Objectives: To determine the costs and trends of telehealth utilization before and during the COVID-19 pandemic for patients with cardiovascular diseases (CVD). Methods: We calculated the proportions of patients with CVD who used telehealth before (January 2019-February 2020) and during (March 2020-April 2021) the pandemic using MarketScan Commercial Claims and Encounters. We compared the trends of telehealth utilization among CVD patients by sex, age, claim type, payment plan, and rural/urban status. We calculated mean, SD, median, and IQR of total and average telehealth costs. Results: The results show that telehealth utilization spiked in March 2020 and further rapidly increased and peaked in April 2020. Telehealth utilization increased from 0.021% in March 2019 to 6.7% in March 2020 and from 0.024% in April 2019 to 39.8% in April 2020. After peaking in April 2020, telehealth utilization rapidly fell in May-June 2020 and then gradually decreased before rebounding in October-December 2020. It resumed the decline through April 2021 remained much higher than the prepandemic level. Telehealth utilization was higher during the pandemic for females than males; for younger age groups (aged 18-44 or 45-64) than older age group (aged 65+); for commercial claims than Medicare supplemental insurance; for capitated insurance plans than non-capitated insurance plans; and for patients in urban areas than rural areas. From March 2020-February 2021, the mean (SD) telehealth cost per visit was $115.7 (66) (median [IQR], $104.8 [$75.8-$139.4]), with patient out-of-pocket cost $25.5 (42.8) (median [IQR], $10 [$0-$30]), insurance cost $90.4 (71.0) (median [IQR], $83 [$45.3-$121.3]), and the mean (SD) number of telehealth utilizations per patient was 1.67 (1.8) (median [IQR], 1 [1-2]). Conclusions: Policymakers, health care practitioners, and insurance companies should be aware of trends and costs of telehealth utilization among patients with CVD. Our results show that telehealth would facilitate better management of CVD. Our results may inform future policies and practices to meet the increased demand for telehealth.
We compared fruit and vegetable (FV) intake, physical activity (PA), and overweight/ obesity among Black and White females attending two- and four-year colleges.We recruited 24,055 students at six colleges in the Southeast to complete an online survey, yielding 4840 responses (20.1% response rate). The current analyses focused on the 2276 Black and White females.Binary logistic regression analyses indicated that recommended FV intake among White females was associated with greater extraversion (Odds Ratio [OR] = 1.05, 95% Confidence Interval [CI] 1.00, 1.11, p = 0.05) and greater conscientiousness (OR = 1.08, CI 1.02, 1.14, p = 0.01), whereas among Black females correlates included greater openness to experience (OR = 1.08, CI 1.01, 1.15, p = 0.03). Ordinal logistic regression analyses indicated that, among White females, greater PA was associated with attending a four-year college (Beta = 0.27, CI 0.01, 0.53, p = 0.04), whereas among Black females, correlates were with younger age (Beta = 0.01, CI 0.17, 0.03, p = 0.003) and greater emotional stability (Beta = 0.07, CI 0.01, 0.13, p = 0.02). Binary logistic regression analyses indicated that, among White females, being overweight or obese was associated with older age (OR = 1.08, CI 1.01, 1.16, p = 0.03), attending a two-year college (OR = 1.62, CI 1.22, 2.16, p = 0.001), and lower satisfaction with life (OR = 0.96, CI 0.94, 0.98, p = 0.002), whereas among Black females, being overweight or obese was associated with older age (OR = 1.87, CI 1.10, 1.28, p < 0.001).Identifying factors related to obesity-related factors is critical in developing interventions targeting factors associated with overweight and obesity among Black and White females attending two- and four-year colleges. Moreover, understanding different college settings and the contextual factors associated with overweight/obesity is critical.
Ultraviolet (UV) light-emitting diodes (LEDs) emitting at 260 nm were evaluated to determine the inactivation kinetics of bacteria, viruses, and spores compared to low-pressure (LP) UV irradiation. Test microbes were Escherichia coli B, a non-enveloped virus (MS-2), and a bacterial spore (Bacillus atrophaeus). For LP UV, 4-log10 reduction doses were: E. coli B, 6.5 mJ/cm(2); MS-2, 59.3 mJ/cm(2); and B. atrophaeus, 30.0 mJ/cm(2). For UV LEDs, the 4-log10 reduction doses were E. coli B, 6.2 mJ/cm(2); MS-2, 58 mJ/cm(2); and B. atrophaeus, 18.7 mJ/cm(2). Microbial inactivation kinetics of the two UV technologies were not significantly different for E. coli B and MS-2, but were different for B. atrophaeus spores. UV LEDs at 260 nm are at least as effective for inactivating microbes in water as conventional LP UV sources and should undergo further development in treatment systems to disinfect drinking water.
To qualitatively explore the impact of a safety communication and recognition program (“B-SAFE”) on safety attitudes and beliefs among construction workers.
Method
B-SAFE consisted of weekly, detailed feedback to foremen and workers on safe and unsafe work practices. B-SAFE ran for approximately 5 months on three commercial construction sites in Eastern Massachusetts. Sites were paired with a similar worksite (and same owner or general contractor), and data collection methods were identical at each site. Focus groups and key informant interviews were conducted to qualitatively assess the program’s impact on workers’ perception of site safety. Transcripts of focus groups and key informant interviews were coded and analysed for thematic content using Atlas.ti (V7).
Results
At B-SAFE intervention sites, workers noted increased levels of safety awareness, communication, and teamwork, when compared to experiences on-site before the program, and to past worksites. Workers attributed an increase in morale to B-SAFE, noting that increasing safety performance feedback helped to improve safety conditions. One worker stated, “[B-SAFE] increased the level of awareness around safety conditions on-site (...) Instead of cutting corners, we’d do it right.” Workers at sites without B-SAFE noted that the safety level was comparable to past worksites.
Conclusions
The B-SAFE program led to many positive changes on-site, including an increase in safety awareness, teambuilding, and collaborative competition. Future quantitative data analysis to evaluate program effectiveness including worker surveys, safety inspections, and injury reports will augment these qualitative results.
We examined correlates of 1) being a virgin; 2) drug or alcohol use prior to the last intercourse; and 3) condom use during the last intercourse in a sample of college students.We recruited 24,055 students at six colleges in the Southeast to complete an online survey, yielding 4840 responses (20.1% response rate), with complete data from 4514.Logistic regression indicated that correlates of virginity included being younger (p < 0.001), male (p = 0.01), being White or other ethnicity (p < 0.001), attending a four-vs. two-year school (p < 0.001), being single/never married (p < 0.001), lower sensation seeking (p < 0.001), more regular religious service attendance (p < 0.001), lower likelihood of smoking (p < 0.001) and marijuana use (p = 0.002), and less frequentdrinking (p < 0.001). Correlates of alcohol or drug use prior to most recent intercourse including being older (p = 0.03), being White (p < 0.01), attending a four-year college (p < 0.001), being homosexual (p = 0.041) or bisexual (p = 0.011), having more lifetime sexual partners (p = 0.005), lower satisfaction with life (p = 0.004), greater likelihood of smoking (p < 0.001) and marijuana use (p < 0.001), and more frequent drinking (p < 0.001). Correlates of condom use during the last sexual intercourse including being older (p = 0.003), being female (p < 0.001), being White (p < 0.001), attending a two-year school (p = 0.04), being single/never married (p = 0.005), being homosexual or bisexual (p = 0.04), and a more frequent drinking (p = 0.001).Four-year college attendees were more likely to be a virgin but, if sexually active, reported higher sexual risk behaviors. These nuances regarding sexual risk may provide targets for sexual health promotion programs and interventions.
Abstract Background: Young adult cancer survivors do not respond similarly to the experience of cancer. Thus, we investigated health behavior profiles of young adult cancer survivors and characterize associated sociodemographic and psychosocial characteristics. Methods: A cross-sectional survey assessed sociodemographics, cancer treatment, health behaviors (e.g., alcohol use, tobacco use, physical activity [PA]), healthcare provider interaction, and psychosocial factors for 106 participants from a southeastern cancer center. In-depth semi-structured interviews with a sub-sample of 26 participants were conducted. Results: For the quantitative study, participants were 22.13 (SD=3.18) years old; 51.0% (n=53) male; and 78.8% (n=82) White. They had the following diagnoses: Hodgkin's lymphoma (23.1%); non-Hodgkin's lymphoma (8.7%); Burkitt's lymphoma (3.8%); acute lymphoblastic leukemia (16.3%); acute myelogenous leukemia (2.9%); blastoma (5.8%); sarcoma (10.6%); thyroid cancer (9.6%); and other (19.2%). Average time since diagnosis was 8.42 (SD=5.73) years. A k-means cluster analysis indicated three distinct clusters based on health behavior profiles that corresponded to high, moderate, and low risk behaviors. The clusters differed significantly in relation to current alcohol use, binge drinking, tobacco use, marijuana use, PA, and number of sex partners (p's<0.001). The High Risk group (n=25) had the highest current use of alcohol, tobacco, and marijuana and the most past-year sexual partners (p's<0.001). However, they had the greatest PA (p<0.001). The High Risk cluster was older than the Low Risk group but younger than Moderate Risk group, and gender composition was mostly male. Compared to the other groups, the High Risk were more likely to have significant depressive symptoms per the Patient Health Questionnaire – 9 item (p=0.052) and had the highest Profile of Moods States (POMS) scores for tension-anxiety (p=0.004), depression-dejection (p=0.018), fatigue-inertia (p=0.033), and confusion-bewilderment (p=0.022). The Moderate Risk group (n=39) had the lowest levels of PA (p<0.001) but was not distinct regarding the other health behaviors. They were the oldest (p<0.001), most likely to be female (p=0.005), were the most likely to be employed (p=0.012), were least likely to be on their parent's insurance (p=0.012), and had the most time lapse since their initial diagnosis (p<0.001). This group also had the least depressive symptoms (p=0.052). The Low Risk group (n=40) reported the lowest current alcohol use, binge drinking, tobacco use, and marijuana use, as well as the lowest number of past-year sexual partners (p's<0.001). This group was the youngest (p<0.001), the most likely to be students (p=0.012), the most likely to be on public insurance (p=0.012), and the most recently diagnosed (p<0.001). This cluster had the lowest POMS scores for tension-anxiety (p=0.004), depression-dejection (p=0.018), fatigue-inertia (p=0.033), and confusion-bewilderment (p=0.022). In qualitative interviews, participants reported that their experience with cancer decreased positively or negatively affected their health behaviors, and some reported no impact. Some participants reported minimal or no assessment or intervention related to substance use, physical activity, or nutrition. On the other hand, some reported that providers assessed and intervened on these health behaviors. Many participants expressed interest in having up-to-date information and education available through various reputable sources. Participants discussed a variety of communication channels and the need for expertise and reliability of the material presented. Conclusions: Greater efforts should be made by providers to routinely and systematically examine substance use, PA, and nutrition as well as mental health and social support among this population. In addition, disseminable and cost-effective programs to support providers in doing so are needed. Citation Format: Carla J. Berg, Kincaid Lowe, Cam Escoffery, Ann Mertens. Distinct health behavior and psychosocial profiles of young adult cancer survivors: A mixed methods study. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B55.
