Digital Commons Network^™

Educational Intervention To Improve Awareness Of The Female Athlete Triad Among Division I Athletes, Carly J. Haring, Jonathan Olson Md

Aesculapius Journal (Health Sciences & Medicine)

Introduction: The Female Athlete Triad poses short- and long-term health risks for female athletes through the interrelated components of low energy availability, menstrual dysfunction, and impaired bone health. Despite its prevalence, awareness and education surrounding the Triad remain limited, contributing to delayed recognition and care. The objective of this project was to assess baseline knowledge and comfort discussing Female Athlete Triad–related topics among Division I female athletes and to evaluate the impact of a brief educational intervention on knowledge, attitudes, and help-seeking intentions.

Methods: A community-based educational initiative was conducted in November 2025 among Division I female athletes …

Food Insecurity’S Influence On Obesity, Hypertension, And Diabetes In Rural Vermont And Adirondack New York, Lindsay Morse

Walden Dissertations and Doctoral Studies

Food insecurity (FI) is a persistent public health challenge in the United States and disproportionately affects rural communities. Guided by syndemic theory, this quantitative cross-sectional study examined associations between FI and chronic disease outcomes among rural residents of Vermont and the Adirondack region of New York. Social determinants of health screenings and electronic medical records from 35 rural primary care sites were analyzed. Secondary data from n = 72,505 adults were used to evaluate these relationships. Binary logistic regression models assessed obesity, hypertension (HTN), and diabetes (DM), and a multinomial logistic regression model evaluated the combined presence of obesity and …

Sound, Speech, And Synapses: Rebuilding The Brain Through Neuroplasticity, Sireen Khader

The Cardinal Edge

No abstract provided.

Development And Validation Of A Life Participation Self-Assessment Tool For People Living With Obesity: The Life Participation Impact Questionnaire (Lpiq-O), Marie-Claude Touchette

Translational Science in Occupation

Purpose: Obesity is a chronic condition affecting over 40% of adults in the U.S. Given the well-documented impact of obesity on life participation, a comprehensive, population-specific assessment tool is needed. We aimed to establish the face and content validity of the Life Participation Impact Questionnaire for People with Obesity (LPIQ-O), an occupation-focused assessment tool measuring the impact of obesity on areas of life participation.

Method: This study included seven iterative phases: (a) literature review, (b) interviews, (c) synthesis of the literature review and interviews, (d) item development, (e) expert validation, (f) face validation, and (g) final expert review. Six participants …

94th Annual Georgia Public Health Association Meeting And Conference Report, Angela H. Peden, Beverley Townsend, Patrina L. Bowles, Sarah L. Mosley

Journal of the Georgia Public Health Association

The 94th Annual Meeting and Conference of the Georgia Public Health Association (GPHA) was held in Jekyll Island, Georgia, at the Jekyll Island Convention Center, on May 1-3, 2024. The goal of the 2024 Georgia Public Health Association Annual Meeting and Conference was to assemble public health professionals, students, County Board of Health members, and stakeholders for networking and educational opportunities to support the mission and vision of GPHA.

The theme for the 2024 Georgia Public Health Association Annual Meeting and Conference was selected by the GPHA Executive Board during a meeting in the early fall of 2023: “Lighting the …

Rural Georgia Hospital Covid-19 Virus Patient Outcomes, Susan P. Smith, Neeraj Dayama, Morgan E. House, Debra Flores, Sharon Hunt, April Dukes, Steven Gautney

Journal of the Georgia Public Health Association

Background: The Coronavirus disease 2019 (COVID-19) has led to over 1.2 million deaths in the United States. Given the staggering scale of the pandemic, rural hospitals faced heightened challenges due to limited resource availability and underlying patient characteristics.

Methods: In this context, we examined patient and hospital-related factors associated with inpatient mortality due to COVID-19. This study is a retrospective chart review of patient outcomes of patients who were hospitalized in a Southwest Georgia rural hospital with COVID-19 during the initial onset of the outbreak and over the following 23 months of the pandemic. Patient demographics, other characteristics, …

Evaluating Strategies For Reducing Rates Of Adult Obesity In The United States Through Childhood Education And Exercise, Ameer M. Abdelkrim

Doctoral Dissertations and Projects

Obesity is a growing national public health crisis, impacting millions of adults and children in the U.S. Untreated obesity causes or aggravates diseases across multiple body systems. The societal impacts of obesity include an avoidable strain on the national healthcare system, with obesity and its comorbid conditions raising healthcare costs. Proactive policy and practices, with strict oversight, are essential for achieving a reduction in obesity rates. One proactive strategy that may be effective is early-age intervention, including enhanced physical activity and nutrition education for U.S. children. This study evaluates adolescent-intervention strategies for reducing rates of adult obesity. The employed methods …

Muscular Fitness Levels Of U.S. Children And Adolescents, Daniel J. Mcdonough, Yong Gao, Lynda B. Ransdell, Haichun Sun

International Journal of Physical Activity and Health

Purpose: To describe muscular fitness (MF) levels and percentile benchmarks among U.S. children and adolescents aged 6–15 years old across sociodemographic, physiological, and behavioral subgroups. Methods: Data were from the 2012 NHANES National Youth Fitness Survey (NNYFS). Four strength tests consisting of the plank, knee extension, modified pull-up, and handgrip, were analyzed by age, sex, race/ethnicity, income, BMI category, cardiorespiratory fitness (CRF), and physical activity (PA) among 1,234 participants (51% male) using SAS SURVEY procedures. Results: Mean ± SEM scores were 69.6 ± 1.8 s (plank), 56.6 ± 4.2 lb (left) and 59.2 ± 4.3 lb (right) knee extension, 5.5 …

A Physician Survey On Research And Implementation Priorities For Caffeine Citrate Use In Newborn Care In Sub-Saharan Africa, Olufunke Bolaji, Osayame Ekhaguere, Franck Houndjahoue, Nicholas Embleton, Helen Nabwera

Centre of Excellence in Women and Child Health

Background:Evidence on caffeine citrate (CC) for apnoeaof prematurity (AOP) originate from high-income countries. This study aimed to develop consensus on research design for evidence in sub-Saharan Africa (SSA).

Methods:We surveyed physicians in newborn units across SSA to assess their opinions on CC research and their preferred study designs.

Participants rated four study designs:a) an observational before-and-after study; a randomized controlled trial (RCT) of b) caffeine versus placebo; c) caffeine versus aminophylline; d) a traditional or stepped wedge cluster trial.  They  assessed  each  design  using  a  Likert  scale  for  evidence, feasibility, and ethics considerations.

Results:Ninety-two   newborn   physicians …

Text Messages To Improve Young Child Diets: Results From A Cluster-Randomized Controlled Trial In Kanchanpur, Nepal, Kenda Cunningham, Sidney Cech, Aman Sen Gupta, Pooja Pandey Rana, Debbie Humphries, Edward A. Frongillo Jr. Ph.D.

Faculty Publications

The objective of this study was to test whether adding a text message campaign about the importance of eating eggs and other nutrition-related behaviours to an on-going package of large-scale, diverse social and behaviour change interventions would improve four types of nutrition-related knowledge and behaviour outcomes: child diets (egg consumption as the primary outcome), maternal diets, maternal nutrition knowledge, and maternal participation in additional interventions. The cluster-randomized controlled trial involved a repeat cross-sectional design, recruiting families with children 12–23 months of age at baseline and endline in one plains district of Nepal. Throughout the 1000-day period, 51 text messages were …

Impact Of Suaahara, An At-Scale Multisectoral Nutrition Programme, On Health Workers’ Maternal And Child Health, And Nutrition Knowledge And Skills In Nepal, Deependra K. Thapa, Edward A. Frongillo Jr. Ph.D., Shalini Suresh, Ramesh P. Adhikari, Bhim Pun, Karuna L. Shakya, Raj Mandal, Subir K. Kole, Kenda Cunningham

Faculty Publications

Suaahara, an at-scale multisectoral nutrition programme in Nepal, aimed to advance knowledge and skills of frontline health workers to improve the quality of nutrition and health services at health facility and community levels. This study assessed the impact of Suaahara interventions on knowledge and skills of health facility workers and Female Community Health Volunteers (FCHVs). The study used a quasi-experimental design in which four Suaahara intervention districts were compared with pair-matched comparison districts. One health facility worker and three FCHVs from each survey cluster were included. Baseline survey consisted of 93 health facility workers (2015) and 118 FCHVs (2012), and …

Caregiver Assessment Of Executive Function Deficits Among Hiv-Infected And Hiv-Exposed Uninfected Preschool Children In Kenya, Antipa Sigilai, Moses Nyongesa, Amin Hassan, Janet Thoya, Rachel Odhiambo, K. Katana, Beatrice Kabunda, Grace Bomu, Charles Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: This study examined caregiver assessment of executive functioning (EF) in perinatally HIV-infected (PHIV) and perinatally HIV-exposed but uninfected (PHEU) Kenyan children, and explored the extent to which various biopsychosocial factors influence EF outcomes.

Methods: Children aged 3–5 years that were PHIV (n = 43), PHEU (n = 52), or HIV-unexposed uninfected (HUU, n = 58) and their caregivers were enrolled in this study. EF was measured using the Childhood Executive Functioning Inventory. Caregivers’ common mental disorders (CMDs) and parenting behaviour were evaluated using the Shona Symptoms Questionnaire (SSQ) and a parenting behaviour scale, respectively. We used analyses …

Key Predictors Of Postpartum Depression And Anxiety Symptoms Among Mothers In Kilifi, Kenya: A Machine Learning Approach, Faith Benson, Rachel Odhiambo, Willie Brink, Anthony Ngugi, Akbar Waljee, Eileen Weinheimer-Haus, Cheryl Moyer, Ji Zhu, Amina Abubakar

Institute for Human Development, East Africa

Background:

The burden of maternal postpartum depression and anxiety is disproportionately high in sub-Saharan Africa (SSA), yet the use of advanced analytical methods to capture the complex interplay of variables influencing these conditions remains underexplored.

Objective:

To apply machine learning (ML) methods to predict depressive and anxiety symptoms in postpartum mothers and to identify key and actionable predictors.

Methods:

This cross-sectional study included 1,995 biological mothers of singleton infants aged 0–6 months, using survey data collected between March 2023 and March 2024 in Kaloleni and Rabai sub-counties, Kilifi County, Kenya, within the Kaloleni–Rabai Health and Demographic Surveillance …

Impact Of Suaahara, An Integrated Nutrition Programme, On Maternal And Child Nutrition At Scale In Nepal, Edward A. Frongillo Jr. Ph.D., Shalini Suresh, Deependra K. Thapa, Kenda Cunningham, Pooja Pandey Rana, Ramesh P. Adhikari, Subir Kole, Bhim Pun, Indra Kshetri, Debendra P. Adhikari, Rolf Klemm

Faculty Publications

Suaahara was an innovative, complex, multi-sectoral, large-scale, nutrition programme in Nepal to increase exposure to nutrition-related information and services, improve nutrition-related knowledge and practices among pregnant women and mothers of infants and young children, and improve their nutrition. This study evaluated the effectiveness of Suaahara to improve nutrition and nutrition-related practices by comparing changes over 10 years between intervention and comparison districts. The samples of households at baseline in 2012 and endline in 2022 were 2040 and 2480, respectively, from 120 old wards. The impact was estimated using intent-to-treat regression models in which survey year, arm and their interaction were …

Exposure To Suaahara Ii Interventions And Knowledge Of Maternal And Child Nutrition And Health Among Mothers, Grandmothers, And Male Household Heads: An Association Study In Nepal, Shalini Suresh, Edward A. Frongillo Jr. Ph.D., Deependra K. Thapa, Ramesh P. Adhikari, Subir K. Kole, Femila Sapkota, Manisha Laxmi Shrestha, Kristine Garn, Pooja Rana Pandey, Indra Kshetri, Dipak Sharma, Kenda Cunningham

Faculty Publications

Suaahara was a USAID-funded multi-sectoral integrated nutrition program that aimed to improve the nutritional status of children under the age of five and their mothers in Nepal. The program included multiple interventions targeted to mothers and children, as well as other caregivers. Caregiver knowledge of optimal nutrition and health practices among household members is an important driver of healthy child and maternal nutrition behaviors. This study investigates the associations between exposure to Suaahara interventions and knowledge of maternal and child nutrition and health practices among mothers (n =, grandmothers (n =, and male household heads (n =. Linear and logistic …

Substance Use Stigma: Examining The Role Of Social Work Education., Eboni Burton

Doctor of Social Work Capstone Projects

This study explored the extent of substance use related stigma among social work students and professionals (i.e., BSW, MSW, PHD and DSW) and its relationship to specialized education/training in substance use and professional practice with people who use drugs (PWUD)/live with a substance use disorder (PWSUD). Stigma was measured using the Opening Minds Provider Attitudes Toward Opioid Use Scale and the Medical Condition Regard Scale. The final sample size was 263. Results indicate that current enrollment in a social work program, post degree or non-curriculum related substance use related training, and personal and professional experience with substance use specifically, mitigate …

Early Insights From A Multi-Centre National Stroke Surveillance Initiative In Tanzania, Sarah Shali Matuja, Azan Nyundo, Emmanuel Assey, Joel Bwelemo, Marieke Dekker, Sarah Urasa, Emanuel Makarius, Peter Kishimbo, Philip Adebayo, Paschal Ruggajo

Internal Medicine, East Africa

Background: Stroke is a leading cause of death and disability globally, with sub-Saharan Africa, bearing the greatest burden. Tanzania has only one active stroke registry, limiting evidence-based care and policy development. We aimed to expand the registry into a multi-centre study across eight major tertiary hospitals to generate baseline data for a national stroke registry.

Methods: From January to August 2024, we analysed de-identified data from adults (≥18 years) admitted with a World Health Organisation defined stroke. Data collected included demographics, risk factors, imaging, and in-hospital mortality. Logistic regression identified predictors of mortality.

Results: A total of 1000 patients were …

Associations Of Moderate-To-Vigorous Physical Activity Timing With Type 2 Diabetes Incidence In Uk Biobank And Prevalent Glycemic Measures In Nhanes, Qiuyu Feng, Gali Albalak, Linjun Ao, Qian Xiao, Heming Wang, Jeroen H P M Van Der Velde, Jessica C Kiefte-De Jong, Martin K Rutter, Charles E Matthews, Joshua R Freeman, Ko Willems Van Dijk, Diana Van Heemst, Raymond Noordam

Faculty, Staff and Student Publications

Objective: We assessed the association between timing of moderate-to-vigorous physical activity (MVPA) with incident type 2 diabetes (T2D) and glycemic measures.

Research design and methods: Regression models were used to assess associations between accelerometer-derived MVPA timing and incident T2D in UK Biobank (UKB) (n = 84,528, prospective), prevalent diabetes, and glycemic measures in the National Health and Nutrition Examination Survey (NHANES) (n = 6,998, cross-sectional).

Results: In UKB, with early morning (0500-0959) MVPA as reference and before adjustment for total MVPA, "variable-timing" MVPA was associated with the lowest incident T2D risk; while after adjustment, afternoon-evening MVPA (1500-2400) showed the lowest …

Undergraduate Health And Wellbeing Course And Study Away Program To Alaska, Lorraine S. Wallace, Steven J. Mousetes, Jennifer Bickley

Journal of Global Education and Research

High-impact practices, such as diversity/global education, have been shown to positively contribute to student development, engagement, and success. As the US is both culturally and linguistically diverse, domestic study away programs can offer students impactful multicultural educational experiences without leaving the country. The purpose of this study was to describe the design of a health and well-being academic course and accompanying study away program to Alaska for undergraduates at The Ohio State University (OSU). The authors (1) describe the application of the backward design process in guiding ELOs development, (2) provide a sample of course assignments and student responses, and …

The Role Of Top-Down Appetite Self-Regulation In The Development Of Healthy Eating Behaviors Among Children: A Narrative Review And Socialization Framework, David J Bridgett, Sheryl O Hughes, Matthew Broussard, Daniela Mccourt, Christina M Croce, Jennifer O Fisher

Faculty, Staff and Students Publications

Appetite self-regulation (ASR) among children is thought to have a fundamental role in shaping the development of healthy eating behaviors, dietary intake, and growth during childhood. Parallel to developmental frameworks for understanding "general" self-regulation among children, ASR has been described as involving children's use of "top-down" cognitive processes to moderate "bottom-up" biological drives around food approach and avoidance in the interest of achieving desired eating behaviors or outcomes. Whereas bottom-up ASR processes during early childhood are well characterized, particularly in the context of dysregulation and obesity risk, the role of top-down ASR processes in the development of healthy eating behaviors …

Urban–Rural Disparities In Metabolic Risk Factors For Hypertension Among The Elderly In Indonesia, Susiana Nugraha, Puri Wulandari

Kesmas

Hypertension remains a major public health challenge among the elderly in low- and middle-income countries. This cross-sectional study examined demographic and metabolic factors associated with hypertension among the elderly living in urban and rural areas of West and Central Java Provinces, Indonesia. This study included 1,920 adults aged ≥60 years who had resided in the study areas for at least six months, were able to communicate effectively, and provided informed consent. Data were collected between March and August 2023 using stratified multistage random sampling, structured questionnaires, and biochemical measurements. Multivariable logistic regression revealed distinct patterns of association across settings. In …

Short-Term Survival And Prognostic Factors In Cervical Cancer Patients Requiring Hemodialysis: A Retrospective Cohort Study, Muhammad Trihatmowijoyo Bundjali, Maruhum Bonar Hasiholan Marbun, Wulyo Rajabto, Ikhwan Rinaldi, Hamzah Shatri, Dwi Lestari Partiningrum, Dadang Makmun, Pringgodigdo Nugroho, Sukamto Koesnoe, Pradana Soewondo

Kesmas

Cervical cancer is a common gynecological malignancy, particularly in developing countries, where it coexists with renal impairment in over one-third of patients. This disease typically presents acutely and progresses rapidly. Consequently, kidney replacement therapy, including hemodialysis (HD), is commonly required. To assess survival rates and associated factors, this retrospective cohort study analyzed the medical records of 252 cervical cancer patients who began HD across a three-month follow-up period. Kaplan–Meier analysis indicated a median short-term survival duration of 71.5 days (range: 7–90), with 1-, 2-, and 3-month survival rates of 56%, 51%, and 49%, respectively. Multivariate Cox regression identified post-HD systolic …

Association Between Dietary Folate And Prostate Cancer Aggressiveness Among African Americans And European Americans, Lihchyun Joseph Su, Sarah O'Connor, Daniela Ramirez Aguilar, Minjae Lee, Harrison Wong, Hui-Yi Lin, Jeannette T. Bensen, James L. Mohler, Lenore Arab, Longgang Zhao, Ebonee N. Butler, Laura Farnan, Susan E. Steck Phd, Mph, Rd

Faculty Publications

Background: Despite the confirmed beneficial effects on preventing neural tube defects, concerns about high intakes of synthetic folate, or folic acid, in promoting cancer progression have been raised. This study evaluated the association between folate intake and prostate cancer (PCa) aggressiveness among African-American (AA) and European-American (EA) males. Methods: This study included 722 AA and 775 EA men with prostate cancer. Folate intake (dietary folate equivalent (DFE), synthetic folate, natural folate) was estimated using the National Cancer Institute Dietary History Questionnaire and detailed dietary supplement use questionnaire. Analyses included univariable comparisons of demographic and clinical characteristics of the two racial …

Trends In Self-Reported Responses To Nutrition Facts Labels Before And After Nutrition Labeling Policy Implementation: A Comparison Of Adults In The United States And Mexico, Jim Thrasher Ph.D., Ma, Ms, Victor Vilalobos, Dai Fang, Alejandra Jáuregui, Alejandra Contreras-Manzano, Rachel Davis Ph.D., Lana Vanderlee, Christine M. White, Rachel B. Acton, James W. Hardin, Edward A. Frongillo Jr. Ph.D., Simón Barquera, David Hammond

Faculty Publications

Background

Objectives

Methods

Gender Differences In College Students’ Physical Activity Self-Efficacy, Social Comparison Beliefs, And External Frames Of Reference, Ken Murfay, Sarah Pyszczynski, Sarah Collins

International Journal of Physical Activity and Health

This study examined whom college-aged individuals believe observing would more likely increase their physical activity self-efficacy (PASE) for a physical skill, whom they are more likely to compare their abilities to within a physical education (PE) class, how often they compare themselves to others in PE, and what students’ PASE scores were. Based on the mean scores for each question, students were more likely to compare themselves to a student than a teacher, friend than a non-friend, and similar or higher skilled peer than a lower skilled peer. To increase students’ confidence for a physical skill, students had higher levels …

Association Between Children’S Secondhand Co-Exposure To Tobacco And Cannabis Smoke And Elevated Urinary Cotinine Levels: A Cross-Sectional Analysis, Bradley N. Collins, Stephen J. Lepore, Vincent Berardi, Renee D. Goodwin, Karen Wilson, Mona Baishya

Psychology Faculty Articles and Research

Background Cannabis use is far more common among adults who smoke tobacco than adults who do not, and its use is increasing among people who smoke tobacco with children living in the home. Given the well-established evidence that caregiver smoking is the primary source of children’s secondhand exposures to these products, the increasing trend in caregiver co-use is raising public health concerns about children’s co-exposure. Emerging data indicates that adult co-use is linked to additive health consequences, such as elevated nicotine and other tobacco-related toxicant blood levels, relative to use of only tobacco. It is unknown whether children’s co-exposure leads …

Survival On Image Regression With Application To Partially Functional Distributional Representation Of Physical Activity, Rahul Ghosal, Sunwoo Emma Cho, Marcos Matabuena

Faculty Publications

Technological advancements in wearable devices and medical imaging often lead to high-dimensional physiological signals in the form of images or surfaces. To address these data structures, we develop a novel survival on image regression model with a specific focus on partially functional distributional representation of wearable data. The existing approaches for functional data and survival outcomes have been primarily developed for uni-dimensional functional predictors. Drawing on recent developments in distributional data analysis, we model temporally varying distributional patterns of physical activity (PA) as a partially functional distributional predictor within a semiparametric Cox model framework. We use tensor product splines to …

Determinasi Minimum Dietary Diversity Pada Anak Usia 6-23 Bulan: Analisis Survei Kesehatan Indonesia 2023, Elfys Ferdynan, Besral Besral

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Keragaman pangan minimum atau minimum dietary diversity (MDD) merupakan indikator penting kualitas konsumsi pangan anak usia 6-23 bulan. Pemenuhan MDD berperan dalam mendukung pertumbuhan optimal dan pencegahan malnutrisi, termasuk stunting. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan pemenuhan MDD pada anak usia 6-23 bulan di Indonesia. Data yang digunakan adalah data Survei Kesehatan Indonesia 2023 dengan desain potong lintang. Subjek penelitian adalah 17.991 anak usia 6-23 bulan. Analisis yang dilakukan menggunakan regresi logistik biner dengan penyesuaian desain complex samples. Hasil penelitian menunjukkan bahwa faktor yang meningkatkan peluang pemenuhan MDD secara signifikan meliputi usia anak 12-23 bulan, …

Efektivitas Pertemuan Tim Multidisiplin Dalam Meningkatkan Outcome Tata Laksana Kanker Di Rumah Sakit: Literature Review, Ngakan Putu Daksa Ganapati, Wahyu Sulistiadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Optimal cancer management requires a multidisciplinary approach to improve the quality of patient care. Multidisciplinary teams (MDTs) enable interprofessional collaboration in designing comprehensive, patient-centered care. However, the implementation of MDTs in Indonesia still faces various challenges, necessitating a systematic review to understand their effectiveness in improving cancer management outcomes. This systematic review employed the PRISMA method, searching articles from the ScienceDirect, Semantic Scholar, and PubMed databases, published between 2014 and 2024. Ten scientific articles were analyzed from 745 articles retrieved to understand the effectiveness of MDTs in improving cancer management outcomes. The results indicate that MDTs improve the quality of …

Global Public Health Feasibility: Digital Dentistry In Geriatric Population, Merna Amr Saleh

Theses and Dissertations

Oral health is a critical yet often overlooked determinant of well-being among older adults in Egypt, where mobility limitations, geographic barriers, and low awareness of preventive practices exacerbate dental disparities. DentalPal, a teledentistry-based mobile application, was developed to provide older adults with remote dental consultations, oral hygiene advice, and triage guidance. The platform enables users to submit oral photographs or radiographs for assessment, seek second opinions, and initiate follow-up chats directly with the healthcare provider. This flexible design allows users to access dental consultations on demand while ensuring continuity of care The question that guided this study was how older …