Browsing by Author "Luningham, Justin M."
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Item Characteristics of Delta-8 THC retailers in a large metropolitan city(2022) LoParco, Cassidy; Walker, Drew; McDonald, Kayla; Pathak, Sunidhi Santosh; Eggleston, Jensen; Olsson, Sofia; Yockey, Robert; Luningham, Justin M.; Kong, Amanda; Henry, Doug; Rossheim, MatthewBackground: Retail sales of Delta-8 THC, an isomer of the more common form of cannabis (Delta-9 THC), have increased in the U.S. market since the passing of the 2018 Farm Bill. Specifically, the Farm Bill allowed for the sale of hemp products, which are classified as products having less than 0.3% Delta-9 THC by dry weight. Importantly, sales of Delta-8 THC are unregulated and may introduce possible risk arising from either psychoactive effects or unregulated solvents left behind from the synthesis of Delta-8 THC from CBD. The current study describes the Delta-8 THC retail sales environment in a large metropolitan city. Methods: Potential Delta-8 THC retailers were identified by identifying lists of current retail locations with alcohol, CBD, and tobacco licenses in Fort Worth, Texas (n = 1,961). Research assistants called retailers between September 8 and October 14, 2021, to query about sales of products containing Delta-8 THC; 69% (n = 1,223) of retailers answered and provided data on Delta-8 THC. Outlets' 9-digit ZIP codes were merged with area socioeconomic deprivation index scores. Chi-squared tests compared socioeconomic deprivation index scores between outlets that sold Delta-8 THC versus those that did not sell Delta-8 THC. Among a subsample of those who did sell Delta-8 THC, t-tests examined associations between prices and the type of Delta-8 THC products. Results: Approximately one in ten retail outlets (11%, n = 133) reported selling products containing Delta-8 THC. Most (96%) sold Delta-8 THC in the form of flower/vapes, and three-fourths (76%) sold edibles. Among the least expensive Delta-8 THC products available at these retail outlets were edibles (mean price = $15.39), which cost $8.58 less than flowers/vapes (mean price: $23.97; p < 0.001) on average. Retail outlets that sold Delta-8 THC, compared to those that did not, were in zip codes with greater deprivation (p = 0.02). Most outlets reported having a minimum age for sales of Delta-8 THC as 21 years; however, 4% reported 18 years or no minimum age for sale of Delta-8 THC products. Discussion: Delta-8 THC retail outlets were disproportionately located in ZIP codes with higher levels of socioeconomic deprivation. Legal intervention, such as zoning laws, may be warranted to prevent potential health disparities from overexposing a subset of communities to these products. Policies, such as increasing Delta-8 THC product prices and restricting the types of products sold may help reduce access and appeal to people under 21 years old.Item Demographic and Psychosocial Correlates of COVID-19 Vaccination Status among a Statewide Sample in Texas(MDPI, 2023-04-28) Luningham, Justin M.; Akpan, Idara N.; Taskin, Tanjila; Alkhatib, Sarah A.; Vishwanatha, Jamboor K.; Thompson, Erika L.The COVID-19 pandemic has been a global public health concern since early 2020 and has required local and state-level responses in the United States. There were several Food and Drug Administration (FDA) approved vaccines available for the prevention of COVID-19 as of August 2022, yet not all states have achieved high vaccination coverage. Texas is a particularly unique state with a history of opposing vaccination mandates, as well as a large and ethnically/racially diverse population. This study explored the demographic and psychosocial correlates of COVID-19 vaccinations among a statewide sample in Texas. A quota sample of 1089 individuals was surveyed online from June-July 2022. The primary outcome in this study was COVID-19 vaccination status (fully vaccinated, partially vaccinated, or unvaccinated) and included independent variables related to demographics, COVID-19 infection/vaccine attitudes and beliefs, and challenges related to the COVID-19 pandemic. Hispanic/Latinx individuals were more likely than non-Hispanic White individuals to be partially vaccinated as opposed to unvaccinated. Higher education levels and confidence that the FDA would ensure a safe COVID-19 vaccine were strongly associated with a higher likelihood of being fully vaccinated. In addition, some challenges brought on by the pandemic and concerns about becoming infected or infecting others were associated with a higher likelihood of being partially or fully vaccinated. These findings emphasize the need to further investigate the interaction between individual and contextual factors in improving COVID-19 vaccination rates, especially among vulnerable and disadvantaged populations.Item The Effect of Trusted News Sources on the Confidence in the Safety of COVID-19 Vaccination(2023) Alkhatib, Sarah A.; Luningham, Justin M.; Akpan, Idara N.; Taskin, Tanjila; Vishwanatha, Jamboor K.; Thompson, Erika L.Purpose: COVID-19 vaccination prevents severe disease manifestations; yet uptake has been suboptimal. Confidence in the safety and efficacy of the vaccine influences COVID-19 vaccination decisions. Exposure to information from a trusted news source can impact perceptions and may contribute to vaccine decisions. This study assessed the association between trusted news sources and confidence in the safety of COVID-19 vaccination among Texas adults. Methods: Participants were recruited through an online panel using quota sampling based on the racial and ethnic distribution of Texas in July 2022 (n=1089). The primary predictor variable was self-reported trusted news sources for COVID-19 related news (16 options), in which respondents were asked to endorse any news source they trusted, with options ranging from print media to cable news to local news. The outcome was confidence in the safety of the COVID-19 vaccine (not at all confident to very confident). Multinomial regression analyses were conducted to model confidence in COVID-19 vaccination and trusted news sources while controlling for education, age, gender, and self-reported race. Results: Through an initial descriptive analysis, Fox News, local cable TV programs, and news broadcasting from one’s home abroad were associated with lower confidence levels. After grouping those three sources as "top news sources” and assessing their effect on confidence through a multinomial model, it was found that individuals who trusted those top sources were significantly less likely to endorse "somewhat confident” (OR=0.59, 95%CI 0.4-0.89) or "very confident” (OR=0.41, 95%CI 0.27- 0.62) compared to being "not at all confident” in the safety of the COVID-19 vaccine. Conclusions: Study findings show that some trusted news sources contributed to participants having less confidence or no confidence in the safety of the COVID-19 vaccine. Public health initiatives should consider how to address vaccine confidence among the public given the diversity of information sources people rely on.Item The influence of race/ethnicity and social determinants of health and HPV vaccination in vaccine-eligible adults in the U.S.(2022-08) Garg, Ashvita; Thompson, Erika; Nguyen, Uyen-Sa D.T.; Luningham, Justin M.Background: Human Papillomavirus (HPV) vaccination is an essential primary prevention measure against HPV-related cancers, currently approved for catch-up for inadequately vaccinated adults by age 26 and for mid-adults aged 27-45 with shared clinical decision-making. Although HPV vaccination rates have been gradually increasing, racial/ethnic disparities and low catch-up among adults persist. Examining the Social Determinants of Health (SDOH) associated with HPV vaccination in different racial groups may help explain these disparities in lower vaccine uptake. Previous studies using national datasets have found differences in estimated prevalence of HPV vaccine uptake across datasets for racial/ethnic minorities, especially for Asian Americans, when compared to non-Hispanic White, with results varying from lower to higher uptakes. Despite Asian Americans being a very diverse racial group, most studies either combine them in one category or with other races, resulting in an incomplete picture of HPV vaccine uptake among different Asian American subgroups. Purpose: Using the SDOH framework, this study aimed to examine the racial/ethnic differences for HPV vaccination across three U.S. national databases among vaccine-eligible adults and examine the association between HPV vaccination and Asian racial subgroups. Methods: For the first aim, the study utilized 2017-2019 NHIS (n=30,788), 2017-2020 pre-pandemic NHANES (n=3,685), and 2017-2019 BRFSS (n=30,324) data, ages 18-45 years. Asian racial subgroup disparities for the second aim were assessed with 2014-2018 NHIS data (n=34,839, ages 18-38). Survey-weighted multivariable logistic regression models identified the association between HPV vaccination status (outcome) and explanatory variables: SDOH indicators, race/ethnicity, sex, nativity, and age. Results: The racial/ethnic differences in HPV vaccine uptake were not similar between the three datasets. In the NHIS dataset, compared to Non-Hispanic White, Non-Hispanic Asian and Non-Hispanic Asian males were more likely to be vaccinated. With NHANES data, Non-Hispanic Asian males were less likely to be vaccinated. While BRFSS data did not show statistically significant differences in HPV vaccination for difference races/ethnicity. However, inverse variance weighted averages indicated that compared to Non-Hispanic White, Non-Hispanic Asian individuals had higher odds of receiving HPV vaccination. Males compared to females and foreign-born compared to U.S.-born individuals were less likely to be vaccinated. Among SDOH factors, education level, time since last healthcare visit, health insurance status, and having a usual place of healthcare were significantly associated with HPV vaccination. Compared to White individuals, Asian Indian were less likely to be vaccinated while Filipino and individuals from other Asian subgroups were more likely to be vaccinated. Additionally, foreign-born Asian Indian compared to foreign-born White individuals and Asian Indian females compared to White females were less likely to be vaccinated. Regarding SDOH factors, education level, insurance status, and time since last healthcare were significantly associated with HPV vaccination. Conclusion: This study identified racial/ethnic differences in HPV vaccine uptake and SDOH indicators associated with HPV vaccination. Findings indicate that more studies are needed to assess the differences in these three surveillance systems that led to the conflicting findings and to explore the reasons for lower vaccination uptake among the Asian Indian population. Finally, tailoring HPV vaccine awareness campaigns and improving vaccination access for males, foreign-born, individuals lacking health insurance, or those failing to have regular healthcare visits could help promote HPV vaccination and reduce HPV-associated cancers.