Digital Commons Network^™

Focus Group Interview: Perspectives Of Virtual Dietary Counseling Method’S Post Covid-19 Pandemic, Maria Mendoza

Journal of the Symposium of University Research and Creative Expression

Project Mentor(s): Nicole Stendell-Hollis, PhD; Tafere Belay, PhD; Katy Williams; Jessica Tyrrell

The purpose of this study is to examine the perceptions related to different delivery methods of dietary counseling. This qualitative research study will examine the perceptions related to different methods of dietary counseling (telephone calls, video calls, or face-to-face visits). Focus group one contained provider participants (N = 7), which were all RDNs and focus group two hosted patient participants (N = 6). Semi structured interviews were performed asking subjects about any personal experiences related to receiving or providing nutrition education, positive or negative, as they participated in …

Prevalence Of Diabetes Related To Acculturation, Dietary Quality, And Sedentary Lifestyle In Mexican Americans: National Health And Nutrition Examination Survey 2011 To 2018, Kivima Acevedo

Journal of the Symposium of University Research and Creative Expression

Project Mentor(s): David Gee, PhD; Kathaleen Briggs Early, PhD, RDN, CDCES; Katy Williams, MS, RDN

Objective: This study examined the prevalence of diabetes in Mexican American adults (MA-adults) and how risk factors like acculturation, dietary quality, and sedentary lifestyle contribute to the rising rates of diabetes, using the National Health and Nutrition Survey (NHANES) 2011 to 2018 data. Methods: We analyzed the NHANES data of MA-adults and Non-Hispanic White adults (NHW-adults) (n= 10670) for the association of diabetes and its risk factors (dietary habits and sedentary lifestyle) by acculturation levels. Diet quality was assessed using the Healthy Eating Index (HEI). …

Documentation And Referral Of Social Determinants Of Health In New Mexico’S Emergency Departments: International Classification Of Disease, Tenth Revision, Clinical Modification, “Z Codes” (Z55-Z65), Samuel L. Swift, Maya Stefanovic, Roselyn Thalathara

Population Health Research and Scholarship

No abstract provided.

Early-Life Exposure To Organic Chemical Pollutants As Assessed In Primary Teeth And Cardiometabolic Risk In Mexican American Children: A Pilot Study, Vidya S. Farook, Feroz Akhtar, Rector Arya, Alice Yau, Srinivas Mummidi, Juan Lopez Alvarenga, Alvaro Diaz-Badillo, Roy G. Resendez, John Blangero

Human Genetics Publications

Early-life exposure to organic chemicals (OCs) may influence childhood obesity and associated cardiometabolic risk. These conditions have been shown to disproportionately affect minority populations such as Mexican Americans (MAs). However, information on the impact of organic chemicals on cardiometabolic risk in MA children is limited. Therefore, we conducted a pilot study to assess the extent to which exposure to organic chemicals influences cardiometabolic traits (CMTs) in MA children. We recalled 25 children from a previous study and collected 25 primary teeth from them. Chemical analyses of the teeth were performed using established protocols. Target analytes included acetaminophen (APAP); 3,5,6-trichloro-2-pyridinol (TCPy), …

Native Hawaiian Culturally Appropriate Substance Use Disorders Formative Program Evaluation, Kelly J. Penn

Walden Dissertations and Doctoral Studies

Substance use disorders (SUDs) disproportionately affects Native Hawaiians, yet conventional treatments often overlook the cultural, spiritual, and relational foundations of well-being for Native Hawaiians. This gap represents a human services problem, as it perpetuates health disparities, limits recovery, and slows social change within Native Hawaiian communities. The purpose of this qualitative single case study was to identify culturally relevant components for an SUD treatment program tailored to Native Hawaiians. The research question guiding this study was, what are culturally appropriate components for a SUD program for Native Hawaiians. The Nā Pou Kihi framework grounded the exploration of Indigenous approaches to …

Examining Factors Influencing Ultra- Processed Food Consumption Among Liberty University Students Aged 18 And Older, Ginika Rosemary Muomah

Masters Theses

Ultra-processed foods (UPFs) are widely consumed among college students and are linked to adverse health outcomes including obesity, poor mental health, and cardiometabolic disease. Despite their rising prevalence, limited research has examined psychosocial and behavioral factors influencing UPF intake within Christian university settings. This study investigated demographic, behavioral, and psychosocial predictors of UPF consumption among Liberty University students, guided by the Health Belief Model (HBM). A cross-sectional survey of students aged 18 and older (N = 337) was conducted. After excluding incomplete or invalid responses, 276 cases remained. The 25-item survey assessed UPF intake, HBM constructs, and demographics. Descriptive statistics …

Relationship Between Alcohol Use And Obesity In Us Adults Aged 20 To 79, Chinwendu Echefu, Ramona Stone

Public Health Sciences Faculty Publications

Purpose: This is a secondary data analysis carried out to determine the asso- ciation between alcohol use and obesity (BMI) in US adults aged 20 to 79 while adjusting for confounding factors that are known to affect obesity. Methods: The 2017-2018 National Health and Nutrition Examination Survey (NHANES) was utilized to provide a weighted sample of 16,548 adults between the ages of 20 and 79 with valid information for the BMI and for the average alcohol con- sumed per day over the past 12 months. Multivariable regression was done to determine the association between obesity, measured by the Body Mass …

Trajectory Of Iron And Red Cell Parameters In Moderately Anemic Iron-Deficient Pregnant Women Receiving Daily Iron-Folic Acid Supplementation: A Prospective Cohort Study, J. P. Akshaykirthan, Manjunath S. Somannavar, S. Yogeshkumar, M. S. Deepthy, Umesh Charantimath, Amaresh Patil, Mrutyunjaya B. Bellad, Richard Derman, Shivaprasad S. Goudar

Global Health Articles

Background/Objectives: The objective is to study the trajectories of hematologic and biochemical markers in moderately anemic pregnant women receiving oral iron supplementation throughout pregnancy. Methods: This prospective cohort study was conducted from August 2021 to September 2023 involving 315 pregnant women from rural areas of Belgaum, Karnataka, India, with hemoglobin levels between 7.0 and 9.9 g/dL and serum ferritin < 30 ng/mL and/or TSAT < 20%. Participants received iron-folic acid supplementation (IFAS) as per Anaemia Mukt Bharat guidelines. Blood samples were collected to measure various hematologic and iron markers and compared across each visits. Results: We report a complete adherence rate of 95.3% for iron and 97.8% for folic acid supplementation throughout pregnancy and also observed significant improvements in hemoglobin (9.36 (8.55, 9.74) to 12.03 (11.49, 12.72)) g/dL, hematocrit (29.93 ± 2.87 to …

Medical Guidelines For Fibrodysplasia Ossificans Progressiva, Frederick S. Kaplan, Mona Al Mukaddam, Genevieve Baujat, Alberto Hidalgo Bravo, Matthew Brown, Amanda Cali, Tae-Joon Cho, Corrie Crowe, Carmen L. De Cunto, Patricia L. R. Delai, Robert J. Diecidue, Elisabeth Marelise W Eekhoff, Lisa Friedlander, Clive S. Friedman, Zvi Grunwald, Nobuhiko Haga, Edward C. Hsiao, Richard Keen, Joseph A. Kitterman, Charles Levy, Vrisha Madhuri, Rolf Morhart, J. Coen Netelenbos, Christiaan Scott, Eileen M. Shore, Michael Zasloff, Keqin Zhang, Robert J. Pignolo

Department of Oral and Maxillofacial Surgery Faculty Papers

Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare genetic condition characterized by congenital malformations of the great toes and progressive heterotopic ossification (HO) in specific anatomic patterns. Present management summarized here is focused on early diagnosis, assiduous avoidance of injury and iatrogenic harm, symptomatic amelioration of painful flare-ups, and optimization of residual function. Twenty-one members of the International Clinical Council on FOP (ICC) and seven consultants from 15 countries, chosen for their clinical expertise in FOP, developed this summary statement. Further advances in therapeutics will be based on rigorous clinical trials to assess novel and emerging treatment and prevention strategies. A …

Two Essays On Health And Health Behavior In China, Jiamin Tan

Lingnan Theses (MPhil & PhD)

This thesis consists of two empirical studies on elderly mental health and on health behaviors. The first study investigates the long-term impact of childhood hunger on mental health in later life, using data from two nationally representative surveys in China. The study finds that childhood hunger exposure significantly increases the risks of depression and anxiety in later life. These effects are most pronounced among individuals exposed after age 5, suggesting that autobiographical memory formation plays an important role beyond socioeconomic and health pathways. The findings further indicate these impacts can be mitigated through economic interventions, such as welfare programs, and …

Obesity Severity And Cancer Screening In Us Adults, Florina Corpodean, Michael Kachmar, Shengping Yang, Michael W. Cook, Philip R. Schauer, Vance L. Albaugh

School of Medicine Faculty Publications

No abstract provided.

Effect Of Vitamin D Supplementation During Pregnancy And Lactation On The Development Of Infants Born To Tanzanian Women Living With Hiv: A Secondary Analysis Of A Randomised Controlled Trial, Temiwunmi Shobanke, Alfa Muhihi, Nandita Perumal Phd, Nzovu Ulenga, Fadhlun M. Alwy Al-Beity, Christopher P. Duggan, Wafaie W. Fawzi, Karim P. Manji, Christopher R. Sudfeld

Faculty Publications

Background Infants born to pregnant women living with HIV (WLHIV) are at greater risk for morbidity and mortality and may also have poorer developmental outcomes as compared with infants who are not exposed to HIV. Nutrition interventions in pregnancy may affect developmental outcomes.

Objectives This study evaluated the effect of maternal vitamin D supplementation on infant development outcomes.

Design We conducted a secondary analysis of a randomised, triple-blind, placebo-controlled trial of maternal vitamin D supplementation from June 2015 to October 2019.

Setting Antenatal care clinics in Dar es Salaam, Tanzania.

Participants Pregnant WLHIV and their offspring.

Interventions Daily 3000 IU …

Postpartum Conversion Type 2 Diabetes In African American Women With Gestational Diabetes, Guerino Tondreau

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus (T2DM) remains a significant public health concern in the United States, with non-Hispanic Black women bearing a disproportionately high burden of the disease. Although this group has a lower overall prevalence of gestational diabetes mellitus (GDM), those who develop GDM face an increased risk of progressing to T2DM. The purpose of this quantitative, correlational study was to explore the relationship between GDM, physical activity, weight status, and T2DM development among non-Hispanic Black women. Secondary data from the National Health and Nutrition Examination Survey, collected from 2017 through March 2020, were analyzed. The health belief model served …

Inovasi Aplikasi Adhimukti Brata Care Stunting Berbasis Appsheet Untuk Pendataan Status Gizi Anak Di Kabupaten Banggai, Moh. Saputra Tambora, Imelda Hutasoit

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Stunting merupakan masalah kesehatan serius di Indonesia, termasuk di Kabupaten Banggai dengan prevalensi 29,1% pada tahun 2023. Keterlambatan intervensi sering terjadi akibat keterbatasan data gizi anak yang akurat, terbaru, dan mudah diakses. Penelitian ini bertujuan mendeskripsikan pengembangan Aplikasi Adhimukti Brata Care Stunting berbasis AppSheet sebagai solusi pendataan gizi anak secara real-time. Metode yang digunakan adalah research and development (R&D) dengan model prototyping, meliputi tahap analisis kebutuhan, perancangan, implementasi, uji coba teknis, dan penyempurnaan. Data diperoleh dari hasil uji coba aplikasi, observasi proses input, serta masukan pengguna awal yaitu petugas DP2KBP3A, PKB, dan kader posyandu. Hasil pengembangan menunjukkan aplikasi …

Spatial-Temporal Variation Of Diarrhea Among Children Under 5 Years Old Between 2010-2020 In Rwanda, Amans Ntakarutimana Dr., Patrick A. Tschida Dr., Elias Nyandwi Dr.

Journal of Social, Behavioral, and Health Sciences

We used secondary data from the Rwanda Demographic and Health Surveys of 2010, 2015, and 2020 to assess the spatial-temporal variation of diarrhea among children under 5 years old between the years 2010 and 2020 in Rwanda. Stratified descriptive statistics, pairwise comparisons, and logistic regression designs were used for data analysis in SPSS. A statistically significant variation of diarrhea among children under 5 years old was observed across districts, regions, and urban–rural areas but not at the national level between 2010–2020. Some districts of the Western region, including Nyabihu (OR = 2.5), Ngororero (OR = 2.3), and Karongi …

Radio And Television Media And Health-Seeking Behavior Among Women In Rural Northern Nigeria, Olufolake Akeju

Walden Dissertations and Doctoral Studies

Poor maternal health-seeking behavior (MHSB) has contributed to persistently high maternal mortality in rural northern Nigeria. Despite increasing access to health information via media platforms, little is known about the association between media exposure and MHSB in this region. In this study, the association between mass media exposure (radio and television) and MHSB was investigated using institutional delivery as a proxy. The health belief model was applied as the theoretical framework for this study and sought to answer two key questions focused on whether there is an association between media exposure and MHSB in rural northern Nigeria and what the …

The Cost Of Malnutrition In Older Adults In The Mountain West, 2020, Taylor Volk, Anirudh Polagani, Olivia K. Cheche, Kristian Thymianos, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents 2020 data on the annual costs of disease-associated malnutrition for adults aged 65 years and older across the five Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah. The data are sourced from “Advancing Policies for Quality Malnutrition Care in Older Adults: A Toolkit for State Legislators,” a report published by Defeat Malnutrition Today and Women in Government.

The "Secret Of Seven Stones": Short-Term Efficacy Of An Online Intergenerational Sexual Health Education Game For Early Adolescents And Their Parents, Ross Shegog, Christine Markham, Melissa Peskin, Robert C Addy, Sara Dube, Diane Santa Maria, Susan Tortolero Emery, Johnny M Wilkerson, Elizabeth Baumler, Laura Armistead, Pooja Chaudhary, Hsing-Yi Song, Angela Spencer, Jeffery Mclaughlin

Faculty, Staff and Student Publications

Objectives: Intergenerational games offer a potential channel to impact parent-youth sexual health communication. The "Secret of Seven Stones" (SSS) is an 18-level online adventure game and parent website designed to engage parents and youth (11-14 years) in conversations about healthy dating relationships and sexual behavior and to provide sexual health skills training to youth. Study hypotheses were that SSS exposure would increase sexual health parent-child communication, increase youth intentions to delay sexual debut, and reduce youth exposure to situations that promote sexual activity.

Materials and Methods: SSS was evaluated in the homes of parent-youth dyads randomly assigned to intervention ( …

Predicting Weaning Failure From Invasive Mechanical Ventilation: The Promise And Pitfalls Of Clinical Prediction Scores, Maneesh Gaddam, Dedeepya Gullapalli, Zayaan A Adrish, Arnav Y Reddy, Muhammad Adrish

Faculty, Staff and Students Publications

Prediction of weaning success from invasive mechanical ventilation remains a challenge in everyday clinical practice. Several prediction scores have been developed to guide success during spontaneous breathing trials to help with weaning decisions. These scores aim to provide a structured framework to support clinical judgment. However, their effectiveness varies across patient populations, and their predictive accuracy remains inconsistent. In this review, we aim to identify the strengths and limitations of commonly used clinical prediction tools in assessing readiness for ventilator liberation. While scores such as the Rapid Shallow Breathing Index and the Integrative Weaning Index are widely adopted, their sensitivity …

Sex-Specific Associations Between Early Life Unpredictability And Trajectories Of Body Mass Index From Infancy To Adolescence, Emily M. Melnick, Lilybelle K. Deer, Jenalee R. Doom, Hal S. Stern, Curt A. Sandman, Laura M. Glynn, Elysia P. Davis

Psychology Faculty Articles and Research

Objective:

Unpredictability in early life is an understudied aspect of early life adversity that provides important signals to the child about their environment. Recent work shows the predictability of patterns of parental signals on a moment-to-moment timescale sculpts the developing brain during sensitive windows, offering a potential pathway through which early life experiences shape child development. Both experimental non-human animal models and observational human research show sex-specific links between early life exposure to unpredictable patterns of parental sensory signals and aberrant offspring development. The impact of predictability of sensory signals on physical health outcomes, such as BMI, remains unknown. Here …

Evidence-Based Best Practices For Diabetes Education And Self-Care In Appalachia: A Literature Review, Angela J. Occidental, Inga M. Zadvinskis, Jacqueline Hoying

Journal of Appalachian Health

Introduction: The Appalachian Region has a higher prevalence of type 2 diabetes mellitus (T2DM) and associated adverse health outcomes. Although numerous papers report best practices for diabetes care and education, a clinician-friendly, synthesized summary of best practices tailored to Appalachian cultural preferences is lacking.

Purpose: This paper uses the Melnyk & Fineout-Overholt evidence-based framework to identify the best practices for T2DM care and education for Appalachian residents.

Methods: A comprehensive literature search using the databases CINAHL, Academic Search Complete, and PubMed was guided by a PICOT question. Quality appraisals were completed for fifty-two articles; thirty papers were selected to synthesize …

Radon Environmental Health Literacy Among Health Council Participants In Northeast Tennessee, Kawther Al Ksir, Stacy Stanifer, Hadii M. Mamudu, Megan Quinn, Deborah L. Slawson

Journal of Appalachian Health

Introduction: Radon, a radioactive gas, poses significant health risks, including lung cancer, and is prevalent in indoor environments. Understanding radon testing behavior and Environmental Health Literacy (EHL) is crucial for individuals to take appropriate preventive measures.

Purpose: This study assessed radon-related EHL among Health Council participants in seven Northeast Tennessee (NETN) counties and examined associations between sociodemographic factors and EHL levels. Understanding radon knowledge and behaviors within this influential group is critical, as they often serve as trusted public health advocates.

Methods: A cross-sectional survey was conducted from September – November 2023 among Health Council participants across seven counties in …

Prevalence Of Screening Patients For Alcohol Use In West Virginia: A Cross-Sectional Observational Study, Bayan Abuhalimeh, Christopher Waters, R. Constance Wiener

Journal of Appalachian Health

Introduction: Consequences of alcohol consumption are well-established and compounded by physiological changes of aging (increased sensitivity; medication interactions; etc.). Alcohol screening for all ages is recommended, especially as most Americans believe moderate drinking is acceptable. Screening is important in high alcohol use regions, such as rural areas where isolation is more likely, especially for older adults. The Appalachian Region has a significant rural population of older adults. West Virginia (WV) is representative of Appalachia. It is a rural state, has many older adults, and all counties are Appalachian.

Purpose: The purpose of this cross-sectional study is to determine the likelihood …

Addressing The Root Causes Of Population Health In Central Appalachian Virginia, David L. Driscoll, Kol Gold

Journal of Appalachian Health

Introduction: The Southwest Virginia Health Authority (SWVHA) recently commissioned a community health needs assessment (CHNA) to reduce the high rate of preventable health problems in Virginia’s (VA) Appalachian Region. The CHNA took place over a two-year period from 2023 – 2025.

Purpose: This iterative, mixed-method CHNA informed the development of a new iteration of the regional Blueprint for Health Improvement and Health-Enabled Prosperity identifying and prioritizing health issues and develop strategic planning to address them in VA’s three westernmost regional health districts.

Methods: The CHNA followed a sequential mixed methods design to assess the regional health status, the contextual factors …

P.L.A.Y. For All Pilot: Effects Of A Community-Based, Inclusive After-School Program On Physical Activity And Motor-Skill Outcomes, Allison R. Tsuchida, Karl-Richard Hennebach, Erin E. Centeio

International Journal of Physical Activity and Health

After-school programs for physical activity (PA) can contribute to helping children and youth achieve the suggested 60 minutes a day of PA. Previous research also suggests that developing motor competency can positively impact long-term PA participation. Additionally, parent and peer support can help children and youth overcome barriers to PA participation. The primary purpose of this pilot research study was to determine the effects of an inclusive after-school program on PA levels and motor-skill outcomes for children with and without disabilities. A secondary purpose was to examine parental support for physical activity and children’s physical activity and motor skills. 38 …

Secondhand Smoke Exposure Among United States Children With Functional Disabilities: National Health And Nutrition Examination Survey, 2021–2023, Raed A. Bahelah

Population Health Science Publications

Objective

Methods

Results

Monitoring Nutrition Security: Perspectives From A Workshop On Nutrition Security Measurement, Ximena Perez-Velazco, Edward A. Frongillo Jr. Ph.D., Joanne F. Guthrie, Alisha Coleman-Jensen, Mariah D. Ehmke, Christian Gregory, Hilary K. Seligman

Faculty Publications

Nutrition security, an emerging concept distinct from and complementary to food security, has gained increasing interest as a focus of efforts to reduce hunger, improve nutrition, and prevent diet-related health conditions. Yet, unlike food security, which has well-established measures, nutrition security lacks standardized measures for assessment. This gap hinders the ability to evaluate progress in improving nutrition security both in the United States and globally. In September 2024, a workshop to explore how to measure nutrition security was hosted by the United States Department of Agriculture Economic Research Service, in collaboration with the Southern University Agricultural Science Center of Excellence …

The Blacker The Berry: Food Environments And Intake Associated With Perinatal Depression And Secondary Breastfeeding Outcomes Among Black Americans In The St. Louis Metropolitan Area, Najjuwah S. Walden

Brown School Graduate Student Theses and Dissertations

The relationship between the food environment, intake, and health is complex. The purpose of this study was to evaluate if food environments in proximity to Black pregnant women in the St. Louis Metropolitan Area were associated with prenatal eating habits and if these eating habits were associated with the risk of developing depressive symptoms in pregnancy and postpartum. The study also aimed to understand if there was a relationship between prenatal eating habits and the decision to breastfeed and if the onset of postpartum depressive symptoms has any effect on this relationship. Due to the importance of nutrient-dense, anti-inflammatory foods …

First-Time Mothers' Experiences Of Breastfeeding During The Early Postpartum Period In Nairobi, Kenya: A Qualitative Study, Viola Siongei, Rose Maina, Eunice Pallangyo

School of Nursing & Midwifery, East Africa

Background/Aims The rate of exclusive breastfeeding in the first 6 months is still low, despite global active promotion of the practice. The exclusive breastfeeding rate among first-time mothers is much lower than among multiparous women, which has been attributed to difficulties assuming the new role and a lack of breastfeeding skills. This study aimed to gain an in-depth understanding of first-time mothers' breastfeeding experiences and the factors that influence these experiences during the early postpartum period in Nairobi, Kenya.

Methods This qualitative explorative, descriptive study involved 17 purposively sampled first-time mothers at 4–6 weeks postpartum. In-depth, face-to-face semi-structured interviews were …

Platelet Transfusion Practices In The Icu: A Prospective Multicenter Cohort Study, Van Stefan, Raasveld Jorinde, Andrew Flint, Jimmy Schenk, Claudia Van Den Oord, Merijn Reuland, Sanne De Bruin, Jan Bakker, Maurizio Cecconi,, Marcus Lance

Anaesthesiology, East Africa

Objective: There is a lack of comprehensive international data regarding platelet transfusion practices in the ICU. This study aimed to evaluate the current occurrence rate of platelet transfusion in the ICU and provide an overview of platelet transfusion practices including indications for a platelet transfusion, thresholds, (non-)adherence and geo-economic region variations.

Design: International prospective cohort study.

Setting: Two hundred thirty-three centers in 30 countries worldwide.

Patients: All patients 18 years old and older, admitted to the ICU during a single study week, selected by each site from one of the 16 predefined weeks (March 2019 to …