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IntroductionChronic kidney disease (CKD) is often accompanied by complications including poor physical activity level. However, only a few studies have objectively characterized physical activity levels in predialysis CKD. Our study sought to measure daily activity levels by accelerometry in individuals with CKD (stages III−V) and to determine the association between daily activity and kidney function.MethodsWe determined kidney function by means of the estimated glomerular filtration rate (eGFR) using the Modification of Diet and Renal Disease (MDRD) equation. Participants wore an accelerometer for 7 consecutive days, and we measured multiple physical activity outcomes including total daily activity, sedentary, light, and moderate−vigorous activity. Average durations and intensity of activity were determined according to stage of CKD. The association between kidney function and activity level was determined by regression analysis.ResultsWe analyzed data from 110 individuals (60% men and 40% women) with stages III to V CKD. The mean age of our participants was 64 years, mean body mass index was 27.5 kg/m2, and mean eGFR was 23.7 ± 1.2 ml/min/1.73 m2. Our participants were primarily sedentary (mean duration of inactivity = 1152 ± 100 minutes per day; 79% of day). Light activity was performed 280 ± 99 minutes per day, and individuals participated in only 6 ± 9 minutes per day of moderate−vigorous activity. The eGFR did not predict physical activity level (P > 0.05 for all).DiscussionIndividuals with stages III to V CKD are sedentary, and do not meet the national recommendations of 150 minutes of moderate−vigorous activity per week. Further study is required to determine whether interventions to increase activity levels in patients with CKD are associated with improved health outcomes.

Background: Black cancer patients face significant disparities in medical care throughout the cancer care continuum. While multilevel factors contribute to these disparities including access to care, socioeconomic status and cultural factors, overt and perceived discrimination in the health care setting may likely exacerbate disparities for black cancer patients. However, little is known about how experiences of racial discrimination unfold for Black cancer patients when navigating care and the consequences of such treatment. Purpose: To explore how experiences of racial discrimination in the health care setting manifests for Black cancer patients and to understand how these experiences might contribute to disparities. Methods: We conducted semi-structured in-depth interviews with 18 Black cancer survivors, lasting between 45 – 60 minutes from 2019-20. All interviews were audio-recorded, professionally transcribed, and uploaded into Dedoose software for analysis. Two independent coders met regularly and analyzed the interview transcripts using a deductive constant comparison approach to establish and modify codes based on facets of the biopsychosocial model of stress. Results: Participants included breast, colorectal, and prostate cancer survivors aged 29 to 88 years old. Most patients expressed experiencing some form of racial discrimination, perceived more than overt when receiving medical care. Participants experienced instances of perceived discrimination from their interactions with healthcare staff, medical assistants, front desk staff, health insurance administrators, or other staff within the facility. Instances of perceived discrimination resulted in patients expressing that they did not trust their provider or was a stressor contributing to their mental well-being. Patients who experienced perceived discrimination noted “walking out” of their visit and not having their health issues addressed, demonstrating a broader link between the two factors. Patients internalized experiences of perceived discrimination, resulting in behavior changes in subsequent visits to mitigate the effects. Overt discrimination in the health care setting was rooted in stereotypes and manifested through verbal microaggressions such recollections of physicians using phrases such as “you people”. Patients still sought care when they experienced discrimination out of necessity and believing it was an inevitable part of the Black experience. Patients who had positive experiences navigating care expressed a personal relationship and emotional connection characterized by mutual respect and compassion between them and their provider. Conclusion: Themes identified in this study support possible mechanisms for discrimination in the health care setting contributing to racial health disparities in cancer care such that discrimination serves as a stressor for Black cancer patients and impacts health-seeking behaviors. Future recommendations for healthcare staff should focus on ensuring patient-centered communication and care to support this vulnerable population. Citation Format: Elleyse Garrett, Albert Farias, Carol Ochoa, Cindy Ma, Stephanie Navarro, Paul Yoon. “You people”- A qualitative analysis of black cancer patients navigating a healthcare system of discrimination [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-007.

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