Research Round-up

COVID’s effect on Black girls

The physical, psychological and sexual development of Black adolescent girls has been “heavily impacted” by the COVID-19 pandemic, says UIC College of Nursing assistant professor Natasha Crooks, PhD, RN.

Crooks published a recent paper, titled, “The Impact of COVID-19 Among Black Girls: A Social-Ecological Perspective,” in the Journal of Pediatric Psychology. The paper reports on the findings of a qualitative study that featured interviews with 25 Black girls—ages 9 to 18—from December 2020 to April 2021. Most participants reported significant psychological and physical consequences, including depression and anxiety, disrupted eating, distorted body image, and changes in self-esteem.

“Black girls are a very vulnerable and unprotected population, especially within the context of COVID,” Crooks says.

Black girls enter puberty and develop secondary sex characteristics earlier than their non-Black peers, according to the paper, causing them to suffer from “adultification” and “sexualization by society.” This can lead to elevated sexual and mental health risks.

Crooks found that only two of the girls in the study received any formal sexual education during the pandemic, as schools opted to delay teaching sex education during online learning due to the sensitive nature of the topic, according to the study.

The pandemic also intersected with the Black Lives Matters movement. The participants saw mistreatment of Black people by police, including the murders of Breonna Taylor and George Floyd, nationally broadcasted. These messages led to mixed feelings among the participants.

“A lot of what the girls talked about was feeling empowered to be Black and having a sense of pride within their identities,” Crooks says. “On the other hand, there was fear that came with color of their skin—fear of being harmed themselves, or their fathers, brothers or other family members being hurt. There was this constant fear and threat to Black families.”

Deterrent to dementia?

Could an exercise program help slow the effects of dementia in older adults with chronic kidney disease?

Ulf Bronas, PhD, ATC, FSVM, FAHA, UIC Nursing associate professor, suspects that it could, and will test his hypothesis with a $2.68 million grant from the NIH.

It matters, Bronas says, because older adults with chronic kidney disease show signs of Alzheimer’s disease and related dementias about 10 years earlier than patients without kidney disease.

By combining comprehensive assessments of cognition with brain imaging, we’ll be able to evaluate the relationship between behavior change, brain neural networks, and cognitive function at a level previously not completed in this understudied population.

Bronas will enroll 140 older adults with mild cognitive impairment and chronic kidney disease in the five-year study, which will examine whether a six-month, home-based walking program improves executive function, cognition, brain matter integrity and neural network connectivity. Bronas and his colleagues will use exercise testing, cognitive testing and MRI to measure and test outcomes of the exercise intervention.

“This study will allow us to address a critical gap in how exercise might be used to prevent and treat age-related cognitive decline,” he says. “By combining comprehensive assessments of cognition with brain imaging, we’ll be able to evaluate the relationship between behavior change, brain neural networks, and cognitive function at a level previously not completed in this understudied population.”

Studying acupuncture for breast cancer pain

Assistant professor Hongjin Li, PhD, was awarded a grant through the National Center for Complementary and Integrative Health to study whether acupuncture could alleviate breast cancer symptoms for patients at a federally qualified health center.

Nearly 94% of breast cancer patients experience symptoms—such as joint pain, hot flashes, sleep disturbance, fatigue, depression and anxiety—during or after endocrine therapy, also known as hormone therapy.

Although past studies have shown acupuncture can holistically address multiple symptoms in patients with other conditions, it has not been investigated among breast cancer patients receiving endocrine therapy.

Significantly, Li’s research will focus on patients at a federally qualified health center (FQHC), which provides care to an underserved population who may experience barriers to health care. Other studies of acupuncture have focused on privately insured clinic settings.

“There is an urgent need to remove barriers and ensure equal access to this evidence-based treatment among breast cancer survivors with limited access to acupuncture,” she wrote in her abstract.

The results will potentially provide the foundation for a larger, multisite study of acupuncture at FQHCs for breast cancer survivors, and could ultimately promote broader insurance coverage for acupuncture, Li says.

Li’s team includes fellow UIC Nursing faculty Ardith Doorenbos, Harriet H. Werley Endowed Chair for Nursing Research, Judith Schlaeger, associate professor and Crystal Patil, professor. It also includes Oana Danciu, associate professor at the UIC College of Medicine, and Zhengjia Chen, associate professor at the UIC School of Public Health.

Words that hurt

Two recent papers by UIC College of Nursing faculty found that microaggressions—common, subtle indignities—can be just as harmful as a major discriminatory event, contributing to negative mental and physical health outcomes in bisexual women.

Associate professor Wendy Bostwick, PhD, MPH, and assistant professor Ariel U. Smith, PhD, RN, were co-authors on both papers, one published in the Journal of Bisexuality and the other in Psychology of Sexual Orientation Gender Diversity, a publication of the American Psychological Association. Both relied on findings from the Women’s Daily Experience Study of 112 ethnically and racially-diverse bisexual women.

Microaggressions that someone has experienced over a lifetime are correlated with mental and physical ailments they experience even today.

Bostwick is principal investigator on a National Institute on Minority Health and Health Disparities grant which funded the Women’s Daily Experience Study, one of the first ever to focus on bi-identified women and mental health. Participants completed a baseline survey, followed by 28 days of e-diaries to capture microaggressions that they may have experienced during the previous 24 hours.

“The old saying goes, ‘sticks and stones may break your bones, but words can never hurt you,’” Smith says. “But you look at the data and realize that’s simply not true. Microaggressions that someone has experienced over a lifetime are correlated with mental and physical ailments they experience even today.”

The researchers looked at microaggressions related to sexual orientation, race and gender. Microaggressions could include denying a person’s bisexuality—such as suggesting it’s “just a phase”—or a rude or insulting comment about lesbian or gay individuals. A comment minimizing or denying the existence of racial discrimination is an example of a racial microaggression.

Participants reported an average of eight microaggressions of any type in the previous month, with almost all women—97%—reporting at least one microaggression throughout the duration of the study.

The studies found that microaggressions were associated with poor mental health and binge drinking, smoking and marijuana use. The most consistent finding was an association between microaggressions and anxiety.

Transparency with research participants

For participants enrolled in research studies, receiving results – both individual health results and broad findings from the study—can be inconsistent.

UIC Nursing clinical assistant professor Denise Kent, PhD, APRN, calls this is an “unregulated part of doing research.”

She received a grant to create a tool to improve the return of results to study participants, allowing patients to take a survey to indicate preferences for receiving results, which she hopes can then be used in other large-scale research studies.

Her pilot study, called MIRROR, is part of a four-year study of long COVID-19, which will enroll around 1,200 patients. “It’s two sides,” Kent says. “We can’t do research without participants. They need to be recognized as a valuable part of the project. If we want to ask people to keep coming, to let us keep poking them so we can get more information, we have to ask, what are we doing for them?”

Kent says that while the participants will receive compensation for their involvement in the study—with cash or gift cards for each visit—she also wants to be sure that participants are receiving valid, usable health information in a personalized format.

This is an evolving study, and scientists don’t know what they’ll learn in the next four years about long COVID, she says.

“Maybe it will be something that will be pertinent to the participants and their families, that they’ll want to know,” she says. “We need to have a mindset of transparency, recognizing that the research participants are a valuable part of the team.”