria E Fernandez, Belinda Reininger, Li Ruosha, Ellen Baker, Kathleen Schmeler

Faculty, Staff and Student Publications

OBJECTIVE: To assess the impact of a multicomponent intervention in women with cervical dysplasia who were treated with loop electrosurgical excision procedure (LEEP), as well as the time between colposcopy and treatment.

DESIGN: Retrospective cohort study.

INTERVENTION: Clinic participation in a multicomponent cervical cancer prevention program that included community outreach, patient in-reach, and navigation, as well as provider capacity building with in-person training and ongoing telementoring through Project ECHO.

MAIN OUTCOME MEASURES: Medical records were reviewed to evaluate women with cervical dysplasia undergoing treatment with LEEP within 90 days of colposcopy, as well as time between colposcopy and treatment. Baseline …

Variant Of The Lactase Lct Gene Explains Association Between Milk Intake And Incident Type 2 Diabetes, Kai Luo, Guo-Chong Chen, Yanbo Zhang, Jee-Young Moon, Jiaqian Xing, Brandilyn A Peters, Mykhaylo Usyk, Zheng Wang, Gang Hu, Jun Li, Elizabeth Selvin, Casey M Rebholz, Tao Wang, Carmen R Isasi, Bing Yu, Rob Knight, Eric Boerwinkle, Robert D Burk, Robert C Kaplan, Qibin Qi

Faculty, Staff and Student Publications

Cow's milk is frequently included in the human diet, but the relationship between milk intake and type 2 diabetes (T2D) remains controversial. Here, using data from the Hispanic Community Health Study/Study of Latinos, we show that in both sexes, higher milk intake is associated with lower risk of T2D in lactase non-persistent (LNP) individuals (determined by a variant of the lactase LCT gene, single nucleotide polymorphism rs4988235 ) but not in lactase persistent individuals. We validate this finding in the UK Biobank. Further analyses reveal that among LNP individuals, higher milk intake is associated with alterations in gut microbiota (for …

The Relationship Of Neighborhood Disadvantage, Biological Aging, And Psychosocial Risk And Resilience Factors In Heart Failure Incidence Among Black Persons: A Moderated Mediation Analysis, Ganga S Bey, James R Pike, Anthony S Zannas, Qian Xiao, Bing Yu, Amil M Shah, Priya Palta

Faculty, Staff and Student Publications

Objectives: Deprived living environments contribute to greater heart failure (HF) risk among non-Hispanic Black persons, who disproportionately occupy disadvantaged neighborhoods. The mechanisms for these effects are not fully explicated, partially attributable to an insufficient understanding of the individual factors that contribute additional risk or resilience to the impact of neighborhood disadvantage on health. The objective of this study was, therefore, to clarify the complex pathways over which such exposures act to facilitate more targeted, effective interventions. Given the evidence for a mediating role of biological age and a moderating role of individual psychosocial characteristics in the neighborhood disadvantage-HF link, we …

Dynamic Risk Score Modeling For Multiple Longitudinal Risk Factors And Survival, Cuihong Zhang, Jing Ning, Jianwen Cai, James E Squires, Steven H Belle, Ruosha Li

Faculty, Staff and Student Publications

Modeling disease risk and survival using longitudinal risk factor trajectories is of interest in various clinical scenarios. The capacity to build a prognostic model using the trajectories of multiple longitudinal risk factors, in the presence of potential dependent censoring, would enable more informed, personalized decision making. A dynamic risk score modeling framework is proposed for multiple longitudinal risk factors and survival in the presence of dependent censoring, where both events depend on participants' post-baseline clinical progression and form a competing risks structure. The model requires relatively few random effects regardless of the number of longitudinal risk factors and can therefore …

Cleaning Tasks And Products And Asthma Among Health Care Professionals, Jenil Patel, David Gimeno Ruiz De Porras, Laura E Mitchell, Arch Carson, Lawrence W Whitehead, Inkyu Han, Lisa Pompeii, Sadie Conway, Jan-Paul Zock, Paul K Henneberger, Riddhi Patel, Joy De Los Reyes, George L Delclos

Faculty, Staff and Student Publications

OBJECTIVE: Health care workers are at risk for work-related asthma, which may be affected by changes in cleaning practices. We examined associations of cleaning tasks and products with work-related asthma in health care workers in 2016, comparing them with prior results from 2003.

METHODS: We estimated asthma prevalence by professional group and explored associations of self-reported asthma with job-exposure matrix-based cleaning tasks/products in a representative Texas sample of 9914 physicians, nurses, respiratory/occupational therapists, and nurse aides.

RESULTS: Response rate was 34.8% (n = 2421). The weighted prevalence rates of physician-diagnosed (15.3%), work-exacerbated (4.1%), and new-onset asthma (6.7%) and bronchial hyperresponsiveness …

The Impact Of Body Mass Index And Physical Disability On Home-Based Anal Self-Sampling, Jenna Nitkowski, Maria E Fernandez, Tim Ridolfi, Elizabeth Chiao, Anna R Giuliano, Vanessa Schick, Michael D Swartz, Jennifer S Smith, Alan G Nyitray

Faculty, Staff and Student Publications

PURPOSE: Self-sampling is increasingly being used in screening programs, yet no studies to date have examined the impact of bodily characteristics on self-sampling experiences. Our objective was to assess whether body mass index (BMI) and physical disability were associated with anal self-sampling difficulty.

METHODS: We recruited sexual minority men (SMM) and trans persons in Milwaukee, Wisconsin to participate in an anal cancer screening study. Between January 2020 and August 2022, 240 participants were randomized to a home (n = 120) or clinic (n = 120) screening arm. Home participants received a mailed at-home anal self-sampling kit and were asked to …

The Perpetual Evidence-Practice Gap: Addressing Ongoing Barriers To Chronic Pain Management In Primary Care In Three Steps, Laura Ellen Ashcraft, Megan E Hamm, Serwaa S Omowale, Valerie Hruschak, Elizabeth Miller, Shaun M Eack, Jessica S Merlin

Faculty, Staff and Student Publications

Background: Most management of chronic pain, a serious illness affecting the physical and psychological wellbeing of millions, occurs in primary care settings. Primary care practitioners (PCPs) attempt to provide evidence-based practices to treat chronic pain. However, there continues to be a gap between the care people receive and the evidence. The objectives for this study were to (1) explore determinants of evidence-based chronic pain management and (2) develop a novel approach to using implementation science to address the evidence-practice gap.

Method: A convenience sample of twenty-one Pennsylvania PCPs participated in one-time semi-structured telephone interviews. Interviews were transcribed verbatim and both …

Self-Perception Of Mental Health, Covid-19 And Associated Sociodemographic-Contextual Factors In Latin America, Pablo Roa, Guillermo Rosas, Gloria Isabel Niño-Cruz, Sergio Mauricio Moreno-López, Juliana Mejía-Grueso, Haney Aguirre-Loaiza, Javiera Alarcón-Aguilar, Rodrigo Reis, Adriano Akira Ferreira Hino, Fernando López, Deborah Salvo, Andrea Ramírez-Varela

Faculty, Staff and Student Publications

This study aimed to estimate the prevalence of alterations in self-perceived mental health during the COVID-19 pandemic and their associated factors in four Latin American countries. This is a cross-sectional study based on data collected from adults in 2021 through the Collaborative Response COVID-19 Survey by the MacDonnell Academy at Washington University in St. Louis (United States). The sample was composed of 8,125 individuals from Brazil, Colombia, Mexico, and Chile. A generalized linear model for a binary outcome variable with a logistic link and fixed country effects was used. There were 2,336 (28.75%) individuals who considered having suffered alterations in …

Prozone Masks Elevated Sars-Cov-2 Antibody Level Measurements, Micaela N Sandoval, Samuel P Mcclellan, Stephen J Pont, Jessica A Ross, Michael D Swartz, Mark A Silberman, Eric Boerwinkle

Faculty, Staff and Student Publications

We report a prozone effect in measurement of SARS-CoV-2 spike protein antibody levels from an antibody surveillance program. Briefly, the prozone effect occurs in immunoassays when excessively high antibody concentration disrupts the immune complex formation, resulting in a spuriously low reported result. Following participant inquiries, we observed anomalously low measurement of SARS-CoV-2 spike protein antibody levels using the Roche Elecsys® Anti-SARS-CoV-2 S immunoassay from participants in the Texas Coronavirus Antibody Research survey (Texas CARES), an ongoing prospective, longitudinal antibody surveillance program. In July, 2022, samples were collected from ten participants with anomalously low results for serial dilution studies, and a …

Colonial Drivers And Cultural Protectors Of Brain Health Among Indigenous Peoples Internationally, Rita Henderson, Joyla A Furlano, Shayla Scott Claringbold, Ashley Cornect-Benoit, Anh Ly, Jennifer Walker, Lisa Zaretsky, Pamela Roach

Faculty, Staff and Student Publications

Despite relatively higher rates of dementia among Indigenous populations internationally, research into drivers of disparities in brain health and cognitive function has tended to focus on modifiable risk factors over cultural understandings and contextual determinants. By seeking to characterize social and cultural factors that shape brain health and cognition in Indigenous populations, this mini scoping review expands prevailing schools of thought to include Indigenous knowledge systems. This reveals important gaps in culturally aligned care. It also reclaims horizons for research important to Indigenous Peoples that have garnered diminished attention in biomedical approaches. Twenty-three sources were included for data extraction. This …

Higher Baseline Serum Bilirubin Levels Are Associated With Increased Risk Of Early Neurological Deterioration In Women With Acute Ischemic Stroke, Meng Sun, Yingfeng Weng, Jiwei Cheng, Guoyi Li, Qian Xiao

Faculty, Staff and Student Publications

BACKGROUND AND OBJECTIVES: Early neurological deterioration (END) occurs in up to one-third of patients with acute ischemic stroke (AIS) and associated with poor outcome. The role of serum bilirubin in END remains controversial. This study aims to investigate the association of total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL) with END.

METHODS: This study was a cross-sectional retrospective study with 344 AIS patients enrolled. We retrospectively reviewed consecutive AIS patients with END through a medical record retrieval system and enrolled patients as control randomly from the AIS patients without END at the same period. The bilirubin levels were …

Health Policies Within The Poverty Agendas Of Lula And Rousseff, Welington Lazarini, Francis Sodré, Carlos Eduardo Siqueira

Gastón Institute Publications

The anti-poverty agenda has been at the heart of the World Bank’s discourse in recent decades. Social policies started to be identified as strategic for combating poverty and promoting development in poor countries. We analyzed the health policy recommendations made by the World Bank to Brazil in the Lula da Silva and Rousseff administrations from 2003 to 2014. Document analysis was used to explore the partnership contracts between the World Bank and Brazil, projects financed by the World Bank in Brazil, and the document “20 Years of Construction of the Health System in Brazil: An Analysis of the Unified Health …

The Lived Experience Of The Covid-19 Pandemic Among Mandate-Resistant Adults In Washington State, Amber N. Peterson

Antioch University Dissertations & Theses

This study examined the lived experience of self-identified, mandate-resistant adults in Washington state. This study explored participants’ experience of the COVID-19 pandemic, from a retrospective framework by uncovering challenges, silver linings, decision-making, and self-reported mental health. Remote interviews were conducted with nine participants. Participants were between 23–31 years old, mostly male, and over half identified as Black. Through semi structured interviews, data was collected and analyzed using Interpretive Phenomenological Analysis (IPA). Participants described their experiences during the COVID-19 pandemic and highlighted significant changes in the way they lived their lives. Most notably, participants described ways in which they defied COVID-19 …

Inhaling The Unseen: Exploring The Presence Of Microplastics In The Human Respiratory Tract, Kara Coffman-Rea

Graduate Research Theses & Dissertations

Microplastics (plastic pieces less than 5 mm) have emerged as a pervasive form of pollution acknowledged as a universal threat to both environmental and human health. Their small size and widespread distribution pose significant risks to marine life, terrestrial ecosystems, and ultimately human health. Microplastics have been reported in food and drink items designated for human consumption, in cosmetics and consumer goods designed for human use, and within the air we breathe, each providing an entry route for microplastics to enter the human body. Recently, microplastic particles have been detected in a variety of human tissue samples (e.g., lung tissue). …

Implementing A Nurse-Driven Clostridium Difficile Screening Protocol, Sandrela Magnuson

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: Clostridium difficile infection (CDI) is a prevalent infection often contracted in hospitals. CDI is also increasingly originating from community settings. In addition to the health risks associated with CDI, diagnosis of a hospital-acquired CDI can have a significant financial impact on hospital systems. When hospital acquired, hospital systems are no longer reimbursed by payers. Secondary to the increasing prevalence of community-acquired CDI, mechanisms for early detection and isolation are warranted.

Local Problem: J.W. Ruby Memorial Hospital has an integrated Clostridium difficile (C. difficile) electronic health record (EHR) screening questionnaire that requires updating to align with current guidelines.

Purpose: …

Examining Anti-Racist Attitudes In Maternity Care Workers, Angelina Aduke Toluhi

All ETDs from UAB

Racism in maternity care has been identified as one of the major contributors to the persistent racial disparities in maternal health outcomes in the United States (US). Antiracism is a term used to describe the practice of actively identifying and opposing racism with the goal of changing policies, attitudes, behaviors, and beliefs that continue to foster racist ideas and actions. The results of this convergent mixed method research study reveal that racism and other forms of racial discrimination during maternity care may lead to adverse pregnancy outcomes in Non-Hispanic Black (NHB) pregnant patients in Southern US. In the first aim, …

Screening For And Addressing Social Determinants Of Health In Hospitals Participating In Accountable Care Organizations, Heather Lee

All ETDs from UAB

There is a growing recognition among hospitals, payers, and policymakers in the United States that addressing social needs of patients is important to improving quality of care, patient outcomes, and lowering health care spending. Accountable care organizations (ACOs) may be especially incentivized to address social needs of patients to meet population health goals related to patient outcomes and costs. This cross-sectional study used data from the American Hospital Association Annual Survey to explore to explore how hospitals participating in or leading ACOs are screening for and addressing individual-level HRSNs of patients and to understand the extent to which ACOs are …

Understanding Disparities In Hypertension Treatment Cascade And Validating Blood Pressure Measurement Among Persons Living With Or At Risk For Hiv, Jessica Blair

All ETDs from UAB

In the United States, 44% of adult women >18 years have hypertension. Although non-Hispanic Black adults were more likely to be aware of and treated for hypertension compared to non-Hispanic White adults, Black individuals had the highest prevalence of uncontrolled hypertension. Persons living with HIV have a higher prevalence of hypertension, which is a major modifiable risk factor for cardiovascular disease. Similar to the geographic distribution of hypertension in the US, people living in the South have higher incidence of both hypertension and HIV diagnoses compared to other US regions. Furthermore, accurate diagnosis of hypertension and initiation of treatment is …

State Of The Science Of Scale-Up Of Cancer Prevention And Early Detection Interventions In Low- And Middle-Income Countries: A Scoping Review, Tara M Friebel-Klingner, Gloria Guevara Alvarez, Hope Lappen, Lydia E Pace, Keng-Yen Huang, Maria E Fernández, Donna Shelley, Anne F Rositch

Faculty, Staff and Student Publications

Purpose: Cancer deaths in low- and middle-income countries (LMICs) will nearly double by 2040. Available evidence-based interventions (EBIs) for cancer prevention and early detection can reduce cancer-related mortality, yet there is a lack of evidence on effectively scaling these EBIs in LMIC settings.

Methods: We conducted a scoping review to identify published literature from six databases between 2012 and 2022 that described efforts for scaling cancer prevention and early detection EBIs in LMICs. Included studies met one of two definitions of scale-up: (1) deliberate efforts to increase the impact of effective intervention to benefit more people or (2) an intervention …

Using Focus Groups To Explore Older Black Men's Perception Of Dietary Interventions., Ashley R Shaw, Eric D Vidoni, Mickeal N Key, Brandon A Yates, Roland Thorpe

Faculty, Staff and Student Publications

Older Black men are underrepresented in research despite being disproportionately affected by Alzheimer’s disease (AD) and cardiovascular (CV) risk factors related to AD compared with non-Hispanic Whites. Although dietary interventions have shown promise to reduce modifiable CV risk factors related to AD, Black Americans have lower adherence likely due to lack of cultural considerations. Using a noninterventional convergent parallel mixed-methods approach, this study examined the cultural contexts that inform perceptions of dietary interventions among older Midwestern Black men. All participants completed an online demographic and dietary habit survey prior to focus group discussions. Two focus group discussion sessions were conducted …