Health Disparities

Researchers are evaluating how forming a physical activity (PA) identity within families can promote long-term physical activity among children aged 6 to 12 years. The study compares an identity formation approach, which includes education and planning plus additional coaching, to a standard education and planning condition. The main goal is to see if children in the identity formation group increase their moderate- to vigorous-intensity physical activity (MVPA) more over six months. Participants are divided into two groups. One group receives sessions, informational booklets, and worksheets based on Canada's PA guidelines, focusing on how parents can support their child's physical activity through encouragement, logistical help, and doing activities together. This group also receives materials on healthy family eating. The other group receives the same materials plus two extra coaching sessions that include family PA identity activities, such as assigning fun PA roles to family members and creating family PA items like t-shirts and photos, to strengthen social identity related to physical activity. During the six-month study, researchers will monitor children's MVPA at baseline, 6 weeks, 3 months, and 6 months. Additional assessments include parent-child activity tracking through accelerometers and self-reports, body measurements, cardiovascular and musculoskeletal fitness tests, and social identity questionnaires. The study aims to understand how family support and identity impact children's physical activity and health outcomes, with the University of Victoria leading the research.

This research aims to evaluate a 5-session cognitive behavioral program called 1MoreStep, designed for Black women living with HIV who have experienced intimate partner violence in the past two years. The study focuses on teaching skills to access personal and external strengths, safety strategies, knowledge about HIV care and stigma, communication skills to handle stigma, and addressing barriers to HIV care. It also examines the program's acceptability and feasibility among participants. Participants are randomly assigned to either the 1MoreStep intervention or an equal attention control group. The intervention includes seven group sessions and one individual session held weekly, led by experienced facilitators from the Black community. Sessions cover topics such as safety planning, HIV care engagement, stigma communication, and goal setting using cognitive behavioral skills. The control group attends weekly support group sessions that cover general health topics important to Black women living with HIV but not directly related to the intervention's goals. Throughout the study, participants complete assessments at baseline, 3 months, and 6 months to measure changes in safety strategies and HIV care engagement. Measures include surveys, medical record reviews, and interviews to evaluate treatment acceptance, session attendance, and participant experiences. The study spans approximately 6 months post-baseline, with follow-up surveys and qualitative interviews to explore program fit and barriers to participation.

This research aims to explore how PhytoRx Families, an innovative produce prescription program, can impact nutrition, health, and healthcare use among families in rural North Carolina facing food insecurity. The study focuses on adults and school-aged children, addressing barriers like limited access to affordable healthy food in lower-resourced rural communities. Participants include 30 adult-child pairs with children aged 8 to 14 years. Healthcare providers at local clinics will refer eligible families who screen positive for food insecurity. The program provides fresh produce boxes and nutrition education over a 16-week period, aiming to improve fruit and vegetable intake and related health outcomes. During the study, participants will complete dietary recalls and health assessments at the start and end of the 16 weeks. Researchers will measure fruit and vegetable intake, diet quality, food security, blood pressure, HbA1C, body mass index, and various nutrition-related behaviors. The study will also track healthcare usage and evaluate changes over the intervention period.

This research investigates ways to reduce HIV-related stigma among nursing students in Iran, a country with the highest HIV burden in the Middle East. The study focuses on how online HIV stigma training might decrease negative attitudes and behaviors during simulated clinical visits with patients living with HIV. The trial compares this stigma-focused training to a general online HIV epidemiology training without stigma content, aiming to improve care for people living with HIV in settings where stigma is a major barrier. Participants are randomly assigned to one of two groups: one receives a 6-hour online HIV stigma training spread over 4 weeks, while the other completes a 6-hour online HIV epidemiology course without stigma content in the same timeframe. Both trainings are delivered online and designed specifically for nursing students to evaluate impact on their attitudes and behaviors toward patients living with HIV. During the study, nursing students will be evaluated up to 4 weeks before and after the training using measures such as stigma scores, behavioral signs of HIV stigma, and empathy scores. A follow-up assessment will occur three months after the intervention to observe longer-term effects. This study involves simulated clinical visits and questionnaires to track changes in attitudes and behaviors, with overall participation lasting several months including training and follow-up.

Researchers are conducting a single-arm prospective pilot study to evaluate early diagnosis of lung cancer in Korean females who have never smoked and have a family history of lung cancer. The study aims to enroll 200 participants over two years at a single institution. It focuses on assessing lung cancer detection rates and related outcomes over a two-year period. Participants will undergo an initial low dose CT (LDCT) screening exam, with results reviewed by a qualified radiologist. Those with negative results will have repeat LDCT exams annually for two additional years. Participants with positive findings may receive further diagnostic work-ups or treatments and may have additional LDCT scans at intervals per Lung-RADS recommendations. Blood samples for a plasma-based assay will be collected at baseline, one year, and two years alongside the imaging. During the study, participants will complete a medical history questionnaire covering ethnicity, family history, environmental exposures, and residential district to estimate pollution exposure. Follow-up includes discussions of scan results and recommendations, with monitoring for lung cancer detection rates and stages. Participants may voluntarily stop active LDCT screening after baseline but can continue follow-up calls for up to 10 years. The total study duration involves repeated annual assessments and long-term observation.

Researchers are studying a communication intervention designed to reduce financial toxicity for patients with cancer. This intervention aims to support cancer care providers in discussing treatment costs more effectively alongside the existing DISCO app for patients. The study involves oncology care providers from Wayne State University and Karmanos Cancer Institute who treat patients at specific clinics. The study will include 20 oncology providers such as medical oncologists, nurses, social workers, and advanced practice providers. Participants will complete a baseline survey and attend two individual meetings. The first meeting focuses on developing the DISCO Provider intervention by gathering feedback on content, organization, and implementation. The second meeting pilots the intervention to assess acceptability, usability, and usefulness for training providers in cost discussions. Participants will provide feedback through audio-recorded interviews, which will be transcribed and analyzed. Researchers will measure the intervention's acceptability, usability, and usefulness immediately after the pilot test. The study monitors how providers respond to training for discussing treatment costs and gathers suggestions for improvement. Total participation includes surveys and two meetings with investigators.

Researchers are evaluating the "SIESTA" intervention, a culturally tailored sleep hygiene program designed to improve sleep health in urban Latino middle school children aged 11 to 13 years who typically sleep 9 hours or less per night. The study aims to see if SIESTA participants have better sleep outcomes, improved sleep hygiene behaviors, and less sleep-related impairment compared to a control group receiving general health education. This large-scale randomized trial will enroll 300 children from Providence, Rhode Island and San Juan, Puerto Rico. The SIESTA intervention involves four one-hour group sessions conducted remotely by a trained facilitator, plus two 90-minute individualized sessions with the child and caregiver delivered at home. The program focuses on key sleep hygiene principles tailored to urban Latino children, including sleep duration, sleep environment, and strategies to improve sleep quality. The control group participates in four group sessions on basic sleep hygiene and general child health topics, along with two individualized sessions, but without tailored behavioral strategies. Participants will complete surveys at baseline, end of treatment, and at 4, 8, and 12 months post-intervention. They will wear electronic sleep watches to objectively track sleep duration and quality throughout the study. Researchers will assess primary outcomes such as sleep duration and efficiency and secondary outcomes including sleep disturbances and sleep-related impairments. The study also involves a process evaluation to understand program reach, adoption, and implementation in urban school settings. Total participation lasts about 14 months.

Researchers are evaluating a single-session, online, parent-focused intervention aimed at preventing body image concerns and disordered eating in young children aged 2 to 6 years. This study addresses the early recognition of societal appearance ideals by children and the role of parents in shaping their children's exposure to these ideals. The study focuses on reducing predictors of body image disturbance, which are linked to serious mental health issues including eating disorders that have significant psychological and physical impacts. The intervention consists of a modular workshop delivered online to parents, covering four key areas: Body Image Development and Body Talk, Food Talk, Picky Eating and Mealtime Conversations, and Media Usage and Social Comparison. Each module lasts about 10 minutes. In the study, 50 parents will receive the full intervention while another 50 parents in the control group will not receive any intervention but will complete knowledge checks. The study aims to test the acceptability and feasibility of this approach. Participants will complete the intervention modules and then provide feedback on their experience, including which module they found most useful, along with knowledge assessments. Researchers will monitor acceptability immediately after the intervention and track recruitment, retention, and data completeness over approximately one year. The study will also evaluate the initial effectiveness of the intervention directly after completion. Participation involves completing online modules and questionnaires during the study period.

This research aims to assess the feasibility and acceptability of Acceptance and Commitment Therapy (ACT) to help Black adolescents and young adults with sickle cell disease cope with race-related stress. The study builds on previous findings showing ACT's potential to reduce stigma and mental health challenges, focusing on youth aged 14 to 21. It also aims to promote mental health and readiness for transitioning to adult care, using a community-based participatory action research approach. Participants will join a 10-session ACT group designed to support coping with race-related stress. The study will run three consecutive groups with approximately 8 to 10 participants per group. A waitlist control group will receive the same intervention 3 to 4 months after the intervention group completes the sessions. The intervention is delivered as part of routine clinical care at the Division of Adolescent and Young Adult Medicine. During the study, participants will engage in weekly group therapy sessions, complete assessments before and after the intervention, and again at follow-ups up to six months. Researchers will measure outcomes including race-related stress, self-efficacy in managing sickle cell disease, internalized stigma, and readiness for care transition. Additional evaluations will cover acceptance, identity, depression, and anxiety. Participants' attendance, engagement, and feedback will be closely monitored throughout the study period, which extends over several years.

This research aims to reduce Black-White maternal health disparities by using interventions to decrease bias in prenatal care, improve care coordination, and increase social support. Known as ACURE4Moms, this pragmatic 4-arm cluster randomized controlled trial involves 39 prenatal practices across North Carolina. The study focuses especially on reducing pregnancy complications and low birthweight deliveries among Black patients, who face higher risks related to institutional racism and discrimination. The study compares four groups: standard care with Medicaid care management for high-risk pregnancies; care management plus Data Accountability and Transparency interventions including electronic warning systems, disparities dashboards, and racial equity training; care management plus Community-Based Doula support providing culturally relevant care during pregnancy, labor, and postpartum; and a combination of both Data Accountability and Transparency and Doula Support interventions. Each practice participates for two years, initiating prenatal care for approximately 750 to 1,500 patients, with outcomes tracked through delivery and one year after birth. Participants include patients who self-identify as Black or African American receiving prenatal care at participating clinics. Researchers collect data from electronic health records on low birthweight and other pregnancy outcomes and gather patient experiences of discrimination through internet surveys at four time points from the first prenatal visit to three months postpartum. Additional interviews with staff, doulas, and facilitators help assess intervention fit. The study is led by a Stakeholder Advisory Board focusing on patient-centered outcomes and policy advocacy.