Digital Commons Network^™

Plans4care, A Web Application Providing Caregivers Personalized Solutions To Manage Dementia-Related Care Challenges: Proof Of Concept And Efficacy Trial, Laura N. Gitlin, Eric Jutkowitz, Catherine V. Piersol, Sokha Koeuth, Taylor Sivori, Melinda J. Webster, Rachel N. Barnett, David L. Roth

Department of Occupational Therapy Faculty Papers

OBJECTIVE: Few dementia caregivers have access to evidence-based support programs. Web applications (app) may address this gap. Plans4Care, a web app, provides caregivers with on-demand personalized solutions to address care challenges. We present results of a proof-of-concept study and describe a trial protocol to test efficacy.

METHODS: To use Plans4Care, caregivers respond to brief onboarding questions, assess dementia patients' cognitive function, identify care challenges, and generate "action plans" (personalized strategies). Telehealth sessions with dementia-trained care advisors are available. A proof-of-concept study evaluated a clickable prototype using standardized technology scales to determine if >75 % scored positively on four criteria (acceptability, …

A299: Research On The Gym Business Model Under The Combination Of Fitness And Health Management Under The Service-Dominant Logic, Jiaming Chen

International Journal of Physical Activity and Health

With the upgrading of healthy consumption and the deepening of national fitness awareness, the business model of traditional gyms with facility leasing as the core is difficult to meet the diversified health needs of users. Purpose: Based on the theory of Service-Dominant Logic, this study focuses on the deep integration of fitness and health management services and explores the innovation path of the gym business model. By deconstructing the core concepts of "value co-creation", "operational resource integration", and "service ecosystem" in the service-oriented logic, combined with the specialization, personalization, and sustainability characteristics of health management services, a gym service framework …

A026: Associations Between Energy Metabolism And Sarcopenia Prevalence And Mortality In Older Adults, Lidian Meng, He Zheng

International Journal of Physical Activity and Health

Sarcopenia, characterized by the progressive loss of skeletal muscle mass, strength, and function, is a geriatric syndrome with a significantly increased incidence with age. It has become a major public health concern affecting the health of middle-aged and older adults. This study aims to investigate the associations between leisure-time physical activity (LPA), occupational physical activity (OPA), and transportation physical activity (TPA) with sarcopenia and all-cause mortality among older adults in the United States. Data were derived from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, with all-cause mortality tracked through the National Death Index (NDI) until …

A107: Multidimensional Influencing Factors And Psychosocial Mechanisms Of Eating Disorders In Female Athletes, Yajing Zhao, Peizhen Zhang, Lumeng Yang

International Journal of Physical Activity and Health

Eating disorders (ED) are prevalent mental health conditions that significantly threaten the physical and psychological well-being of female athletes. The risk of ED is driven by the interplay of multiple factors, including sport-specific training environments, psychological vulnerabilities, and sociocultural pressures. Although existing research has identified several independent risk factors, a systematic understanding of the sport-related psychosocial mechanisms remains insufficient. This study aims to synthesize empirical evidence from the past five years to elucidate the multidimensional pathways of ED in female athletes, with a particular focus on intervention targets from a sport psychology perspective. A systematic literature review was conducted, retrieving …

A143: Analysis Of Fast-Food Consumption Behavior Among Physically Active Male Students In A Beijing University, Hui Hu, Yi Yan

International Journal of Physical Activity and Health

This study aims to analyze the fast-food consumption behavior among physically active college students in a university in Beijing and provide a scientific basis for future nutritional education and intervention strategies targeting this population. A simple random sampling method was used to select 850 undergraduate students from a sports-focused university in Beijing. Data on fast-food consumption were collected through a self-administered questionnaire. The survey assessed the frequency of fast-food consumption, reasons for food choices, and students’ perceptions of nutritional value. A total of 807 valid questionnaires were collected, yielding a response rate of 95.8%. The reported consumption of Western and …

A146: Independent And Joint Role Of Inflammatory Diet And Physical Activity In The Acceleration Of Aging, Shuting Peng, Yu Jiang

International Journal of Physical Activity and Health

Biological aging arises from the accumulation of molecular changes or “hallmarks”, which can represent a person's aging status than chronological age. A healthy lifestyle can slow biological aging and prevent or delay the onset of multiple age-related diseases. This study is the first to investigate the independent and joint association of physical activity (PA) and inflammatory diet with acceleration of aging. Method: Data from 4767 participants in the 2017-2020 National Health and Nutrition Examination Survey (NHANES) were analyzed. Binary logistic regression models, adjusted for age, sex, race, socioeconomic status, smoking, and sleep disturbances, were used to assess the independent and …

A167: Relationship Between Health-Promoting Lifestyles And Physical And Mental Health: A Cross-Sectional Study Among University Students, Ke Wang, Mengzhen Hao, Yangguiyi Zhao

International Journal of Physical Activity and Health

University students’ sedentary behavior, insufficient sleep, and other unhealthy lifestyle habits, compounded by social competition, academic pressure, and digital “screen dependence,” have exacerbated mental health issues and health risks. A health-promoting lifestyle, as a proactive approach to improving well-being, is a key pathway to alleviating these challenges. This study explores the relationship between health-promoting lifestyles and physical and mental health, providing scientific evidence for university health interventions. Method: A stratified random sampling method was used to select 1,383 male undergraduate students as the study sample. During the spring semester of 2021, researchers distributed a demographic questionnaire, the Health-Promoting Lifestyle Profile-II …

Protocol For The Development Of The Who Gestational Weight Gain Charts, Thais Rangel Bousquet Carrilho, Olufemi Taiwo Oladapo, Jennifer A. Hutcheon, Giovanna Gatica-Domínquez, Kathleen M. Rasmussen, Monica C. Flores-Urrutia, Richard Kumapley, Ӧzge Tunçalp, Dang Bahya-Batinda, Amel A. Fayed, Annick Bogaerts, Aris T. Papageorghiou, Cinthya Muñoz-Manrique, Dayana Rodrigues Farias, Eric Ohuma, Harshpal Sachdev, Hayfaa A. Wahabi, Helena J. Teede, Molin Wang, Nandita Perumal Phd

Faculty Publications

Introduction Gestational weight gain (GWG) is an important indicator of maternal nutrition to be monitored during pregnancy. However, there is no evidence-based tool that can be used to monitor it across all geographic locations and pre-pregnancy body mass index (BMI) categories. The WHO is undertaking a project to develop GWG charts by pre-pregnancy BMI category, and to identify GWG ranges associated with the lowest risks of adverse maternal and infant outcomes. This protocol describes all the steps that will be used to accomplish the development of these GWG charts.

Methods and analysis This project will involve the analysis of individual …

Factors Influencing Sugary Drink Consumption Among Residential Students At Liberty University, Chinonso Felistas Eziechi

Masters Theses

Introduction/Background: Sugary drink consumption among college students remains a public health concern due to its association with obesity, diabetes, and cardiovascular disease. Despite high awareness of health risks, consumption among emerging adults remains elevated. Guided by the Social Cognitive Theory, this study examined the psychosocial, behavioral, and environmental determinants of sugary drink consumption among residential students at Liberty University. Objective: To identify key predictors of sugary drink consumption and evaluate how expectations, self-regulation, and environmental factors shape beverage behaviors. Design, Setting, Participants: This cross-sectional study used an anonymous Qualtrics survey distributed on campus. Of approximately 745 eligible residential students, 473 …

Unseen But Felt: Exploring The Emotional And Developmental Impacts Of Father Absence On The Lives Of African American Daughters, Michelle Laniece Mayberry

Doctoral Dissertations and Projects

This phenomenological study explored the lived experiences of African American daughters who grew up with absent fathers, examining how this experience influenced development, relationships, identity formation, and resilience. Through in-depth interviews and thematic analysis, six central themes emerged: (1) father-daughter relationship, (2) emotional and psychological impact, (3) identity and development, (4) social and relational outcomes, (5) decision-making and achievement, and (6) resilience and adaptation. Each theme was interpreted through the lens of attachment and social learning theories with a biblical worldview. The findings revealed that father absence often left emotional and developmental wounds in the lives of the participants. The …

Respiratory Health And Environmental Risks Among California Children: The Role Of Socioeconomic Status, Wen Chieh Chia

Walden Dissertations and Doctoral Studies

Abstract Air pollution has been cited as a factor in the development of respiratory illness in children. Socioeconomic differences can intensify the effects of air pollution exposure on low-income children compared to higher-income children. This correlational study examined the relationship between air pollution exposure and respiratory health outcomes among California children, as well as the moderating role of socioeconomic status. The study was guided by the environmental health disparities framework and used secondary data from the California Environmental Health Tracking Program, analyzing data from 49 California counties (n = 49). Independent variables were PM2.5 concentrations and the number of ozone …

Asian Reference Values For Handgrip Strength, Gait Speed, Five-Times-Sit-To-Stand Test, Muscle Mass And Calf Circumference, Jozo Grgic, Siew Ling Tey, Dieu Thi Thu Huynh, Yen Ling Low, Zeljko Pedisic, Nina Schaller, Vanessa Kristina Wazny, Weilan Wang, Yasuhiko Saito, Ravindra P Rannan-Eliya, Hala Ghattas Ph.D., Monique Chaaya, Carlos Mendes De Leon, Preeti Gupta, Ecosse L Lamoureux, Mythily Subramaniam, Edimansyah Abdin, Rahul Malhotra, Angelique Chan, Bayasgalan Tumenbayar, Oyunbileg Luvsandavaajav, Bolormaa Enkhtuvshin, Norma Mansor, Halimah Awang, Andrea B Maier

Faculty Publications

Background:Handgrip strength, gait speed, Five-Times-Sit-to-Stand Test (FTSST) performance, skeletal muscle mass and calf circumference are important health outcomes, particularly useful for diagnosing sarcopenia. The aim of this study was to establish reference (normative) values for handgrip strength, gait speed, FTSST performance, skeletal muscle mass and calf circumference by pooling individual participant data from national cohorts in Asia.

>Methods:We conducted a pooled analysis of individual participant data from 20 national cohorts representing 12 Asian countries (China, India, Indonesia, Israel, Japan, Lebanon, Malaysia, Mongolia, Philippines, Republic of Korea, Singapore and Sri Lanka). We included cohorts with data on at least …

Dual Challenges, Shared Wins: Unlocking Climate Financing For Nutrition, Chiara Dell’Aira, Natalia Rovelo-Velazquez, Sarah Lahaye, Xiu Xin Catherine Lok, Stella Nordhagen, Stephen Dorey, Mireya Vilar-Compte

Department of Public Health Scholarship and Creative Works

Background

The intertwined challenges of climate change and malnutrition amplify each other, with climate change exacerbating malnutrition, particularly in vulnerable populations; and food systems significantly contributing to emissions and environmental degradation. Addressing these issues together offers opportunities for shared gains, yet funding streams for these sectors remain siloed and misaligned.

Objective

This study developed a scoring methodology to assess the compatibility of climate funds with financing nutrition-related actions where synergies align with climate funds’ primary goals, referred to as the “scope for nutrition integration”.

Methods

Using the Climate Funds Update database, 18 active climate funds were systematically reviewed …

Advancing Screening For Intimate Partner Violence In Pregnant Individuals Throughout The Perinatal Period To Prevent Adverse Pregnancy And Maternal Outcomes, Emilia R. Valdez

Nursing | Senior Theses

Background: Intimate Partner Violence experienced by pregnant individuals contributes to adverse pregnancy outcomes and maternal health. A mother’s exposure to Intimate Partner Violence (IPV) can affect their ability to carry a healthy pregnancy to term (38 – 40 weeks gestational age) and places them at risk for comorbidities including; Preterm birth, Intrauterine Growth Restriction, Low Birth Weight/ Small for Gestational Age, Premature Rupture of Membranes and Miscarriage. The incidence of IPV screening is not accessible to all pregnant individuals due to healthcare providers lack of education, time constraints in the workplace, bias and discomfort towards IPV. The implementation of IPV …

Guidelines For Community Engaged Health Research, Carrie Leach, Hayley Thompson, Alex Sass, Patricia Wren, Rodlescia Sneed, Rhonda Dailey, Elizabeth Towner, Maha Albdour, Carla Caringi, Alyssa W. Beavers, Theresa A. Hastert, Vanessa Rorai, Peter A. Lichtenberg, Angulique Outlaw, Ijeoma Nnodim Opara

Institute of Gerontology

Executive Summary:

Wayne State University’s Guidelines for Community Engaged Health Research provide a practical framework for designing, conducting, and evaluating ethical, equitable, and impactful health research that engages community experts in projects that advance health equity in Detroit.

Purpose 

Developed for WSU faculty, staff, and research teams, the guidelines support the meaningful involvement of community experts across all phases of research. They respond to common challenges in community-engaged work, including limited experience with engagement approaches, the need for reflexive and equitable practices, and the time and coordination required for authentic collaboration.

The document defines Community-Engaged Research (CEnR) as collaborative work …

Sleepiness In Pregnancy And Adverse Perinatal Outcomes, Rachel Friedlander, Xiaoning Huang, Phyllis Zee, Sadiya S. Khan, Philip Greenland, Francesca L. Facco, Judith Chung, William A. Grobman, Shalini Manchanda, Uma M. Reddy, George R. Saade, Robert M. Silver, Lynn M. Yee

Department of Obstetrics & Gynecology Faculty Publications

Background

Sleep disorders in pregnancy have been associated with adverse pregnancy outcomes including hypertensive disorders of pregnancy, preterm birth, and gestational diabetes mellitus, yet these findings are largely from retrospective studies. Using data from a prospective study that used validated tools to assess sleepiness in pregnancy, we aimed to assess the association of sleepiness in pregnancy with adverse pregnancy outcomes.

Methods

In this secondary analysis of data from a large, diverse prospective cohort of nulliparous individuals conducted at eight United States medical centers, those with self-reported sleep data were included. Sleepiness was evaluated in early (6-13 weeks) and mid-pregnancy (22-29 …

Meta-Analysis: Diabetes Mellitus And The Risk Of Endometrial Cancer, Tricia Ho, Marika Ongpauco, Han Ha Ngoc Nguyen

Physician Assistant Studies | Graduate Research Papers

Background: Many studies have looked at the relationship between diabetes mellitus and development of endometrial cancer. This study provides an updated systematic review and meta-analysis of the estimated effect of diabetes and the risk of endometrial cancer.

Methods: Some studies were found on databases such as PubMed and Iceberg. The remaining studies were extracted from the initial studies found. Binary data was collected and the raw data was imputed into a Fixed Effects Model.

Results: A total of 25 studies were included in this meta-analysis, generating statistically significant results (p < 0.001, OR 2.05, 95% Cl 1.92-2.19).

Discussion: Diabetes is found to be …

Child Poverty And Nutritional Health In Rural And Non-Rural Ohio Counties, Viraj Chegu, Macy Puthoff

Scholarship in Medicine - All Papers

Child poverty is an ongoing issue in the United States, placing children at a risk of nutritional deficits. While community interventions and reduced price school lunch programs have improved food insecurity outcomes for children, there is limited knowledge of how these programs can alleviate potential health problems in rural versus urban areas. Thus, this project aims to compare various variables such as food environment index, food insecurity, and enrollment in reduced price school lunch among counties in Ohio of different poverty levels as well as whether the counties are rural or nonrural. Methods: Factors such as food insecurity, food environment …

Childhood Factors That Affect Adult Obesity In Ohio And Mississippi, Rhea Lal, Danielle Wolford

Scholarship in Medicine - All Papers

Over 40% of adults in the United States struggle with obesity. While several social determinants of health have been tied to obesity, only limited research on the effect of childhood education, food environments, and physical activity resources on a state-wide level has been conducted. It is imperative that we identify connections between obesity, associated comorbidities, education, and SDoH as these will inform improvements in national social structures and healthcare systems. States Ohio (OH) and Mississippi (MS) differ in high school completion rates, food access, and exercise opportunities yet both states continue to experience rising adult obesity rates. This study analyzed …

Review Of Current Research Describing The Influence Of Non-Health Care Drivers Of Health In Rural And Urban Populations, Katie Youngen, Julia Cecil, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Social determinants of health (SDOH) (also called social drivers of health) are the conditions of the environment where people live, learn, work, and play that are known to affect health outcomes.¹ The primary objective of this literature review is to summarize the most recent literature related to the Healthy People 2030 domains of a) economic stability, b) education access and quality, c) neighborhood and built environment, and d) social and community context.² Our particular focus is on non-health care drivers of health. The secondary objective is to identify gaps in literature applied to rural populations.

Felt Ambivalence Weakens The Attitude-Intention Pathway For Regular Leisure-Time Physical Activity In Chinese Adolescents: A Three-Wavee Prospective Study, Yaogang Han, Yubing Wang, Pan Li, Guohua Zheng

Human Movement Studies & Special Education Faculty Publications

Background: Favorable attitudes toward regular leisure-time physical activity may not always translate into intention if adolescents feel ambivalent about the behavior. This study tested whether felt ambivalence weakens the prospective attitude–intention association and the indirect effect of attitude on later behavior through intention. Methods: Chinese adolescents (N = 1714; Grades 7–12; mean age = 15.0 years) completed a three-wave survey at approximately two-week intervals. Wave 1 assessed attitudes toward regular leisure-time moderate-to-vigorous physical activity, felt ambivalence, and physical activity habit; Wave 2 assessed intention; and Wave 3 assessed leisure-time physical activity. Moderated mediation was tested in a structural equation model …

"It's A Dance": Examining Midwives As Choreographers Of Reproduction In Maine, Annie Goldstein

Honors Theses

This thesis examines the contemporary work of community-based Maine midwives through the theoretical framework of choreography. In the context of this work, choreography can be understood as the well-thought-out, purposeful undertaking of a process during which negotiation, coordination, and improvisation are required to adapt to constantly changing circumstances. Using choreography, this thesis attempts to understand how Maine midwives navigate global market processes and practice under authoritative forms of biomedicine, ultimately linking them to other midwives across various global sites. Situated within Maine’s maternal health landscape that is characterized by the ongoing closure of labor and delivery units and rural hospitals, …

Meconium Metal Concentrations And Infant Temperament And Development, Fiona Fogarty

Dissertations and Theses

BACKGROUND: Prenatal exposure to metals poses significant health consequences for early childhood development. Understanding the factors influencing metal concentrations that infants are exposed to in-utero is crucial for developing targeted interventions, particularly when maternal characteristics and environmental factors, may contribute to varying levels. Meconium offers insight into in-utero exposures for the developing infant, and the effect of each individual metal may be mediated or exacerbated by another and therefore should be studied in the context of a mixture. The effect of metal mixture exposure, as measured in meconium, on milestone and temperament outcomes has yet to be determined.

DESIGN: …

Addressing Obesity And Diabetes In Appalachian Kentucky, Hannah E. Orens

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Type 2 diabetes and obesity are major public health concerns in Appalachian Kentucky. Populations in this region experience much higher rates of chronic disease than the rest of the state, have limited access to preventive care, and ongoing economic challenges that affect health. Many rural counties face increased poverty, transportation challenges, and shortages of healthcare professionals, all of which contributed to poor health outcomes and reduced access to evidence-based prevention programs. As a result, there is a strong need for focused, feasible, community-based interventions that improve access to evidence-based prevention while addressing the social and economic factors influencing health in …

Purchasing A Healthier Future: A Nutrition-Focused, Community-Centered Approach To Reduce Obesity And Diabetes In Graves County, Kentucky, Marissa Stephens

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Obesity and type 2 diabetes are among the most significant public health challenges in the United States, with Kentucky consistently ranking among the states with the highest prevalence of both conditions. Together, these conditions contribute to reduced quality of life, rising healthcare costs, and increased morbidity and mortality, underscoring the need for targeted, community-centered interventions. The disease burden of obesity and diabetes is particularly pronounced in rural areas, including the state’s westernmost region, the Jackson Purchase. Among rural populations, chronic disease risk is driven by a combination of factors, including low socioeconomic status, limited access to healthcare/supermarket options, and food …

Longitudinal Implementation Of A Neurodevelopmental Screening Program For Children Born To Mothers Living With Hiv In Maternal–Child Clinics In Kenya: A Mixed Methods Study, Megan S. Mchenry, Eren Oyungu, Amina Abubakar, Ananda Roselyne Ombitsa, Micaela Gaviola, Cleophas Cherop, Beatrice Kaniaru, Carolyne Jerop, Alan Mcguire, Rachel C. Vreeman

Institute for Human Development, East Africa

Background: Children with perinatal HIV exposure are at increased risk for neurodevelopmental (ND) delays, yet little is known about ND screening implementation for this population.

Methods: This longitudinal study evaluated ND screening implementation at a health clinic in Kenya, from 9/2021 to 8/2023. Children aged 18-36 months with perinatal HIV exposure were screened using a 12-item general ND tool. Implementation outcomes—acceptability, feasibility, fidelity, and sustainability—were assessed through time-motion observations, clinic records, and semi-structured interviews with caregivers and staff.

Results: Of 507 eligible children, 405 (80%) were screened. Screening rates were consistent over 24 months, with average time …

Feeding Missoula: Food Insecurity In Rural Children And Youth, Chani Brammer, Braelee Cheeks, Jordin Holland, Rayne Mccollough, Laurel Palmer, Therese Solomon

Undergraduate Theses, Professional Papers, and Capstone Artifacts

In Montana, approximately one in seven children live in a food-insecure household, with rural Montanans in particular facing significant barriers. Existing needs-based food assistance programs, such as SNAP and WIC, have structural weaknesses: SNAP benefits are often not sufficient to last through the month, and those eligible for these programs face a confusing application process, shame and stigma, and logistical hurdles, such as limited transportation.

“Feeding Missoula” began with an evaluation of how current food assistance programs met or failed to meet the needs of rural youth. Our methodology integrated a comprehensive review of existing literature and structured interviews with …

Increasing Oral-Gut Axis Health Literacy In Underserved Communities With Community-Involved, Pantry-Accessible Nutrition Education: A Conceptual Framework And Program, Audrey Kho, Yinon Gankin, Polina Pine

Chemistry: Faculty Publications and Other Works

In metropolitan U.S. areas, health inequities caused by socioeconomic disparity continue to influence oral health, nutritional status, and the risk of chronic diseases. Diets heavy in added sugars and poor in fiber and vital micronutrients are especially harmful to the oral–gut axis, which connects diet, microbial balance, inflammation, and systemic and neurological health. Due to institutional hurdles to health literacy, limited access to preventive health education, and food poverty, these eating habits are more common among low-income individuals. Only 36% of low-income parents in Chicago report being in good health, compared to 75% of parents with better incomes, underscoring the …

Health Disparities In Cardiovascular Care: The Impact Of Diabetes Education And Post-Discharge Interventions For African American Adults At Risk For And After Myocardial Infarction, Trinity L. Billingsley

Nursing | Senior Theses

Background: Cardiovascular disease is the leading cause of death in the United States, affecting African American adults at higher rates compared to other racial and ethnic groups. Diabetes as a comorbidity is one of the risk factors of experiencing a myocardial infarction, remaining one of the leading causes of death among individuals with diabetes. Objective: To examine the effectiveness of structured diabetes education tailored to African American adults who are at risk for and after a myocardial infarction. Additionally assessing the complications of a myocardial infarction, the outcomes associated with structured education will be compared to the outcomes of …

The Association Between The Degree Of Social Vulnerability And Maternal Anemia And Other Adverse Perinatal Outcomes, Rubymel J. Knupp, Christina T. Blanchard, Ariann Nassel, Ashley Shea, Lindsay S. Robbins, Jeff M. Szychowski, Ashley N. Battarbee, Akila Subramaniam

Department of Obstetrics & Gynecology Faculty Publications

Objective

Maternal anemia in pregnancy is associated with many adverse maternal, fetal, and neonatal outcomes. The role of social determinants of health (SDOH) in the development of maternal anemia and other adverse outcomes is continually evolving. One such newer tool, the Social Vulnerability Index (SVI), measures an individual's community-level SDOH, with higher SVI denoting higher vulnerability. Our objective was to evaluate the association between SVI, maternal anemia, and other adverse perinatal outcomes.

Methods

Retrospective cohort study of pregnant individuals delivering singletons at a gestational age ≥23 weeks at a single center from 2014 to 2018. Patients with sickle cell disease, …