Michael D. Celestin

Prostate Cancer (PCa) is the most commonly diagnosed cancer and the second leading cause of cancer death among men. In Louisiana (LA), Black men are disproportionately diagnosed at later stages compared to White men. This study explores environmental risk factors as potential intermediate variables linking race to cancer diagnosis stage. The Louisiana Tumor Registry data included 24,647 male patients diagnosed with PCa in LA between 2010 and 2018. Among them, 15,875 (64.40%) were Caucasian American (CA) and 8772 (35.59%) African American (AA). Mediation analysis using multiple additive regression trees (MART) identified possible intermediate variables that potentially explain the observed disparity. The study found that individual characteristics and environmental factors jointly explained 84% (95% CI: 44.1%, 94.6%) and 18.6% (95% CI: 7.3%, 53.7%) of the observed racial disparity in PCa stage at diagnosis, respectively. Individual factors included BMI (35.9%), marital status (28.5%), CDI (8.2%), female-headed households (2.3%), comorbidity (3.9%), and insurance status (6.3%). Environmental contributors included cancer risk due to air toxicity exposure (7.2%), asthma prevalence (6.6%), acetaldehyde levels (2.1%), railroad proximity (2.1%), walkability (0.3%), and ozone level (−0.1%). Environmental factors jointly played a significant role in the observed racial disparity. The factors such as air toxicity, acetaldehyde levels, and asthma prevalence highlight the need to address industrial pollutants to reduce the differences.

By Kennedy Dorsey, Nubaira Rizvi, Donald Mercante, et al., Published on 05/28/25

By Almetra Granger, Tyra Gross, Ty-Runet Bryant, et al., Published on 11/01/24

Background: Previous research has identified differences in e-cigarette use and socioeconomic factors between different racial groups However, there is little research examining specific risk factors contributing to the racial differences. Objective: This study sought to identify racial disparities in e-cigarette use and to determine risk factors that help explain these differences. Methods: We used Wave 5 (2018–2019) of the Adult Population Assessment of Tobacco and Health (PATH) Study. First, we conducted descriptive statistics of e-smoking across our risk factor variables. Next, we used multiple logistic regression to check the risk effects by adjusting all covariates. Finally, we conducted a mediation analysis to determine whether identified factors showed evidence of influencing the association between race and e-cigarette use. All analyses were performed in R or SAS. The R package mma was used for the mediation analysis. Results: Between Hispanic and non-Hispanic White populations, our potential risk factors collectively explain 17.5% of the racial difference, former cigarette smoking explains 7.6%, receiving e-cigarette advertising 2.6%, and perception of e-cigarette harm explains 27.8% of the racial difference. Between non-Hispanic Black and non-Hispanic White populations, former cigarette smoking, receiving e-cigarette advertising, and perception of e-cigarette harm explain 5.2%, 1.8%, and 6.8% of the racial difference, respectively. E-cigarette use is most prevalent in the non-Hispanic White population compared to non-Hispanic Black and Hispanic populations, which may be explained by former cigarette smoking, exposure to e-cigarette advertising, and e-cigarette harm perception. Conclusions: These findings suggest that racial differences in e-cigarette use may be reduced by increasing knowledge of the dangers associated with e-cigarette use and reducing exposure to e-cigarette advertisements. This comprehensive analysis of risk factors can be used to significantly guide smoking cessation efforts and address potential health burden disparities arising from differences in e-cigarette usage.

While there is evidence that organizational supports may lead to better employee health, research on implementing such organizational supports is lacking. This research sought to understand organizational supports and implementation of those supports using an Explanatory Sequential Mixed Methods design approach. Employee survey responses ( n = 202) were used to classify organizations into “high” and “low” categories for employee-reported health behavior improvement, agreement, and readiness for implementing change. For the qualitative phase of research (organization-level), semi-structured interviews were conducted with organization leads, and data were analyzed through constant comparative analysis procedure. Analyses sought to identify differences between “high” versus “low” organizations. In addition, the researcher used the “high” and “low” classifications to further review themes that emerged, to determine where there may be differences in organizations classified as “high” versus “low.” Study results found the following nine themes to explain how organizations can improve implementing organizational supports: provide a contracted wellness program, formalized programming, and wellness incentives; create a culture of wellness in the organization; provide consistency in the supports offered; provide clear communication to employees; utilize leadership role modeling to show support; focus on leadership support that ensures organizational supports are implemented and sustained; and work to combat employee hesitation of organizational supports. The results of this study show that organizations have the opportunity to improve implementation of their organizational supports by applying the nine themes found.

By Michael D. Celestin Jr., Tyra Toston-Gross, Leonor Okwara, et al., Published on 11/01/22

Preventing Chronic Disease (PCD) is a peer-reviewed electronic journal established by the National Center for Chronic Disease Prevention and Health Promotion. PCD provides an open exchange of information and knowledge among researchers, practitioners, policy makers, and others who strive to improve the health of the public through chronic disease prevention.

Preventing Chronic Disease (PCD) is a peer-reviewed electronic journal established by the National Center for Chronic Disease Prevention and Health Promotion. PCD provides an open exchange of information and knowledge among researchers, practitioners, policy makers, and others who strive to improve the health of the public through chronic disease prevention.

Background: The purpose of this study is to investigate knowledge, attitudes, and smoking cessation needs for African Americans who receive low dose computed tomography (LDCT) in an effort to reduce the health burden of lung cancer. Methods: A mixed method study was conducted among African Americans who received LDCT. Data were gathered using a self-administered questionnaire and structured in-depth interview. Descriptive statistics were used to provide summary information on knowledge, attitude and smoking behaviors. Thematic analysis was used to analyze interview data. The sample size for both the quantitative and qualitative approach was fifteen. Results: The results showed that 73% of participants were male, the mean age was 61.8 (SD =4.6) years old, and 66.7% of participants had an income less than $20,000. Eighty percent had an education level of high school or below and 73.3% were overweight or obese. Smoking history was long (mean years =39 SD =14.9), but the number of cigarettes smoked per day was low (mean =9.2 SD =7.3), and 64% of the patients had a low nicotine dependence. Assessment of knowledge and attitudes towards LDCT revealed that participants had a moderate/lower knowledge score (mean =4.3 SD =2.6), and most had a positive attitude. All participants planned to quit smoking, with 73% planning to quit within the next 6 months. Similar findings were also observed in the qualitative analysis. Conclusions: African Americans who receive LDCT lung cancer screening in this study have a moderate/lower knowledge score and positive attitude towards LDCT. Most were not heavy smokers and had a lower nicotine dependence. Understanding the factors associated with smoking cessation among at-risk African American smokers will help reduce disparities in lung cancer burden, and is important to improve health for medically underserved minority populations.