Vitamin C, well-established in immune function and a key factor in epigenetic inflammatory modifications, is only obtained through consistent dietary intake. Identifying individuals at risk for Vitamin C insufficiency may guide prevention and treatment, however, national surveillance has not been evaluated in the United States since 2006. A descriptive, cross-sectional secondary analysis was performed utilizing data from the 2003–2006 National Health and Nutrition Examination Surveys (NHANES) assessing non-institutionalized adults. Five categories of plasma Vitamin C were delineated: deficiency (<11 μmol/L), hypovitaminosis (11–23 μmol/L), inadequate (23–49 μmol/L), adequate (50–69 μmol/L), and saturating (≥70 μmol/L). Results indicated 41.8% of the population possessed insufficient levels (deficiency, hypovitaminosis, and inadequate) of Vitamin C. Males, adults aged 20–59, Black and Mexican Americans, smokers, individuals with increased BMI, middle and high poverty to income ratio and food insecurity were significantly associated with insufficient Vitamin C plasma levels. Plasma Vitamin C levels reveal a large proportion of the population still at risk for inflammatory driven disease with little to no symptoms of Vitamin C hypovitaminosis. Recognition and regulation of the health impact of Vitamin C support the goal of Nutrition and Healthy Eating as part of the Healthy People 2030.

The representation of racial and ethnic minority populations in clinical trials continues to be a challenge despite mandates, good intentions, and concerted efforts by funding agencies, regulatory bodies, and researchers to close the clinical trials gap. A lack of diversity in research results in both continued disparities and poorer health outcomes. It is thus imperative that investigators understand and effectively address the challenges of clinical trials participation by underrepresented populations. In this paper, we expound on best practices for participatory research by clearly defining the community, highlighting the importance of proper identification and engagement of strong community partners, and exploring patient- and provider-level barriers and facilitators that require consideration. A clearer understanding of the balance of power between researchers and community partners is needed for any approach that addresses clinical trials representation. Unintended biases in study design and methods may continue to prevent racial and ethnic minority participants from taking part, and significant organizational changes are necessary for efficient and transparent relationships. Comprehensive community engagement in research includes dissemination of clinical trial results within and in partnership with community partners. Through careful deliberation and honest reflection, investigators, institutions, and community partners can develop the tailored blueprints of research collaborations essential for true equity in clinical trials.

Background: By 2030, nearly one-quarter of the U.S. population will be over age 65, emphasizing the need to understand factors that promote healthy aging. Vitality is often reduced to physical indicators in clinical frameworks, overlooking its multidimensional nature. Methods: This qualitative descriptive study explored how independently living older adults define and experience vitality, focusing on physical, emotional, cognitive, and social dimensions. Guided by Self-Determination Theory, semi-structured interviews were conducted with 10 participants aged 61–83 years purposively recruited from community and faith-based settings in Northeast Florida. Results: Thematic analysis revealed four interconnected themes: (1) Make Adjustments, Keep Going; (2) Being Mentally Jubilant; (3) Bonds that Keep Me Going; and (4) Thriving Amid Uncertainty. Conclusions: Findings suggest that participants perceived vitality as a dynamic, multidimensional process shaped by adaptation, purpose, and connection rather than physical health alone. These insights underscore the need for holistic approaches to vitality assessment and interventions that support autonomy, competence, and relatedness in later life.

High ambient temperature poses a significant public health challenge, particularly for low-income older adults (LOAs) with preexisting health and social issues and disproportionate living conditions, placing them at a vulnerable condition of heat-related illnesses and associated public health risks. This study aims to utilize advanced statistical regression and machine learning methods to analyze complex relationships between elevated temperature, physical activity (PA), sociodemographic factors and fall incidents among LOAs. We collected data from a cohort of 304 LOAs aged 60 and above, living in free-living conditions in low-income communities in Central Florida, USA. Zero-inflated Poisson regression was employed to examine the linear relationships, which reflect the zero-abundant nature of fall incidents. Then, an advanced machine learning approach—the mixed undirected graphical model (MUGM)—was employed to further explore the intricate, nonlinear relationships among daily PA, daily temperature, and fall incidents. The findings suggest that more moderate-to-vigorous PA is significantly associated with fewer fall incidents (RR = 0.90, 95% CI: (0.816, 0.993), $p=0.037$), after adjusting for other variables. In contrast, elevated temperature is strongly linked to a greater risk of falls (RR = 1.733, 95% CI: (1.581, 1.901), p < 0.0001), potentially reflecting seasonal influences. Although higher temperature increases fall events, this effect is mitigated among LOAs with increased sedentary behavior ($p<0.0001$). Additionally, findings from the MUGM reinforce the intricate nature of falls. Fall counts were highly correlated with race and positively associated with temperature, highlighting the importance of tailoring fall prevention strategies to account for seasonal variations and health disparities, and promoting PA.

INTRODUCTION In the past decade, Jacksonville, Florida has seen an increase in African immigrants. However, little is known about their health needs and perspectives related to community health and clinical trials. The Mayo Clinic Comprehensive Cancer Center (MCCCC) Community Outreach and Engagement (COE) Office and Programs partnered with multiple community-based organizations as part of the FL Community Engagement Alliance Against COVID-19 to hold a series of focus groups with African immigrants to better understand their perspectives surroudning these determinants. METHODS This was a qualitative study with African immigrants residing in Jacksonville, Florida. Data was collected by community partner, Jocelyn Turner Consulting, who has led multiple community-based studies in Florida. Recruitment was in partnership with African businesses and churches. Using a guide developed by MCCCC COE, three focus groups were held to explore African immigrants’ 1) general experiences, 2) access to social services, 3) perspective of community health and diseases, 4) access and use of healthcare services, 5) knowledge and participation in clinical trials, and 6) appropriate strategies for providing community education and enhancing participation in research studies. RESULTS 24 participants participated in the focus groups. 83% had recently immigrated from Africa (Democratic of the Congo, Benin, Ghana, Sudan, Mali, Nigeria, Ethiopia, and Nigeria). The remaining 17% recently immigrated from Haiti or came to the US as a baby. Participants reported suprise to the proliferation of chronic diseases, such as increased cancer diagnoses of those who immigrated to the United States. Most participants associated this with the Western sedentary lifestyle, dietary habits, and lack of access to fresh food. Participants connected to refugee organizations reported knowledge of the ability to access health education resources and mental/physical care services, but those not connected with similar organizations expressed limited knowledge about access. Similarly, participants with no connection to refugee organizations reported not knowing where to access healthcare services and not seeking services until home remedies had failed. Only 33% of participants reported knowledge of clinical trials and all reported mistrust of research. Many of the participants expressed a need for health-related information upon arrival in the United States. CONCLUSION There is currently little infrastructure in place to support African immigrants in Jacksonville, Florida, which can contribute to cancer health disparities in this population. Strong community engagement is needed to partner with African immigrant communities to address culturally specific needs identified of this underrepresented population. The needs expressed by participants include information on physical activity, nutrition, and healthcare/clinical trials. A strong partnership with African immigrant communities has the potential to address cancer disparities and increase both trust and participation in clinical trials. Citation Format: Jocelyn Turner, Laureen Husband, Jessica Otero, Opeyemi Bolajoko, Parisa Fathi, Jennifer Crook, Folakemi Odedina. Perspectives of African immigrants on community health needs and clinical trials [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A052.

Background: Older adults initiating chemotherapy are highly vulnerable to symptom burden and treatment interference. Nutritional insecurity (NI), barriers in food access, preparation, tolerance, and consumption, is a potentially modifiable determinant of treatment vulnerability, yet its role in shaping symptom pathways during chemotherapy is poorly understood. Objective: To characterize NI as a symptom phenotype and examine associations between NI and symptom burden, functional limitations, life interference, and inflammatory biomarkers in older adults undergoing chemotherapy. Methods: In a cross-sectional analysis nested within a prospective cohort, 79 adults ≥55 years newly diagnosed with cancer and receiving first-line chemotherapy completed NI screening and assessments of physical, psychological, and cognitive symptoms; functional limitations; inflammatory biomarkers (NPAR, NLR, MLR, PLR); and life interference at either pre-chemotherapy (T1) or final chemotherapy (TFinal). Participants were categorized as nutritionally secure (NS) or nutritionally insecure (NI). Group differences were evaluated using chi-square tests, Cramér’s V, Mann–Whitney U tests, ANOVA, and risk differences. Results: NI prevalence was 34.2%. Participant demographic and clinical characteristics were largely similar between NI and NS groups in both cohorts. NI participants reported higher prevalence of nearly all symptoms at both time points, with the strongest separation in continuous symptom burden at TFinal (mean rank 33.53 vs. 21.36; p = 0.005). Functional limitations showed minimal NI-related differences. Life interference was greater among NI participants in the T1 cohort but not in TFinal. Inflammatory biomarkers did not differ by NI status, and exploratory analyses showed no biomarker-symptom associations. Conclusions: NI represents a distinct symptom-heavy phenotype marked by elevated symptom burden and early-life interference, without corresponding functional decline or inflammatory abnormalities. Findings support universal NI surveillance in oncology and motivate longitudinal research to clarify NI–symptom–interference pathways and inform targeted interventions for older adults initiating chemotherapy.