Digital Commons Network^™

Impact Of Military-Related Moves On Spousal Perinatal Depression Screening And Mental Health Services, Chambraia Jones

Walden Dissertations and Doctoral Studies

Maternal depression, including perinatal depression (PND), poses significant public health risks to women, infants, and families. Although routine PND screening is recommended, limited research has examined screening and referrals among military spouses, an underserved population affected by frequent relocations and deployments. This study examined how permanent change of station (PCS) frequency affects PND screening and referrals to mental health services. Grounded in Bronfenbrenner’s socioecological model and the CDC’s social ecological model of health, eight research questions explored associations between PCS frequency, PND screening, referrals, and the moderating roles of military branch and deployment status. A quantitative cross-sectional design was used …

The Relationship Between Prenatal Stressful Life Events And Breastfeeding Initiation Among Mississippi Mothers, Candon Garbo, Katie C. Hall, Disha Jhaveri, Jung Hye S. Lee, Deanna Howington, Mina Qobadi, Mary Wesley

Journal of Public Health in the Deep South

Background: Early initiation of breastfeeding increases the likelihood of exclusive breastfeeding, which can be linked to improving both the mother’s and infant’s health. However, breastfeeding rates in Mississippi continue to be one of the lowest in the United States, with infant mortality and morbidity rates at the highest. Purpose: This study aims to explore the impact SLEs may have on initiating breastfeeding, as research is limited. Methods: Analyzed data from 2016 to 2021 Pregnancy Risk Assessment and Monitoring System (PRAMS) was used to determine a correlation between life stressor experiences during pregnancy and initiation of exclusive breastfeeding with a sample …

Healthy Moms/Healthy Babies Of Mississippi Initial Provider Engagement And Student Feedback Loop Project, Corban Jackson Mph, Jillian Harper-Peavy Lmsw, Imh-E, Starica Harper, Vernesia Wilson Phd, Mph

Journal of Public Health in the Deep South

Background Between 2017 and 2022, 83% of maternal deaths in Mississippi were preventable. Unfortunately, there is a persistent shortage of OB-GYNs in Mississippi, feeding the rise of maternal care deserts and the lapse in collaboration between providers and state maternal health organizations. Purpose Healthy Moms/Healthy Babies of Mississippi, a care management program for high-risk mothers and infants, has partnered with the Mississippi Alliance for Innovation on Maternal Health initiative (AIM) to improve maternal health outcomes through building healthcare networks with existing providers. Methods 33 medical students from the University of Mississippi Medical Center School of Medicine and William Carey University …

Hypertensive Disorders Of Pregnancy And Perinatal Outcomes: Two Prospective Cohort Studies Of Nulliparous Women In India And Tanzania, Andrea B. Pembe, Pratibha Dwarkanath, Amani Kikula, John Michael Raj, Nandita Perumal Phd, Heavenlight A. Paulo, Rajalakshmi M, Christopher P. Duggan, Honorati M. Masanja, Nandini Chopra, Mary M. Sando, Tinku Thomas, Cara A. Yelverton, Alfa Muhihi, Anura V. Kurpad, Wafaie E. Fawzi, Blair J. Wylie, Christopher R. Sudfeld

Faculty Publications

Introduction Hypertensive disorders of pregnancy (HDP) have been linked with increased risk for maternal and offspring complications in high-income settings. However, in resource-limited settings, studies with robust measurement of HDP, including severity and timing, and perinatal outcomes are limited.

Methods We analysed data from two prospective cohorts of nulliparous women in India (n=10 570 pregnancies) and Tanzania (n=10 299 pregnancies) who were enrolled in calcium supplementation trials and had blood pressure and proteinuria assessments throughout pregnancy and at the time of labour and delivery. Generalised estimating equations were used to assess the relationship between HDP severity categories (gestational hypertension, preeclampsia …

When Access Is Not Enough: The Role Of Utilization Barriers In Nutrition Security And Cardiometabolic Risk, Maha Almohamad, Ruosha Li, Natalia I Heredia, Jayna M Dave, Eric E Calloway, Anjail Z Sharrief, Shreela V Sharma

Faculty, Staff and Student Publications

Background: Food and nutrition security are key social determinants of cardiometabolic health. While food security reflects access to sufficient food, nutrition security incorporates the quality, consistency, and usability of food that supports long-term health. However, few studies have examined how household-level barriers to food utilization shape these relationships. Objective: This study assessed whether tangible (e.g., equipment, storage) and intangible (e.g., time, knowledge) food utilization barriers modify the associations between food and nutrition security and cardiometabolic outcomes in low-income adults.

Methods: A cross-sectional survey was conducted among 486 low-income adults across five U.S. states. Participants reported household food security (USDA …

Cardiovascular Health In Cardiac Rehabilitation: Applying The American Heart Association Life's Simple 7 Framework In A Center-Based Cohort, Audry Chacin-Suarez, Tomoaki Hama, Matthew P. Johnson, Helayna Abraham, Thomas P. Olson, Laprincess C. Brewer

Einstein Health Papers

BACKGROUND: Cardiac rehabilitation (CR) is a comprehensive secondary cardiovascular disease program with structured lifestyle interventions to reduce morbidity and mortality. The American Heart Association cardiovascular health (CVH) framework measures health-promoting behaviors and clinical factors, but it has not been rigorously evaluated in the CR setting.

METHODS: This retrospective cohort study analyzed patients attending CR from January 2018 to September 2020. Patients were evaluated at baseline (pre-CR) and completion (post-CR) using 3 clinical factors (blood pressure, cholesterol, and hemoglobin A1c) and 4 health behaviors (smoking, body mass index, physical activity, and diet). CVH score was computed as a composite of each …

How Do Montessori-Based Activities Affect Behaviors For Older People With Dementia: A Literature Review, Isabel Quigley

University Honors Theses

Objectives: This literature review is meant to analyze the development on the research on Montessori-based activities for adults with dementia.

Introduction: Baby Boomers are the largest generation to enter senior age (65+) in history due to the advancement in medicine to increase life expectancy. Dementia is a neurocognitive disease that affects parts of the brain related to memory and signs typically surface around 65 years old. Dementia is not considered healthy aging. Montessori-based activities have been recently developed as an intervention to encourage a feeling of accomplishment and success for adults with dementia.

Methods: Two electronic databases …

Predictive Model For Hemoglobin Levels Using Multiple Linear Regression, Dien Gusta Anggraini Nursal, Muhammad Daffa Atthariq Winata, Nohan Arum Romadlona, Noura Rizki, Sabillah Nasitoh, Muhammad Sakhi Baretta

Journal of Health Research

Background: Anemia is a condition in which the number of red blood cells or hemoglobin (Hb) levels fall below normal, limiting the ability of blood to transport oxygen effectively. This study aimed to develop a predictive model for Hb levels by identifying significant risk factors.

Method: This observational analytic study was conducted among 103 randomly selected students of Bung Hatta University in Padang, Indonesia. Data were collected with a questionnaire and a hemoglobin test between April to May 2024. Pearson’s correlation analysis and multiple linear regression were performed in this study.

Results: Bivariate analysis showed significant correlations between Hb levels …

Nafld Surveillance In The Alaska Native/American Indian Population, Wileina Saumara Rhodes

Walden Dissertations and Doctoral Studies

In the United States, the prevalence of NAFLD is estimated at 24% of the population, and by 2030, the incidence of NAFLD will increase to 100.9 million cases. This study aimed to determine the prevalence and rate of non-alcoholic fatty liver disease (NAFLD) progression in the Alaska Native/ American Indian population (AN/AI) with and without elevated liver function tests. Two research questions guided the study: Do outcomes (abnormal/normal) of LFTs, A1C, lipids, BMI, and inflammatory markers predict or have a relationship with NAFLD progression? Does NAFLD surveillance have a relationship with the patient’s outcome as measured by the NAFLD Fibrosis …

Food Environments And Mental Health: Analyzing The Impact Of Fast-Food Availability On U.S. Adults (2011-2016), Nicole Tenner

NYMC Student Theses and Dissertations

This study investigates the relationship between the availability of fast food in US territories and mental health outcomes. Utilizing a cross-sectional design, the study examines data from the 2011 and 2016 Behavioral Risk Factor Surveillance System (BRFSS) from the CDC, along with data from the U.S. Department of Agriculture’s Food Environment Atlas. The analysis included a nationally representative sample of 351,823 participants across all 50 US states. Multiple regression models examined the association between fast food availability and two primary mental health outcomes: the number of self-reported poor mental health days and the likelihood of being diagnosed with a depressive …

One Health Integration To Control And Prevent Zoonoses: Application Of Organizational Theory Literature, Lisset M. Dumet Poma, Sherril Gelmon, Julia M. Goodman, Seth E. O’Neal

Hatfield Graduate Journal of Public Affairs

Zoonoses are infectious diseases transmitted between animals and people that disproportionately affect low- and middle-income countries (LMICs). The One Health (OH) approach aims to integrate systems, incentivizing collaboration among animal, human, and environmental systems to address zoonoses and improve health. Innovative solutions for effectively and sustainably achieving systems integration are needed. Organizational theories can facilitate the study of the context of OH implementation, applying comprehensive approaches that recognize the interconnections among organisms, the environment, and social systems, including the diverse entities needing integration (e.g., policy, community, public organizations). This narrative review examines organization and systems literature to provide recommendations for …

Community Perspectives On Cancer And Cancer Research: Findings From Listening Sessions With Diverse Groups In Philadelphia, Karen Glanz, Emma A. Soliva, Krista Scheffey, Yawei Song, Charnita Zeigler-Johnson, Evelyn T. González, Thierry Fortune, Nilsa Graciani, Amy E. Leader

Kimmel Cancer Center Faculty Papers

BACKGROUND: Listening sessions are useful for understanding community perspectives on cancer disparities. The Philadelphia Communities Conquering Cancer (PC3) coalition conducted listening sessions to identify community priorities for cancer prevention and control research among diverse communities in Philadelphia.

METHODS: Guided by a Stakeholder Advisory Committee, PC3 partnered with community-based organizations to conduct 8 listening sessions with diverse communities (including Black, Hispanic, Asian, Russian, LGBTQ + , and veterans) to learn about perceptions of cancer, research priorities, and training and communication preferences. Sessions were facilitated by community members or PC3 members in the primary language of participants. Sessions were audio recorded, transcribed, …

The Relationship Between Food Label Comprehension And Consumer Dietary Choices, Marline Denis

Walden Dissertations and Doctoral Studies

Poor dietary choices and limited understanding of nutritional information are ongoing public health concerns that contribute to the rise of chronic illnesses such as obesity, diabetes, and heart disease. This quantitative, cross-sectional, correlational study investigated the associations between health literacy and food label comprehension with consumer dietary choices and adherence to dietary guidelines among individuals aged 16 and older in the United States. Guided by the Nutrition Label Literacy (NLL) framework, this study explored whether components such as basic nutritional knowledge, numeracy skills, health motivation, and label usage predict healthier food choices. Age, education, and gender were included as covariates. …

Race, Resources, And American Adolescents’ Mental Health During The Covid-19 Pandemic, Chineze Nkemeh

Walden Dissertations and Doctoral Studies

During the COVID-19 pandemic, African American adolescents experienced reduced access to needed resources and may have suffered poorer mental health outcomes as a result. The purpose of this quantitative study was to examine the association between race and the availability of mental health resources, food, medical health resources and mental health outcomes among African American adolescents in the United States during the COVID-19 pandemic compared to their White counterparts. The theoretical framework that grounded this study was the Socio Ecological Model. Secondary data from the Centers for Disease Control and Prevention’s Adolescent Behaviors and Experiences Survey database were analyzed. These …

Covid-19 & Healthcare (Re)Privatization? A Comparative Analysis Of High And Medium Per Capita Gdp Countries, Kristina Donders, Kaitlyn Matthews, Brittany Reyes, Frank. H. Rizzo

Working Papers Series

This paper examines whether the COVID-19 pandemic accelerated healthcare privatization in high- and medium-GDP countries. Drawing on political economy theories of path dependence and privatization, we analyze changes in public and private healthcare expenditures in eight countries: Canada, Chile, Denmark, Georgia, Luxembourg, Norway, the Philippines, and South Korea—comparing data from 2019 and 2022. Using World Bank indicators on healthcare financing, GDP, aging populations, and food insecurity, we find that although healthcare expenditures generally increased during the pandemic, this increase was primarily in public, not private, spending. Case studies of Georgia and South Korea reveal that local economic and demographic pressures, …

How Far-Right Populism Harms Ethnic Minorities’ Health: The Case Of The United States, Dina Rosenberg

Working Papers Series

Public health is a political issue, and the health of ethnic minorities is a key component of it. We argue that far-right populism, whether grassroots or elitist, harms the health of immigrants and minorities. Anti-minority attitudes and policies—such as health chauvinism promoted by far-right populists—along with hate rhetoric and ensuing personal and institutional discrimination create a climate of hostility that negatively affects health outcomes in underprivileged communities. We hypothesize that immigrants and ethnic minorities living in such a climate are more likely to experience health problems and underutilize healthcare. To test this, we leverage the significant variation between U.S. states …

Walk A Mile: Exploring Cause-Based Charity Event Participation As A Catalyst For Increasing Physical Activity Behavior, Kimberly S. Fasczewski, Andrey A. Sanko Posada, Meg Hopkins

Journal of Social, Behavioral, and Health Sciences

Despite the known benefits of physical activity (PA), more than half of U.S. adults do not meet the American College of Sports Medicine’s PA recommendations for health, often resulting in negative health outcomes. Developing programming that increases motivation for PA participation is critical for healthcare professionals to combat physical inactivity. Previous research has demonstrated that framing disease-based PA charity fundraising events as “helping a cause” improved motivation for PA due to the individual’s emotional connection to the cause. There is currently no congruent research on motivation for participation in cause-based charity events. Behavioral economics theory posits that cognitive, emotional, and …

Understanding Garden Resource Use By Low-Income Families With Children, Mai Thao, Rita S. Stephenson, Katherine R. Arlinghaus, Abby L. Gold

Journal of Human Sciences and Extension

Home gardens are an important supplemental source of food for many families and provide multiple health benefits. However, the practice of gardening may be more challenging for low-income families with limited access to gardening resources. The University of Minnesota Extension offers gardening resources, but it is unclear how these resources are used by low-income families with children. Aim 1 of the project was to understand access to and use of Extension and other vegetable gardening resources by low-income families with children. Aim 2 of the project was to develop a set of recommendations for improving access to existing resources and …

Using Industry-Level Characteristics To Assess The Degree To Which Interventions Engage An Employee Population, Haley C. Trust, Brett Amazon, Anthony Puline, Evan Sassenberger, Kristin Horan

The Kennesaw Journal of Undergraduate Research

Participation is an essential component in workplace health and safety programs or interventions. While those who conduct interventions often report participation rates among the overall organization, it could be useful to compare participants to industry statistics, given that health and safety risks can diverge widely among industries. Research students from Kennesaw State University analyzed a sample of published papers that focus on occupational health psychology interventions. This narrative review analyzed existing studies to look for similarities or dissimilarities between a sample of intervention participants and employees of their industry as a whole. The students considered demographic, socioeconomic, job-related, and health-related …

Exploring Early Childhood Development Programming In Kenya’S Arid And Semi-Arid Lands, Phyllis Magoma, Amina Abubakar, Martha Kaniala, Barack Aoko, Moses Wesala, Joyce Marangu, Susan Nyamanya, Margaret Kabue, Anil Khamis, Esther Chongwo

Institute for Human Development, East Africa

Background: Promoting high-quality early childhood development (ECD) is vital for individuals’ physical and social well-being and yields significant societal returns. However, children in marginalised regions like Kenya’s arid and semi-arid lands (ASALs) face significant barriers to accessing quality ECD services.

Aim: This study aimed to document existing ECD services in Kenya’s ASAL areas, including their availability, types and key characteristics; identify gaps in their provision and propose solutions to enhance access and quality. Setting: This qualitative study was conducted in 10 ASAL counties in Kenya.

Methods: Using purposive and snowball sampling techniques, 103 key informants, including pre-primary …

Supplementation With Ready-To-Use Therapeutic Food Has No Effect On Adverse Outcomes Among Undernourished Children Aged 6–59 Months With Severe Pneumonia, Damalie Nalwanga, Elisa Giallongo, Victor Musiime, Sarah Kiguli, Peter Olupot-Olupot, Florence Alaroker, Robert Opoka, Abner Tagoola, Mainga Hamaluba, Christabel Mogaka

Paediatrics and Child Health, East Africa

Objectives: To investigate the effect of supplementation with ready-to-use therapeutic food (RUTF) on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia.

Methods: This secondary analysis of the COAST-Nutrition (ISRCTN10829073) included children hospitalized for severe pneumonia in Uganda and Kenya. Undernutrition was defined as having either a weight-for-age z score, height-for-age z score, or weight-for-height/length z score below the median of the WHO reference population (< 0) or mid-upper arm circumference (MUAC) below 13.5 cm. Participants were randomized to receive 1 sachet of RUTF daily for 8 weeks in addition to the usual diet (intervention) or usual diet alone (control). The primary composite outcome for adverse events was any one of mortality, re-admission, or deterioration of nutritional status by day 90 of follow-up.

Results: Of 846 main trial participants, 741 (88%) met the inclusion criteria (intervention: 374 versus control: 367). Of 687 (93%) participants in whom the primary outcome was assessed, 370 …

Down Syndrome In Africa: Challenges, Opportunities, And Future Directions, Eimear Mcglinchey, Salina Tewolde, Amanda He, Juan Fortea, Lingani Mbakile-Mahlanza, Ayda Tefera, Emmanuel Epenge, Jason Hassenstab, Rachel Maina, Zul Merali

Brain and Mind Institute

INTRODUCTION: As life expectancy improves for people with Down syndrome (DS) in Africa, the risk of developing DS-associated Alzheimer’s disease (DSAD) will rise. There is a pressing need to plan for this emerging challenge, particularly in the context of existing health and social disparities.

METHODS: This work emerged from a pan-African collaboration, including discussions at the Brain Ageing and Dementia in Low- and Middle-Income Countries conference held in Nairobi in 2024, where stakeholders identified regional priorities for DS and dementia care.

RESULTS: Limited epidemiological, cognitive, biomarker data, delayed diagnoses, and gaps in specialized services may impact access …

Sunlight Exposure And The Risk Of Mortality And Breast Cancer Incidence, Noor Nadhim

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Prolonged sun exposure increases the risk of skin cancer. However, multiple sunlight-related health benefits have been identified. The overall impact of sun exposure on mortality is not clear. Sunlight could be associated with breast cancer risk via stimulating vitamin D photosynthesis; however, evidence has been mixed. Objectives: To investigate the association of time spent outdoors in daylight (in warmer and cooler months, and the total [annual]) and UV irradiance using the residential locations of participants with the risks of mortality (all-cause and cause-specific: cancer, cardiovascular [CVD], and non-cancer non-CVD) and primary invasive breast cancer.

Methods: This research …

Digesting The Details: How Cooking Shapes The Microbiome And Influences Obesity, Tracy Lieu

University Honors Theses

Obesity is a growing global health concern linked to chronic diseases and changes in the gut microbiome. While diet is known to affect gut microbes, less attention has been given to how food processing methods, such as heating, fermentation, and cold processing, change food in ways that influence the gut microbiome and health. This thesis reviews research on how different cooking and preparation techniques affect the availability of nutrients for microbial fermentation and the resulting effects on microbial diversity and metabolism. The findings show that fermentation and cold processing are the most supportive of gut health. These methods help preserve …

The Impact Of Implementing The Women's Reproductive Rights Agenda On Climate Change, Marleen Temmerman, Emilie Peeters, Celine Delacroix, Malachi Arunda, Sara Khalid, Claudia Hanson, Samuel Ojong

Centre of Excellence in Women and Child Health

The 1994 International Conference on Population and Development (ICPD) established sexual and reproductive health and rights (SRHR) as foundational to sustainable development. Thirty years later, advancing women's reproductive rights (WRR), encompassing agency, decision-making autonomy, and universal access to family planning—remains critical not only for health and gender equity but also for mitigating environmental degradation. By reducing unintended pregnancies and empowering women to align childbearing with personal and ecological capacity, WRR alleviates ecological stressors such as deforestation while enhancing health resilience in climate-vulnerable communities. Yet, despite well-documented linkages between population dynamics and environmental change, contemporary climate policies and funding mechanisms persistently …

Understanding Utilization And Prevention Measures Associated With A Caries Risk Assessment In Oral Health Transformation, Melody Mcgee, Ryan Brandon, Muhammad Walji, Joel White, Kristen Moses, Eric P Tranby, Lisa J Heaton, Kristen Simmons

Faculty, Staff and Student Publications

Objectives: Dental decay is endemic in the United States, underscoring the need to measure the utilization of caries risk management tools to elucidate the effect of prevention interventions in reducing the dental decay rates of individuals. An academic institution partnered with a third-party institute to call attention to the utilization and prevention measures associated with caries risk assessment (CRA) used with children 0-18 years. This environmental scan examined claims across the United States to evaluate the proportion of dental examinations, CRAs, and caries prevention procedures within a calendar year.

Methods: A 12-month deidentified participant list categorized by age, race, sex, …

Dietary Interventions To Support And Improve Sleep Disturbances And Insomnia Disorder In Menopause: From Bench To Bedside, Rosie H Musgrave, Sara Nowakowski, Tamlyn J Watermeyer, Emily J Arentson-Lantz, Greg J Elder

Faculty, Staff and Students Publications

Sleep is essential for maintaining physical and psychological health, and also cognitive health (referred to as 'brain health'). However, the transition to menopause has a direct impact upon sleep. Sleep disturbances are reported by approximately 40%-60% of menopausal women, and insomnia disorder is also prevalent. Diet-based interventions could potentially be used to improve subjective sleep quality in this population, and although there are several promising interventions which have been used in other groups that could be trialled, the evidence base is currently lacking. One particularly promising area for future research is that these interventions might be used alongside, or instead …

Epidemiology Of Intestinal Parasite Infections And Multiparasitism And Their Impact On Growth And Hemoglobin Levels During Childhood In Tropical Ecuador: A Longitudinal Study Using Molecular Detection Methods, Rojelio Mejia, Irina Chis Ster, Martha E Chico, Irene Guadalupe, Andrea Arévalo-Cortés, Andrea Lopez, Aida Y Oviedo-Vera, Philip J Cooper

Faculty, Staff and Students Publications

Background: There are few longitudinal epidemiological studies of intestinal parasitic infections (IPI) and their health effects. We studied the epidemiology and determinants of IPI and multiparasitism during childhood using molecular methods for parasite detection and analysed their effects on growth and hemoglobin levels.

Methods: Random sample of 401 children from an Ecuadorian birth cohort followed up to 8 years of age. Data on environmental and sociodemographic characteristics were collected by questionnaires. Stool samples were collected, and weight, height, and hemoglobin levels were measured at 7 and 13 months, and 2, 3, 5, and 8 years. Stool samples were analysed using …

Consumers' Perspectives On The Design Of A New Digital Frailty Education Course, ‘Focus On Frailty’: A Qualitative Co-Design Study, Kristiana Ludlow, Benignus Logan, Jhalak Arora, Sarah Martin, Elizabeth Miller, Ruth E. Hubbard, Nicola Warren, Olivia Gallagher, Rosemary Saunders

Research outputs 2022 to 2026

Introduction: Frailty-focused care in hospitals is hindered by systemic barriers, ageism and stereotypes about older adults and frailty. There is a need for frailty education to increase healthcare professionals' and students' understanding of frailty. Objective: As part of a larger study to co-design a new digital frailty education course, ‘Focus on Frailty’, this study aimed to explore consumers' and caregivers' perspectives on (i) how frailty and older adults should be represented in frailty education and (ii) what healthcare professionals should be taught about caring for older adults and people who are frail in hospitals. Design: This was a qualitative co-design …

Food Hygiene And Sanitation Of The University Canteens In South Sumatra Province, Indonesia, Anita Rahmiwati, Fatmalina Febry, Fenny Etrawati, Indah Purnama Sari, Yeni Yeni, Virgina Putri Sabila, Erike Septa Prautami, Maretalinia Maretalinia

Kesmas

Food safety is a critical public health issue, especially in institutional settings such as university canteens, where large populations are served daily. Inadequate hygiene and sanitation practices by food handlers can lead to foodborne illnesses, placing students and staff at risk. This study evaluated hygiene and sanitation conditions in the canteens of a leading public university in South Sumatra Province, Indonesia, known for its active food service facilities. This study examined food handlers’ knowledge, attitudes, and practices and assessed the microbiological safety of chicken curry by testing for Escherichia coli (E. coli) contamination and total plate count. Using a cross-sectional …