Research interests of family physicians applying for research training.

BACKGROUND: There is an ongoing need for research to support the practice of high quality family medicine. The Family Medicine Discovers Rapid Cycle Scientific Discovery and Innovation (FMD RapSDI) program is designed to build capacity for family medicine scientific discovery and innovation in the United States. Our objective was to describe the applicants and research questions submitted to the RapSDI program in 2019 and 2020. METHODS: Descriptive analysis for applicant characteristics and rapid qualitative analysis using principles of grounded theory and content analysis to examine the research questions and associated themes. We examined differences by year of application submission and the applicant's career stage. RESULTS: Sixty-five family physicians submitted 70 applications to the RapSDI program; 45 in 2019 and 25 in 2020. 41% of applicants were in practice for five years or less (n = 27), 18% (n = 12) were in in practice 6-10 years, and 40% (n = 26) were ≥ 11 years in practice. With significant diversity in questions, the most common themes were studies of new innovations (n = 20, 28%), interventions to reduce cost (n = 20, 28%), improving screening or diagnosis (n = 19, 27%), ways to address mental or behavioral health (n = 18, 26%), and improving care for vulnerable populations (n = 18, 26%). CONCLUSION: Applicants proposed a range of research questions and described why family medicine is optimally suited to address the questions. Applicants had a desire to develop knowledge to help other family physicians, their patients, and their communities. Findings from this study can help inform other family medicine research capacity building initiatives.

Exploring the barriers and facilitators towards physical activity among church members in Lagos, Nigeria: a qualitative study.

Background: Physical inactivity is substantially linked to the rise in the global burden of non-communicable diseases. Faith-based organizations are recognized as potential partners for sustainable health interventions. Objective: This study aims to explore the facilitators and barriers towards physical activity among adult church members in Lagos, Nigeria. Methods: Sixteen focus group discussions (n-163) were conducted among adult male and female church members in twelve Anglican churches. The discussions were audio-taped, transcribed verbatim and analysed along with the field notes for themes using sequential approach with the aid of the Dedoose® software. Results: Individual facilitators of PA included self-discipline, and personal habits. Individual barriers were laziness, ill-health, fear of injury and pre-existing health conditions. Organizational facilitators included biblical verses promoting PA, while deterring factors were lack of safe spaces for PA and poor knowledge among church leadership. The community-level facilitators included pro-physical activity cultural practices, while the prevailing practice hiring house-helps, high costs of gym membership and gender norms discouraging men from participating in household chores served as deterring community-level factors. Environmental facilitators were the availability of safe spaces for PA while deterring factors were city living and high traffic density. Conclusion: Several multi-level factors influence physical activity among church members. While it is pertinent to address personal factors, family and community factors also promote PA, therefore, group-level interventions may be warranted. Strategies that address the socio-cultural norms that serve as barriers to PA should also be included in the design of church-based PA programmes.

Smoking reduction among homeless smokers in a randomized controlled trial targeting cessation.

INTRODUCTION: Homeless populations have high rates of smoking and unique barriers to quitting. General cessation strategies have been unsuccessful in this population. Smoking reduction may be a good intermediate goal. We conducted a secondary analysis to identify predictors of smoking reduction in a cohort of homeless smokers enrolled in a 26-week randomized clinical trial (RCT) targeting smoking cessation. METHODS: Data are from an RCT comparing motivational interviewing counseling plus nicotine replacement therapy (NRT) to brief advice to quit (standard care) plus NRT among homeless smokers. Using bivariate analyses and multinomial logistic regression, we compared demographics, health and psychosocial variables, tobacco use, substance use, and NRT adherence among those who reported: quitting; reducing smoking by 50-99%; and not reducing smoking by 50%. RESULTS: Of 324 participants who completed 26-week follow-up, 18.8% and 63.9% self-reported quitting and reducing, respectively. Compared to those who did not reduce smoking, participants reporting reducing indicated higher baseline cigarette use (OR=1.08; CI:1.04-1.12) and menthol use (OR=2.24; CI:1.05-4.77). Compared to participants who reduced, participants reporting quitting were more likely to be male (OR=1.998; CI:1.00-3.98), experience more housing instability (OR=1.97; CI:1.08-3.59), indicate higher importance of quitting (OR=1.27; CI:1.041.55), have higher NRT adherence (OR=1.75; CI:1.00-3.06), and lower odds of reported illicit drug use (OR=0.48; CI:0.24-0.95). CONCLUSIONS: Over half of participants reduced smoking by at least 50%, indicating reduction is feasible among homeless smokers. Further research is required to understand the impact of reduction on future cessation attempts in homeless smokers. This study shows that reduction is achievable and may be a valid intermediate goal.

Targeted faith-based and faith-placed interventions for noncommunicable disease prevention and control in low- and middle-income countries: a systematic review protocol.

BACKGROUND: Low- and middle-income countries (LMICs) bear a disproportionately high burden of noncommunicable diseases (NCDs) with severe socioeconomic consequences. Targeted interventions that are faith-based or take place in faith-based settings are historically viable for health promotion and disease prevention programmes. However, evidence of their effectiveness often comes from high-income countries. This paper outlines the protocol for the systematic review of faith-based and faith-placed interventions for NCDs in low- and middle-income countries. OBJECTIVE: To determine the effectiveness of faith-based and faith-placed interventions or interventions within faith-based settings targeted at NCDs and/or their risk factors in LMICs. METHODS: We will conduct a systematic search of PubMed, Embase, Scopus, WHO Library, and grey literature to locate published and unpublished studies. We will consider quantitative studies that report on interventions (a) with faith-based components or that take place in faith-based settings (b) for the prevention and control of one or more of the top ten NCDs listed in the Global Burden of Disease or their known risk factors (c) occurring among adults aged 18 and above (d) that take place in one or more LMICs. We will screen the titles, abstracts, and full text of articles for eligibility. Included articles will be critically appraised for quality and the inclusion of faith-based components by at least two independent reviewers. Data extraction will be performed for study characteristics and findings. A meta-analysis will be used to synthesize the results; if impossible, a narrative synthesis will be performed. DISCUSSION: This review will attempt to synthesize up-to-date evidence to guide effective decision-making, allocation of health resources, and the design of future trials to test the efficacy of NCD interventions in faith-based settings. The study will increase the understanding of the existing evidence, highlight the need for additional evidence, and guide possible directions for future collaborations between public health professionals and faith-based health service providers. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020186299.

Implementing a smoking cessation intervention for people experiencing homelessness: Participants' preferences, feedback, and satisfaction with the 'power to quit' program.

BACKGROUND: Smoking rates among populations experiencing homelessness are three times higher than in the general population. Developing smoking cessation interventions for people experiencing homelessness is often challenging. Understanding participant perceptions of such interventions may provide valuable insights for intervention development and implementation. We assessed participants' satisfaction and preferences for the Power to Quit (PTQ) program. METHODS: PTQ was a 26-week community-based smoking-cessation RCT among people experiencing homelessness. A total of 315 of the 430 enrolled participants completed the 26 week-study feedback survey. Overall program satisfaction was measured on a 5-point Likert scale by asking the question "Overall, how satisfied were you with the Power to Quit Program?" Analyses were conducted to identify factors associated with overall program satisfaction. RESULTS: Participants were mostly male (74.9%), African American (59.0%), 40 years and older (78.2%), and not married or living with a partner (94.9%). Visa gift cards were the most preferred incentive followed by bus tokens and Subway restaurant coupons. The patch and counseling were the top-ranked intervention component, 55.3% rated the patch as very helpful; 59.4% felt counseling sessions was very helpful; 48.6% found reminder phone calls or messages most helpful for appointment reminders. Majority (78.7%) said they were very satisfied overall, 80.0% were very satisfied with the program schedule, and 85.4% were very satisfied with program staff. Race and age at smoking initiation were predictors of overall program satisfaction. African American/Black participants were 1.9 times more likely to be satisfied with the program compared to White participants. CONCLUSION: Majority of the participants of PTQ were satisfied with the program. This study supports the acceptability of a smoking cessation program implemented in a population experiencing homelessness. The high rate of satisfaction among African American participants may be in part because of race concordance between participants, study staff, and community advisory board. Including staff that have a shared lived experience with participants in a smoking cessation study may improve the participant satisfaction within such studies.

Barriers and Facilitators of Fruit and Vegetable Consumption among Nigerian Adults in a Faith-Based Setting: A Pre-Intervention Qualitative Inquiry.

BACKGROUND: Inadequate consumption of fruit and vegetable is a risk factor for morbidity and mortality associated with non-communicable diseases (NCDs). An understanding of the barriers and facilitators to consumption is important for effectiveness of intervention in Africa. We present insights among church members before developing a church-based multi-component intervention to address the inadequate consumption of fruit and vegetable. METHODS: We conducted eighteen focus group discussions among 163 church members. All discussions were audio-taped, transcribed verbatim, and were analyzed for thematic content. RESULTS: We identified five main themes; Personal: awareness and knowledge of benefits, choice, habits, and curiosity, dietary restrictions and gastrointestinal symptoms following fruit and vegetable consumption. Familial: practices promoting the ready availability of fruit and vegetables in the home or habits that encourage children to eat vegetables as they transition into adulthood, pre-existing health problems of family members and the long preparation time of some traditional vegetables. Socio-cultural: Cultural practices that encourage F&V consumption, the high cost of fruits and vegetables, alternatives foregone, and cultural taboos. Environmental: inadequate farmland and storage facilities, seasonality of several fruit and vegetables, and sharp practices of force-ripening with chemicals. Church-related: inadequate space provided by the church for arable cultivation and lack of knowledge of the benefits among church leaders, church activities that involve serving fruits and vegetables and the biblical support for the consumption of fruits and vegetables. CONCLUSION: It is essential to leverage practices that promote fruit and vegetable intake and address barriers mentioned by the participants when designing such interventions.

Variations of a group coaching intervention to support early-career biomedical researchers in Grant proposal development: a pragmatic, four-arm, group-randomized trial.

BACKGROUND: Funded grant proposals provide biomedical researchers with the resources needed to build their research programs, support trainees, and advance public health. Studies using National Institutes of Health (NIH) data have found that investigators from underrepresented groups in the biomedical workforce are awarded NIH research grants at disproportionately lower rates. Grant writing training initiatives are available, but there is a dearth of rigorous research to determine the effectiveness of such interventions and to discern their essential features. METHODS: This 2 × 2, unblinded, group-randomized study compares the effectiveness of variations of an NIH-focused, grant writing, group coaching intervention for biomedical postdoctoral fellows and early-career faculty. The key study outcomes are proposal submission rates and funding rates. Participants, drawn from across the United States, are enrolled as dyads with a self-selected scientific advisor in their content area, then placed into coaching groups led by senior NIH-funded investigators who are trained in the intervention's coaching practices. Target enrollment is 72 coaching groups of 4-5 dyads each. Groups are randomized to one of four intervention arms that differ on two factors: [1] duration of coaching support (regular dose = 5 months of group coaching, versus extended dose = regular dose plus an additional 18 months of one-on-one coaching); and [2] mode of engaging scientific advisors with the regular dose group coaching process (unstructured versus structured engagement). Intervention variations were informed by programs previously offered by the NIH National Research Mentoring Network. Participant data are collected via written surveys (baseline and 6, 12, 18, and 24 months after start of the regular dose) and semi-structured interviews (end of regular dose and 24 months). Quantitative analyses will be intention-to-treat, using a 2-sided test of equality of the effects of each factor. An inductive, constant comparison analysis of interview transcripts will be used to identify contextual factors -- associated with individual participants, their engagement with the coaching intervention, and their institutional setting - that influence intervention effectiveness. DISCUSSION: Results of this study will provide an empirical basis for a readily translatable coaching approach to supporting the essential grant writing activities of faculty, fellows, and other research trainees, including those from underrepresented groups.

A Randomized Trial of Nicotine versus No-nicotine E-cigarettes Among African American Smokers: Changes in Smoking and Tobacco Biomarkers.

INTRODUCTION: The objective of this clinical trial was to compare the effects of e-cigarettes with and without nicotine on patterns of combustible cigarette use and biomarkers of exposure to tobacco toxicants among African American smokers. METHODS: African American smokers (n = 234) were enrolled in a 12-week, single blind, randomized controlled trial and assigned to ad lib use of nicotine e-cigarettes with or without menthol (2.4% nicotine [equivalent to combustible cigarettes], n = 118), or no-nicotine e-cigarettes (n = 116) for 6 weeks. Surveys were administered at baseline, 2, 6, and 12 weeks, and urinary biomarkers 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and total nicotine equivalents (TNE) were assessed at baseline and 6 weeks. RESULTS: Participants smoked an average of 11.4 cigarettes per day (CPD) and 88% used menthol cigarettes at baseline. At Week 6, the nicotine group reported using e-cigarettes 9.1 times per day compared to 11.4 times in the no-nicotine group (p = 0.42). Combustible cigarette smoking decreased 3.0 CPD in the nicotine group compared to 2.7 CPD in the no-nicotine group (p = 0.74). Neither TNE nor NNAL changed significantly between baseline and Week 6. There were no differences in nicotine withdrawal symptoms between treatment groups. Smoking reduction persisted in both groups at Week 12. CONCLUSIONS: Contrary to our hypotheses, nicotine e-cigarettes did not significantly reduce the use of combustible cigarettes compared to no-nicotine e-cigarettes in this cohort of African American smokers. Findings suggest e-cigarettes are modestly associated with the decreased use of combustible cigarettes among non-treatment seeking smokers, regardless of nicotine content, but without a reduction in tobacco toxicants. IMPLICATIONS: Although e-cigarettes have the potential to reduce harm if substituted for combusted cigarettes (or if they promoted cessation) because of lower levels of tobacco toxicants, this study suggests ad lib use of e-cigarettes among African American smokers, with or without nicotine, results in modest smoking reduction but does not change toxicant exposure in a cohort where smoking cessation or reduction is not the goal. These data suggest that testing future harm reduction interventions using e-cigarettes should include more specific behavioral change coaching, including substituting for or completely stopping combusted cigarettes. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov - NCT03084315.

Inequities in Hypertension Control in the United States Exposed and Exacerbated by COVID-19 and the Role of Home Blood Pressure and Virtual Health Care During and After the COVID-19 Pandemic.

The COVID-19 pandemic is a public health crisis, having killed more than 514 000 US adults as of March 2, 2021. COVID-19 mitigation strategies have unintended consequences on managing chronic conditions such as hypertension, a leading cause of cardiovascular disease and health disparities in the United States. During the first wave of the pandemic in the United States, the combination of observed racial/ethnic inequities in COVID-19 deaths and social unrest reinvigorated a national conversation about systemic racism in health care and society. The 4th Annual University of Utah Translational Hypertension Symposium gathered frontline clinicians, researchers, and leaders from diverse backgrounds to discuss the intersection of these 2 critical social and public health phenomena and to highlight preexisting disparities in hypertension treatment and control exacerbated by COVID-19. The discussion underscored environmental and socioeconomic factors that are deeply embedded in US health care and research that impact inequities in hypertension. Structural racism plays a central role at both the health system and individual levels. At the same time, virtual healthcare platforms are being accelerated into widespread use by COVID-19, which may widen the divide in healthcare access across levels of wealth, geography, and education. Blood pressure control rates are declining, especially among communities of color and those without health insurance or access to health care. Hypertension awareness, therapeutic lifestyle changes, and evidence-based pharmacotherapy are essential. There is a need to improve the implementation of community-based interventions and blood pressure self-monitoring, which can help build patient trust and increase healthcare engagement.

Effects on Smoking Behavior of Switching Menthol Smokers to Non-menthol Cigarettes.

INTRODUCTION: Bans of menthol characterizing flavor in cigarettes have been implemented in some localities and have been proposed more broadly. One proposed benefit of such a ban is to increase cessation rates among current menthol smokers. There is currently relatively limited data regarding how smoking behavior changes if menthol smokers switch to non-menthol cigarettes. AIMS AND METHODS: African American menthol smokers interested in quitting smoking were randomized to either continue smoking menthol (n = 60) or switch to non-menthol cigarettes (n = 62) for 1 month prior to a cessation attempt. Cessation results were reported previously; this analysis reports the results from the pre-cessation visits at which amount smoked, exhaled carbon monoxide (CO) concentration, urinary cotinine concentrations, and subjective measures were assessed. RESULTS: Over the 4-week study period, those switching to non-menthol (vs. continuing to smoke menthol) cigarettes smoked fewer cigarettes per day (mean ratio: 0.86; 95% confidence interval [CI]: 0.76, 0.98; p = .02), reported lower withdrawal symptom severity (mean difference -1.29; 95% CI: -2.6 to -0.01; p = .05) and higher perceived effectiveness of their skills for quitting smoking (mean difference 0.56; 95% CI: 0.02-1.10; p = .05). No significant differences were found between groups in exhaled CO, urinary cotinine concentrations, or most other subjective effects including support for a ban on menthol characterizing flavor in cigarettes. CONCLUSIONS: These results suggest that were menthol cigarettes no longer available, those that switch to non-menthol cigarettes would not change their smoking behavior in a way that is likely to be more hazardous, with some indicators suggesting that there may be some benefit.Clinicaltrials.gov # NCT02342327. IMPLICATIONS: A ban on menthol characterizing flavor in cigarettes has been proposed as a potential means by which to increase smoking cessation rates among current menthol cigarette smokers. This study evaluated how African American menthol cigarette smokers adjusted their smoking behavior after switching to non-menthol cigarettes. Although the overall differences between groups were modest, they were in a direction consistent with decreased smoking suggesting that current smokers would not adjust their behavior in a way that is likely to be more hazardous, with some indicators suggesting that there may be some benefits.

Effects on time to lapse of switching menthol smokers to non-menthol cigarettes prior to a cessation attempt: a pilot study.

INTRODUCTION: Menthol smokers (particularly African-Americans) have lower cessation success rates than non-menthol smokers. With bans being considered on characterising menthol flavour in cigarettes, data are needed regarding how switching to non-menthol cigarettes impacts cessation measures. METHODS: In this randomised pilot study, African-American menthol cigarette smokers interested in quitting smoking either continued smoking menthol cigarettes (n=60) or switched to non-menthol cigarettes (n=62) for a 1-month period prior to a cessation attempt. The primary endpoint was time to smoking lapse (ie, time from quitting until any smoking). Additional endpoints included time to smoking relapse (ie, number of days from quitting until the first of seven consecutive smoking days) and difference between groups in subjective measures. RESULTS: After attempting to quit, the non-menthol cigarette group had indications of delayed time to lapse (HR 0.82; 95% CI 0.55 to 1.22; p=0.33) and time to relapse (HR 0.67; 95% CI 0.42 to 1.06; p=0.09), although these were not statistically significant. Post hoc analyses suggest that observed differences were largely due to a smaller proportion of participants in the non-menthol group relapsing within the first day of quitting (21% vs 40%; p=0.05). Values of other measures assessed postcessation were largely similar between groups. CONCLUSIONS: These data suggest that among African-American smokers, a menthol cigarette ban would not undermine short-term cessation measures and may result in some benefits. Future research is needed to assess longer term cessation rates and to identify interventions to maximise cessation success in the event of a menthol ban. TRIAL REGISTRATION NUMBER: NCT02342327.

Grant application outcomes for biomedical researchers who participated in the National Research Mentoring Network's Grant Writing Coaching Programs.

BACKGROUND: A diverse research workforce is essential for catalyzing biomedical advancements, but this workforce goal is hindered by persistent sex and racial/ethnic disparities among investigators receiving research grants from the National Institutes of Health (NIH). In response, the NIH-funded National Research Mentoring Network implemented a Grant Writing Coaching Program (GCP) to provide diverse cohorts of early-career investigators across the United States with intensive coaching throughout the proposal development process. We evaluated the GCP's national reach and short-term impact on participants' proposal submissions and funding outcomes. METHODS: The GCP was delivered as six similar but distinct models. All models began with an in-person group session, followed by a series of coaching sessions over 4 to 12 months. Participants were surveyed at 6-, 12- and 18-months after program completion to assess proposal outcomes (submissions, awards). Self-reported data were verified and supplemented by searches of public repositories of awarded grants when available. Submission and award rates were derived from counts of participants who submitted or were awarded at least one grant proposal in a category (NIH, other federal, non-federal). RESULTS: From June 2015 through March 2019, 545 investigators (67% female, 61% under-represented racial/ethnic minority, URM) from 187 different institutions participated in the GCP. Among them, 324 (59% of participants) submitted at least one grant application and 134 (41% of submitters) received funding. A total of 164 grants were awarded, the majority being from the NIH (93, 56%). Of the 74 R01 (or similar) NIH research proposals submitted by GCP participants, 16 have been funded thus far (56% to URM, 75% to women). This 22% award rate exceeded the 2016-2018 NIH success rates for new R01s. CONCLUSION: Inter- and intra-institutional grant writing coaching groups are a feasible and effective approach to supporting the grant acquisition efforts of early-career biomedical investigators, including women and those from URM groups.

Body, Soul and Spirit, an adaptation of two evidence-based interventions to promote physical activity and healthy eating among adults in churches in Lagos Nigeria: a three-arm cluster randomized controlled pilot trial.

BACKGROUND: Physical inactivity and unhealthy eating are two leading behavioral risk factors contributing to preventable non-communicable diseases (NCDs). Evidence-based interventions (EBI) using community-engaged approaches to address these risks abound in high-income countries. Comparatively, evidence of such interventions is sparse in low- and middle-income countries, where NCD mortality is greater. This paper describes the protocol for the development of the cultural adaptation and pilot testing of a combination of two EBI (i.e., Body and Soul and the Healthy Body Healthy Spirit), in church-based settings in Lagos, Nigeria. In addition, we describe the development of the inclusion of an additional component, i.e., faith-based text messages, into one of the treatment arms. Our objective is to assess the feasibility of developing and implementing the adapted interventions with the ultimate aim of developing a fully powered trial. METHODS: This pilot study will assess the design and implementation of a three-arm cluster-randomized pilot trial in 12 randomly selected Anglican churches (4 in each arm). First, we will design a cultural adaptation of the two EBI's to form a multifaceted combined intervention known as the Body Soul and Spirit. The second treatment arm, i.e., Body Soul and Spirit Plus, will retain all the components of Body Soul and Spirit with the inclusion of faith-based text messages using mobile phones. Participants in the control arm will receive information leaflets designed to increase physical activity and healthy food consumption. The outcome measures include participant recruitment and retention, program participation and satisfaction, and data collection completion rates. The outcomes for the proposed definitive trial will be the number of servings of fruit and vegetables and minutes of moderate to vigorous physical activity per day will be assessed at baseline, 3 and 6-month follow-up. Implementation outcomes will be assessed using qualitative and quantitative methods. DISCUSSION: The study will enhance the understanding of how best to design and implement behavioral interventions in church-based settings using community-based participatory approaches. It will also inform the development of a definitive randomized controlled trial. TRIAL REGISTRATION: Pan African Clinical Trials Registry on 12th July 2018. PACTR201807136835945. Available at https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3481.

Disparities in current cigarette smoking among US adults, 2002-2016.

BACKGROUND: To assess disparities in current (past 30 days) cigarette smoking among US adults aged ≥ 18 years during 2002-2016. METHODS: Nine indicators associated with social disadvantage were analysed from the 2002 to 2016 National Survey on Drug Use and Health: education, annual family income, sex, race/ethnicity, urbanicity, serious psychological distress, health insurance, public assistance, and employment status. Using descriptive and multivariable analyses, we measured trends in smoking overall and within the assessed variables. We also evaluated effect of interactions on disparities and estimated the excess number of smokers attributable to disparities. RESULTS: During 2002-2016, current cigarette smoking prevalence declined overall (27.5%-20.7%; p trend < 0.01), and among all subgroups except Medicare insurees and American Indians/Alaska Natives (AI/ANs). Overall inequalities in cigarette smoking grew even wider or remained unchanged for several indicators during the study period. In 2016, comparing groups with the least versus the most social advantage, the single largest disparity in current smoking prevalence was seen by race/ethnicity (prevalence ratio = 5.1, AI/ANs vs Asians). Education differences alone explained 38.0% of the observed racial/ethnic disparity in smoking prevalence. Interactions were also present; compared with the population-averaged prevalence among all AI/AN individuals (34.0%), prevalence was much higher among AI/ANs with

Impact of the Society for Research on Nicotine and Tobacco Health Disparities Network's Scholarship on Professional Development of Its Recipients.

INTRODUCTION: Diversifying the workforce is an important strategy to reducing health disparities. Since 2007, the Society for Research on Nicotine and Tobacco (SRNT) Health Disparities Network has funded a travel scholarship to promote inclusion, professional development, and diversity among investigators interested in tobacco-related health disparities research. This study examined indicators of productivity among former scholarship recipients.Methods: Scholarship recipients between 2007 and 2014 were invited to complete a survey online. The survey assessed demographic characteristics, academic productivity, and perceived professional benefit resulting from the scholarship.Results: Of the 117 scholarships recipients, 89 (77%) responded. Respondents were 67% female and had a mean age of 37.8 years. Twenty eight percent were African American, 25% Asian American, and 17% Latino. Most respondents worked in academia (80%) and nearly three-quarters (74%) reported publishing manuscripts on tobacco-related disparities, with a mean of 3.8 (SD 4.4) disparities-related publications since receiving the scholarship. Respondents' work focused on a wide range of health disparities topics and nearly all respondents reported that the scholarship removed barriers to attending the meeting and reported professional benefit from receiving the travel scholarship. Following receipt of the SRNT travel scholarship, a diverse group of scientists demonstrated scholarly productivity, professional development, and advancement of health disparities research. Similar efforts are encouraged in other professional societies. IMPLICATIONS: This study examines the productivity of early career recipients of the SRNT Health Disparities Scholarship. Results suggest that the investment in annual travel scholarships by a professional organization is an important support system for emerging scientists from diverse backgrounds. This investment may help to advance the science of health disparities and engage researchers in an area where there are critical gaps in the research workforce.

Early career biomedical grantsmanship self-efficacy: validation of an abbreviated self-assessment tool.

A hallmark of success for early career biomedical researchers is the acquisition of research funding. There are marked disparities among principal investigators who submit grants and the likelihood of receiving national funding. The National Research Mentoring Network was funded by the National Institutes of Health to diversify the biomedical research workforce and included grantsmanship training for early career researchers. Self-efficacy in developing research grant applications is significantly improved over time with training and experience. We created a 19-item self-efficacy assessment inventory. Our aims were to confirm the internal consistency of a three-factor solution for grantsmanship confidence and to test the likelihood that self-efficacy influences grant proposal submission timing. We gathered data from 190 diverse biomedical trainees who completed NRMN grantsmanship training between August 2015 and June 2017. Findings revealed high internal consistency for items in each of three factors. There was a statistically significant association between self-efficacy mean scores and grant submission timing predicting that, for every one-point increase in the mean score, the odds of submitting a grant 6 months post-training increased by 69%. An abbreviated inventory of grantsmanship skills self-efficacy is a promising tool for monitoring changes over time in early career researchers and for promoting tailored grantsmanship interventions.

Association between smoking cessation and weight gain in treatment-seeking African Americans.

INTRODUCTION: Research has shown that African Americans gain more than average weight after smoking cessation. However, African Americans have been underrepresented in post-cessation weight gain research. The current study examined 1) the pattern of weight gain and 2) the association between smoking status and weight gain in a sample of African Americans seeking smoking cessation treatment. METHODS: Data were drawn from a randomized controlled trial testing the efficacy of a 4-week culturally specific smoking cessation cognitive behavioral therapy (CBT) intervention among African American smokers (N = 342). Weight was measured and self-reported smoking status was biochemically verified at baseline, end of counseling, 3-, 6-, and 12-month follow-ups. Random effects multilevel modeling was used to examine weight gain over twelve months post CBT, and a fully unconditional model tested the pattern of weight gain over time. Smoking status was included as a time-varying factor to examine its effect on weight gain, controlling for potential confounding variables. RESULTS: Weight significantly increased among those who remained abstinent over 12 months post CBT [average gain of seven lbs. (three kg)]. Controlling for covariates, abstinence was predictive of the rate of weight gain for those with high weight concern. CONCLUSIONS: Weight gain among African American abstainers was comparable to the average post-cessation weight gain observed among the general population. It is possible that exposure to CBT (culturally specific or standard) may have mitigated excessive weight gain. Future research should assess predictors of weight gain in African American smokers to inform future smoking cessation interventions and help elucidate factors that contribute to tobacco- and obesity-related health disparities.

Pro-tobacco advertisement exposure among African American smokers: An ecological momentary assessment study.

INTRODUCTION: Many African Americans live in communities with a disproportionately high density of tobacco advertisements compared to Whites. Some research indicates that point-of-sale advertising is associated with impulse purchases of cigarettes and smoking. Ecological Momentary Assessment (EMA) can be used to examine associations between tobacco advertisement exposure and smoking variables in the natural environment. METHODS: Non-treatment seeking African American smokers were given a mobile device for 2weeks (N=56). They were prompted four times per day and responded to questions about recent exposure to tobacco advertisements. Participants were also asked to indicate the number of cigarettes smoked, and if they made any purchase, or an impulse purchase, since the last assessment. Linear mixed models (LMMs) analyzed between- and within-subject associations between exposure and outcomes. RESULTS: Participants reported seeing at least one advertisement on 33% of assessments. Of those assessments, they reported seeing menthol advertisements on 87% of assessments. Between-subject analyses revealed that participants who on average saw more advertisements were generally more likely to report purchasing cigarettes and to purchase cigarettes on impulse. Within-subject analyses revealed that when an individual participant reported seeing more advertisements than usual they were more likely to have reported purchasing cigarettes, making an impulse purchase and smoking more cigarettes during the same period, but not the subsequent time period. CONCLUSIONS: Many African American smokers are frequently exposed to pro-tobacco marketing. Advertisement exposure is cross-sectionally associated with impulse purchases and smoking. Future research should assess prospective associations in more detail.

Colorectal Cancer Screening Uptake's Association With Psychosocial and Sociodemographic Factors Among Homeless Blacks and Whites.

The homeless represent an extremely disadvantaged population that fare worse than minority groups in access to preventive services and health, and minority groups fare worse than Whites. Early detection screening for colorectal cancer (CRC) saves lives, but empirical data about CRC screening practices among homeless Blacks and Whites are limited. Psychosocial risk factors may serve as a barrier to CRC screening completion among homeless Black individuals. A secondary data analysis of a randomized clinical trial for smoking cessation among homeless smokers was conducted to determine whether psychosocial factors and sociodemographic factors were more highly associated with CRC screening uptake among homeless Blacks than among their White counterparts. Study participants ( N = 124) were surveyed on their CRC screening status, sociodemographic variables, and psychosocial correlate measures including anxiety, depression, hopelessness, depression severity, and perceived stress. Associations between these factors were examined with logistic regression. White participants who were currently disabled/unable to work were 6.2 times more likely to ever receive CRC screening than those who were employed. Black participants with public health insurance coverage were 90% less likely to ever obtain CRC screening than participants without health insurance. Black and White participants had similar levels of anxiety symptoms, depression, and hopelessness, yet depression was the only psychosocial variable negatively associated with CRC screening status. Black and White participants with symptoms of depression were 58% less likely to complete screening than those without depression. Mental health risk and sociodemographic factors may serve as barriers to CRC screening among homeless Blacks and Whites.