Public Health Commons^™

Us Vs. Wales: Comparing And Improving Refugee Health Policy, Payton Ramsey

Senior Theses

Inadequate strides have been made to bolster the short and long-term health of growing numbers of refugees awaiting resettlement. The United Nations Higher Commission for Refugees (UNHCR), as well as many countries of resettlement, guarantee the right to health as signatories of the UN 1951 Refugee Convention, but in many situations refugee accessibility to healthcare and health resources is limited by time restrictions on benefits, immigration status, and/or financial circumstances.

This thesis provides a synopsis of the historical roots of current policies and legislative frameworks relating to refugee health for Wales and the US. Through the analysis of governmental policy …

The Effects Of The Use Of Medical Interpreters Amongst The Latina Population In The Context Of Sexual And Reproductive Health, Carson Collins

Senior Theses

The Latino population in the United States is large and consistently growing. These individuals, due to cultural and systemic factors, are at greater risk for a variety of health problems, especially in the context of sexual and reproductive health. Many of these patients may not speak English as their first language and thus need to access interpretative services to receive care. This study sought to examine whether medical facilities using certified medical interpreters and requiring cultural competency training for their staff could reduce the cultural and communication barriers LEP Latinas experience when receiving sexual and reproductive health care services. An …

A Multilevel And Spatial Analysis Of Oral And Pharyngeal Cancer In South Carolina, Deborah M. Hurley

Theses and Dissertations

Objective: Disparities in the distribution of oral and pharyngeal cancer exist worldwide. This is also true in the United States and in South Carolina. Differences exist in oral and pharyngeal cancer stage and survival by race and sex, with higher incidence rates for Whites but higher proportions of late-stage cancer and lower survival for Blacks. This study was conducted to evaluate whether any differences exist in the spatial distribution of oral and pharyngeal cancer stage at diagnosis and survival, and to evaluate the association of income inequality, material deprivation and other measures of social determinants of health (contextual risk factors) …

Female Athlete Triad: Evaluation Of The Cumulative Risk Assessment Tool For Female Collegiate Athletes, Jessica Pia

Senior Theses

Content: As the pressure on collegiate and elite female athletes to perform at their highest possible capabilities has grown, so to have the consequences associated with their high energy expending lifestyles. The Female Athlete Triad (Triad) is a syndrome defined as having one or more of the following conditions: LEA with or without disordered eating, menstrual dysfunction, and/or low BMD. Due to potential long-term, irreversible health consequences of the Triad, the Female Athlete Triad Coalition developed a risk assessment tool known as the Triad CRA to identify at-risk athletes and subsequent return-to-play status. Objective: To determine the risk …

Defining Septicemia Incidence And Mortality In South Carolina Through Access To Health Care, Behavioral Health, And Low Socio-Economic Status, Raeann Vossberg

Senior Theses

This study aims to provide an in-depth view of septicemia mortality and incidence in the state of South Carolina through the lenses of socio-economic factors, access to healthcare, and behavioral health factors. This study was conducted using data from the South Carolina Revenue and Fiscal Affairs Office, utilizing their Hospitalization, Inpatient, Emergency Department, and Outpatient data both separately and combined depending on the data point, along with additional data sources for support (see works cited). We hypothesize that the higher rates of septicemia mortality and incidence in the southeastern United States, as well as in South Carolina in particular, could …

The Utilization And Effectiveness Of Telemedicine In The Wake Of Covid-19, Maxwell Sharawy

Senior Theses

The COVID-19 pandemic devastated the world, in every industry. Almost none were hit as hard as the healthcare system. Through the use of telemedicine, healthcare providers were able to care for their patients without rise of infection. Through a review of published literature and interviews conducted with three practicing physicians of various specialties, a diagnosis was developed to determine if the care provided through telemedicine was as effective as in-person care. It was hypothesized that when used properly, telemedicine can be used as an effective replacement for in-person care across a wide range of specialties. After review of the literature …

Are Adverse Childhood Experiences Associated With Health Behaviors Among College Students: Emotion Regulation As A Potential Moderator, Margaret Winters

Senior Theses

In this study, we sought to examine the relations among adverse childhood experiences (ACEs), physical activity (PA), sleep quality, and emotion regulation in college students. ACEs have been proven to have a dose-response relation with adverse health outcomes in adulthood, including heart disease, cancer, lung disease, liver disease, poor mental health, and risky health behaviors (Felitti et al., 1998; Merrick et al., 2016; Zhang et al., 2020). ACEs have also been previously associated with poor sleep quality and emotion dysregulation (Kajeepeta, Gelaye, Jackson, & Williams, 2015[WL1] ; Kim & Cicchetti, 2010). Given these findings, we sought to examine how …

Killing The Planet But Saving The People: How The American Healthcare Industry Impacts The Environment, Malorie Webb

Senior Theses

The American population is rapidly growing and aging. In order to accommodate such a large population and its associated challenges, the healthcare industry has had to continually expand and adapt. The United States healthcare industry is now one of the largest, most expensive components of the economy. As such, it produces vast amounts of waste. Healthcare waste can damage the environment and contribute to climate change, which in turn can contribute to worsening health outcomes in the population. This thesis aims to explore both the immediate and prolonged impacts of the American healthcare industry on the environment, as well as …

The Current State Of Health Care Facility Preparedness, Health Care Utilization, And Covid-19 Knowledge Amidst The Covid-19 Pandemic In The Malaria-Endemic Setting Of Manicaland Province, Zimbabwe, Julia Grace Scott

Theses and Dissertations

The impact of the coronavirus disease 2019 (COVID-19) pandemic has been felt worldwide, especially in Sub-Saharan Africa (SSA). With fractured health systems, disrupted supply chains, limited resources, and continued fighting of endemic diseases such as malaria, SSA is at risk for greater impact. Manicaland Province has the highest incidence rate of malaria in Zimbabwe, and a higher malaria mortality rate than the national average. Manicaland also has the third highest number of COVID-19 cases and deaths in Zimbabwe. In this study, health care facilities and households throughout Makoni, Mutare, and Buhera districts in Manicaland Province were administered cross-sectional surveys. We …

Feasibility Of Integrating Survivors Of Stroke Into Cardiac Rehabilitation: A Mixed Methods Pilot Study, Elizabeth W. Regan, Reed Handlery, Jill C. Stewart, Joseph Lee Pearson Ms,Drph, Sara Wilcox Ph.D., Stacy Fritz

Faculty Publications

Background Survivors of stroke are often deconditioned and have limited opportunities for exercise post-rehabilitation. Cardiac Rehabilitation (CR), a structured exercise program offered post-cardiac event in the United States (U.S.), may provide an opportunity for continued exercise.

The purpose of this study was to examine the feasibility of integrating survivors of stroke into an existing, hospital-based CR program through an assessment of (1) recruitment, uptake and retention, (2) adherence and fidelity, (3) acceptability and (4) safety.

Methods A mixed methods design combined a single group, pre-post design, pilot feasibility study with an imbedded qualitative inquiry. Survivors of stroke were recruited into …

Association Of Erectile Dysfunction With Tinnitus: A Nationwide Population-Based Study, Yen-Fu Cheng, Sudha Xirasagar Mbbs., Ph.D., Nai-Wen Kuo, Shiu-Dong Chung, Herng-Ching Lin

Faculty Publications

With many previous studies indicating a higher prevalence of sexual problems in patients with tinnitus, the association between tinnitus and erectile dysfunction (ED) has become an interesting topic that warrants further research. In our study, we hypothesized that tinnitus may be associated with ED and aimed to further explore the relationship between these two medical conditions using a nationwide population-based database. After retrieving data of 19,329 patients with ED and 19,329 propensity score-matched patients without ED (controls) from Taiwan’s National Health Insurance Dataset, we defined the diagnosis date (the date of the first ED claim) for patients with ED as …

Characterization, Bio-Uptake And Toxicity Of Polymer-Coated Silver Nanoparticles And Their Interaction With Human Peripheral Blood Mononuclear Cells, Sahar Pourhoseini, Reilly T. Enos, Angela E. Murphy, Bo Cai Ph.D., Jamie Lead

Faculty Publications

Silver nanoparticles (AgNPs) are widely used in medical applications due to their antibacterial and antiviral properties. Despite the extensive study of AgNPs, their toxicity and their effect on human health is poorly understood, as a result of issues such as poor control of NP properties and lack of proper characterization. The aim of this study was to investigate the combined characterization, bio-uptake, and toxicity of well-characterized polyvinylpyrrolidone (PVP)-coated AgNPs in exposure media during exposure time using primary human cells (peripheral blood mononuclear cells (PBMCs)). AgNPs were synthesized in-house and characterized using a multimethod approach. Results indicated the transformation of NPs …

Relationship Between Diet Quality Scores And The Risk Of Frailty And Mortality In Adults Across A Wide Age Spectrum, Kulapong Jayanama, Olga Theou, Judith Godin, Leah Cahill, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert, Michael David Wirth Msph, Phd, Yong-Moon Park, Teresa T. Fung, Kenneth Rockwood

Faculty Publications

Background

Beyond intakes of total energy and individual nutrient, eating patterns may influence health, and thereby the risk of adverse outcomes. How different diet measures relate to frailty—a general measure of increased vulnerability to unfavorable health outcomes—and mortality risk, and how this might vary across the life course, is not known. We investigated the associations of five dietary indices (Nutrition Index (NI), the energy-density Dietary Inflammatory Index (E-DII™), Healthy Eating Index-2015 (HEI-2015), Mediterranean Diet Score (MDS), and Dietary Approaches to Stop Hypertension (DASH)) with frailty and mortality.

Methods

We included 15,249 participants aged ≥ 20 years from the 2007–2012 cohorts …

The Association Between Quitline Characteristics And Smoking Cessation By Educational Attainment, Income, Race/Ethnicity, And Sex, David C. Colston, Bethany J. Simard, Yanmei Xie, Marshall Chandler Mcleod, Micheal R. Elliott, Jim F. Thrasher Ph.D., Ma, Ms, Nancy L. Fleischer

Faculty Publications

Little research examines how tobacco quitlines affect disparities in smoking cessation in the United States. Our study utilized data from the Tobacco Use Supplement to the Current Population Survey (2010, 2011, 2012, 2015, 2018) (TUS-CPS) and state-level quitline data from the North American Quitline Consortium and National Quitline Data Warehouse. We ran multilevel logistic regression models assessing a state-run quitline’s budget, reach, number of counseling sessions offered per caller, and hours of operation on 90-day smoking cessation. Multiplicative interactions between all exposures and sex, race/ethnicity, income, and education were tested to understand potential effect modification. We found no evidence that …

Elaborating The Science Of Food Choice For Rapidly Changing Food Systems In Low-And Middle-Income Countries, Christine E. Blake Ph.D., Rd, Edward A. Frongillo Jr. Ph.D., Andrea M. Warren, Shilpa V. Constantinides, Krystal K. Rampalli, Shiva Bhandari

Faculty Publications

The world’s food systems and environments have been changing dramatically, concomitant with changes in overand undernutrition. We elaborate the science of food choice to better understand, analyze, and respond to relationships between changing food environments and food choice. The science of food choice is concerned with generating knowledge about causal drivers of food choice decision making processes and behavior within immediate food and social environments. Three fundamental and interconnected questions undergird this science; 1) what do people eat from the options available and accessible?; 2) how do people interact with food environments?; and 3) why do people decide to acquire, …

Association Between Height And Hypertension Among Us Adults: Analyses Of National Health And Nutrition Examination Survey 2007-18, Rajat Das Gupta, Maxwell Akonde, Ibrahim Hossain Sajal, Gulam Muhammed Al Kibria

Publications

Background

Previous studies that investigated association of height with prevalence and control of hypertension found mixed results. This cross-sectional study explored these associations among US adults (≥20 years).

Methods

The National Health and Nutrition Examination Survey (NHANES) 2007–18 data was analyzed. Height was measured in meters and was converted into centimeters (cm) and was further divided into quartiles: Q1 (135.3–159.2 cm), Q2 (159.3–166.2 cm), Q3 (166.3–173.6 cm), Q4 (173.7–204.5 cm). Hypertension definition of the ‘2017 American College of Cardiology/American Heart Association Guideline’ was used. Logistic regression analyses were conducted to find out the association between the dependent variable and the …

Validity Of The Food Insecurity Experience Scale (Fies) For Use In League Of Arab States (Las) And Characteristics Of Food Insecure Individuals By The Human Development Index (Hdi), Olfat B. Sheikomar, Wesley Dean, Hala Ghattas Ph.D., Nadine R. Sahyoun

Faculty Publications

Background

The Food Insecurity Experience Scale (FIES) is a UN FAO Voices of the Hungry (FAO-VoH) experiential metric of food insecurity (FI). It was pilot tested in some countries but not in Arab speaking ones and validated using global data. Yet, its psychometric properties may vary in the League of Arab States (LAS) due to cultural and linguistic differences.

Objectives

1) assess the validity of FIES for use in the LAS region, 2) determine the prevalence of FI, by gender, age group, and the human development index (HDI), and 3) examine sociodemographic characteristics of severe FI individuals.

Methods

To assess …

Maternal Dietary Quality, Inflammatory Potential And Childhood Adiposity: An Individual Participant Data Pooled Analysis Of Seven European Cohorts In The Alphabet Consortium, Ling-Wei Chen, Adrien M. Aubert, Nitin Shivappa, Jonathan Y. Bernard, Sara M. Mensink-Bout, Aisling A. Geraghty, John Mehegan, Matthew Suderman, Kinga Polanska, Wojciech Hanke, Agnieszka Jankowska, Caroline L. Relton, Sarah R. Crozier, Nicholas C. Harvey, Cyrus Cooper, Mark Hanson, Keith M. Godfrey, Romy Gaillard, Liesbeth Duijts, Barbara Heude, James Hébert Scd, Fionnuala M. Mcauliffe, Cecily Kelleher, Catherine M. Phillips

Faculty Publications

Background

Mounting evidence suggests that maternal diet influences pregnancy and birth outcomes, but its contribution to the global epidemic of childhood obesity has not as yet been definitively characterized. We investigated whether maternal whole diet quality and inflammatory potential influence childhood adiposity.

Methods

We harmonized and pooled individual participant data from 16,295 mother-child pairs in seven European birth cohorts. Maternal pre-, early-, late-, and whole-pregnancy (any time during pregnancy) dietary quality and inflammatory potential assessed with the Dietary Approaches to Stop Hypertension (DASH) score and the energy-adjusted Dietary Inflammatory Index (E-DII™) score, respectively. Primary outcome was childhood overweight and obesity …

Greater Pain Severity Is Associated With Higher Glucocorticoid Levels In Hair Among A Cohort Of People Living With Hiv, Quan Zhang, Xiaoming Li Ph.D., Shan Qiao Ph.D., Shuaifeng Liu, Zhiyong Shen, Yuejiao Zhou

Faculty Publications

Background: Pain is a common occurrence and persistent symptom, which has an adverse impact on individual well-being and quality of life among people living with HIV (PLHIV). Alteration in the activity of the Hypothalamic-Pituitary-Adrenal (HPA) axis resulting in abnormal glucocorticoid levels had been proposed to play important roles in those associations. Purpose: This study aimed to investigate whether pain severity was associated with hair glucocorticoid levels, a novel method of measuring long-term glucocorticoid exposure, among a large cohort of Chinese PLHIV. Methods: A measure of pain severity and hair samples were collected from 431 adults PLHIV in Guangxi, China. Glucocorticoid …

Dietary Quality And Dietary Inflammatory Potential During Pregnancy And Offspring Emotional And Behavioral Symptoms In Childhood: An Individual Participant Data Meta-Analysis Of Four European Cohorts, Kinga Polanska, Pawel Kaluzny, Adrien M. Aubert, Liesbeth Duijts, Hanan El Marroun, Wojciech Hanke, James R. Hébert, Barbara Heude, Agnieszka Jankowska, Giulia Mancano, Sara M. Mensink-Bout, Caroline Relton, Nitin Shivappa Mbbs, Mph, Ph.D., Matthew Suderman, Elzbieta Trafalska, Ewelina Wesolowska, Raquel Garcia-Esteban, Mònica Guxens, Maribel Casas, Catherine M. Phillips

Faculty Publications

Background

The impact of maternal diet during pregnancy on child neurodevelopment is of public health and clinical relevance. We evaluated the associations of dietary quality based on the Dietary Approaches to Stop Hypertension (DASH) score and dietary inflammatory potential based on the energy-adjusted Dietary Inflammatory Index (E-DII) score during pregnancy with emotional and behavioral symptoms of offspring at 7 to 10 years of age.

Methods

Individual participant data for 11,870 mother–child pairs from four European cohorts participating in the ALPHABET project were analyzed. Maternal antenatal DASH and E-DII scores were generated from self-completed food frequency questionnaires. Symptoms of depression …

The Intersection Of Rural Residence And Minority Race/Ethnicity In Cancer Disparities In The United States, Whitney Zahnd, Cathryn Murphy, Marie Knoll, Gabriel A. Benavidez, Kelsey R. Day, Radhika Ranganathan, Parthenia Luke, Anja Zgodic, Kewei Shi, Melinda A. Merrell, Elizabeth L. Crouch, Heather M. Brandt, Jan Eberth

Faculty Publications

One in every twenty-five persons in America is a racial/ethnic minority who lives in a rural area. Our objective was to summarize how racism and, subsequently, the social determinants of health disproportionately affect rural racial/ethnic minority populations, provide a review of the cancer disparities experienced by rural racial/ethnic minority groups, and recommend policy, research, and intervention approaches to reduce these disparities. We found that rural Black and American Indian/Alaska Native populations experience greater poverty and lack of access to care, which expose them to greater risk of developing cancer and experiencing poorer cancer outcomes in treatment and ultimately survival. There …

The Intersection Of Rural Residence And Minority Race/Ethnicity In Cancer Disparities In The United States, Whitney Zahnd, Cathryn Murphy, Marie Knoll, Gabriel A. Benavidez, Kelsey R. Day, Radhika Ranganathan, Parthenia Luke, Anja Zgodic, Kewei Shi, Melinda A. Merrell, Elizabeth L. Crouch, Heather M. Brandt, Jan Eberth

Faculty Publications

One in every twenty-five persons in America is a racial/ethnic minority who lives in a rural area. Our objective was to summarize how racism and, subsequently, the social determinants of health disproportionately affect rural racial/ethnic minority populations, provide a review of the cancer disparities experienced by rural racial/ethnic minority groups, and recommend policy, research, and intervention approaches to reduce these disparities. We found that rural Black and American Indian/Alaska Native populations experience greater poverty and lack of access to care, which expose them to greater risk of developing cancer and experiencing poorer cancer outcomes in treatment and ultimately survival. There …

The Intersection Of Rural Residence And Minority Race/Ethnicity In Cancer Disparities In The United States, Whitney Zahnd, Cathryn Murphy, Marie Knoll, Gabriel A. Benavidez, Kelsey R. Day, Radhika Ranganathan, Parthenia Luke, Anja Zgodic, Kewei Shi, Melinda A. Merrell, Elizabeth L. Crouch, Heather M. Brandt, Jan M. Eberth

Faculty Publications

One in every twenty-five persons in America is a racial/ethnic minority who lives in a rural area. Our objective was to summarize how racism and, subsequently, the social determinants of health disproportionately affect rural racial/ethnic minority populations, provide a review of the cancer disparities experienced by rural racial/ethnic minority groups, and recommend policy, research, and intervention approaches to reduce these disparities. We found that rural Black and American Indian/Alaska Native populations experience greater poverty and lack of access to care, which expose them to greater risk of developing cancer and experiencing poorer cancer outcomes in treatment and ultimately survival. There …

The Intersection Of Rural Residence And Minority Race/Ethnicity In Cancer Disparities In The United States, Whitney E. Zhand, Cathryn Murphy, Marie Knoll, Gabriel A. Benavidez, Kelsey R. Day, Radhika Ranganathan, Parthenia Luke, Anja Zgodic, Kewei Shi, Melinda A. Merrell, Elizabeth L. Crouch, Heather M. Brandt, Jan M. Eberth

Faculty Publications

One in every twenty-five persons in America is a racial/ethnic minority who lives in a rural area. Our objective was to summarize how racism and, subsequently, the social determinants of health disproportionately affect rural racial/ethnic minority populations, provide a review of the cancer disparities experienced by rural racial/ethnic minority groups, and recommend policy, research, and intervention approaches to reduce these disparities. We found that rural Black and American Indian/Alaska Native populations experience greater poverty and lack of access to care, which expose them to greater risk of developing cancer and experiencing poorer cancer outcomes in treatment and ultimately survival. There …

A Cluster-Based Approach For Identifying Prognostic Microrna Signatures In Digestive System Cancers, Jun Zhou, Xiang Cui, Feifei Xiao, Guoshuai Cai

Faculty Publications

Cancer remains the second leading cause of death all over the world. Aberrant expression of miRNA has shown diagnostic and prognostic value in many kinds of cancer. This study aims to provide a novel strategy to identify reliable miRNA signatures and develop improved cancer prognostic models from reported cancer-associated miRNAs. We proposed a new cluster-based approach to identify distinct cluster(s) of cancers and corresponding miRNAs. Further, with samples from TCGA and other independent studies, we identified prognostic markers and validated their prognostic value in prediction models. We also performed KEGG pathway analysis to investigate the functions of miRNAs associated with …

Structural Insights Into The Disruption Of Tnf-Tnfr1 Signalling By Small Molecules Stabilising A Distorted Tnf, David Mcmillan, Carlos Martinez-Fleites, John Porter, David Fox, Rachel E. Davis, Prashant Mori, Tom Ceska, Bruce Carrington, Alastair Lawson, Tim Bourne, James O'Connell

Faculty Publications

Tumour necrosis factor (TNF) is a trimeric protein which signals through two membrane receptors, TNFR1 and TNFR2. Previously, we identified small molecules that inhibit human TNF by stabilising a distorted trimer and reduce the number of receptors bound to TNF from three to two. Here we present a biochemical and structural characterisation of the small molecule-stabilised TNF-TNFR1 complex, providing insights into how a distorted TNF trimer can alter signalling function. We demonstrate that the inhibitors reduce the binding affinity of TNF to the third TNFR1 molecule. In support of this, we show by X-ray crystallography that the inhibitor-bound, distorted, TNF …

Psychiatric Symptoms, Risk, And Protective Factors Among University Students In Quarantine During The Covid-19 Pandemic In China, Shufang Sun, Simon B. Goldberg, Danhua Lin, Shan Qiao Ph.D., Don Operario

Faculty Publications

Background: The COVID-19 pandemic has made unprecedented impact on the psychological health of university students, a population vulnerable to distress and mental health disorders. This study investigated psychiatric symptoms (anxiety, depression, and traumatic stress) during state-enforced quarantine among university students in China (N = 1912) through a cross-sectional survey during March and April 2020. Results: Psychiatric symptoms were alarmingly prevalent: 67.05% reported traumatic stress, 46.55% had depressive symptoms, and 34.73% reported anxiety symptoms. Further, 19.56% endorsed suicidal ideation. We explored risk and protective factors of psychological health, including demographic variables, two known protective factors for mental health (mindfulness, perceived social …

A Nationwide Population-Based Study On The Incidence Of Parapharyngeal And Retropharyngeal Abscess-A 10-Year Study, Tzong-Hann Yang, Sudha Xirasagar Mbbs., Ph.D., Yen-Fu Cheng, Chuan-Song Wu, Yi-Wei Kao, Herng-Ching Lin

Faculty Publications

This study aimed to investigate the annual incidence of parapharyngeal and retropharyngeal abscess (PRPA) based on 10-year population-based data. Patients with PRPA were identified from the Taiwan Health Insurance Research Database, a database of all medical claims of a randomly selected, population-representative sample of over two million enrollees of the National Health Insurance system that covers over 99% of Taiwan’s citizens. During 2007–2016, 5779 patients received a diagnosis of PRPA. We calculated the population-wide incidence rates of PRPA by sex and age group (20–44, 45–64, and >64) as well as in-hospital mortality. The annual incidence rate of PRPA was 2.64 …

Neighborhood Characteristics And The Mental Health Of Caregivers Cohabiting With Care Recipients Diagnosed With Alzheimer’S Disease, Dana M. Alhasan, Jana A. Hirsch, Chandra L. Jackson, Margaret Chandlee Miller, Bo Cai Ph.D., Matthew C. Lohman Ph.D.

Faculty Publications

While studies have documented the influence of caregiver and care recipient factors on caregiver health, it is important to address the potential impact of neighborhood contexts. This study estimated the cross-sectional associations between neighborhood characteristics and mental health among caregivers cohabiting with Alzheimer’s disease care recipients that were experiencing severe or non-severe neuropsychiatric symptoms (NPSs) (e.g., aggression/anxiety). We obtained data collected in 2010 on caregivers and care recipients (n

While studies have documented the influence of caregiver and care recipient factors on caregiver health, it is important to address the potential impact of neighborhood contexts. This study estimated the cross-sectional …

Program Implementation And Church Members' Health Behaviors In A Countywide Study Of The Faith, Activity, And Nutrition Program, John Bernhart Ph.D., Mph, Ches, Sarah Wilcox Phd, Ruth P. Saunders Ph.D., Brent E. Hutto Msph, Jessica Stucker

Faculty Publications

Implementation research of health programs in faith-based organizations is lacking. The Faith, Activity, and Nutrition (FAN) program helps churches improve physical activity and fruit and vegetable behaviors of members. This study examined associations between implementation of FAN intervention components and church members' physical activity, fruit and vegetable behaviors, and self-efficacy for improving these behaviors. FAN was implemented in 35 churches in a southeastern US county. After attending in-person training, led by community health advisors, church committees received 12 months of telephone-delivered technical assistance to implement FAN according to 4 components: increasing opportunities, increasing guidelines and policies, increasing pastor support, and …