Digital Commons Network^™

Linking Training To Confidence: A Literature Review On Advancing Nutrition Environments In Child Care Programs, Jeanne M. Vanorsdal

Capstone Experience: Master of Public Health

This comprehensive literature review examined child care nutrition training interventions using the Health Belief Model (HBM) to understand how to increase providers’ ability to serve nutritious food. By analyzing HBM constructs such as perceived severity, benefits, and barriers, the review assessed how training influences provider abilities and identified barriers and facilitators to consistently offering healthy meals and snacks. Studies were 1) published in English; 2) research conducted in the United States; 3) population involved home-based or center-based child care providers caring for children from birth to age 5; 4) articles published from January 1, 2015, to October 5, 2025; 5) …

Association Of Epigenetic Age Acceleration And Mitochondrial Dna-Based Aging Metrics Provides Insights Into Mechanisms Of Aging-Related Diseases, Mengyao Wang, Yinan Zheng, Meng Lai, Emmanuel Saake, Xue Liu, Xiuqing Guo, Kent D Taylor, Tianxiao Huan, Roby Joehanes, Drew R Nannini, Kai Zhang, Nicole J Lake, Christina A Castellani, Stephen S Rich, Jerome I Rotter, Yongmei Liu, Laura M Raffield, April P Carson, Myriam Fornage, Jiantao Ma, Dan E Arking, Lifang Hou, Daniel Levy, Chunyu Liu

Faculty, Staff and Student Publications

Investigating the interplay between mitochondrial DNA (mtDNA) variations and epigenetic aging metrics may elucidate biological mechanisms associated with age-related diseases. We estimated epigenetic age acceleration (EAA) metrics from DNA methylation data and derived mtDNA metrics, including heteroplasmic variants and mtDNA copy number (mtDNA CN) from whole genome sequencing. Linear regressions and meta-analyses were conducted to assess associations between EAA and mtDNA metrics, adjusting for chronological age, self-identified sex, and other covariates in 6,316 participants (58% female, 41% non-White Americans). Mediation analysis was conducted to examine whether EAA mediated the relationship between mtDNA CN and metabolic traits. A higher burden of …

Assessing Post-Pandemic Engagement In The Supplemental Nutrition Program For Women, Infants, And Children (Wic) In Northeast Tennessee, Christen Minnick

Electronic Theses and Dissertations

Since 1974, the federal Supplemental Nutrition Program for Women, Infants, and Children (WIC) has provided healthy food resources, nutrition education, and provider referrals for families at risk for poor nutrition. Public health professionals have consistently presented evidence that WIC engagement reduces premature births and infant mortality, improves child health and development, and increases specialized care access for participants. While average monthly participation in WIC has increased since the program’s inception, trends indicate that only around half of eligible families have consistently engaged with the program since 2011. Research has linked declining WIC participation to administrative burden, citing learning, psychological, compliance, …

Pet Ownership And Health-Related Quality Of Life Among Middle-Aged Adults, Kristi Martin

Walden Dissertations and Doctoral Studies

Pet ownership continues to be part of modern society in the United States. Researchers have explored pet ownership’s impact on chronic diseases and aging populations, but research on health-related quality of life is limited. Grounded in the socioecological model, this quantitative study analyzed data from the 2005-2006 National Health and Nutrition Examination Survey (N = 10,348) to investigate the impact of pet ownership on health-related quality of life among low-income adults aged 30-50 years. Chi-square tests were performed to analyze the associations between age, income, gender, and race with three health-related quality of life metrics. Results showed no statistically significant …

Letter From The Editor, Sarah J. Nechuta

Michigan Journal of Public Health

No abstract provided.

Deficiencies In Non-Emergency Medical Transportation For Aging Rural Residents Of Iosco County, Michigan, Richard L. Douglass, Donald Stansloski, James Mortimer, Sam Purdy, Dale Evilsizer, Scott Rice

Michigan Journal of Public Health

Introduction: The rural aging population in Michigan struggles to access medical care often available only at significant distances due to limited health system resources and provider shortages. Access to routine care is challenged by lack of non-emergency medical transportation (NEMT). The Iosco County Commission on Aging provides home-delivered meals to eligible county residents. The Rural Health Group investigated the needs of home-delivered meal recipients (aged ≥60 years) for healthcare transportation access. Utilizing data from this investigation, we examined if medical care needs were hindered by problems with transportation in rural Iosco County, Michigan.

Methods: We conducted a cross-sectional survey with …

A Community-Based After-School Wellness Camp’S Effect On Healthy Habit Beliefs, Staci A. O'Brien, Ranelle Brew, Madeline Krawciw, Jodie Seese, Tess Scheidel

Michigan Journal of Public Health

Introduction: Children in the United States face declining physical activity, poor nutrition, and increasing mental health concerns. As school time for wellness declines, out-of-school programs offer an alternative to promote healthy habits to students. A community-driven, multi-component after-school wellness camp was developed in response to a small-town needs assessment and implemented at a local elementary school to determine whether it would change participants’ beliefs held towards healthy habits.

Methods: Third to fifth graders at a local elementary school in Lowell, Michigan, participated in an after-school wellness camp for four weeks through education and hands-on activities focused on physical …

Associations Between Food Insecurity And Gpa Among Full-Time California State University Undergraduates During Covid-19: The Impact Of Mental Health, Lindsey Jones

Master's Theses

Food insecurity is a persistent public health concern among college students that has been associated with student’s academic and mental health outcomes. This thesis examined the associations between food insecurity, academic performance (measured by GPA) and mental health (using Kessler 6 psychological distress and self-perceived mental health impacts on academic performance), among full-time undergraduate students within the California State University (CSU) system. Cross-sectional analyses were conducted using data from the Spring 2021 CSU National College Health Assessment, administered across all 23 campuses. Of the 20,167 respondents, 12,899 students were included in the analytical sample. Bivariate analyses were conducted to analyze …

Metabolomic Signatures Of Prediabetes In Mexican Americans: The Role Of Genetics And Macronutrients, Shinhye Chung, Charles Evans, Charles F Burant, Han Chen, Bing Yu, David Aguilar, Eric L Brown, Craig L Hanis, Goo Jun

Faculty, Staff and Student Publications

Prediabetes is one of the main health concerns in public health, and various etiological factors contribute to its onset. This study aimed to evaluate genetic associations and gene‐macronutrient interaction with prediabetes‐related metabolites to understand how genetic variation and dietary intake contribute to dysglycemia. We analyzed a total of 482 self‐identified Mexican American participants recruited from Starr County, Texas in 2018‐2019. Untargeted metabolomic profiling was performed using LC‐MS. Nutrient densities of six macronutrients were derived from a 106‐item food frequency questionnaire. Genetic associations for each metabolite were tested using Generalized linear Mixed Model Association Tests (GMMAT). Gene‐macronutrient interactions on prediabetes‐associated metabolites …

Maternal Folic Acid Supplement Use, Folate Intake, And Preterm Birth Among Infants With Spina Bifida, Renata H Benjamin, Katherine L Ludorf, Rachel P Allred, Jenil R Patel, Wendy N Nembhard, Gary M Shaw, Suzan L Carmichael, Tania A Desrosiers, Eirini Nestoridi, Eva M Williford, A J Agopian

Faculty, Staff and Student Publications

Background: We sought to assess the extent to which folic acid supplementation and dietary folate intake are associated with preterm delivery among infants with spina bifida.

Methods: We conducted a retrospective population-based study using the National Birth Defects Prevention Study (NBDPS; 1999-2011) and the Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS; 2014-2019). We utilized robust Poisson regression to calculate the risk ratio (RR) and 95% confidence interval (CI) for the associations between preterm birth (< 37 weeks) and maternal use of folic acid-containing supplements, dietary folate intake quartile, and a combined variable accounting for supplementation and dietary folate status.

Results: Among 1199 infants with spina bifida (1011 in NBDPS, 188 in BD-STEPS), 217 (18.1%) were born preterm. There were no statistically significant associations …

Understanding Dental Hygienists’ Knowledge, Attitudes, And Practices Regarding Hpv Vaccination, Paula M Cuccaro, Jihye Choi, Kawtar Zouaidi, Efrat K Gabay, Michael Mackert, Josefine Ortiz Wolfe

Faculty, Staff and Student Publications

The American Dental Association and American Academy of Pediatric Dentistry encourage oral health professionals to strongly recommend human papillomavirus (HPV) vaccination to prevent HPV-associated oropharyngeal cancer. This study examined oral health professionals' knowledge, attitudes, and practices regarding HPV vaccination. We used purposive sampling to recruit participants through state and national oral health societies and social media platforms. Flyers outlining eligibility criteria were distributed, and eligible participants completed an online survey. Primary measures included participants' HPV-related knowledge, attitudes, and practices, and willingness to receive HPV-related training and recommend HPV vaccination to patients, including parents of adolescents. Only responses from dental hygienists …

Updated Prevalence Estimates Of Obesity Among Adults In The United States, 2005–2018, Ashley W. Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

Introduction

Body mass index is an imperfect measure of excess adiposity but is ingrained in both research and clinical practice to define and diagnose adult obesity. The addition of waist circumference measure is recommended to fully capture obesity-related health risks at a population level. The latest reframing of obesity by the Lancet Commission relies on body mass index and waist circumference, as well as organ dysfunction and functional limitations, to differentiate between preclinical and clinical obesity.

Methods

Using data from the National Health and Nutrition Examination Survey (2005–2018), we adhere to the proposed redefinition to examine obesity trends in the …

Combine Ebis: A Novel Collaborative Method For Building Interventions From Existing Evidence-Based Interventions, Justin Knox, Kara Portier, Christopher Magana, Maggie Denning, Christopher M Ferraris, Emily Dove-Medows, Cho-Hee Shrader, Ohemaa Poku, Phil Kreniske, Robert Remien, Efrat Aharonovich, Jennifer C Elliott, Denis Nash, Kathryn Lancaster, Till Baernighausen, Kayo Fujimoto, Adam Carrico, John A Schneider, Alida Bouris, D Scott Batey, Sheree R Schwartz, Jose Bauermeister, Patrick S Sullivan, Joseph G Rosen, Gina Wingood, Milton Wainberg, Deborah Hasin, Elvin Geng, Patrick A Wilson, Stefan D Baral

Faculty, Staff and Student Publications

Purpose: Combining evidence-based interventions (EBIs) is a discrete process from adapting EBIs, and specific guidance for how to combine EBIs could be helpful amidst the proliferation of frameworks that combine and stage EBIs and calls for services to be combined or bundled. To address this gap, we developed and applied the COllaborative Method for Building INterventions from Existing Evidence-Based Interventions (COMBINE-EBIs) approach, a five-step process for combining EBIs.

Methods: The five steps of COMBINE-EBIs are: (1) Identify and Select EBIs, (2) Develop a Shared Conceptual Model, (3) Evaluate the Conceptual Model, (4) Create a Single Combined Protocol, and (5) Refine …

Potential Adverse Effects On Lifestyle And Food Intake Pattern In Night Shift Workers, Stacie L. Coleman

Electronic Theses, Projects, and Dissertations

Abstract

Night shift work is prevalent in healthcare and other industries, yet its effects on lifestyle factors such as food intake, sleep quality, and mental health remain underexplored. This study investigates the impact of night shift schedules on nurses’ wellness, focusing on eating patterns, sleep, physical activity, and mood. A sample of 13 nurses were divided into two shift groups: day (n=5) and night (n=8); and they completed a questionnaire to assess the variables related to their behavior, food choices, eating habits, sleep patterns.

The results of previous research studies indicate that night shift nurses are more likely to adopt …

Prevalence And Trends Of Coexisting Forms Of Malnutrition And Its Associated Factors Among Children Aged 6–59 Months In South And Southeast Asia, 1996–2022: A Cross-Sectional Time Series Study, Wenjie Guo, Maggie Zgambo, Sanmei Chen, Yoko Shimpuku

Research outputs 2022 to 2026

Background: South and Southeast Asia face severe malnutrition in children under five, with coexisting forms of malnutrition (CFM) exacerbating mortality risks and posing greater challenges than isolated forms of malnutrition. We aimed to assess the prevalence, trends, and factors of CFM among children aged 6–59 months in South and Southeast Asian countries and the entire region. Methods: We used anthropometric and hemoglobin data from 515,170 children aged 6–59 months in seven low- and middle-income South and Southeast Asian countries, based on Demographic and Health Surveys conducted between 1996 and 2022. Weighted multivariable logistic regression was performed to identify the sociodemographic …

A Cross-Sectional Audit Of The Australian Community Food Environment Highlights The Prominent Role Of Chain Food Outlets, Claire Elizabeth Pulker, Lucy Meredith Butcher, Frith Klug, Clare Whitton, Gina S.A. Trapp

Research outputs 2022 to 2026

Background: Food retail and food service outlets can be part of a chain, or independently operated. Chain food outlets are likely to have the most influence over community food environments but have not been routinely identified in studies which map and monitor access to food, highlighting an important knowledge gap. This study aimed to identify the food retail and food service outlets present within metropolitan Perth, including presence of chain and independent food outlets; and examine differences across local governments. Methods: A nutrition-focused classification framework was applied to all food businesses registered by 32 local governments in Perth, Western Australia, …

Feasibility Of Home-Based Urine Collection In Children Under 5 Years In The Origins Birth Cohort Study: Mixed Method Protocol And Sample Completion Results, Courtney D.A. Kidd, Najma A. Moumin, Andrea Macrae, Tim J. Green, Desiree T. Silva, Susan L. Prescott, Nina D’Vaz

Research outputs 2022 to 2026

Background: Urine is an attractive biospecimen for nutritional status and population health surveys. It is an excellent non-invasive alternative to blood for appropriate biomarkers in young children and is suitable for home-based collection, enabling representative collections across a population. However, the bulk of literature in this population is restricted to collection in primary care settings. Feasibility of home-based collection at scale has not been tested. Here, we describe a mixed method approach to collect urine samples in a large cohort study with children under 5 years. Methods: The ORIGINS Project is an ongoing birth cohort investigating early life influences on …

Analysis Of Public Knowledge, Attitudes, And Practices In Food And Drug Selection In Indonesia, Tina Wikara, Sri Astuti, Sri Nurhayati, Rotua Uli Carolina, Evi Ratna Sari

Kesmas

As consumers, the public plays a vital role in ensuring the safe and appropriate use of products. This study aimed to assess awareness of food and drug safety and quality among the Indonesian population. Using a cross-sectional survey, the authors measured public awareness across three key dimensions: knowledge, attitudes, and practices. Data were collected from 20,610 respondents aged 17–65 years from 34 provinces in Indonesia. The survey approach employed a three-stage stratified sampling design. Data were collected through structured face-to-face interviews, and the results were presented as an index ranging from 0 to 100 (low to high awareness). The respondents …

Post-Release Health Insurance Utilization Among Ex-Prisoners: A Scoping Review, Icha Khaerunnisa, Megah Andriany, Luky Dwiantoro

Kesmas

The lack of health insurance coverage after prison release significantly reduces access to essential healthcare services, hindering the continuity of care during community reintegration. The evidence on studies of health insurance use following prison release is limited. This scoping review aimed to summarize research on health insurance utilization after release from prison. Literature searches were conducted across databases including ScienceDirect, PubMed, and Scopus. Relevant articles were selected through a two-stage screening process. Data were extracted from the included studies and presented in tabular and descriptive formats. The keywords used were "health insurance AND post-release" and "inmates OR prisoners." This scoping …

Workplace Policy And Associated Factors Of Minimum Acceptable Diet Practices: An Online Survey Among Working Mothers In Indonesia, Fadhila Iswi Deandra, Judhiastuty Februhartanty, Muchtaruddin Mansyur

Kesmas

Working mothers in Indonesia may influence complementary feeding practices, particularly their ability to ensure that their infants properly meet the minimum acceptable diet (MAD). In this cross-sectional study, an online survey was distributed through various online platforms where participants were recruited using convenience sampling. The questionnaire covered sociodemographic factors, workplace policies, and infant and young child feeding (IYCF) practices. Descriptive and logistic regression analyses were conducted. A total of 394 working mothers participated, of which over 90% of the respondents reported meeting minimum dietary diversity, minimum milk frequency, minimum milk feeding frequency, and MAD indicators as assessed with a standardized …

Challenges And Policies For Female Sex Workers’ Readiness To Participate In Pre-Exposure Prophylaxis Program: An Explorative Qualitative Study, Rico Januar Sitorus, Anita Rahmiwati, Diana Dewi Sartika, Elvi Sunarsih, Asri Maharani

Kesmas

The prevalence of human immunodeficiency virus is high among female sex workers (FSWs) in Indonesia, underscoring the need for integrated prevention strategies supported by strong government policies. This study aimed to investigate FSWs' willingness to participate in a pre-exposure prophylaxis (PrEP) program. This qualitative study employed semi-structured interviews with 20 participants residing in Pangkal Pinang City, Indonesia (4 stakeholders and 16 FSWs), recruited through purposive sampling. Data were collected from July to September 2024. This non-probability sampling method was adopted due to the focus on specific study objectives and a targeted population. The analysis of the interviews revealed three theme …

Gender Differences In Healthy Eating Index As Informed By The Awareness Of Diagnosis Of Metabolic Dysfunction-Associated Steatotic Liver Disease, Wei Ting Lin, Madeline Novack, Suthat Liangpunsakul, Chiung Kuei Huang, Hui Yi Lin, Po Hung Chen, Tung Sung Tseng, Peng Sheng Ting

School of Public Health Faculty Publications

Background/Objectives: Dietary quality is a driver of metabolic dysfunction-associated steatotic liver disease (MASLD). Men and women often have different levels of adherence to medical advice, but the effect of gender on adherence to dietary advice as a function of awareness of MASLD is understudied. We aim to investigate the differences in diet quality between men and women who are aware of their diagnosis of MASLD compared to their undiagnosed counterparts. Methods: We utilized the National Health and Nutrition Examination Survey 2017–2020 to identify a nationally representative sample of subjects with MASLD, 127 of whom reported a diagnosis of MASLD (diagnosed …

Analyzing The Global Happiness Index, Victoria Hernandez, Christy W. Wachira

SMU Data Science Review

This study explores the Global Happiness Index using data compiled from the OECD and Our World in Data to identify key factors contributing to societal well-being. Six primary predictors were analyzed: GDP per capita, social support, healthy life expectancy, freedom to make life choices, generosity, and perceptions of corruption. Regression and clustering techniques were employed to uncover patterns among countries. By expanding the analytical scope beyond conventional economic and social indicators, this study helps identify new pathways for improving well-being across diverse cultural and economic landscapes. Additional variables such as perceived safety, political engagement, and values related to family and …

The National Landscape On Wellness Culture And Well-Being Best Practices In Healthcare Systems And Academic Institutions: Results From The Fourth National Summit On Promoting Clinician Well-Being, Megan Amaya, Bernadette Mazurek-Melnyk, Josh Winn, Jeff Messinger

Journal of Wellness

Introduction: The health of our nation’s healthcare workforce continues to decline. A comprehensive, whole-system, evidence-based approach is key to a successful wellness initiative and is the foundation for culture change. Building a culture of wellness leads to better mental health outcomes, healthier lifestyle behaviors, higher levels of engagement and job satisfaction, improved patient satisfaction and employee retention, and a positive return (ROI) and value on investment (VOI).

Methods: The purpose of this cross-sectional, descriptive, anonymous survey was to assess the organizational wellness culture of participants who attended the National Summit on Promoting Well-being and Resilience in Healthcare Professionals. …

Epidemiology Of Metabolic Syndrome In Patients With Inflammatory Bowel Disease: A Population-Level Cohort Study From The United States, Aakash Desai, Himsikhar Khataniar, Jana G. Hashash, Priya Sehgal, Francis A. Farraye, Gursimran S. Kochhar

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Epidemiological data on metabolic syndrome (MetS) in patients with inflammatory bowel disease (IBD) are limited.

METHODS: A retrospective cohort study was conducted using the United States (US) Collaborative Network (TriNetX) to obtain data for patients with IBD between 2010 and 2023. The primary aim of the study was to estimate the prevalence of MetS in ulcerative colitis (UC) and Crohn's disease (CD). Prevalence was further characterized by age, sex, race, disease location, IBD medications, history of surgery, and IBD phenotype.

RESULTS: Among 100,890 patients with IBD, metabolic syndrome (MetS) affected 34.4% overall (UC 32.4%, CD 34.3%). Prevalence rose sharply …

Volume 5 November '25 Full Issue, Donna Williams

Journal of the Louisiana Public Health Association

No abstract provided.

Association Between Food Insecurity And Nervous System Disorders In Caddo Parish, La: A Call To Action For Health, Megan Gremillion, Morgan Uebinger, Claire Crosby, Kaitlyn Tholen, Marie Vazquez Morgan, Ammar Husan

Journal of the Louisiana Public Health Association

Background: Food insecurity (FI)–the lack of access to affordable, nutritious food–affects millions of Americans. Caddo Parish, Louisiana, is of interest due to high FI prevalence and socioeconomic risk factors. While FI is known to exacerbate chronic health issues, its association with neurological health remains understudied, especially in high-risk communities. Methods: A cross-sectional study was conducted among adult patients in Caddo Parish in 2022 using Epic Electronic Medical Record data to identify diagnoses of migraine, dementia, and stroke—the top neurological causes of disability-adjusted life years (DALYs) in the United States. FI status was determined using the Hunger Vital Sign screening questionnaire. …

Volume 5 November '25 Cover, Publishing, And Table Of Contents, Donna Wlliams

Journal of the Louisiana Public Health Association

No abstract provided.

The Time-Dependent Association Between Irritable Bowel Syndrome And All-Cause And Cause-Specific Mortality In The Nih-Aarp Cohort Study, Daniela S Gutiérrez-Torres, Fangyu Li, Linda M Liao, Carrie R Daniel, Shreela V Sharma, Ruosha Li, Eric L Brown, Qing Lan, Maki Inoue-Choi, Baharak Moshiree, Paul Albert, Rashmi Sinha, Emily Vogtmann

Faculty, Staff and Student Publications

Introduction: Evidence on the association between irritable bowel syndrome (IBS) and mortality is conflicting. In this study, we estimated the association between IBS and all-cause and cause-specific mortality in the NIH-AARP Diet and Health Study.

Methods: IBS diagnoses between 1994 and 2008 were identified from Medicare claims data, and mortality outcomes through 2019 were obtained through linkage to the National Death Index. Using multivariable Cox proportional hazards regression models, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality within partitioned follow-up time categories (>2-5, >5-8, >8-11, >11-14, >14-17, and >17 years) with adjustment …

Mpox Insights: From Structure To Human Cell Interaction, Md. S. Zaman, Robert C. Sizemore, Draven Rodriguez, Emilio Lopez, S. M. Golam Alam, Suleyman Tufa, Juan C Lopez Alvarenga, Nuraly S. Akimbekov, Mohammed S. Razzaque

School of Medicine Publications

Mpox, a zoonotic viral disease, has emerged as a global concern due to outbreaks in both endemic and non-endemic regions in 2022. Rodents, including African squirrels and Gambian pouched rats, are suspected key reservoirs, with human infections occurring through direct contact with infected animals or bushmeat consumption. Previously confined to rural Africa, mpox has spread via international travel and the exotic pet trade. Human-to-human transmission occurs mainly via respiratory droplets and direct contact with bodily fluids or lesions. The virus has a double-stranded DNA genome within a lipid envelope. Despite lower mutation rates in DNA viruses, mpox has developed mutations, …