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Article ; Online: Sociodemographic Differences in Menthol Cigarette Use in the United States.

Talluri, Rajesh / Shete, Sanjay

2023 Volume 44, Issue 1, Page(s) 91–95

Abstract: Background: Menthol cigarette use is associated with higher smoking initiation and reduced smoking cessation. We investigated sociodemographic differences in menthol and nonmenthol cigarette use in the United States.: Methods: We used the most recent ...

Abstract	Background: Menthol cigarette use is associated with higher smoking initiation and reduced smoking cessation. We investigated sociodemographic differences in menthol and nonmenthol cigarette use in the United States. Methods: We used the most recent available data from the May 2019 wave of the nationally-representative Tobacco Use Supplement to the Current Population Survey. The survey weights were used to estimate the national prevalence of individuals who currently smoke among individuals who use menthol and nonmenthol cigarettes. Survey-weighted logistic regression methods were used to estimate the association of menthol cigarette use with formerly smoking cigarettes and attempting to quit within the past 12 months while adjusting for several sociodemographic factors associated with smoking. Results: The prevalence of current smoking in individuals who ever smoked menthol cigarettes was higher 45.6% (44.5%-46.6%) compared to 35.8% (35.2%-36.4%) in individuals who ever smoked nonmenthol cigarettes. Non-Hispanics Blacks who used menthol cigarettes had a higher likelihood of being an individual who currently smokes (OR 1.8, 95% CI: [1.6-2.0], Conclusions: Individuals who currently use menthol cigarettes are more likely to make attempts to quit smoking. However, this did not translate to successfully quitting smoking, as evidenced by the proportion of individuals who formerly smoked within the population which used menthol cigarettes.
MeSH term(s)	United States/epidemiology ; Humans ; Menthol ; Smoking/epidemiology ; Tobacco Use ; Tobacco Products ; White
Chemical Substances	Menthol (1490-04-6)
Language	English
Publishing date	2023-05-13
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1458030-5
ISSN	1547-0164 ; 0889-7077
ISSN (online)	1547-0164
ISSN	0889-7077
DOI	10.1177/08897077231174683
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Article ; Online: Approaches to estimate bidirectional causal effects using Mendelian randomization with application to body mass index and fasting glucose.

Zou, Jinhao / Talluri, Rajesh / Shete, Sanjay

PloS one

2024 Volume 19, Issue 3, Page(s) e0293510

Abstract: Mendelian randomization (MR) is an epidemiological framework using genetic variants as instrumental variables (IVs) to examine the causal effect of exposures on outcomes. Statistical methods based on unidirectional MR (UMR) are widely used to estimate ... ...

Abstract	Mendelian randomization (MR) is an epidemiological framework using genetic variants as instrumental variables (IVs) to examine the causal effect of exposures on outcomes. Statistical methods based on unidirectional MR (UMR) are widely used to estimate the causal effects of exposures on outcomes in observational studies. To estimate the bidirectional causal effects between two phenotypes, investigators have naively applied UMR methods separately in each direction. However, bidirectional causal effects between two phenotypes create a feedback loop that biases the estimation when UMR methods are naively applied. To overcome this limitation, we proposed two novel approaches to estimate bidirectional causal effects using MR: BiRatio and BiLIML, which are extensions of the standard ratio, and limited information maximum likelihood (LIML) methods, respectively. We compared the performance of the two proposed methods with the naive application of UMR methods through extensive simulations of several scenarios involving varying numbers of strong and weak IVs. Our simulation results showed that when multiple strong IVs are used, the proposed methods provided accurate bidirectional causal effect estimation in terms of median absolute bias and relative median absolute bias. Furthermore, compared to the BiRatio method, the BiLIML method provided a more accurate estimation of causal effects when weak IVs were used. Therefore, based on our simulations, we concluded that the BiLIML should be used for bidirectional causal effect estimation. We applied the proposed methods to investigate the potential bidirectional relationship between obesity and diabetes using the data from the Multi-Ethnic Study of Atherosclerosis cohort. We used body mass index (BMI) and fasting glucose (FG) as measures of obesity and type 2 diabetes, respectively. Our results from the BiLIML method revealed the bidirectional causal relationship between BMI and FG in across all racial populations. Specifically, in the White/Caucasian population, a 1 kg/m2 increase in BMI increased FG by 0.70 mg/dL (95% confidence interval [CI]: 0.3517-1.0489; p = 8.43×10-5), and 1 mg/dL increase in FG increased BMI by 0.10 kg/m2 (95% CI: 0.0441-0.1640; p = 6.79×10-4). Our study provides novel findings and quantifies the effect sizes of the bidirectional causal relationship between BMI and FG. However, further studies are needed to understand the biological and functional mechanisms underlying the bidirectional pathway.
MeSH term(s)	Humans ; Body Mass Index ; Glucose ; Diabetes Mellitus, Type 2/genetics ; Mendelian Randomization Analysis ; Obesity/genetics ; Fasting ; Genome-Wide Association Study
Chemical Substances	Glucose (IY9XDZ35W2)
Language	English
Publishing date	2024-03-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0293510
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Article: An Approach to Identifying Spatial Variability in Observed Infectious Disease Spread in a Prospective Time-Space Series with Applications to COVID-19 and Dengue Incidence.

Wu, Chih-Chieh / Chen, Chien-Hsiun / Wang, Shann-Rong / Shete, Sanjay

Research square

2024

Abstract: Most of the growing prospective analytic methods in space-time disease surveillance and intended functions of disease surveillance systems focus on earlier detection of disease outbreaks, disease clusters, or increased incidence. The spread of the virus ... ...

Abstract	Most of the growing prospective analytic methods in space-time disease surveillance and intended functions of disease surveillance systems focus on earlier detection of disease outbreaks, disease clusters, or increased incidence. The spread of the virus such as SARS-CoV-2 has not been spatially and temporally uniform in an outbreak. With the identification of an infectious disease outbreak, recognizing and evaluating anomalies (excess and decline) of disease incidence spread at the time of occurrence during the course of an outbreak is a logical next step. We propose and formulate a hypergeometric probability model that investigates anomalies of infectious disease incidence spread at the time of occurrence in the timeline for many geographically described populations (e.g., hospitals, towns, counties) in an ongoing daily monitoring process. It is structured to determine whether the incidence grows or declines more rapidly in a region on the single current day or the most recent few days compared to the occurrence of the incidence during the previous few days relative to elsewhere in the surveillance period. The new method uses a time-varying baseline risk model, accounting for regularly (e.g., daily) updated information on disease incidence at the time of occurrence, and evaluates the probability of the deviation of particular frequencies to be attributed to sampling fluctuations, accounting for the unequal variances of the rates due to different population bases in geographical units. We attempt to present and illustrate a new model to advance the investigation of anomalies of infectious disease incidence spread by analyzing subsamples of spatiotemporal disease surveillance data from Taiwan on dengue and COVID-19 incidence which are mosquito-borne and contagious infectious diseases, respectively. Efficient R programs for computation are available to implement the two approximate formulae of the hypergeometric probability model for large numbers of events.
Language	English
Publishing date	2024-01-24
Publishing country	United States
Document type	Preprint
DOI	10.21203/rs.3.rs-3859620/v1
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Article ; Online: Barriers to the assessment and recommendation of HPV vaccination among healthcare providers in Texas.

Chido-Amajuoyi, Onyema G / Osaghae, Ikponmwosa / Onyeaka, Henry K / Shete, Sanjay

Vaccine: X

2024 Volume 18, Page(s) 100471

Abstract: Background: Healthcare providers (HCPs) recommendations for HPV vaccination plays a critical role in increasing vaccination uptake. This study assesses the prevalence of reported barriers to HPV vaccination assessment and recommendation among HCPs in ... ...

Abstract	Background: Healthcare providers (HCPs) recommendations for HPV vaccination plays a critical role in increasing vaccination uptake. This study assesses the prevalence of reported barriers to HPV vaccination assessment and recommendation among HCPs in Texas. Methods: Study data were obtained from a population-based survey of HCPs currently practicing in Texas. Participants were asked about their HPV vaccination assessment and recommendation practices and the reasons for not assessing or recommending the vaccine. Barriers were stratified by HCP characteristics including age, sex, race/ethnicity, location of practice, provider type, and type of facility. Results: Among the 826 HCPs included in this study, 47.3 % never, 49.6 % sometimes, and 3.0 % often/always assessed a patient's HPV vaccination status. Similarly, 36.0 % never, 36.2 % sometimes, and 27.9 % often/always recommended HPV vaccination. The most frequently reported barriers to assessment and recommendation of HPV vaccination were time constraints (22.9 %), delegating the task to others (15.0 %), lack of effective tools and information to give patients (12.0 %), and requiring additional training (9.2 %). HCPs who were female, less than 35 years old, non-Hispanic black, and nonphysician HCPs (Physician Assistant, Nurse Practitioner) most frequently reported lacking effective tools and information and a need for additional training. Conclusion: The assessment and recommendation for HPV vaccination among HCPs in Texas is suboptimal. Barriers reported varied based on the provider's characteristics. Addressing these barriers, such as by providing more effective tools and information and offering additional training to HCPs, could potentially increase HPV vaccination rates in Texas. The findings also suggest that interventions should be tailored to specific demographic groups.
Language	English
Publishing date	2024-03-13
Publishing country	England
Document type	Journal Article
ISSN	2590-1362
ISSN (online)	2590-1362
DOI	10.1016/j.jvacx.2024.100471
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Article: Association between employer-based health promotion programs and adherence to breast cancer screening in Texas.

Chandra, Monalisa / Yu, Robert / Shete, Sanjay

Preventive medicine reports

2023 Volume 32, Page(s) 102128

Abstract: Breast cancer is the most common cancer diagnosed among women in Texas. Although adherence to recommended screening mammogram guidelines enables early detection and reduces breast cancer risks, screening mammogram adherence is low in Texas. With the ... ...

Abstract	Breast cancer is the most common cancer diagnosed among women in Texas. Although adherence to recommended screening mammogram guidelines enables early detection and reduces breast cancer risks, screening mammogram adherence is low in Texas. With the rising percentage of women in the workforce, employer-based health promotion programs could be an effective measure in increasing mammogram adherence, thereby reducing breast cancer risk in Texas. Although employer-based health programs are common in the state, little is known about their effectiveness in increasing screening mammogram adherence among age-eligible employed females. The study survey was administered using Qualtrics and the study participants were representative of the Texas population. The study population included 318 females from Texas who were 50-74 years old. Among those who had access to employer-based health promotion programs, 65.4 % were adherent and 34.6 % were non-adherent to the guidelines. Population-weighted survey logistic regression analysis showed no significant association between access to employer-based health promotion programs and mammogram adherence for employed women (AOR: 0.85 [0.15-4.79], p-value = 0.86). However, access to healthcare coverage (AOR: 7.58 [2.89-19.88], p-value < 0.001), those who disagree with the fatalistic belief that everything causes cancer (AOR: 2.99 [1.45-6.19], p-value < 0.001), and those who perceive cancer screening important (AOR: 12.36 [2.26-67.47], p < 0.05) were found as significant determinants of mammogram adherence among females in Texas. The study concluded that access to employer-based health promotion programs alone was insufficient to improve breast cancer screening. The employers and the insurance companies, with support from the government, should develop a comprehensive program that addresses all structural and psychosocial barriers to employee breast cancer screening adherence.
Language	English
Publishing date	2023-02-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2785569-7
ISSN	2211-3355
ISSN	2211-3355
DOI	10.1016/j.pmedr.2023.102128
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Article ; Online: Barriers to human papillomavirus vaccine uptake: role of state religiosity and healthcare professionals' participation in a state vaccine program.

Chandra, Monalisa / Osaghae, Ikponmwosa / Talluri, Rajesh / Shete, Sanjay

JNCI cancer spectrum

2023 Volume 7, Issue 5

Abstract: Background: Despite the known benefits of preventing human papillomavirus (HPV)-related cancers, HPV vaccine coverage is low in the United States. Grounded in Social Ecological theory, we assessed the macro-level (state) and meso-level (organization) ... ...

Abstract	Background: Despite the known benefits of preventing human papillomavirus (HPV)-related cancers, HPV vaccine coverage is low in the United States. Grounded in Social Ecological theory, we assessed the macro-level (state) and meso-level (organization) factors associated with HPV vaccine initiation and up-to-date. Methods: Data from 2020 National Immunization Survey-Teen were used to study a sample of 20 163 US adolescents (aged 13-17 years). The data were collected from each teen's parents or guardians and health-care professionals. Weighted prevalence estimates were calculated, and multivariable regression analyses were conducted. Results: The prevalence of HPV vaccine initiation was 75.1% and of remaining up-to-date was 58.6%. At the macro level, teens living in states with high and moderate religiosity had lower odds of HPV vaccine initiation (high religiosity adjusted odds ratio [AOR] = 0.63, 95% confidence interval [CI] = 0.50 to 0.78; moderate religiosity AOR = 0.68, 95% CI = 0.55 to 0.85) and up-to-date (high religiosity AOR = 0.69, 95% CI = 0.56 to 0.85; moderate religiosity AOR = 0.74, 95% CI = 0.61 to 0.91) than states with low religiosity. At the meso level, when none of their healthcare professionals ordered vaccine from the state, teens had lower odds of initiation (AOR = 0.68, 95% CI = 0.53 to 0.87) and up-to-date (AOR = 0.76, 95% CI = 0.60 to 0.95) than teens whose healthcare professionals ordered vaccine from the state. In addition, race and ethnicity, age, mother's education level, household income, well-child examination status, and doctor's recommendation were significantly associated with HPV vaccine uptake. Conclusion: A multiprong approach is needed to address religious and systemic barriers to HPV vaccination and expand healthcare professionals' access and enrollment in state vaccine initiatives, such as the Vaccine for Children program.
MeSH term(s)	Adolescent ; Humans ; United States/epidemiology ; Human Papillomavirus Viruses ; Papillomavirus Vaccines/therapeutic use ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/prevention & control ; Vaccination ; Health Services Accessibility
Chemical Substances	Papillomavirus Vaccines
Language	English
Publishing date	2023-11-01
Publishing country	England
Document type	Journal Article
ISSN	2515-5091
ISSN (online)	2515-5091
DOI	10.1093/jncics/pkad068
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Article ; Online: Reasons patients cite to their health-care professional for not initiating or completing human papillomavirus vaccination.

Chido-Amajuoyi, Onyema Greg / Osaghae, Ikponmwosa / Shete, Sanjay

JNCI cancer spectrum

2023 Volume 7, Issue 4

Abstract: Background: Vaccination against human papillomavirus (HPV) is critical to the prevention of HPV-associated cancers. This study aimed to describe the reasons patients cited for not initiating or completing the HPV vaccination series, as reported by ... ...

Abstract	Background: Vaccination against human papillomavirus (HPV) is critical to the prevention of HPV-associated cancers. This study aimed to describe the reasons patients cited for not initiating or completing the HPV vaccination series, as reported by health-care professionals. Methods: Study data were obtained from a University of Texas MD Anderson Cancer Center population-based cross-sectional survey of health-care professionals practicing in Texas. Prevalence estimates of reasons cited for not initiating or completing HPV vaccination were estimated by patient population (parents of children and adult patients). Results: The study included 973 primary care clinicians, of whom 45.53% were physicians and 54.47% were midlevel care professionals. For parents who did not initiate HPV vaccination for their child, the most commonly cited reasons were the belief that the vaccine was not needed (52.54%, 95% CI = 48.90% to 56.15%), that the child was not sexually active (52.54%, 95% CI = 48.90% to 56.15%), and safety concerns/side effects (47.05%, 95% CI = 43.44% to 50.69%). Among age-eligible adults who did not initiate HPV vaccination, lack of knowledge and awareness was the most commonly cited reason (30.52%, 95% CI = 27.71% to 33.50%). For noncompletion of the HPV vaccine series, parents most commonly cited competing priorities (41.29%, 95% CI = 37.76% to 44.91%), followed by adverse reactions after the first dose (16.05%, 95% CI = 13.56% to 18.90%). Similarly, for noncompletion of the HPV vaccine series among adults, competing priorities was the most cited reason (31.04%, 95% CI = 28.20% to 34.02%). Conclusion: These findings highlight the importance of addressing misconceptions and improving education about HPV vaccination to increase vaccination uptake rates and prevent HPV-related cancers.
MeSH term(s)	Adult ; Humans ; Human Papillomavirus Viruses ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/prevention & control ; Cross-Sectional Studies ; Patient Acceptance of Health Care ; Papillomavirus Vaccines/therapeutic use ; Health Knowledge, Attitudes, Practice ; Vaccination
Chemical Substances	Papillomavirus Vaccines
Language	English
Publishing date	2023-07-21
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ISSN	2515-5091
ISSN (online)	2515-5091
DOI	10.1093/jncics/pkad047
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Article ; Online: Individual, systemic and state factors associated with provider recommendation of HPV vaccination: Findings from NIS-Teen, 2020.

Osaghae, Ikponmwosa / Chandra, Monalisa / Talluri, Rajesh / Shete, Sanjay

Human vaccines & immunotherapeutics

2023 Volume 19, Issue 2, Page(s) 2239678

Abstract: The most important determinant of HPV vaccination uptake is healthcare provider recommendation, yet not all eligible patients receive HPV vaccination recommendations. We used data from the 2020 National Immunization Survey-Teen to determine individual, ... ...

Abstract	The most important determinant of HPV vaccination uptake is healthcare provider recommendation, yet not all eligible patients receive HPV vaccination recommendations. We used data from the 2020 National Immunization Survey-Teen to determine individual, systemic, and state factors associated with provider recommendation of HPV vaccination. A total of 18,534 teens were included, with 81.4% receiving provider recommendations for HPV vaccination. HPV vaccination recommendation was higher among females compared to males (AOR: 1.57; 95% CI: 1.27-1.93), teens who received a well-child exam at 11 or 12 years compared to those who did not (AOR: 2.10; 95% CI: 1.61-2.74), and teens whose mothers had college, some college or at least a high school education compared to those with less than high school education. In addition to individual factors, provider recommendation of HPV vaccination was higher in hospitals (AOR: 1.51; 95% CI: 1.00-2.29) and STD/school/teen clinics (AOR: 2.47; 95% CI: 1.05-5.78) compared to public facilities. However, the odds of provider recommendation were lower when none of the teen's providers ordered vaccines from the state compared to when all teen providers ordered vaccines from the state (AOR: 0.69; 95% CI: 0.52-0.93). Moreover, the state's mean prevalence of provider recommendations of HPV vaccination was 7.2% lower (Coefficient: -0.072; 95% CI: -0.107 - -0.036) in states with high religious ideology compared to those with low religious ideology. Interventions to increase provider recommendation of HPV vaccination should take a multiprong and comprehensive approach that addresses religious and systemic barriers to HPV vaccination recommendation.
MeSH term(s)	Male ; Female ; Humans ; Adolescent ; United States ; Papillomavirus Infections/prevention & control ; Vaccination ; Immunization ; Mothers ; Papillomavirus Vaccines ; Health Knowledge, Attitudes, Practice
Chemical Substances	Papillomavirus Vaccines
Language	English
Publishing date	2023-08-07
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2664176-8
ISSN	2164-554X ; 2164-5515
ISSN (online)	2164-554X
ISSN	2164-5515
DOI	10.1080/21645515.2023.2239678
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Article ; Online: Political Ideology and the Support or Opposition to United States Tobacco Control Policies.

Shete, Sahil S / Yu, Robert / Shete, Sanjay

JAMA network open

2021 Volume 4, Issue 9, Page(s) e2125385

MeSH term(s)	Adult ; Advertising/legislation & jurisprudence ; Consumer Health Information ; Cross-Sectional Studies ; Female ; Health Policy ; Humans ; Male ; Politics ; Product Labeling ; Smoking/legislation & jurisprudence ; United States
Language	English
Publishing date	2021-09-01
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2021.25385
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Article ; Online: Association between employer-based health promotion programs and adherence to breast cancer screening in Texas

Monalisa Chandra / Robert Yu / Sanjay Shete

Preventive Medicine Reports, Vol 32, Iss , Pp 102128- (2023)

2023

Abstract	Breast cancer is the most common cancer diagnosed among women in Texas. Although adherence to recommended screening mammogram guidelines enables early detection and reduces breast cancer risks, screening mammogram adherence is low in Texas. With the rising percentage of women in the workforce, employer-based health promotion programs could be an effective measure in increasing mammogram adherence, thereby reducing breast cancer risk in Texas. Although employer-based health programs are common in the state, little is known about their effectiveness in increasing screening mammogram adherence among age-eligible employed females. The study survey was administered using Qualtrics and the study participants were representative of the Texas population. The study population included 318 females from Texas who were 50–74 years old. Among those who had access to employer-based health promotion programs, 65.4 % were adherent and 34.6 % were non-adherent to the guidelines. Population-weighted survey logistic regression analysis showed no significant association between access to employer-based health promotion programs and mammogram adherence for employed women (AOR: 0.85 [0.15–4.79], p-value = 0.86). However, access to healthcare coverage (AOR: 7.58 [2.89–19.88], p-value < 0.001), those who disagree with the fatalistic belief that everything causes cancer (AOR: 2.99 [1.45–6.19], p-value < 0.001), and those who perceive cancer screening important (AOR: 12.36 [2.26–67.47], p < 0.05) were found as significant determinants of mammogram adherence among females in Texas. The study concluded that access to employer-based health promotion programs alone was insufficient to improve breast cancer screening. The employers and the insurance companies, with support from the government, should develop a comprehensive program that addresses all structural and psychosocial barriers to employee breast cancer screening adherence.
Keywords	Mammogram ; Screening-adherence ; Health-promotion ; Prevention ; Breast cancer ; Cancer beliefs and perceptions ; Medicine ; R
Subject code	360
Language	English
Publishing date	2023-04-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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