Tumor genomic profiling (TGP) is used in oncology practice to optimize cancer treatment and improve survival rates. However, TGP is underutilized among Black and African American (AA) patients, creating potential disparities in cancer treatment outcomes. Cost, accuracy, and privacy are barriers to genetic testing, but medical mistrust (MM) may also influence how Black and AA cancer patients perceive TGP. From December 2019 to February 2020, 112 Black and AA adults from two outpatient oncology sites in Philadelphia, PA without a known history of having TGP testing conducted completed a cross-sectional survey. Items queried included sociodemographic characteristics, clinical factors, patient–oncologist relationship quality, medical mistrust, and concerns about TGP. A k-means cluster analysis revealed two distinct psychographic clusters: high (MM-H) versus low (MM-L) medical mistrust. Clusters were not associated with any sociodemographic or clinical factors, except for age (MM-H patients older than MM-L patients, p = 0.006). Eleven TGP concerns were assessed; MM-H patients expressed greater concerns than MM-L patients, including distrust of the government, insurance carriers, and pharmaceutical companies. TGP concerns varied significantly based on level of medical mistrust, irrespective of sociodemographic characteristics. Targeted communications addressing TGP concerns may mitigate disparities in TGP uptake among those with medical mistrust.

Background: As an overrepresented population on the transplant waitlist, stagnated rates of organ donation registration among Latinxs must be redressed. Promotoras (community health workers), who are effective at advocating and spearheading health promotion efforts in the Latinx community, show promise in their ability to educate about organ donation and donor registration.Objective: This study aimed (1) to develop an interactive, evidence-based program to educate promotoras about organ donation, the need for organ donors in the Latinx American community, and ways to register as deceased organ donors and (2) to train promotoras to lead discussions about organ donation and to promote the act of donor registration.Methods: In partnership with 4 promotoras organizations, the culturally targeted Promotoras de Donación eLearning module was developed based on input from 12 focus groups conducted with Latina women (n=61) and promotoras (n=37). Formative work, existing literature, the Vested Interest Theory, and the Organ Donation Model guided curriculum development. In partnership with the Gift of Life Institute and regional promotoras, the curriculum was designed, filmed, and developed in a visually appealing module interface. The module was beta-tested with promotoras before launch.Results: Promotoras de Donación, available in Spanish with English subtitling, lasts just over an hour. The module comprised 6 sections including various activities and videos, with the curriculum divided into a skills-based communication component and a didactic educational component. Pre- and posttests assessed the module’s direct effects on promotoras’ organ donation knowledge and attitudes as well as confidence promoting the act of donor registration.Conclusions: This novel, theoretically and empirically based intervention leveraged the existing network of promotoras to promote the act of donor registration. Future research should assess whether the module helps increase rates of donor registration within Latinx communities and reduce disparities in access to transplantation.Trial Registration: ClinicalTrials.gov NCT04007419; https://www.clinicaltrials.gov/ct2/show/NCT04007419

Considerable research has explored psychosocial characteristics of individuals who seek aesthetic procedures as well as psychological changes experienced after successful treatment. Little research, however, has explored the experiences of transgender individuals who have undergone nonsurgical injectable procedures (NSIPs). This study examined theoretically relevant psychosocial characteristics of transgender individuals who have and have not undergone NSIPs. An online survey of demographic and psychosocial constructs was disseminated through transgender-specific support groups and Facebook groups from December 2019 to February 2020. Psychosocial measures included self-esteem (Rosenberg Self-Esteem Inventory), anticipated discrimination (Intersectional-Anticipated Discrimination), gender identity and physicality congruence (Transgender Congruence Scale), body image (Body Image Quality of Life Inventory), and overall satisfaction with facial appearance (FACE-Q Face Overall). The Mann–Whitney U test assessed differences by history of NSIPs, and the Kruskal–Wallis test assessed gender and racial differences. A P-value of <0.05 was considered significant. Participants (N = 101) were transfeminine (n = 58), transmasculine (n = 31), gender-diverse (n = 12), and mostly (71%) white. Almost two-thirds of respondents (62%) reported using NSIPs; 6 participants reported undergoing NSIPs from non-licensed providers. History of NSIPs was associated with greater self-esteem (P < 0.01), less anticipated discrimination (P < 0.01), greater physicality and gender identity congruence(P < 0.001), greater body image quality of life (P < 0.001), and greater satisfaction with overall facial appearance (P < 0.01). Use of NSIPs was associated with more positive psychosocial symptoms. Experiences with NSIPs may play an important role in psychosocial functioning for transgender individuals.

Background: The United States opioid crisis has been worsened by the emergence of fentanyl adulterated or associated with the veterinary sedative xylazine. Designated by the White House as an “emerging threat to the US” in 2023, xylazine use is associated with severe skin wounds. Methods: This research explored beliefs, concerns, and treatment behaviors for skin wounds among 93 participants recruited outside of a Philadelphia, Pennsylvania harm reduction agency who reported past-6-month history of a skin wound via a cross-sectional survey administered August-September 2022 (group 1; n = 33). Following a December 2022 Philadelphia Department of Public Health Report that indicated xylazine was becoming more prevalent in the Philadelphian drug supply, additional data was collected with new participants from February-March 2023 (group 2; n = 60) using the same survey. Participants were ≥18 years old, reported past-year fentanyl use, and spoke English. Our 17-item tool measured skin wound-related beliefs, concerns, treatment behaviors, and treatment sources. An open-response item explored why participants self-treat skin wounds. Results: Participants averaged 41 years old (SD = 9), slightly more than half were men ( n = 54, 58%), 31% ( n = 29) were non-White, and most ( n = 66, 71%) were unhoused. Overall, 79% of participants self-treated skin wounds. Participants endorsed worry about limb loss ( n = 77; 83%), wound shame ( n = 76; 82%), and appearance changes ( n = 80; 86%). Sixty participants (65%) reported waiting to see wound severity before seeking care. Forty-one participants (44%) delayed wound care because of withdrawal fears. Conclusions: People with probable xylazine-associated skin wounds have psychosocial concerns about and self-treat these wounds. Findings may be a harbinger of skin wound harm in other regions of the United States and internationally where xylazine is increasing.