Public Health Commons^™

The Problem Of The Color Line: Spatial Access To Hospital Services For Minoritized Racial And Ethnic Groups, Jan M. Eberth, Pelvin Hung, Gabriel A. Benavidez, Janice Probst, Whitney E. Zahnd, Mary-Katherine Mcnatt, Ebony Toussaint, Melinda A. Merrell, Elizabeth L. Crouch

Faculty Publications

Examining how spatial access to health care varies across geography is key to documenting structural inequalities in the United States. In this article and the accompanying StoryMap, our team identified ZIP Code Tabulation Areas (ZCTAs) with the largest share of minoritized racial and ethnic populations and measured distances to the nearest hospital offering emergency services, trauma care, obstetrics, outpatient surgery, intensive care, and cardiac care. In rural areas, ZCTAs with high Black or American Indian/Alaska Native representation were significantly farther from services than ZCTAs with high White representation. The opposite was true for urban ZCTAs, with high White ZCTAs being …

Social Determinants Of Health And Depression Among African American Adults: A Scoping Review Of Current Research, Brooks Yelton, Daniela B. Friedman, Samuel Noblet, Matthew C. Lohman, Mark M. Macauda, Mayank Sakhuja, Katherine H. Leith

Faculty Publications

Depression in the United States (US) is increasing across all races and ethnicities and is attributed to multiple social determinants of health (SDOH). For members of historically marginalized races and ethnicities, depression is often underreported and undertreated, and can present as more severe. Limited research explores multiple SDOH and depression among African American adults in the US. Guided by Healthy People (HP) 2030, and using cross-disciplinary mental health terminology, we conducted a comprehensive search to capture studies specific to African American adults in the US published after 2016. We applied known scoping review methodology and followed Preferred Reporting Items for …

The Effectiveness Of Two Implementation Strategies For Improving Teachers’ Delivery Of An Evidenced-Based Hiv Prevention Program, Bo Wang, Lynette Deveaux, Lesley Cottrell, Xiaoming Li, Richard Adderley, Barbara Dorsett, Regina Firpo-Triplett, Veronica Koci, Sharon Marshall, Nikkiah Forbes, Bonita Stanton

Faculty Publications

Background Efective implementation strategies are needed to enhance the success of evidence-based prevention programs. The current study evaluates the efects of two implementation strategies on teachers’ implementation of an evidenced-based HIV intervention.

Methods Using our 7-item pre-implementation school screening tool, we identifed teachers who were at-risk for not implementing the Focus on Youth HIV-risk reduction intervention curriculum which targets grade six through grade 8 students. After completing a two-day curriculum workshop, 81 low- and moderate-performing teachers were randomly assigned to one of four experimental conditions and were asked to teach the two-month intervention curriculum. This optimization trial examines the impact …

The Mediating Effect Of Depression On The Relation Between Interpersonal Needs And Suicidal Ideation Among Chinese Transgender Women, Ruijie Chang, Chengbo Zeng, Shan Qiao Ph.D., Huwen Wang, Chen Xu, Xiaoyue Yu, Tiecheng Ma, Ying Wang, Xiaoming Li Ph.D., Yong Cai

Faculty Publications

Background: Transgender women are at high risk of depression and suicidal ideation. The interpersonal theory of suicide proposes that suicidal ideation could be a consequence of high interpersonal needs (thwarted belongingness and perceived burdensomeness). The current study tests this theory and investigates whether depression could mediate the relationship between interpersonal needs and suicidal ideation among transgender women in Shenyang, China.

Methods: A total of 198 transgender women were recruited by snowball sampling. A cross-sectional study was conducted through a structured questionnaire. Suicidal ideation, depression, and interpersonal needs were assessed. Path analysis was used to carry out the research goals and …

Scanner: A Web Platform For Annotation, Visualization And Sharing Of Single Cell Rna-Seq Data, Guoshuai Cai, Xuanxuan Yu, Choonhan Youn, Jun Zhou, Feifei Xiao

Faculty Publications

In recent years, efficient scRNA-seq methods have been developed, enabling the transcriptome profiling of single cells massively in parallel. Meanwhile, its high dimensionality and complexity bring challenges to the data analysis and require extensive collaborations between biologists and bioinformaticians and/or biostatisticians. The communication between these two units demands a platform for easy data sharing and exploration. Here we developed Single-Cell Transcriptomics Annotated Viewer (SCANNER), as a public web resource for the scientific community, for sharing and analyzing scRNA-seq data in a collaborative manner. It is easy-to-use without requiring special software or extensive coding skills. Moreover, it equipped a real-time database …

The Isocaloric Substitution Of Plant-Based And Animal-Based Protein In Relation To Aging-Related Health Outcomes: A Systematic Review, Jiali Zheng, Tianren Zhu, Guanghuan Yang, Longgang Zhao, Fangyu Li, Yong-Moon Park, Fred K. Tabung, Susan E. Steck Phd, Mph, Rd, Xiaoguang Li, Hui Wang

Faculty Publications

Plant-based and animal-based protein intake have differential effects on various aging-related health outcomes, but less is known about the health effect of isocaloric substitution of plant-based and animal-based protein. This systematic review summarized current evidence of the isocaloric substitutional effect of plant-based and animal-based protein on aging-related health outcomes. PubMed and Embase databases were searched for epidemiologic observational studies published in English up to 15 March 2021. Studies that included adults ≥18 years old; use of a nutritional substitution model to define isocaloric substitution of plant protein and animal protein; health outcomes covering mortality, aging-related diseases or indices; and reported …

Future Orientation Among Children Affected By Parental Hiv In China: An Exploratory Analysis Of Complex Interactions, Heather L. Mcdaniel, Sayward E. Harrison, Amanda J. Fairchild, Xiaoming Li Ph.D.

Faculty Publications

We utilized an exploratory analytic approach to examine predictors of children's future beliefs, an internal asset associated with resilience among children affected by HIV, with emphasis on complex interactions among multisystem factors. Children (N = 1221) affected by parental HIV in China reported on psychosocial functioning, as well as internal, familial, and community resilience assets. Exploratory data analysis was conducted using a binary segmentation program. Six binary splits on predictors accounted for 22.78% of the variance in future expectation, suggesting interactions between children's perceived control of their future, loneliness, caregiver trust, and social support. Four binary splits accounted for …

Extent Of Inclusion Of “Rural” In Comprehensive Cancer Control Plans In The United States, Inti Barrientos-Gutierrez, Katia Gallegos-Carrillo, Lizeth Cruz-Jimenez, Rosibel Rodriguez- Bolaños, Edna Arillo-Santillán, Jim F. Thrasher Ph.D., Ma, Ms

Faculty Publications

Objectives. To evaluate the prevalence of exposure to Internet communications on and advertising of electronic cigarettes (e-cigarettes) and their association with perceptions of the social acceptability of e-cigarettes in Mexico.

Methods. Data were analyzed from eight surveys (2018–2021) of an online sample of Mexican adult (> 18 years) smokers and dual users (of combustible and electronic cigarettes). Self-reported exposure to e-cigarette advertising across various marketing channels was assessed, as well as visits to e-cigarette websites. Logistic regression analysis was used to evaluate the association between perceptions of the social acceptability of e-cigarette use and level of advertising exposure and visits …

Healthcare System Responses To Non-Communicable Diseases’ Needs Of Syrian Refugees: The Cases Of Jordan And Lebanon, Chaza Akik, Farah Asfahani, Tatiana Elghossain, Sandra Mesmar, Miriam Rabkin, Wafaa El Sadr, Fouad M. Fouad, Hala Ghattas Ph.D.

Faculty Publications

Introduction:

Since the start of the Syrian conflict in 2011, Jordan and Lebanon have hosted large refugee populations, with a high pre-conflict burden of non-communicable diseases (NCDs). We aimed to explore NCD service provision to Syrian refugees in these two host countries and to identify lessons learned that may inform the global response to the changing health needs of refugees.

Methods: Between January 2017 and June 2018, we conducted 36 in-depth interviews with stakeholders from Jordan and Lebanon, as well as global stakeholders, to understand the context, the achievements, gaps and priorities in the provision and uptake of NCD prevention, …

Family Composition And Stability For Orphans: A Longitudinal Study Of Well-Being In 5 Low- And Middle-Income Countries, Christine L. Gray, Kathryn Whetten, Julie L. Daniels, Michael G. Hudgens, Audrey E. Pettifor, Amy M. Hobbie, Nathan M. Thielman, Misganaw E. Dubie, Dafrosa Itemba, Ira Madan, Vanroth Vann, Austine I. Wasonga, Rachel Manongi, Jan Ostermann Ph.D., Rachel A. Whetten, Brian W. Pence

Faculty Publications

Objectives: Many orphaned children in low- and middle-income countries live with family. Yet, their household composition and its stability are not well-characterized, nor is impact of stability on longer-term outcomes.

Methods: We used the longitudinal, multi-country Positive Outcomes for Orphans cohort to describe adult family living with orphans. Stability was measured by changes in presence of six familial relations over time, and related to three outcomes: 1) incident abuse, 2) cognitive functioning, 3) emotional difficulties. Associations were estimated using generalized linear models fit with generalized estimating equations. For abuse, Poisson regression estimated risk ratios. For continuous scores of cognitive functioning …

Acute Pediatric Chagas Disease In Antioquia, Colombia: A Geographic Location Of Suspected Oral Transmission, Lídia Gual-Gonzalez, Catalina Aango-Ferreira, Laura Camila Lopera-Restrepo, Omar Cantillo-Barraza, Daniela Velásquez Marín, Natalia Restrepo Bustamante, Omar Triana-Chavez, Melissa Nolan Ph.D., Mph

Faculty Publications

Chagas disease, Trypanosoma cruzi infection, is an insidious cause of heart failure in Latin America. Early diagnosis and treatment are critical to prevent irreversible myocardial damage that progressively accumulates over decades. Several structural barriers account for the less than 1% of cases in Colombia being treated, including poor physician knowledge, especially considering that some regions are considered non-endemic. The two cases reported here represent an emerging epidemiologic scenario associated with pediatric Chagas disease. Both cases are suspected oral transmitted parasitic infection in a geographic region of Colombia (Andean region of Antioquia) where no previous oral transmission of Chagas disease had …

Basis For Changes In The Disease Burden Estimates Related To Vitamin A And Zinc Deficiencies In The 2017 And 2019 Global Burden Of Disease Studies, Sonja Y. Hess, Alexander C. Mclain, Haley Lescinsky, Kenneth H. Brown, Ashkan Afshin, Reed Atkin, Saskia Jm Osendarp

Faculty Publications

Background:

The Global Burden of Disease (GBD) Study provides estimates of death and disability from eighty-seven risk factors, including some micronutrient deficiencies. Objectives:

To review methodological changes that led to large differences in the disease burden estimates for vitamin A and Zn deficiencies between the GBD 2017 and 2019 Studies. Methods:

GBD publications were reviewed; additional information was provided by GBD researchers. Results:

Vitamin A deficiency prevalence is based on plasma retinol concentration, whereas the estimate for Zn deficiency prevalence uses dietary adequacy as a proxy. The estimated global prevalence of vitamin A deficiency for children aged 1–4 years in …

Nutrient Intake And Dietary Inflammatory Potential In Current And Recovered Anorexia Nervosa, Olivia Patsalos, Bethan Dalton, Christia Kyprianou, Joseph Firth, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd, Ulrike Schmidt, Hubertus Himmerich

Faculty Publications

Anorexia nervosa (AN) is characterised by disrupted and restrictive eating patterns. Recent investigations and meta-analyses have found altered concentrations of inflammatory markers in people with current AN. We aimed to assess nutrient intake in participants with current or recovered AN, as compared to healthy individuals, and explore group differences in dietary inflammatory potential as a possible explanation for the observed alterations in inflammatory markers. We recruited participants with current AN (n = 51), those recovered from AN (n = 23), and healthy controls (n = 49). We used the Food Frequency Questionnaire (FFQ), to calculate a Dietary …

Covid-19 Vaccine Acceptance In Older Syrian Refugees: Preliminary Findings From An Ongoing Study, Noura Salibi, Sawsan Abdulrahim, Maria El Haddad, Stephanie Bassil, Zeina El Khoury, Hala Ghattas Ph.D., Stephen J. Mccall

Faculty Publications

This study assesses COVID-19 vaccine intentions among a sample of older Syrian refugee beneficiaries of a humanitarian organization in Lebanon, and explores factors associated with vaccine refusal. The findings are part of an ongoing rotating 4-wave panel study. The sample was limited to participants from the first panel who completed a phone interview between January-February 2021. Out of 1,037 beneficiaries, almost a third (29%) reported no intention to vaccinate. Reasons for refusal were: newness of the vaccine (35%); preference to maintain precaution measures (21%); belief that the COVID-19 vaccine is not essential (21%); and other (23%). COVID-19 vaccine refusal was …

Occasions, Purposes, And Contexts For Offering Snacks To Preschool-Aged Children: Schemas Of Caregivers With Low-Income Backgrounds, Christine E. Blake, Kirsten K. Davison, Rachel E. Blaine, Jennifer O. Fisher

Faculty Publications

Objective Snacking among preschool aged children is nearly universal and has been associated with overconsumed nutrients, particularly solid fats and added sugars (SoFAS). This research examined caregivers’ schemas, or cognitive frameworks, for offering snacks to preschool-aged children.

Methods A qualitative design utilizing card sort methods was employed. Participants were 59 Black, Hispanic, and White caregivers of children aged 3–5 years with low-income backgrounds. Caregivers sorted 63 cards with images of commonly consumed foods/beverages by preschool-aged children in three separate card sorts to characterize snacking occasions, purposes, and contexts. The mean SoFAS content (kcal/100 g) of foods/beverages was evaluated by snacking …

Actions In Global Nutrition Initiatives To Promote Sustainable Healthy Diets, Ligia I. Reyes, Shilpa V. Constantinides, Shiva Bhandari, Edward A. Frongillo Jr. Ph.D., Pepijn Schreinemachers, Sigrid Wertheim-Heck, Helen Walls, Michelle Holdsworth, Amos Laar, Tuan Nguyen, Christopher Turner, Kate Wallard, Christine E. Blake Ph.D., Rd

Faculty Publications

Multiple recent global nutrition initiatives have recommended actions to transform food systems to improve food environments and food choice. This study aimed to identify actions recommended by these initiatives and understand their similarities and differences. Twelve global nutrition initiatives were reviewed, collectively spanning 13 action themes and accompanying strategies. Action themes were analyzed according to primary focus on either food environments and their food system drivers or food choice. Representation of the 13 actions varied across initiatives. Some actions overlapped; others were infrequently represented. Strategies targeting food environments and their food system drivers were more frequently recommended than strategies targeting …

Fostering Distance Education: Lessons From A United States-England Partnered Collaborative Online International Learning Approach, Lucy A. Ingram, Courtney M. Monroe, Haley Wright, Amy Burrell, Rebecca Jenks, Simon Cheung, Daniela B. Friedman Ph.D.

Faculty Publications

Collaborative Online International Learning (COIL) is a teaching and learning approach whereby entire courses or modules are co-developed and team taught by instructors from different institutions for students of both institutions. Since 2006, the approach has been gaining in mass appeal; however, considering our present-day global coronavirus pandemic, COILs have a renewed relevance in academia. Faculty from the University of South Carolina (United States) and Coventry University (England) embarked on a COIL partnership yielding a valuable experience that can serve as a model for other institutions that are interested in developing innovative and cross-cultural distance learning opportunities. The purpose of …

Challenges For Estimating The Global Prevalence Of Micronutrient Deficiencies And Related Disease Burden: A Case Study Of The Global Burden Of Disease Study, Sonja Y. Hess, Alexander C. Mclain Ph.D., Edward A. Frongillo Jr. Ph.D., Ashkan Afshin, Nicholas J. Kassebaum, Saskia Jm Osendarp, Reed Atkin, Rahul Rawat, Kenneth H. Brown

Faculty Publications

Information on the prevalence of micronutrient deficiencies is needed to determine related disease burden; underpin evidence-based advocacy; and design, deliver, and monitor safe, effective interventions. Assessing the global prevalence of deficiency requires a valid micronutrient status biomarker with an appropriate cutoff to define deficiency and relevant data from representative surveys across multiple locations and years. The Global Burden of Disease Study includes prevalence estimates for iodine, iron, zinc, and vitamin A deficiencies, for which recommended biomarkers and appropriate deficiency cutoffs exist. Because representative survey data are lacking, only retinol concentration is used to model vitamin A deficiency, and proxy indicators …

A Healthy Dietary Pattern With A Low Inflammatory Potential Reduces The Risk Of Gestational Diabetes Mellitus, Lotta Pajunen, Liisa Korkalo, Noora Houttu, Outi Pellonperä, Kati Mokkala, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd, Tero Vahlberg, Kristina Tertti, Kirsi Laitinen

Faculty Publications

Purpose An optimal diet for lowering the risk of gestational diabetes mellitus (GDM) is still to be defined, but may comprise of nutrient intakes, dietary patterns, diet quality, and eating frequency. This study was designed to investigate the contribution of diet in developing GDM in a comprehensive way. Methods The dietary intake of overweight or obese women, a risk group for GDM (n = 351), was assessed using 3-day food diaries and diet quality questionnaires in early pregnancy. Eating frequency and nutrient intakes were calculated, and dietary patterns identified using principal component analysis. The inflammatory potential of the diet was …

Performance Of A Validated Spontaneous Preterm Delivery Predictor In South Asian And Sub-Saharan African Women: A Nested Case Control Study, Rasheda Khanam, Tracy C. Fleischer, Nansi Boghossian, Imran Nisar, Usha Dhingra, Sayedur Rahman, Angela C. Fox, Muhammad Iiyas, Arup Dutta, Nurun Naher, Ashoka D. Polpitiya, Usma Mehmood, Saikat Deb, Aziz Ahmed Choudhury, Md Bahadur Badsha, Karim Muhammad, Said Mohammed Ali, Salahuddin Ahmed, Durlin E. Hickok, Najeeha Iqbal, Et. Al.

Faculty Publications

Objectives

To address the disproportionate burden of preterm birth (PTB) in low- and middle-income countries, this study aimed to (1) verify the performance of the United States-validated spontaneous PTB (sPTB) predictor, comprised of the IBP4/SHBG protein ratio, in subjects from Bangladesh, Pakistan and Tanzania enrolled in the Alliance for Maternal and Newborn Health Improvement (AMANHI) biorepository study, and (2) discover biomarkers that improve performance of IBP4/SHBG in the AMANHI cohort.

Study design

The performance of the IBP4/SHBG biomarker was first evaluated in a nested case control validation study, then utilized in a follow-on discovery study performed on the same samples. …

Causal Effects On Low Apgar At 5-Min And Stillbirth In A Malaria Maternal–Fetal Health Outcome Investigation: A Large Perinatal Surveillance Study In The Brazilian Amazon, Julio Abel Seijas-Chávez, Melissa Nolan Ph.D., Mph, Mary K. Lynn, Maria José Francalino Da Rocha, Muana Da Costa Araújo, Fernando Luiz Affonso Fonseca, Gabriel Zorello Laporta

Faculty Publications

Background

Malaria elimination in Brazil poses several challenges, including the control of Plasmodium falciparum foci and the hidden burden of Plasmodium vivax in pregnancy. Maternal malaria and fetal health outcomes were investigated with a perinatal surveillance study in the municipality of Cruzeiro do Sul, Acre state, Brazilian Amazon. The research questions are: what are the causal effects of low birth weight on low Apgar at 5-min and of perinatal anaemia on stillbirth?

Methods

From November 2018 to October 2019, pregnant women of ≥ 22 weeks or puerperal mothers, who delivered at the referral maternity hospital (Juruá Women and Children’s Hospital), …

Social Determinants Of Health Related To Stay-At-Home Order Adherence And Social Distancing Attitudes Among A Diverse Deep South Population, Jennifer L. Lemacks, Tammy Greer, Sermin Aras, Laurie Abbott, Darlene Willis, June Gipson, Mohamed O. Elasri

Faculty Publications

Objective: To describe COVID-19 related symptoms and medical care experienced in the first six months of the pandemic as well as stay-at-home order adherence, and attitudes related to COVID-19 risk and social distancing among a diverse sample of adults in the Deep South.

Methods: Survey data were collected from 411 Louisiana and Mississippi residents for three weeks in June 2020 through social media.

Results: Over half (52.5%) of participants who experienced COVID-19 related symptoms (with 41.5% experiencing at least one symptom) did not feel the severity of symptoms warranted seeking medical care. 91.6% of the Deep South …

Blood Donation Fear, Perceived Rewards, Self-Efficacy, And Intention To Return Among Whole Blood Donors In China: A Social Cognitive Perspective, Zhong Li, Shuge Lei, Xiamoing Li Ph.D., Yilun Zhao, Yudong Dai, Shengxuan Jin, Qiang Fu, Xubing Cai, Zhenping Lin, Xiaoming Tu

Faculty Publications

With the increasing demand from aging population and seasonal blood shortage, recruiting and retaining blood donors has become an urgent issue for the blood collection centers in China. This study aims to understand intention to donate again from a social cognitive perspective among whole blood donors in China through investigating the association between the blood donation fear, perceived rewards, self-efficacy, and intention to return. A cross-sectional survey was conducted in six cities, which are geographically and socioeconomically distinct areas in Jiangsu, China. Respondents completed a self-administrated questionnaire interviewed by two well-trained medical students. A total of 191 blood donors were …

The Dietary Inflammatory Index Is Not Associated With Gut Permeability Or Biomarkers Of Systemic Inflammation In Hiv Immunologic Non-Responders, Fat Malazogu, Rodney K. Rousseau, Nitin Shivappa Mbbs, Mph, Ph.D., Sanja Huibner, Sharon L. Walmsley, Colin M. Kovacs, Erika Benko, Robert J. Reinhard, Ron Rosenes, James R. Hébert, Rupert Kaul

Faculty Publications

Immunologic non-responders (INRs) are a subset of individuals living with HIV who have suboptimal blood CD4+ T cell recovery despite effective antiretroviral therapy (ART). They are at an increased risk of serious non-AIDS co-morbidities and death, and demonstrate enhanced systemic immune activation. In other populations diet has been correlated with markers of systemic inflammation through the Diet Inflammatory Index (DII), but this association has not been studied in persons living with HIV (PLWH). Blood was collected from 28 INR PLWH with a blood CD4+ T cell count <350/μL despite ≥2 years of effective ART. Participants completed a Canadian Diet History Questionnaire, and their responses were used to calculate the DII. Plasma inflammatory markers (IFNγ, TNF, IL-6, sVCAM, D-dimer, sCD14 and CRP) were assayed by ELISA, cellular immune activation (HLA-DR and CD38 on CD4+ and CD8+ T cells) was quantified using flow cytometry, and small bowel permeability assessed by calculation of the urine LacMan ratio after drinking a mix of lactulose and mannitol. Participants were a median age of 57 years, had been on effective ART for 15 years, and the median DII was −1.91 (range of −3.78 to +2.23). No correlation was observed between DII and plasma markers of inflammation, levels of T cell activation, gut permeability, or the biomarker of bacterial translocation sCD14. Self-reported alcohol intake, a potential confounder of the relationship between diet and inflammatory biomarkers, was also not associated with systemic inflammation or gut permeability. Our findings suggest that other mechanisms, rather than diet, are likely to be the major driver of systemic inflammation in INR individuals.

Association Between Diet Quality Indices And Incidence Of Type 2 Diabetes In The Melbourne Collaborative Cohort Study, Allison M. Hodge, Md Nazmul Karim, James Hébert Scd, Nitin Shivappa Mbbs, Mph, Ph.D., Barbora De Courten

Faculty Publications

Type 2 diabetes mellitus is a common condition whose incidence is increasing worldwide, and for which obesity and diet are important risk factors. The aim of this study was to assess the association of three diet quality scores with diabetes risk and how much of the association was mediated through body size. The Melbourne Collaborative Cohort Study recruited 41,513 men and women aged 40–69 years during 1990–1994. At baseline, data were collected on lifestyle and diet, anthropometric measures were performed. Incident diabetes was assessed by self-report at follow-up surveys in 1994–1998 and 2003–2007. The associations between the dietary inflammatory index …

Challenges For Estimating The Global Prevalence Of Micronutrient Deficiencies And Related Disease Burden: A Case Study Of The Global Burden Of Disease Study, Sonja Y. Hess, Alexander C. Mclain, Edward A. Frongillo Jr., Ashkan Afshin, Nicholas J. Kassebaum, Saskia J. Osendarp, Reed Atkin, Rahul Rawat, Kenneth H. Brown

Faculty Publications

Information on the prevalence of micronutrient deficiencies is needed to determine related disease burden; underpin evidence-based advocacy; and design, deliver, and monitor safe, effective interventions. Assessing the global prevalence of deficiency requires a valid micronutrient status biomarker with an appropriate cutoff to define deficiency and relevant data from representative surveys across multiple locations and years. The Global Burden of Disease Study includes prevalence estimates for iodine, iron, zinc, and vitamin A deficiencies, for which recommended biomarkers and appropriate deficiency cutoffs exist. Because representative survey data are lacking, only retinol concentration is used to model vitamin A deficiency, and proxy indicators …

Shaper-Pnd Trial: Clinical Effectiveness Protocol Of A Community Singing Intervention For Postnatal Depression, Carolina Estevao, Rebecca Bind, Daisy Fancourt, Kristi Sawyer, Paola Dazzan, Nick Sevdalis, Anthony Woods, Nikki Crane, Lavinia Rebecchini, Katie Hazelgrove, Manonmani Manoharan, Alexandra Burton, Hannah Dye, Tim Osborn, Rachel E. Davis, Tayana Soukup, Jorge Arias De La Torre, Ioannis Bakolis, Andy Healey, Rosie Perkins, Carmine Pariante

Faculty Publications

INTRODUCTION: Postnatal depression (PND) affects approximately 13% of new mothers. Community-based activities are sought after by many mothers, especially mothers that prefer not to access pharmacological or psychological interventions. Singing has shown positive effects in maternal mood and mother-child bonding. The Scaling-Up Health-Arts Programmes: Implementation and Effectiveness Research-Postnatal Depression study will analyse the clinical and implementation effectiveness of 10-week singing sessions for PND in new mothers. This protocol paper will focus on the clinical effectiveness of this trial. METHODS AND ANALYSIS: A total of 400 mothers with PND (with a score of at least 10 on the Edinburgh Postnatal Depression …

Association Between Neighborhood Social Deprivation And Stage At Diagnosis Among Breast Cancer Patients In South Carolina, Oluwole Adeyemi Babatunde, Whitney Zahnd Ph.D., Jan Eberth Ph.D., Andrew B. Lawson, Swann Arp Adams, Eric Adjei Boakye, Melanie S. Jefferson, Caitlin G. Allen, John L. Pearce, Hong Li, Chanita Hughes Halbert

Faculty Publications

The purpose of this study was to examine the association between neighborhood social deprivation and individual-level characteristics on breast cancer staging in African American and white breast cancer patients. We established a retrospective cohort of patients with breast cancer diagnosed from 1996 to 2015 using the South Carolina Central Cancer Registry. We abstracted sociodemographic and clinical variables from the registry and linked these data to a county-level composite that captured neighborhood social conditions—the social deprivation index (SDI). Data were analyzed using chi-square tests, Student’s t-test, and multivariable ordinal regression analysis to evaluate associations. The study sample included 52,803 female patients …

Differences By School Location In Summer And School Monthly Weight Change: Findings From A Nationally Representative Sample, Ethan T. Hunt, Bridget Armstrong Ph.D., Gabrielle Turner-Mcgrievy Ph.D., Rd, Michael Beets Med, Mph, Phd, Robert Weaver Med, Phd

Faculty Publications

Objectives: To examine changes in accelerations of Body Mass Index (BMI), age-and-sex specific body mass index (zBMI), and 95th percentile of BMI (%BMIp95) during the summer months and school year by school location designation (i.e., urban, suburban, exurban). This study utilized the Early Childhood Longitudinal Study Kindergarten Class of 2010-2011.

Methods: Of the 18,174 children in the ECLS-K:2011 dataset, I restricted participants to those with at least two consecutive measures that occurred August/September or April/May. Mixed-effect regression analyses estimated differences in monthly change in BMI, zBMI, and %BMIp95 between the summer and school year while accounting for the ECLS-K complex …

Impact Of Front-Of-Pack Labels On The Perceived Healthfulness Of A Sweetened Fruit Drink: A Randomised Experiment In Five Countries, Alejandra Jauregui, Christine M. White, Lana Vanderlee, Marissa G. Hall, Alejandra Contreras-Manzano, Claudia Nieto, Gary Sacks, Jim Thrasher Ph.D., Ma, Ms, David Hammond, Simón Barquera

Faculty Publications

Objective: Front-of-pack (FOP) nutrition labelling is a globally recommended strategy to encourage healthier food choices. We evaluated the effect of FOP labels on the perceived healthfulness of a sweetened fruit drink in an international sample of adult consumers.

Design: Six-arm randomised controlled experiment to examine the impact of FOP labels (no label control, Guideline Daily Amounts (GDA), Multiple Traffic Lights, the Health Star Ratings (HSR), Health Warning Labels, and 'High-in' Warning Labels (HIWL)) on the perceived healthfulness of the drink. Linear regression models by country examined healthfulness perceptions on FOP nutrition labels, testing for interactions by demographic characteristics.

Setting: Online …