Biostatistics Commons^™

Maternal Vulnerability Index And Severe Maternal Morbidity, Nansi S. Boghossian, Joshua Radack, Molly Passarella, Ciaran S. Phibbs, Lucy T. Greenberg, Jeffrey S. Buzas, George R. Saade, Jeannette Rogowski, Scott A. Lorch

Faculty Publications

Importance: Few studies have investigated the association of composite measures of neighborhood social determinants of health with severe maternal morbidity (SMM), and no research has examined this association for indices tailored to maternal health. Objective: To examine the association of scores in the Maternal Vulnerability Index (MVI), a tool developed to measure maternal risk of adverse health outcomes, with SMM. Design, Setting, and Participants: This retrospective, population-based cohort study was conducted in 5 states (2008-2020 for Michigan, Oregon, and South Carolina; 2008-2018 for Pennsylvania; and 2008-2012 for California) among individuals delivering a fetal death or a live birth between 22 …

Caregiving Burdens Of Task Time And Task Difficulty Among Paid And Unpaid Caregivers Of Persons Living With Dementia, Matthew Lee Smith, Jodi L. Southerland, Malinee Neelamegam, Gang Han, Shinduk Lee, Chung Lin Kew, Juanita Dawne R. Bacsu, Elyse Couch, Steffi M. Kim, Monique J. Brown Ph.D., Mph, Ayse Malatyali, Lucas Wilson, Zahra Rahemi, Jeremy Holloway, Marcia G. Ory

Faculty Publications

Background: Demands of caregivers of persons living with dementia (PLWD) are often influenced by the context of their caregiving situation. This study examines common and unique factors associated with caregiving burden in terms of task time and task difficulty among paid and unpaid caregivers of PLWD. Methods: Cross-sectional baseline survey data were analyzed from 107 paid and unpaid caregivers of PLWD participating in a larger NIH-funded study assessing the feasibility of using a novel in-situ sensor system. Oberst Caregiving Burden Scale constructs of task time and task difficulty served as dependent variables. Two least squares regression models were fitted, controlling …

Investing In The Development Of The Next Generation Of Mch Leaders, Karen A. Mcdonnell, Jamal Percy, Lisa Anders, Monique J. Brown Ph.D., Mph, Alice R. Richman, Julianna Deardorff, Monica S. Ruiz, Jihong Liu Sc.D., Kelli Russell, Audrey Snyder, Cassondra Marshall

Faculty Publications

The public health landscape is constantly evolving to address the strengths and needs of the community. Training for the public health workforce is leading the way, establishing an ecosystem approach that integrates individuals within social, political, and environmental contexts to promote health equity within a framework of social justice. One area of public health that is innovatively preparing the next generation of leaders is maternal and child health (MCH). In the United States, key indicators of health disparities within MCH remain stagnant, highlighting the need for training programs that develop future MCH professionals from diverse backgrounds. These professionals will deliver …

Healthcare Providers’ Perspective On Hiv Testing And Hypothetical Mhealth-Connected Linkage To Care Among Men Who Have Sex With Men (Msm) In South Carolina, Tony Brown, Prince Nii Ossah Addo, Monique J. Brown Ph.D., Mph, Xiaoming Li, Oluwafemi Adeagbo

Faculty Publications

Background: HIV continues to be an important public health concern in South Carolina (SC). However, an examination of providers’ willingness to use mHealth technologies to address ongoing barriers to HIV care and prevention strategies, particularly among men who have sex with men (MSM) is currently lacking in SC. We therefore explored HIV care providers’ perceptions of HIV testing and treatment uptake among MSM, and providers’ willingness to use mHealth technology to address barriers to HIV testing and treatment in SC. Methods: Between August and December 2021, we conducted semistructured virtual interviews with 10 HIV care providers recruited purposively based on …

Sars-Cov-2 Detection And Persistence In A Remote Amazonian Settlement, Glauco M. Silva, Roberto C. Ilacqua, Franciely G. Gonçalves, Carla M. Santana, Felipe T. Jordão, Paula R. Prist, Melissa S. Nolan Ph.D., Mph, Andreia F. Brilhante, Marcia A. Sperança, Gabriel Z. Laporta

Faculty Publications

Background: COVID-19 continues to pose a major global health challenge. Despite its geographic distance from Brazil’s major urban centers, Acre state has experienced notable outbreaks. This study assessed the detection and persistence of SARS-CoV-2 in the rural settlement of Santa Luzia, located in the remote municipality of Cruzeiro do Sul, Acre state, Brazil. Methods: In July 2022, a cross-sectional survey was conducted at 40 sites from an ongoing environmental study, selected by deforestation patterns and proximity to health posts. Saliva samples were collected from residents aged 5–90 years, followed by nucleic acid extraction and multiplex RT-qPCR for SARS-CoV-2 detection. Results: …

Immune Checkpoint Inhibitor-Associated Cutaneous Adverse Events: Mechanisms Of Occurrence, Abdulaziz M. Eshaq, Thomas W. Flanagan, Abdulqader A. Ba Abbad, Zain Alabden A. Makarem, Mohammed S. Bokir, Ahmed K. Alasheq, Sara A. Al Asheikh, Abdullah M. Almashhor, Faroq Binyamani, Waleed A. Al-Amoudi, Abdulaziz S. Bawzir, Youssef Haikel, Mossad Megahed, Mohamed Hassan

School of Medicine Faculty Publications

Immunotherapy, particularly that based on blocking checkpoint proteins in many tumors, including melanoma, Merkel cell carcinoma, non-small cell lung cancer (NSCLC), triple-negative breast (TNB cancer), renal cancer, and gastrointestinal and endometrial neoplasms, is a therapeutic alternative to chemotherapy. Immune checkpoint inhibitor (ICI)-based therapies have the potential to target different pathways leading to the destruction of cancer cells. Although ICIs are an effective treatment strategy for patients with highly immune-infiltrated cancers, the development of different adverse effects including cutaneous adverse effects during and after the treatment with ICIs is common. ICI-associated cutaneous adverse effects include mostly inflammatory and bullous dermatoses, as …

Racial And Ethnic Differences In Outcomes Of Neonates Born At Less Than 30 Weeks' Gestation, 2018-2022, Nansi S. Boghossian, Marco Geraci, Erika M. Edwards, Jeffrey D. Horbar

Faculty Publications

Importance: Previous research has examined outcomes among very preterm newborns by the birthing parent's race and ethnicity, but knowledge about these trends during the COVID-19 pandemic is limited. Objective: To examine trends in outcomes among Black, Hispanic, and Asian preterm newborns compared with White preterm newborns. Design, Setting, and Participants: This cohort study (2018-2022) took place at 774 neonatal intensive care units in the Vermont Oxford Network. Participants were newborns born at 22 to 29 weeks' gestation. Exposure: Race and ethnicity. Main Outcomes and Measures: The primary outcomes were mortality and complications, including respiratory distress syndrome, necrotizing enterocolitis (NEC), early-onset …

Mental Health Care Disparities Among Us Pregnant Individuals In 2020–2021: A Cross-Sectional Study, Julisa Tindall, Monique J. Brown Ph.D., Mph, Peiyin Hung

Faculty Publications

Purpose

To examine maternal characteristics associated with perceived unmet mental health needs and mental health care settings, focusing on residential rurality and race/ethnicity.

Methods

This cross-sectional study analyzed self-reported unmet mental health needs and mental health care settings among 1097 pregnant respondents in the 2020–2021 National Survey on Drug Use and Health, incorporating the complex sampling weights for national representativeness.

Findings

Non-Hispanic Black pregnant individuals and those living in nonmetro rural areas reported lower odds of unmet mental health needs compared to those in large metro areas and non-Hispanic White individuals. Pregnant individuals in nonmetro rural areas and non-Hispanic other …

Spatial Pattern And Differential Expression Analysis With Spatial Transcriptomic Data, Fei Qin, Xizhi Luo, Bo Cai Ph.D., Feifei Xiao, Guoshuai Cai

Faculty Publications

The emergence of spatial transcriptomic technologies has opened new avenues for investigating gene activities while preserving the spatial context of tissues. Utilizing data generated by such technologies, the identification of spatially variable (SV) genes is an essential step in exploring tissue landscapes and biological processes. Particularly in typical experimental designs, such as case-control or longitudinal studies, identifying SV genes between groups is crucial for discovering significant biomarkers or developing targeted therapies for diseases. However, current methods available for analyzing spatial transcriptomic data are still in their infancy, and none of the existing methods are capable of identifying SV genes between …

Peptide Receptor Radionuclide Therapy And Clinical Associations With Renal And Hematological Toxicities And Survival In Patients With Neuroendocrine Tumors: An Analysis From Two U.S. Medical Centers, Tao Xu, Joseph S. Dillon, Mary A. Maluccio, Dawn E. Quelle, Sarah H. Nash, Hyunkeun Cho, Kristen E. Limbach, Nicholas J. Skill, Yvette Bren-Mattison, Michael A. O’Rorke

School of Medicine Faculty Publications

Purpose: Renal and hematological toxicity are side effects and dose-limiting factors of Peptide Receptor Radionuclide Therapy (PRRT). We aimed to assess the changes in renal and hematological function and associations with survival in neuroendocrine tumor (NET) patients treated with PRRT. Methods: A retrospective cohort of 448 NET patients treated with either 177Lu-DOTATATE or 90Y-DOTATOC were followed for changes of renal and hematological function. Renal function was assessed by monitoring changes in serum creatinine, blood urea nitrogen and estimated glomerular filtration rate. Hematological function was determined by examining changes in white blood cell counts (WBC), platelet counts, and hemoglobin levels over …

Using Causal Diagrams Within The Grading Of Recommendations, Assessment, Development And Evaluation Framework To Evaluate Confounding Adjustment In Observational Studies, Kevin Mcintyre, Karina N Tassiopoulos, Curtis Jeffrey, Saverio Stranges, Janet Martin

Epidemiology and Biostatistics Publications

BACKGROUND AND OBJECTIVES: The current Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system instructs appraisers to evaluate whether individual observational studies have sufficiently adjusted for confounding. However, it does not provide an explicit, transparent, or reproducible method for doing so. This article explores how implementing causal graphs into the GRADE framework can help appraisers and end-users of GRADE products to evaluate the adequacy of confounding control from observational studies.

METHODS: Using modern epidemiological theory, we propose a system for incorporating causal diagrams into the GRADE process to assess confounding control.

RESULTS: Integrating causal graphs into the GRADE framework enables …

Adverse Childhood Experiences And Hiv-Related Stigma: A Quantitative Survey Of Tanzanian Men, June 2019, Amandeep Kaur, Monique J. Brown Ph.D., Mph, Geoffrey K. Kangogo, Xiaoming Li Ph.D., Ivan E. Teri, Gaspar Mbita, Aima A. Ahonkhai, Donaldson F. Conserve

Faculty Publications

Experiencing adverse childhood experiences (ACEs) may impact personal opinions, attitudes, and judgments, which can further result in HIV-related stigma. HIV-related stigma consequentially may impact HIV preventive measures such as HIV testing, pre-exposure prophylaxis uptake, and condom use. The extent to which ACEs influence HIV-related stigma perception has not been well studied. Therefore, the study aimed to examine the association between ACEs and perceived and interpersonal HIV-related stigma among Tanzanian HIV-negative men. Quantitative survey data were obtained from the Tanzania STEP (Self-Testing Education and Promotion) project established in four wards: Mabibo, Manzese, Tandale, and Mwanyanamala. A total of 507 men responded …

Evaluation And Lessons Learned From The Dissemination And Implementation Science Scholars Program In The National Cancer Prevention And Control Research Network, Daniela B. Friedman, Cam Escoffery, Elaine H. Morrato, Cynthia A. Thomson, Courtney N. Petagna, Freda Allyson Hucek, Mary Wangen, Aubrey Villalobos, James R. Hébert Scd, Samuel Noblet, Mayank Sakhuja, David O. Garcia, Jennifer L. Cruz, Stephanie B. Wheeler

Faculty Publications

Background:

The Centers for Disease Control and Prevention (CDC)-funded Cancer Prevention and Control Research Network (CPCRN) has been a leader in cancer-related dissemination & implementation (D&I) science. Given increased demand for D&I research, the CPCRN Scholars Program launched in 2021 to expand the number of practitioners, researchers, and trainees proficient in cancer D&I science methods. Methods:

The evaluation was informed by a logic model and data collected through electronic surveys. Through an application process (baseline survey), we assessed scholars’ competencies in D&I science domains/subdomains, collected demographic data, and asked scholars to share proposed project ideas. We distributed an exit survey …

A Genome-Wide Association Study Identifies Genetic Determinants Of Hemoglobin Glycation Index With Implications Across Sex And Ethnicity, John S. House, Joseph H. Breeyear, Farida S. Akhtari, Violet Evans, John B. Buse, James Hempe, Alessandro Doria, Josyf C. Mychaleckyi, Vivian Fonseca, Mengyao Shi, Changwei Li, Shuqian Liu, Tanika N. Kelly, Daniel Rotroff, Alison A. Motsinger-Reif

School of Medicine Faculty Publications

Introduction: We investigated the genetic determinants of variation in the hemoglobin glycation index (HGI), an emerging biomarker for the risk of diabetes complications. Methods: We conducted a genome-wide association study (GWAS) for HGI in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial (N = 7,913) using linear regression and additive genotype encoding on variants with minor allele frequency greater than 3%. We conducted replication analyses of top findings in the Atherosclerosis Risk in Communities (ARIC) study with inverse variance-weighted meta-analysis. We followed up with stratified GWAS analyses by sex and self-reported race. Results: In ACCORD, we identified single …

Exploring The Association Between Parenting Stress And A Child’S Exposure To Positive Childhood Experiences (Pces), Elizabeth Crouch Ph.D., Elizabeth Radcliff, Monique J. Brown Ph.D., Mph, Peiyin Hung Ph.D

Faculty Publications

High levels of parenting stress, defined as a caregiver or parent feeling stress or aggravation from parenting, has been previously shown to be associated with an increased likelihood of neglect, child maltreatment, and household dysfunction: adverse childhood experiences (ACEs). Despite the potential mitigation of positive childhood experiences (PCEs) on ACEs, prior studies on the increased likelihood of a child experiencing ACEs due to parenting stress have left a critical question unanswered: whether high parenting stress may decrease a child’s likelihood of experiencing PCEs. We analyzed the 2019–2020 National Survey of Children’s Health to examine whether higher levels of parenting stress …

Social Isolation And Loneliness Prevention Among Rural Older Adults Aging-In-Place: A Needs Assessment, Jodi L. Southerland, Shimin Zheng, Kayla Dodson, Erin Mauck, Juanita-Dawne R. Bacsu, Monique J. Brown Ph.D., Mph, Jeremy Holloway, Steffi M. Kim, Ayse Malatyali, Matthew Lee Smith

Faculty Publications

Introduction: The adverse effects of social isolation and loneliness (SI/L) have been documented among older adults in rural communities and contribute to poor health outcomes, premature disability and mortality, and increased burden on the healthcare system. The identification of factors contributing to SI/L among older adults can build the foundation for rural policymakers and leaders to allocate resources and develop tailored strategies more efficiently. The purpose of this article is to describe findings from a needs assessment designed to understand local factors that contribute to SI/L among rural older adults in a county in Northeast Tennessee. Findings from the needs …

Reframing And Advancing Academic Mentorship To Support New And Early Career Faculty Members, Juanita-Dawne R. Bacsu, Patricia C. Heyn, Steffi Kim, Zahra Rahemi, Monique J. Brown, Darina V. Petrovsky, Justine S. Sefcik, Jodi L. Southerland, Jeremy Holloway, Elyse Couch, Ayse Malatyali, Matthew L. Smith

Faculty Publications

Mentorship is critical to fostering professional growth and career development in academia. However, academic mentorship is often an informal activity that is overlooked and under researched. There is much ambiguity and uncertainty surrounding mentorship roles and strategies in academia. This paper provides recommendations and strategies to reframe and advance academic mentorship to support new and early career faculty.

Allura Red Ac Is A Xenobiotic. Is It Also A Carcinogen?, Lorne J. Hofseth Ph.D., James Hébert Scd, Elizabeth Angela Murphy, Erica Trauner, Athul Vikas, Quinn Harris, Alexander A. Chumanevich

Faculty Publications

Merriam-Webster and Oxford define a xenobiotic as any substance foreign to living systems. Allura Red AC (a.k.a., E129; FD&C Red No. 40), a synthetic food dye extensively used in manufacturing ultra-processed foods and therefore highly prevalent in our food supply, falls under this category. The surge in synthetic food dye consumption during the 70s and 80s was followed by an epidemic of metabolic diseases and the emergence of early-onset colorectal cancer in the 1990s. This temporal association raises significant concerns, particularly given the widespread inclusion of synthetic food dyes in ultra-processed products, notably those marketed toward children. Given its interactions …

Allura Red Ac Is A Xenobiotic. Is It Also A Carcinogen?, Lorne J. Hofseth, James R. Hébert Scd, Elizabeth Angela Murphy, Erica Trauner, Athul Vikas, Quinn Harris, Alexander A. Chumanevich

Faculty Publications

Merriam-Webster and Oxford define a xenobiotic as any substance foreign to living systems. Allura Red AC (a.k.a., E129; FD&C Red No. 40), a synthetic food dye extensively used in manufacturing ultra-processed foods and therefore highly prevalent in our food supply, falls under this category. The surge in synthetic food dye consumption during the 70s and 80s was followed by an epidemic of metabolic diseases and the emergence of early-onset colorectal cancer in the 1990s. This temporal association raises significant concerns, particularly given the widespread inclusion of synthetic food dyes in ultra-processed products, notably those marketed toward children. Given its interactions …

Burden Of Disease Attributable To High Body Mass Index: An Analysis Of Data From The Global Burden Of Disease Study 2021, Xiao-Dong Zhou, Qin-Fen Chen, Wah Yang, Mauricio Zuluaga, Giovanni Targher, Christopher Byrne, Luca Valentu, Fei Luo, Christos Katsouras, Christopher Opio

Internal Medicine, East Africa

Background: Obesity represents a major global health challenge with important clinical implications. Despite its recognized importance, the global disease burden attributable to high body mass index (BMI) remains less well understood.

Methods: We systematically analyzed global deaths and disability-adjusted life years (DALYs) attributable to high BMI using the methodology and analytical approaches of the Global Burden of Disease Study (GBD) 2021. High BMI was defined as a BMI over 25 kg/m2 for individuals aged ≥20 years. The Socio-Demographic Index (SDI) was used as a composite measure to assess the level of socio-economic development across different regions. Subgroup analyses considered age, …

Risk Factors For Cognitive Impairment In Adult Population Of Coastal Area: A Cross-Sectional Study In Maringkik Island, Indonesia, Herpan Syafii Harahap, Arina Windri Rivarti, Nurhidayati Nurhidayati, Fitriannisa Faradina Zubaidi, Dini Suryani, Legis Ocktaviana Saputri, Yanna Indrayana, Athalita Andhera, Muhammad Hilam, Abiyyu Didar Haq

Kesmas

Cognitive impairment is a medical condition commonly found in elderly populations, which can be due to vascular risk factors in patients. There remains limited data on risk factors for cognitive impairment among coastal region populations. This study aimed to investigate risk factors for cognitive impairment in the adult population of Maringkik Island, West Nusa Tenggara Province, Indonesia. Data collected were age, sex, education level, hypertension, antihypertensive treatment, diabetes mellitus, cigarette smoking, and body mass index status. A total of 114 participants were recruited using a consecutive sampling method. The participants’ cognitive function assessment used the Mini-Cog instrument. The cognitive impairment …

Variation And Predictors Of Covid-19 Mortality In Hospitalized Cases In West Sumatra Province, Indonesia: A Retrospective Observational Study, Defriman Djafri, Ade Suzana Eka Putri, Yudi Pradipta

Kesmas

During 2020, the year of the COVID-19 pandemic, different Indonesian provinces had different numbers of COVID-19 infections and fatalities, particularly in West Sumatra Province. This study aimed to investigate the variation of confirmed COVID-19 cases and determine predictors of mortality in hospitalized patients across districts in West Sumatra Province. A retrospective observational study was conducted during the COVID-19 pandemic. From March 2020 to June 2021, 46,005 confirmed cases were collected in the province, of which 42,308 were hospitalized and analyzed. Confirmed cases and deaths were compared by geographic location using spatial analysis. The risk predictors of death were estimated using …

Exploration Of Positive Deviance In Prevention Of Underweight In The Under-Five: A Qualitative Study On Low-Income Urban Families, Irwan Budiono, Lukman Fauzi, Dewi Sari Rochmayani

Kesmas

Children under the age of five (the under-five) from low-income families are more vulnerable to experience underweight. This nutritional vulnerability is evident in the preliminary study, where 35.1% of the under-five experience underweight, and 28.48% are low-income families. This study aimed to explore Positive Deviance (PD) behaviors in preventing underweight among the under-five. The study applied a qualitative approach with a case study design. Data collection took place in July-August 2022, focusing on low-income families in the Gunung Brintik area. Data were collected through two focus group discussions, seven in-depth interviews, and five key informant interviews. Coding, subtheme, and theme …

Cluster Effect For Snp-Snp Interaction Pairs For Predicting Complex Traits, Hui Yi Lin, Harun Mazumder, Indrani Sarkar, Po Yu Huang, Rosalind A. Eeles, Zsofia Kote-Jarai, Kenneth R. Muir, Johanna Schleutker, Nora Pashayan, Jyotsna Batra, David E. Neal, Sune F. Nielsen, Børge G. Nordestgaard, Henrik Grönberg, Fredrik Wiklund, Robert J. Macinnis, Christopher A. Haiman, Ruth C. Travis, Janet L. Stanford, Adam S. Kibel, Cezary Cybulski, Kay Tee Khaw, Christiane Maier, Stephen N. Thibodeau, Manuel R. Teixeira, Lisa Cannon-Albright, Hermann Brenner, Radka Kaneva, Hardev Pandha, Et Al

School of Public Health Faculty Publications

Single nucleotide polymorphism (SNP) interactions are the key to improving polygenic risk scores. Previous studies reported several significant SNP-SNP interaction pairs that shared a common SNP to form a cluster, but some identified pairs might be false positives. This study aims to identify factors associated with the cluster effect of false positivity and develop strategies to enhance the accuracy of SNP-SNP interactions. The results showed the cluster effect is a major cause of false-positive findings of SNP-SNP interactions. This cluster effect is due to high correlations between a causal pair and null pairs in a cluster. The clusters with a …

Disparities And Protective Factors In Pandemic-Related Mental Health Outcomes: A Louisiana-Based Study, Ariane L. Rung, Evrim Oral, Tyler Prusisz, Edward S. Peters

School of Public Health Faculty Publications

Introduction: The COVID-19 pandemic has had a wide-ranging impact on mental health. Diverse populations experienced the pandemic differently, highlighting pre-existing inequalities and creating new challenges in recovery. Understanding the effects across diverse populations and identifying protective factors is crucial for guiding future pandemic preparedness. The objectives of this study were to (1) describe the specific COVID-19-related impacts associated with general well-being, (2) identify protective factors associated with better mental health outcomes, and (3) assess racial disparities in pandemic impact and protective factors. Methods: A cross-sectional survey of Louisiana residents was conducted in summer 2020, yielding a sample of 986 Black …

Non-Receptor Tyrosine Kinases: Their Structure And Mechanistic Role In Tumor Progression And Resistance, Abdulaziz M. Eshaq, Thomas W. Flanagan, Sofie Yasmin Hassan, Sara A. Al Asheikh, Waleed A. Al-Amoudi, Simeon Santourlidis, Sarah Lilly Hassan, Maryam O. Alamodi, Marcelo L. Bendhack, Mohammed O. Alamodi, Youssef Haikel, Mossad Megahed, Mohamed Hassan

School of Graduate Studies Faculty Publications

Protein tyrosine kinases (PTKs) function as key molecules in the signaling pathways in addition to their impact as a therapeutic target for the treatment of many human diseases, including cancer. PTKs are characterized by their ability to phosphorylate serine, threonine, or tyrosine residues and can thereby rapidly and reversibly alter the function of their protein substrates in the form of significant changes in protein confirmation and affinity for their interaction with protein partners to drive cellular functions under normal and pathological conditions. PTKs are classified into two groups: one of which represents tyrosine kinases, while the other one includes the …

Interpregnancy Interval And Adverse Perinatal Outcomes: A Within-Individual Comparative Method, Maria Sevoyan, Marco Geraci, Edward A. Frongillo, Jihong Liu, Nansi S. Boghossian

Faculty Publications

Background and Aim: Previously observed associations between interpregnancy interval (IPI) and perinatal outcomes using a between-individual method may be confounded by unmeasured maternal factors. This study aims to examine the association between IPI and adverse perinatal outcomes using within-individual comparative analyses. Methods: We studied 10,647 individuals from the National Institute of Child Health and Human Development Consecutive Pregnancies Study in Utah with ≥3 liveborn singleton pregnancies. We matched two IPIs per individual and used conditional logistic regression to examine the association between IPI and adverse perinatal outcomes, including preterm birth (PTB, < 37 weeks’ gestation), small-for-gestational-age (SGA, < 10th percentile of sex-specific birthweight for gestational age), low birthweight (LBW, < 2,500 g), and neonatal intensive care unit (NICU) admission. Point and 95% confidence interval (CI) estimates were adjusted for factors that vary across pregnancies within individuals. Results: CIs did not unequivocally support either an increase or a decrease in the odds of PTB (adjusted odds ratio [aOR]: 1.31, 95% CI: 0.87, 1.96), SGA (aOR: 0.81, 95% CI: 0.51, 1.28), LBW (aOR: 1.59, 95% CI: 0.90, 2.80), or NICU admission (aOR: 0.96, 95% CI: 0.66, 1.40) for an IPI < 6 months compared to 18–23-months IPI (reference), and neither did the CIs for the aOR of IPIs of 6–11 and 12–18 months compared to the reference. In contrast, an IPI ≥24 months was associated with increased odds of LBW (aOR: 1.66, 95% CI: 1.03, 2.66 for 24–29 months; aOR: 2.27, 95% CI: 1.21, 4.29 for 30–35 months; and aOR: 2.09, 95% CI: 1.17, 3.72 for ≥36 months). Conclusions: Using a within-individual comparative method, we did not find evidence that a short IPI compared to the recommended IPI of 18–23 months was associated with increased odds of PTB, SGA, LBW, and NICU admission. IPI ≥ 24 months was associated with increased odds of delivering an LBW infant.

Childhood Sexual Abuse And Compulsive Sexual Behavior Among Men Who Have Sex With Men Newly Diagnosed With Hiv, Monique J. Brown, Medinat Omobola Osinubi, Daniel Amoatika, Mohammad Rifat Haider, Sally Kirklewski, Patrick Wilson, Nathan B. Hansen

Faculty Publications

Childhood sexual abuse (CSA) continues to be a public health challenge. The prevalence of experiencing CSA is higher among men who have sex with men (MSM) than the general population. CSA has been linked to compulsive sexual behavior (CSB) among varying populations but has not been examined among MSM who were newly diagnosed with HIV. Therefore, the aims of this study were to assess the direct association between CSA and CSB among newly diagnosed MSM living with HIV, and to identify the potential mediating roles of depressive symptoms and emotion regulation in the association between CSA and CSB. The study …

Primary Care Payment Models And Avoidable Hospitalizations In Ontario, Canada: A Multivalued Treatment Effects Analysis., Nibene Habib Somé, Rose Anne Devlin, Nirav Mehta, Sisira Sarma

Epidemiology and Biostatistics Publications

Improving access to primary care physicians' services may help reduce hospitalizations due to Ambulatory Care Sensitive Conditions (ACSCs). Ontario, Canada's most populous province, introduced blended payment models for primary care physicians in the early- to mid-2000s to increase access to primary care, preventive care, and better chronic disease management. We study the impact of payment models on avoidable hospitalizations due to two incentivized ACSCs (diabetes and congestive heart failure) and two non-incentivized ACSCs (angina and asthma). The data for our study came from health administrative data on practicing primary care physicians in Ontario between 2006 and 2015. We employ a …

Access To Prostate-Specific Antigen Testing And Mortality Among Men With Prostate Cancer, Hari S. Iyer, Benjamin V. Stone, Charlotte Roscoe, Mei Chin Hsieh, Antoinette M. Stroup, Charles L. Wiggins, Fredrick R. Schumacher, Scarlett L. Gomez, Timothy R. Rebbeck, Quoc Dien Trinh

School of Public Health Faculty Publications

Importance: Prostate-specific antigen (PSA) screening for prostate cancer is controversial but may be associated with benefit for certain high-risk groups. Objectives: To evaluate associations of county-level PSA screening prevalence with prostate cancer outcomes, as well as variation by sociodemographic and clinical factors. Design, Setting, and Participants: This cohort study used data from cancer registries based in 8 US states on Hispanic, non-Hispanic Black, and non-Hispanic White men aged 40 to 99 years who received a diagnosis of prostate cancer between January 1, 2000, and December 31, 2015. Participants were followed up until death or censored after 10 years or December …