OBJECTIVES:Latinos are disproportionately impacted by Alzheimer's disease and related dementias (ADRD). It is estimated that interventions targeting lifestyle and health behaviors could prevent or delay up to 50% of ADRD cases worldwide. This study aimed to explore middle-aged Latinos' perceptions of the link between physical activity and nutrition with the maintenance of brain health. DESIGN:Individual, semi-structured interviews were conducted with 30 English- or Spanish-speaking Latinos 35 to 64 years old. Participants were recruited via social media, flyers, direct contact of participants from prior studies, and snowball sampling. Questions addressed knowledge about the brain, perceptions of aging, and ideas of how to care for the brain. Responses that emerged pertaining to physical activity and nutrition were analyzed using conceptual content analysis to quantify the frequency of themes and identify trends. RESULTS:Most participants were female (n = 18) and college educated (n = 17), with an average age of 47 years; two thirds reported being foreign born, and half reported lower acculturation levels. Physical activity and nutrition were spontaneously described as strategies to promote brain health by 22 and 24 participants, respectively. With regards to physical activity, walking was most often mentioned (n = 8), followed by yoga (n = 4). Few participants clarified frequency (n = 3), duration (n = 1), or intensity (n = 2). With regards to nutrition, common strategies mentioned were increasing fruit and vegetable consumption (n = 19), limiting processed foods (n = 9), and taking vitamins or supplements (n = 9). CONCLUSION:Most participants demonstrated foundational knowledge of the link between nutrition, physical activity, and brain health. Some misconceptions were identified, such as participants overestimating the benefits of vitamins/supplements, which have weak correlations with preventing cognitive decline. Messaging may benefit from emphasizing recommendations regarding the role of frequency, duration, and intensity in physical activity, and specific nutrient, portioning, and preparation recommendations for dietary practices. Incorporating these messages into intergenerational programming may be particularly beneficial.

Alzheimer's disease and related dementias (ADRD) disproportionately impact Latinos in the US. Interventions that promote engagement in established protective behaviors throughout the life course may offer an opportunity to address disparities. To inform brain health promotion efforts, this study aimed to examine current brain health-related attitudes, awareness, and actions of middle-aged Latinos. A cross-sectional, online survey was completed by 200 Latinos 35-64 years old. Survey items assessed concern about ADRD, beliefs related to ways to support brain health, knowledge of protective behaviors, and actual engagement in protective behaviors. Multivariable analyses examined differences in knowledge, attitudinal, and behavioral outcomes by sociodemographic and psychosocial factors including health literacy and health activation. A third (36.0%) of participants were "very concerned" about ADRD. Nearly two thirds (61.0%) "strongly agreed" steps can be taken to reduce risk of ADRD. Less than a third (29.5%) were able to name three steps to support brain health, and 45.5% reported currently engaging in behaviors to support brain health. In multivariable analyses, participants with lower acculturation were more likely to be "very concerned" about ADRD and to "strongly agree" that steps can be taken to support brain health. Participants with low health activation were less likely to agree that steps can be taken. Those who were older and had a family member with ADRD were more likely to be able to name three steps that can be taken. Most middle-aged Latinos believed brain health is actionable, while concern for ADRD, awareness of ways to protect the brain, and engagement in science-based protective behaviors was variable. Opportunities exist for increasing education about well-established modifiable risk factors for ADRD, yet more research is needed to understand these factors in historically minoritized communities.

Cardiovascular disease (CVD) remains the number one cause of death in the US. Annual costs of CVD are estimated at $600 billion annually, and projected to top $1.1 trillion by 2035. Modifiable behavior and psychosocial factors contribute more than 50% to CVD risk, prognosis, and health-related quality of life. Leading cardiology professional groups have called for attention to these factors as part of prevention and treatment of CVD, yet the integration of behavioral and psychosocial health as part of overall CV care remains to be realized. The field of cardiovascular behavioral medicine could address this evidence-to-implementation gap; policy implications for changes in research, training and healthcare will be required.

OBJECTIVES:Latinos living in the US are disproportionately impacted by Alzheimer's disease and related dementias (ADRD). To develop culturally-informed interventions, a first step is engaging with key stakeholders. The present study aimed to explore perspectives on brain health and aging among middle-aged Latinos living in Chicago, IL. METHODS:Individual, semi-structured interviews were conducted with 30 English- or Spanish-speaking Latinos between 35 to 64 years old. Questions from a previously used interview guide were leveraged and addressed knowledge about the brain, perceptions of healthy and unhealthy aging, ideas of how to care for the brain, where knowledge was acquired, and suggestions for disseminating brain health education. Responses were analyzed using thematic analysis. RESULTS:The following themes were identified: (1) Understanding of the brain is varied (including cognitive, behavioral, anatomical, and psychological descriptions); (2) Perceptions surrounding healthy aging are broad and demonstrate a depth of understanding (e.g., physical and cognitive abilities, independence, positive emotions, and sociability), yet understanding of signs of an unhealthy brain is somewhat limited (e.g., focus on memory); (3) Brain health promotion is largely viewed as actionable (spanning physical health, cognitively stimulating activities, emotional wellbeing, medical self-management, and social connectedness); (4) Suggestions for disseminating education included media, clinics, churches, libraries, and community centers, with consideration of possible barriers and facilitators to behavior change (e.g., finances, prioritizing family). CONCLUSIONS:Results showed significant heterogeneity in understanding of the brain, albeit with promising attitudes that actions can be taken to protect one's brain from ADRD. PRACTICE IMPLICATIONS:Takeaways include the need for increasing education on normative versus nonnormative memory loss and signs of ADRD beyond memory impairment. Messaging may benefit from utilizing analogies, considering familism and spirituality, and highlighting lifestyle changes that do not carry a financial burden or place blame on individuals.

• Latino adults are disproportionately impacted by dementia due to high exposure to adverse social determinants of health (SDOH). • "Brain health literacy" in middle adulthood may be a modifiable factor that could help mitigate later life risk of cognitive decline. • The proposed Brain Health Literacy framework can guide health promotion efforts, with the ultimate goal of increasing brain health equity.

PURPOSE:Our purpose was to evaluate the measurement properties of patient-reported outcome (PRO) measures used in the ongoing RadComp pragmatic randomized clinical trial (PRCT). METHODS AND MATERIALS:The deidentified and blinded data set included 774 English-speaking female participants who completed their 6-month posttreatment assessment. Eleven PRO measures were evaluated, including the Trial Outcome Index from the Functional Assessment of Cancer Therapy-Breast (FACT-B), Satisfaction with Breast Cosmetic Outcomes, the BREAST-Q, and selected Patient-Reported Outcomes Measurement Information System (PROMIS) measures. PROs were measured at 3 timepoints: baseline, completion of radiation therapy (RT), and 6 months post-RT. Ten variables were used as validity anchors. Pearson or Spearman correlations were calculated between PROs and convergent validity indicators. Mean PRO differences between clinically distinct categories were compared with analysis of variance methods (known-groups validity). PRO change scores were mapped to change in other variables (sensitivity to change). RESULTS:Most correlations between PROs and validity indicators were large (≥0.5). Mean score for Satisfaction with Breast Cosmetic Outcomes was higher (better) for those with a lumpectomy compared with those with a mastectomy (P < .001). Mean scores for the FACT-B Trial Outcome Index and for PROMIS Fatigue and Ability to Participate in Social Roles and Activities were better for those with good baseline performance status compared with those with poorer baseline performance status (P < .05). At completion of RT and post-RT, mean scores for Satisfaction with Breast Cosmetic Outcomes and BREAST-Q Radiation were significantly different (P < .001) across categories for all Functional Assessment of Chronic Illness Therapy -Treatment Satisfaction - General items. There were medium-sized correlations between change scores for FACT-B Trial Outcome Index, Fatigue, Anxiety, and Ability to Participate in Social Roles and change scores in the Visual Analog Scale. CONCLUSIONS:For patients with nonmetastatic breast cancer receiving radiation in the RadComp PRCT, our findings demonstrate high reliability and validity for important PRO measures, supporting their psychometric strength and usefulness to reflect the effect of RT on health-related quality of life.

The psychological safety of health care workers is an important but often overlooked aspect of the rising rates of burnout and workforce shortages. In addition, mental health conditions are prevalent among health care workers, but the associated stigma is a significant barrier to accessing adequate care. More efforts are therefore needed to foster health care work environments that are safe and supportive of self-care. The purpose of this brief document is to promote a culture of psychological safety in health care organizations. We review ways in which organizations can create a psychologically safe workplace, the benefits of a psychologically safe workplace, and strategies to promote mental health and reduce suicide risk.

It is unknown whether racial disparities in access to heart transplantation (HT) are amplified when coupled with substance use. We examined patients evaluated for HT over 8 years at an urban transplant center. We evaluated substance use and race/ethnicity as independent and interactive predictors of HT and left ventricular assist device (LVAD) implantation. Of 1,148 patients evaluated for HT, substance use was cited as an ineligibility factor in 151 (13%) patients, 16 (11%) of whom ultimately received HT. Significantly more non-Hispanic Black (NHB) patients were deemed ineligible due to substance use (n = 59, 19%) compared to other races/ethnicities (non-Hispanic white: n = 68, 12%; other race/ethnicity: n = 24, p = 0.002). No racial differences were observed in the likelihood of HT among patients initially excluded for substances, but more NHB patients ultimately received LVAD than the other racial groups. This study encourages greater awareness of the role of substance use and race in the HT evaluation. (c) 2024 International Society for Heart and Lung Transplantation. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

OBJECTIVES:Latinos in the USA are 1.5 times more likely to develop Alzheimer's Disease and Related Dementias (ADRD) than non-Latino Whites. This systematic review aims to summarize current understanding of the perceptions, knowledge, beliefs, and attitudes about ADRD and brain health of Latinos to inform public health efforts addressing disparities.METHODS:Searches were completed across six databases (Medline, PsycINFO, WoS, LILACS, ProQUEST, and CINAHL). Studies were required to capture attitudes and/or knowledge of ADRD or brain health among US-based Latino adults who were not cognitively impaired and were not caregivers or healthcare providers. Results were synthesized narratively.RESULTS:A total of 5528 unique records were identified. Following de-duplication and screening, 24 articles met the inclusion criteria for this review. Overall, knowledge about brain health and ADRD among Latinos is quite mixed. A consistent finding was that participants recognized memory loss as a symptom of cognitive impairment, but demonstrated limited recognition of other signs of impairment. The studies also highlighted variable knowledge of protective factors for maintaining brain health.CONCLUSIONS:Opportunities exist to increase knowledge of ADRD signs and symptoms, and awareness of risk and protective factors. Given the heterogeneity of Latinos in the USA, more research is warranted to better elucidate nuances in conceptualizations of brain health and aging among diverse Latino subgroups.

Background Mindfulness-based interventions (MBIs) are well-positioned to address health disparities among racial-ethnic minority communities, given their focus on stress reduction and potential for greater accessibility and acceptability than conventional mental health treatments. Yet, there are currently no peer-reviewed studies of MBIs in an Arab, Middle Eastern, or North African (MENA) American sample. Addressing this gap in the literature is critical for advancing integrative health equity, given the high burden of stress and high prevalence of stress-related health conditions among Arab/MENA Americans. Objective The present study sought to explore perceptions of mindfulness among Arab/MENA Americans and identify potential cultural adaptations to MBIs for this population. Methods 4 focus groups were conducted with 26 Arab/MENA American adults who had participated in an introductory mindfulness workshop. Participants were asked about their experience learning mindfulness skills, the usefulness of mindfulness for problems they face, the alignment of mindfulness with their cultural values and practices, and suggestions for adapting mindfulness programs. Qualitative coding of focus group session transcriptions was conducted to identify themes in the data. Conclusion The participants in this study described experiencing high levels of stress and identified micro- and macro-level stressors related to their Arab/MENA American identity, including discrimination, exclusion, historical and intergenerational trauma, and protracted sociopolitical crises in their heritage countries. They viewed mindfulness as a potentially useful approach to coping with stress. At the same time, participants identified aspects of mindfulness that could be adjusted to better align with their cultural values and experiences. Potential adaptations to MBIs for Arab/MENA Americans were identified based on suggestions from participants and issues they raised while discussing cultural strengths, stressors they face, and perceived barriers and facilitators to engaging in mindfulness practice.

Psychological and behavioral factors increase risk for primary cardiovascular disease (CVD) and worsen prognosis and quality of life among patients with CVD. The current paper highlights the unique psychological, behavioral, and psychosocial challenges faced by patients with CVD, particularly among vulnerable and historically marginalized populations, and offers recommendations and considerations for evidence-based treatments. A case example is utilized to illustrate the biopsychosocial experience of CVD and related treatment, as well as the opportunities for psychosocial and behavioral interventions. Psychologists with specialized training in cardiac psychology are uniquely positioned to address these risk factors, collaborate with interdisciplinary teams in diverse medical settings, and significantly improve patients’ cardiovascular health and quality of life.

Study participants (n =272) completed 12 Patient-Reported Outcomes Measurement Information System (PROMIS) physical, mental and social health measures (questionnaires) prior to implantation of a left ventricular assist device (LVAD) and again at 3 and 6 months postimplant. All but 1 PROMIS measure demonstrated significant improvement from pre-implant to 3 months; there was little change between 3 and 6 months. Because PROMIS measures were developed in the general population, patients with an LVAD, their caregivers and their clinicians can interpret the meaning of PROMIS scores in relation to the general population, helping them to monitor a return to normalcy in everyday life. (J Cardiac Fail 2023;29:1398-1411)