Public Health Commons^™

Living Next Door To Mcdonald’S: A Qualitative Study Of Community Submissions And Resident Realities Pre- And Post Development, Roslyn Giglia, Jacinta Francis, Jana Buckle, Clare Whitton, Ros Sambell, Frith Klug, Lukar Thornton, Siobhan Hickling, Katherine Kent, Gina Trapp

Research outputs 2022 to 2026

Background: The proliferation of fast-food outlets (FFOs) in residential areas has raised growing concerns about their impact on community health, safety, and wellbeing. This qualitative study examined both pre-development community consultation submissions and post-development resident experiences surrounding the development of a McDonald’s outlet in a newly established suburb on the urban fringe of Perth, Western Australia (WA). Methods: Using a qualitative descriptive design, the study analyzed 183 community submissions lodged with the local council prior to development and conducted semi-structured interviews with 11 residents living within 300 m of the outlet after construction. Results: Content analysis revealed strong opposition, with …

Dietary Patterns And Factors Associated With Breast Cancer Risk In Ethnically Diverse Women: Observational And Full Plate Living Lifestyle Intervention Findings, Padma P. Tadi Uppala, Elmer C. Rivera, Sherri Isaak, Jean Cadet, Dixon Anjejo, Victoria Rios-Rivas, Michael Uppala, Nicole Bodetti

Faculty Publications

Background

Ethnic disparities in diet quality, adiposity, and previously identified factors contribute to metabolic dysregulation and breast cancer risk. However, integrated evidence linking dietary patterns, metabolic markers, and lifestyle intervention outcomes across diverse populations remains limited.

Methods

This study presents findings from three complementary investigations conducted within a broader research program and examined within a structured conceptual and comparative framework. Studies 1 and 2 are cross-sectional analyses conducted in ethnically diverse women recruited from community sites in California and Michigan, and Study 3 is a 16-week whole food plant-based, water and fiber-rich dietary intervention conducted in a university lifestyle medicine …

Barriers And Facilitators To Health Literacy Among Black Americans With Overweight And Obesity In South Carolina: A Mini-Ethnographic Study, Shelly Campbell-Timmons

Doctoral Dissertations and Projects

The purpose of this qualitative mini ethnography adapted from traditional ethnography with limited time and scope, was to explore and understand perceptions of barriers and facilitators to health literacy among Black Americans with overweight and obesity in three South Carolina counties. Population data showed that approximately 40.3% of U.S. adults are obese. Moreover, Non-Hispanic Black communities are disproportionately affected by overweight and obesity despite efforts to combat the weight-related health risk. Still, limited health literacy should be the focus of public health strategies like teach-back and plain language communication, to address overweight and obesity prevalence and disparities. The study was …

The Association Between Rapid Growth In Children Under The Age Of Five And Adolescent Obesity, Ratu Ayu Dewi Sartika, Fadila Wirawan, Iche Andriyani Liberty, Nurul Husna Mohd Shukri, Siti Arifah Pujonarti, Edy Purwanto, Munaya Fauziah

Kesmas

Early-life nutrition is a critical predictor of long-term health, yet the association between rapid early-childhood growth and adolescent obesity, particularly in relation to the “double burden of malnutrition,” remains under-researched in Indonesia. This study aimed to analyze the association between rapid growth and adolescent obesity. Data were obtained from the 1997, 2000, and 2014 waves of the Indonesian Family Life Survey (IFLS). This study included 641 children (aged 0–23 months at baseline) with complete anthropometric measurements across all three waves. Rapid growth was defined as an increase in z-scores of >0.67 in weight-for-age (WAZ), height-for-age (HAZ), or weight-for-height (WHZ) between …

Assessing Healthcare Access Among Overweight And Obese Individuals In Türkiye Using Latent Variable Modeling, Banu Beyaz Sipahi

Makara Journal of Health Research

Background: Overweight and obesity are critical determinants of healthcare access, yet evidence on how the COVID-19 pandemic reshaped these dynamics in Türkiye remains limited. This study investigates whether the early post-pandemic recovery period altered healthcare access patterns for individuals with excess weight.

Methods: Using nationally representative microdata from the 2014, 2016, 2019, and 2022 Turkish Health Surveys, we constructed a latent Healthcare Access Index based on six indicators of unmet care needs. Probit models were estimated to assess associations between BMI categories and healthcare access, controlling for socioeconomic and demographic factors. The 2022 wave serves as the early …

Experiences Of Cholesterol Management Among Obese Individuals: A Qualitative Exploration Of Statin Use, Diet, And Physical Activity, Ke'andra S. Foggie

Doctoral Dissertations and Projects

The prevalence of hypercholesterolemia has increased over the past decade, with obesity identified as a major contributing factor. This study examined how individuals with obesity and hypercholesterolemia managed cholesterol and experienced related challenges within their daily lives. Guided by the Chronic Care Model, the research explored participant-reported experiences of statin therapy and lifestyle practices, including dietary behaviors and physical activity, as components of cholesterol management. Qualitative data were collected through semi-structured interviews, observations, and document analysis to analyze participant-reported barriers, supports, and contextual factors that shape how these practices are incorporated into daily routines. Although extensive research has examined statin …

Persistent Gaps In Management And Risk Factor Control Among Patients With Atherosclerotic Cardiovascular Disease: All Of Us Research Program, Yakubu Bene-Alhasan, Soad Al Osta, Yussif Issaka, Isaac Acquah, Ahmad Alkhatib, Leen Othman, Samuel Mensah, Ato Howard, Christie Ballantyne, Salim S. Virani

Population Health, East Africa

Background

Methods

Sagittal Abdominal Diameter And Abdominal Aortic Calcification Are Associated With Incident Major Adverse Cardiovascular Events: The Manitoba Bone Density Registry, Haftom N. Abraha, Abadi K. Gebre, Marc Sim, Cassandra Smith, Syed Zulqarnain Gilani, Zaid Ilyas, Fatima Zarzour, John T. Schousboe, Lisa M. Lix, Neil Binkley, Siobhan Reid, Barret A. Monchka, Douglas Kimelman, Joshua R. Lewis, William D. Leslie

Research outputs 2022 to 2026

BackgroundSagittal abdominal diameter (SAD), a measure of visceral adiposity, has been linked to major adverse cardiovascular events (MACE). However, the relationship between SAD and abdominal aortic calcification (AAC), a marker of subclinical vascular disease, and whether they independently and jointly predict MACE remains unclear.ObjectiveTo investigate whether weight-normalized SAD and AAC scored using a validated machine learning algorithm (ML-AAC24) are independently and jointly associated with incident MACE.MethodsSAD and ML-AAC24 were measured from dual-energy X-ray absorptiometry (DXA) posteroanterior and lateral spine images, respectively, from the Manitoba Bone Density registry.ResultsAmong 8806 individuals (mean age 75.1 ± 6.6 years, 93.9% women), 11.3% experienced MACE …

Health Disparities In El Paso's Low-Income Hispanic Communities: A Mixed-Methods Analysis Of Acculturation, Obesity Metrics, And Socio-Cultural Determinants, Karen Del Rio

Open Access Theses & Dissertations

Health disparities among low-income Hispanic immigrants in the United States are shaped by complex interactions between acculturation, structural inequality, and socio-cultural determinants that behavioral and epidemiological models have not fully explained. This dissertation examines the relationship between acculturation and obesity-related outcomes among uninsured and low-income Hispanic adults of Mexican descent in El Paso, Texas, using a three-article, sequential, explanatory, mixed-methods design grounded in Latina/o Critical Race Theory (LatCrit).Article 1 presents a systematic review of 20 peer-reviewed studies examining acculturation and obesity among Mexican Americans, finding consistent evidence that longer U.S. residence is associated with increased BMI and obesity prevalence, mediated …

The Relationship Between Consumption Frequency And Energy Intake Of Ultra-Processed Food And Obesity Based On Body Fat Percentage Among Fph Ui Students In 2025, Sarah Keisya Budiargo, Triyanti Triyanti, Asih Setiarini, Dieta Nurrika

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is the accumulation of excessive body fat and increases the risk of various non-communicable diseases. Obesity prevalence among FPH UI students based on health examination data in 2022-2024 has reached 13.6%, exceeding the public health concern threshold and requiring more accurate measurement than Body Mass Index. This study aimed to determine the relationship between ultra-processed food (UPF) consumption frequency and energy intake with obesity incidence based on body fat percentage among 147 FPH UI students in 2025. This cross-sectional study utilized the Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) based on NOVA classification to assess UPF intake. Body fat percentage was …

The Relationship Between Obesity Among Children And Adolescents With Dietary Intake And Physical Activity: A Scoping Review, Devi Dwi Yolani, Tania Okta Wardhani, Rani Aqilah Ni’Matul Maula, Almira Sitasari, Tri Siswati

Indonesian Journal of Public Health Nutrition (IJPHN)

Childhood and adolescent obesity remain a significant public health issue worldwide. This review summarizes research on the relationship among obesity, physical activity, and diet. This study aims to investigate the relationship between children's and adolescents' obesity, their physical activity levels, and diet. A scoping review was conducted by assessing 81 research journal articles from 2014 to 2023 from electronic databases such as Google Scholar and PubMed. The search strategy used Boolean operators as follows: (“child*” OR “adolescent”) AND (“obesity”) AND (“diet” OR “food intake”) AND (“physical activity”), selected based on the inclusion criteria of children and adolescents aged 1-18 years …

Cross-Sectional Associations Of Metabolically Healthy Obesity, Lifestyle Factors, And Steatotic Liver Disease In Adults From The Fels Longitudinal Study, Stefan A Czerwinski

Faculty, Staff and Student Publications

Objective: To examine the associations of metabolic health and obesity phenotypes with liver fat accumulation and hepatic steatosis in adults.

Methods: We analyzed 676 non-Hispanic white adults (18-95 years; 55.8% female) from the Fels Longitudinal Study using a cross-sectional design. Participants were classified into metabolically healthy normal weight (MHNW), metabolically healthy obesity (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obesity (MUO) phenotypes. Metabolically unhealthy status was defined as the presence of ≥1 metabolic dysfunction, consistent with prior epidemiological definitions; secondary analyses using ≥2 were also performed. Obesity was defined using DXA-derived body fat percentage. Liver fat (%) was …

Cross-Sectional Associations Of Metabolically Healthy Obesity, Lifestyle Factors, And Steatotic Liver Disease In Adults From The Fels Longitudinal Study, Ariana L. Garza, Audrey C. Choh, John Blangero, Cici X. Bauer, Stefan A. Czerwinski, Miryoung Lee

School of Medicine Publications

Objective: To examine the associations of metabolic health and obesity phenotypes with liver fat accumulation and hepatic steatosis in adults. Methods: We analyzed 676 non-Hispanic white adults (18–95 years; 55.8% female) from the Fels Longitudinal Study using a cross-sectional design. Participants were classified into metabolically healthy normal weight (MHNW), metabolically healthy obesity (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obesity (MUO) phenotypes. Metabolically unhealthy status was defined as the presence of ≥1 metabolic dysfunction, consistent with prior epidemiological definitions; secondary analyses using ≥2 were also performed. Obesity was defined using DXA-derived body fat percentage. Liver fat (%) was …

Obesity In The Rio Grande Valley: Applying An Evidence-Based Public Health Approach, Erika Pineda-Horta

Posters - 2026

What structural and social determinants drive elevated adult obesity rates in the Rio Grande Valley, and what evidence-based interventions can reduce adult obesity prevalence in Hidalgo County by 5% by 2030?

Objective: This study applies an EBPH framework to (1) characterize the burden and structural determinants of adult obesity in the RGV, and (2) propose a culturally responsive, evidence-based intervention targeting adults aged 18+ in Hidalgo County.

Adult obesity is clinically defined as a Body Mass Index (BMI) ≥30 kg/m² in adults aged 18 and older (CDC, 2022). It is a chronic, multifactorial non-communicable disease shaped by structural, social, and …

Development And Validation Of A Life Participation Self-Assessment Tool For People Living With Obesity: The Life Participation Impact Questionnaire (Lpiq-O), Marie-Claude Touchette

Translational Science in Occupation

Purpose: Obesity is a chronic condition affecting over 40% of adults in the U.S. Given the well-documented impact of obesity on life participation, a comprehensive, population-specific assessment tool is needed. We aimed to establish the face and content validity of the Life Participation Impact Questionnaire for People with Obesity (LPIQ-O), an occupation-focused assessment tool measuring the impact of obesity on areas of life participation.

Method: This study included seven iterative phases: (a) literature review, (b) interviews, (c) synthesis of the literature review and interviews, (d) item development, (e) expert validation, (f) face validation, and (g) final expert review. Six participants …

Evaluating Strategies For Reducing Rates Of Adult Obesity In The United States Through Childhood Education And Exercise, Ameer M. Abdelkrim

Doctoral Dissertations and Projects

Obesity is a growing national public health crisis, impacting millions of adults and children in the U.S. Untreated obesity causes or aggravates diseases across multiple body systems. The societal impacts of obesity include an avoidable strain on the national healthcare system, with obesity and its comorbid conditions raising healthcare costs. Proactive policy and practices, with strict oversight, are essential for achieving a reduction in obesity rates. One proactive strategy that may be effective is early-age intervention, including enhanced physical activity and nutrition education for U.S. children. This study evaluates adolescent-intervention strategies for reducing rates of adult obesity. The employed methods …

Multilevel Analysis Of The Food And Physical Activity Environment And Adult Obesity Across U.S. Counties And States

Faculty, Staff and Student Publications

Adult obesity rates have risen steadily across the United States over the past decade, with more than 40% of adults affected. Persistent geographic and demographic disparities exist in obesity prevalence across the nation. While prior research has examined individual or environmental associated factors of obesity, limited studies have addressed both physical activity and food environments across the nation using multilevel approaches. This cross-sectional ecological study (2014-2024) used a two-level random intercept model to assess the association between county- and state-level factors and adult obesity prevalence across over 3000 U.S. counties nested within 51 states. County-level associated factors included food insecurity, …

Obesity And Long Covid: Intersecting Epidemics?, Michael Gottlieb, Huihui Yu, Ji Chen, Erica S. Spatz, Nicole L. Gentile, Rachel E. Geyer, Michelle Santangelo, Caitlin Malicki, Kristyn Gatling, Kelli N. O'Laughlin, Kari A. Stephens, Joann G. Elmore, Lauren E. Wisk, Michelle L'Hommedieu, Robert M. Rodriguez, Juan Carlos C. Montoy, Ralph C. Wang, Kristin L. Rising, Efrat Kean, Jonathan W. Dyal, Mandy J. Hill, Arjun K. Venkatesh, Robert A. Weinstein, Inspire Group

Jefferson Center for Connected Care Faculty Papers

BACKGROUND: Obesity affects over 10% of the world population and has significant public health implications. With rising recognition of the long-term effects of Long COVID (LC) coupled with new agents to facilitate weight loss, it is critical to understand the influence of obesity on LC. This study assessed the association of obesity with rates of LC and degree of LC-related mental and physical health outcomes among participants up to three years after initial infection.

METHODS: This was a cross-sectional, multisite study of participants with SARS-CoV-2 infection from 12/11/2020–8/29/2022, with data collected through 4/2/2024. Surveys included validated tools for physical and …

Childhood Factors That Affect Adult Obesity In Ohio And Mississippi, Rhea Lal, Danielle Wolford

Scholarship in Medicine - All Papers

Over 40% of adults in the United States struggle with obesity. While several social determinants of health have been tied to obesity, only limited research on the effect of childhood education, food environments, and physical activity resources on a state-wide level has been conducted. It is imperative that we identify connections between obesity, associated comorbidities, education, and SDoH as these will inform improvements in national social structures and healthcare systems. States Ohio (OH) and Mississippi (MS) differ in high school completion rates, food access, and exercise opportunities yet both states continue to experience rising adult obesity rates. This study analyzed …

The Impact Of Gastric Sleeve And Roux-En-Y Gastric Bypass On Chief Cell Function And Protein Digestion In Obese Patients, Garikoitz Mikel Gainza

Honors Undergraduate Theses

Obesity has become one of the largest global health concerns of the 21^st century, correlating with numerous associated diseases. To help address the growing prevalence and burden of obesity, sleeve gastrectomy and Roux-en-Y gastric bypass have become two commonly performed surgical procedures done to promote weight loss by altering the anatomical structure of the stomach and surrounding organs of the gastrointestinal system. Although the benefits of improved metabolism linked to these surgical procedures are well studied, their impact on the physiology of gastric cells, and more specifically chief cells as they relate to protein digestion post-surgery, is yet to …

The Connection Between Medicaid And Obesity In Northeast Ohio, Sophie Kheder, Emmie Kelley

Williams Honors College, Honors Research Projects

Obesity is a major public health concern in the United States that is projected to increase exponentially over the next few years. Obesity is commonly associated with a lower socioeconomic status. Lower-income individuals tend to be supported by Medicaid, a federal insurance program for low-income Americans. Prior studies have shown a positive correlation between income status and obesity prevalence. Our goal was to find if there was a correlation between Medicaid patients and obesity in Northeast Ohio, to provide physicians with a set of characteristics to better combat obesity, since preventative and treatment guidelines are tailored to national trends. We …

Baseline Body Mass Index Category And Incident Treated Hypertension In Australian Men: A Linked Prospective Cohort Study Using Pbs/Mbs Data, Ebenezer Afrifa-Yamoah

Research outputs 2022 to 2026

Background: Excess adiposity is a major modifiable risk factor for hypertension; however, the incremental prognostic value of body mass index (BMI) beyond standard predictors remains unclear. We examined the associations between baseline BMI category and incident treated hypertension, and assessed whether BMI improved risk prediction.

Methods: Data were obtained from the Ten to Men longitudinal study (2013–2024) linked to Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) records. The cohort comprised 12,742 men aged ≥ 18 years without treated hypertension at baseline, followed for 133,038 person-years. Adjusted Cox proportional hazards models were fitted. Discrimination, calibration, decision curve analysis, E-values, …

Advancing Virus-Associated Lymphoma Research In Latin America: A Global Opportunity For Cancer Science, Luis Malpica

Faculty, Staff and Student Publications

No abstract provided.

The Longitudinal Effect Of Repetition And Practice On The Accuracy Of Lay Anal Examinations For Detecting Perianal And Anal Canal Abnormalities: A Prospective Study, Michael D Swartz, Ellen Almirol, John A Schneider, J Michael Wilkerson, Lu-Yu Hwang, Derek Smith, Duo Yu, Aniruddha Hazra, Elizabeth Y Chiao

Faculty, Staff and Student Publications

Background: While anal cancer screening is now recommended in several countries for high-incidence populations, barriers impede screening uptake. It is well known that patient recognition of symptoms increases cancer screening uptake, and we previously demonstrated that patients can detect small masses at the perianus and in the anal canal. In this current analysis, we aimed to longitudinally assess the effect of repetition and practice on patient self-recognition of small masses.

Methods: Individuals and couples of sexual minority men and transgender women were taught to conduct an anal self-examination or anal companion examination (ASE/ACE) at visit 1 and then randomized to …

A Cross-Sectional Study Investigating The Relationship Between The Fto Gene Polymorphism In Relation To Obesity Traits And Vitamin D Status In Adolescence, Ahmad Al-Serri, Rabeah A. Al-Temaimi, Abdullah Al-Taiar, Lemia Shaban, Reem Al-Sabah, Abdur Rahman, Ali H. Ziyab

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background and Objective: Obesity affects 18%-25% of adolescents globally and represents a major public health challenge. Genetic factors contribute to obesity susceptibility, with the FTO gene variant rs9939609 consistently associated with obesity in adults; however, evidence in adolescents is limited. This study examined the association between FTO and obesity traits in adolescents and explored potential interactions with vitamin D status.

Methods: In this cross-sectional study, 509 adolescents aged 10-15 years were genotyped for FTO rs9939609. Obesity traits, including BMI, BMI z-score, and waist circumference, were assessed. Associations with genotype were analyzed using an additive genetic model, and potential interactions with …

Vitamin D Status During Pregnancy Modulates The Effect Of Pre-Pregnancy Obesity On Gestational Diabetes Mellitus Risk: A Birth Cohort Study, Ali H. Ziyab, Abdullah Al-Taiar, Reem Al-Sabah, Majeda S. Hammoud, Saeed Akhtar

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objective:

To determine whether gestational vitamin D status modulates the effect of pre-pregnancy obesity on gestational diabetes mellitus (GDM) risk while stratifying by maternal age.

Design:

Birth cohort.

Setting:

A major maternity hospital in Kuwait.

Participants:

Pregnant women in their second/third trimester of gestation were enrolled. Pre-pregnancy body mass index (BMI, kg/m²) was categorized as under/normal weight (< 25.0), overweight (25.0 to < 30.0), and obesity (≥30.0). Gestational 25-hydroxyvitamin D concentrations were categorized as deficiency (< 50 nmol/L) or insufficiency/sufficiency (≥50 nmol/L). GDM status was ascertained according to international guidelines. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated using logistic regression.

Results:

Data from 957 pregnant women were analyzed, with GDM affecting 166 (17.4%) pregnancies. Pre-pregnancy obesity and gestational vitamin D deficiency was ascertained in 275 (28.7%) and 533 (55.7%) pregnant women, respectively. The association between pre-pregnancy obesity and GDM risk differed according …

Systematic Review And Meta‑Analysis Of United States Childhood Obesity Public Policy Interventions, Marilyn Frenn, Maharaj Singh, Julia A. Snethen, Leigh Small, Nancy Browne, Cindy Smith Greenberg, Emily Horner, Sharon Y. Irving, Eric A. Hodges

College of Nursing Data

No abstract provided.

Epidemiology, Presentation, And Diagnosis Of Type 2 Diabetes Mellitus In Children And Adolescents, Bisher Alsabbagh, Whard Alsabbagh

School of Integrative Biological & Chemical Sciences (Formerly Dept. of Biology)

The prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents has increased substantially over recent decades, paralleling rising rates of pediatric obesity and metabolic risk. Youth-onset T2DM is characterized by significant insulin resistance accompanied by an inadequate compensatory insulin response, resulting in progressive hyperglycemia and early beta-cell dysfunction. Incidence varies widely among racial and ethnic groups, with the highest rates observed in non-Hispanic Black, Hispanic, Native American, Asian American, and Pacific Islander youth. Risk factors include obesity, family history, high-risk ethnicity, pubertal insulin resistance, prenatal metabolic exposures, and comorbid conditions such as polycystic ovary syndrome. Clinical presentation ranges …

Across The Pond, Across The Waistline: A Comparative Look At The Childhood Obesity Crisis In The United States And United Kingdom, Samantha N. Eales

Honors College Theses

Childhood obesity is no longer just a local concern; it’s a global epidemic shaping the health of future generations. This paper compares how two similar nations with drastically different healthcare systems, the United States and the United Kingdom, tackle this growing crisis. Although both countries struggle with fast food culture, sedentary lifestyles, and targeted marketing, their health policy strategies differ dramatically. The U.S. leans on community programs and education, while the U.K. enforces stronger national regulations and advertising restrictions. By examining nutrition, physical activity, and policy, this thesis explores what each country does well and where they fall short. It …

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

Sociology Faculty Articles and Research

Introduction

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

Methods

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