Maternal and Child Health Commons^™

Nourishing Births: A Program Evaluation Proposal For Community-Based Nutrition Education, Food Access, And Garden Engagement Among Black Birthing People, Naa Deedei-Vera Hammond

Master's Projects and Capstones

Black birthing people in the United States continue to experience unequal maternal health outcomes, shaped in part by racism and barriers to nutritious food, culturally relevant health education, and supportive community spaces. While prenatal nutrition education and food assistance programs can provide important resources, information alone cannot address the challenges many people face when trying to access healthy and affordable food during pregnancy. The Nourishing Births Initiative is a proposed community-based maternal health program designed to respond to these needs by bringing together prenatal nutrition education, help connecting to food resources, community gardening, and peer support for Black birthing people …

Healthcare Access And The Persistent Racial Disparities In Low Birth Weight, Zaheda A. Hussain, Yadanar Moe

DePaul Discoveries

Low birth weight (LBW), defined as less than 2,500 grams, is an influential factor contributing to infant mortality in the United States, with significant racial disparities between Black and White mothers. This study analyzed data from 3,054 Black and White mothers collected from the 2018 National Health Interview Survey to explore the association between access to medical care and LBW within different racial groups. The prevalence of LBW was 8.0%. Overall, mothers without a usual place of medical care had, on average, an 18% higher risk of LBW than those with a usual place (OR = 1.18, 95% CI: 0.80–1.74). …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Intervention Levers For Stunting Reduction In Indonesia: Evidence From The 2023 Indonesian Health Survey Data, Iwan Ariawan, Hafizah Jusril, Zahra Izza Afifa, Azka Fitri, Elmarizha Sekar Utami, Mikail Hasan, Dwi Puspasari

Kesmas

Stunting remains the largest public health challenge among macro-nutrition problems in Indonesia, affecting almost a quarter of children under five in 2023. The prevalence is considered high according to the World Health Organization standard. This study analyzed 15 aggregated provincial variables from the 2023 Indonesian Health Survey using Structural Equation Modeling (SEM), focusing on determinants of stunting among children under two to identify primary intervention levers. Findings indicated that intervention urgency should focus on the first 1,000 days, particularly the steep increase in stunting prevalence observed in the 12–24-month age range. While the highest prevalence is in Eastern provinces (e.g., …

When Faced With Persistent Crying, Will Adults Follow The Advice To Take A Break?, Lauren J. Duplessis, Remington K. Asta, Benjamin N. Witts

InnovateHER Meeting 2026

Inconsolable crying in early infancy can have detrimental effects on caregiver mental health, the caregiver-infant relationship, and infant safety. Professionals often advise caregivers to walk away and take a break. This study used n-of-1 methodology to examine how frequently undergraduate students will follow this advice when tasked with calming a simulated inconsolable infant. Results are mixed, but suggest active training prior to the baby’s arrival might yield promising outcomes

Start With What They Know: Using Motivational Interviewing To Create A Cooking Class, A Culinary Intervention For Teens (Autistic And Non-Autistic), Gwendolyn S. Tedder

LEND Trainee Presentations

Autistic teens are at greater risk for having heart disease and diabetes as adults. Food particularity, sensory issues, fixed mindset, and anxiety over trying new things can slow down their interest in preparing food for themselves. Nurturing basic cooking skills and gently encouraging trying new foods would provide more nutritional options to teens as they move into adulthood. A cooking class preceded by Motivational Interviewing (MI) developed further interest in preparing food afterward in teens, both autistic and non-autistic, and in trying new foods for autistic teens with food concerns.

Determinants Of Stunting Among Under-Five Children (0–59 Months) In Central Sulawesi Province, Marchell Bamba, Mondastri Korib Sudaryo, Ratna Djuwita, Helwiah Umniyati

Jurnal Epidemiologi Kesehatan Indonesia

Stunting is caused by chronic malnutrition which can be caused by various factors including poverty, poor nutritional intake and maternal health, and inappropriate infant feeding. This study was conducted to determine what factors cause stunting in Central Sulawesi Province. This study was conducted using a cross-sectional observational analysis method using secondary data from the Survei Kesehatan Indonesia (SKI) 2023. The analysis was carried out using logistic regression. The sample used was 2179 respondents. The dependent variable is stunting while the independent variables are age, gender, area of residence, gestational age, provision of PMT, exclusive breastfeeding, maternal occupation, maternal education, and …

Determinasi Minimum Dietary Diversity Pada Anak Usia 6-23 Bulan: Analisis Survei Kesehatan Indonesia 2023, Elfys Ferdynan, Besral Besral

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Keragaman pangan minimum atau minimum dietary diversity (MDD) merupakan indikator penting kualitas konsumsi pangan anak usia 6-23 bulan. Pemenuhan MDD berperan dalam mendukung pertumbuhan optimal dan pencegahan malnutrisi, termasuk stunting. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan pemenuhan MDD pada anak usia 6-23 bulan di Indonesia. Data yang digunakan adalah data Survei Kesehatan Indonesia 2023 dengan desain potong lintang. Subjek penelitian adalah 17.991 anak usia 6-23 bulan. Analisis yang dilakukan menggunakan regresi logistik biner dengan penyesuaian desain complex samples. Hasil penelitian menunjukkan bahwa faktor yang meningkatkan peluang pemenuhan MDD secara signifikan meliputi usia anak 12-23 bulan, …

Feeding Mode Is Associated With Infant Night Sleep Trajectories During The First Postnatal Year, Magdalena Olson, Li Liu, Elizabeth Reifsnider, Dean V. Coonrod, Sarada S. Panchanathan, Megan E. Petrov, Corrie M. Whisner

Ellmer School of Nursing Faculty Publications

Background: Short sleep and formula feeding during infancy are associated with increased risk of childhood obesity. Feeding practices and sleep arrangements vary during infancy and may also be dynamic, yet their impact on infant night sleep duration remains unclear. Understanding these relationships is crucial for formulating recommendations to support breastfeeding and address sleep concerns. Objective: We examined the association between feeding mode and parent-reported infant night sleep duration during the first postnatal year, while additionally evaluating night-weaning and bedsharing as contextual sleep-related practices. Methods: Infants in the Phoenix Metropolitan Area (n = 193) were followed up at 3, 8, 13, …

Sleep Problems In Children With Adhd: Associations With Internalizing Symptoms And Physical Activity, Xiao Liang, Mengping Zhao, Li Su, Justin A. Haegele, Richard H. Xu, Jiayue Li, Jinxian Guo, Choi-Yeung Tse, Shirley X. Li, David H. K. Shum

Human Movement Studies & Special Education Faculty Publications

Children with attention deficit hyperactivity disorder (ADHD) experience high rates of sleep problems and are at increased risk for developing internalizing problems. This study aimed to examine the association of sleep problems and physical activity with internalizing symptoms in children with ADHD. This cross-sectional study included 188 children with ADHD (M age = 8.60 ± 1.38, 78.7% boys). Self-reported questionnaires were used to assess sleep problems (Pittsburgh Sleep Quality Index [PSQI]) and internalizing symptoms (Depression Anxiety Stress Scale 21 [DASS 21]). The presence of sleep problems was defined as a PSQI score > 5. Physical activity was recorded by an ActiGraph …

Associations Between Accelerometer-Measured Physical Activity And Sleep Duration And Health Indicators In Children And Adolescents With Attention-Deficit Hyperactivity Disorder: A Systematic Review And Meta-Analysis, Xiao Liang, Hui Qiu, Justin A. Haegele, Xiao Li, Minghui Li, Jiayue Li, Shirley Xin Li

Human Movement Studies & Special Education Faculty Publications

Objective

This systematic review and meta-analysis synthesized available studies to explore relationships between accelerometer-measured physical activity (PA) levels or sleep duration and health-related outcomes in children and adolescents with attention-deficit hyperactivity disorder (ADHD).

Methods

Following the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines, the six databases APA PsychInfo, CINAHL Ultimate, Embase, MEDLINE, SPORTDiscus with Full Text and Web of Science were searched from inception through July 2024. The correlation coefficient (r) was employed to determine the effect size in the meta-analysis. A random-effects model was utilised to estimate the potentially heterogeneously distributed effect sizes with a 95 % …

The Effects Of Physical Activity Timing And Adherence To Physical Activity Guidelines On Sleep In Children With Adhd, Xiao Liang, Mengping Zhao, Li Su, Justin A. Haegele, Richard H. Xu, Jingjing Li, Andy Choi-Yeung Tse, Shirley X. Li

Human Movement Studies & Special Education Faculty Publications

Regular physical activity (PA) has been shown to benefit sleep. However, the effects of PA timing and adherence to the WHO's recommended 60-min moderate-to-vigorous physical activity (MVPA) guideline on sleep are unclear, especially for children with ADHD who often experience sleep problems. This study examined whether timing of MVPA influenced objectively measured sleep, including sleep latency (SL), sleep efficiency (SE), total sleep time (TST), and wake after sleep onset (WASO), among children with ADHD. This cross-sectional study involved 253 children with ADHD (Mage = 8.60 ± 1.31 years, 81% boys). MVPA timing was categorized as more than 8 h before …

Health And Nutrition In The First 1000 Days Of Life, Yaojiang Shi, Qi Zhang, Yiliang Zhu, Jingchun Nie

Health Behavior, Policy & Management Faculty Publications

Malnutrition and health issues remain persistent global crises, with developing regions bearing the brunt of the burden. According to the World Health Organization, nearly half of under-five deaths in low-and middle-income countries are linked to malnutrition, while stunting, wasting, and micronutrient deficiencies impair the development of millions of children annually. The studies in this special issue focus on countries facing distinct yet interconnected challenges: Sub-Saharan African nations grapple with high rates of stunting and maternal high-risk fertility behaviors; China confronts rural-urban disparities in dietary diversity and grandparenting practices; Colombia struggles with intersectional inequalities driving infant mortality; and Zambia faces unique …

Reframing Sexual Assault And Intimate Partner Violence Through A Maternal And Child Health Lens: Implications For Integrated Prevention, Policy, And Practice, Daija C. Gibson

Theses and Dissertations

Sexual assault and intimate partner violence remain persistent public health concerns in the United States, with significant consequences for individual health, family stability, and population well-being. Although these forms of violence are frequently addressed through criminal justice and behavioral health frameworks, less attention has been given to their implications within maternal and child health, where relational dynamics, life course development, and intergenerational outcomes are central. This study reframed SA and IPV as core MCH issues to examine how integrated, systems-based approaches can strengthen prevention efforts. A structured literature review and systematic synthesis of peer-reviewed studies published between 2015 and 2026 …

Small For Gestational Age Subgroups Have Differential Morbidity, Growth, And Neurodevelopment At Age 2: The Interbio-21st Newborn Study, Aris T. Papageorghiou, María C. Restrepo-Ménde, Rose Mcgready, Fernando C. Barros, Francois Nosten, Shama Munim, Roseline Ochieng, Rachel Craik, Hellen C. Barsosio, Zulfiqar Ahmed Bhutta

Department of Obstetrics & Gynaecology

Background: Small for gestational age is a complex perinatal syndrome associated with increased neonatal morbidity, mortality, and impaired childhood growth and neurodevelopment. Current classifications rely primarily on birthweight, which does not capture the heterogeneity of the condition nor predict long-term health outcomes. Here we aim to identify and characterize distinct small for gestational age subgroups and assess their neonatal and early childhood health trajectories.
Objective: To refine the classification of small for gestational age by identifying subgroups based on maternal, fetal, and environmental factors and evaluating their associations with neonatal morbidity, growth, and neurodevelopment at age 2.
Study design: Prospective …

Proportion Of Chronic Energy Deficiency In Relation To Macronutrient Intake And Other Determinants Among Pregnant Women In Selected Community Health Center Service Areas In Bogor 2025, Fathimah Afliansa, Ratu Ayu Dewi Sartika, Diah Mulyawati Utari, Suparno Suparno

Indonesian Journal of Public Health Nutrition (IJPHN)

The prevalence of chronic energy deficiency (CED) among pregnant women in Indonesia remains relatively high, ranging from 11.6% to 57.6%. This study aimed to examine the differences in the proportion of CED based on macronutrient intake and related factors. The study used a quantitative cross-sectional design with secondary data involving 124 pregnant women in selected areas served by community health centers in Bogor City and Regency. Data were analyzed using the chi-square test. CED prevalence was 11.3% in the overall areas, with 10.9% in Bogor City and 11.7% in Bogor Regency. Significant differences in the CED proportion were found based …

The Relationship Between Anemia, Chronic Energy Deficiency, Knowledge, And Other Factors And Anc Attendance Among Pregnant Women In Bogor City And Regency 2025, Winfried Ichtussend Hartnajaya Chrisna, Ratu Ayu Dewi Sartika, Nurul Dina Rahmawati, Daden Setiawan

Indonesian Journal of Public Health Nutrition (IJPHN)

Antenatal Care (ANC) is a comprehensive health service to optimize pregnancy outcomes. In 2023 in Bogor City, the ANC K6 coverage rate has reached the target (98.63%), but this is not the case with the coverage in Bogor Regency (62.25%). ANC visits that do not reach the standard can be influenced by predisposing factors, supporting factors, and health needs factors. The inequality that occurs can hinder efforts to reduce maternal mortality. This study aims to determine the relationship between knowledge and other factors with ANC visits in Bogor City and Regency in 2025. This study is quantitative with a cross-sectional …

Appearance Over Function - The Impact Of Long-Term Oral Contraceptive Use On Brain Development, Breast Tissue Composition, And Future Lactation Outcomes, Fiona M. Wang

Dissertations

This integrative review examines the long-term effects of combined oral contraceptive (COC) use beginning in puberty on brain development, breast tissue composition, and future breastfeeding outcomes. Puberty is a critical developmental stage during which hormonal changes significantly impact the neurological and reproductive systems. The introduction of synthetic estrogen and progestin through COC use during this time may disrupt natural hormonal pathways, potentially altering neuroendocrine signaling and breast tissue maturation. Such changes may have lasting consequences, including impaired milk production, a weakened milk ejection reflex, disrupted maternal-infant bonding, and reduced overall breastfeeding success. The review synthesizes findings from endocrinology, neuroscience, and …

Hubungan Kualitas Pemeriksaan Kehamilan Terhadap Kejadian Stunting Pada Anak Usia 6-23 Bulan Di Indonesia (Analisis Ski 2023), Hanna Audila, Helda Helda, Sudarto Ronoatmodjo

Jurnal Epidemiologi Kesehatan Indonesia

Stunting is still a nutritional problem and remains a major public health issue. Especially in Indonesia, the prevalence of stunting among children under two years old (toddlers) remains high, at 18.50%. The annual average rate of reduction of stunting among toddlers has been relatively slow for over the past 10 years. Therefore, optimizing stunting interventions-particularly during the first 1000 days of life is essential, including through antenatal care (ANC). This study aims to analyze the relationship between the quality of antenatal care and the incidence of stunting among children aged 6-23 months-old in Indonesia, after being controlled by the other …

Sex-Specific Effects Of Early-Life Unpredictability On Hippocampal And Amygdala Responses To Novelty In Adolescents, Elysia Poggi Davis, Bianca T. Leonard, Robert J. Jirsaraie, David B. Keator, Steven L. Small, Curt A. Sandman, Victoria B. Risbrough, Hal S. Stern, Laura M. Glynn, Michael A. Yassa, Tallie Z. Baram, Jerod M. Rasmussen

Psychology Faculty Articles and Research

Background

Unpredictable childhood experiences are an understudied form of early-life adversity that impact neurodevelopment. The neurobiological processes by which exposure to early-life unpredictability impact development and vulnerability to psychopathology remain poorly understood. In the current study, we investigated the sex-specific consequences of early-life unpredictability on the limbic network, focusing on the hippocampus and the amygdala.

Methods

Participants included 150 youths (54% female). Early-life unpredictability was assessed using the Questionnaire of Unpredictability in Childhood (QUIC). Participants engaged in 1 or more task–functional magnetic resonance imaging scans between the ages of 8 and 17 (223 total observations) measuring blood oxygen level–dependent (BOLD) …

Exploring Muslim American Attitudes Toward Genetic Testing: Perceptions, Barriers, And Ethical Considerations, Hannah Mahmoud

University Honors Theses

This thesis explores perceptions and attitudes toward genetic testing within the Muslim American community, a group often underrepresented in genomic research and public health discourse. Using a community-distributed digital survey, data was collected from 50 self-identified Muslim Americans on their familiarity with genetic testing, reproductive and ethical considerations, and the influence of religious factors. While only 18% had undergone genetic testing themselves, many were familiar through family or friends, and most expressed cautious interest—especially when results could influence future family planning. Education level, age, and religious values shaped both comfort and understanding.

A key theme was the desire for culturally …

The Impact Of Prenatal Yoga On Hip Mobility And Delivery Outcomes, Zoe Avery

Mahurin Honors College Capstone Experience/Thesis Projects

Yoga has been shown to decrease lumbar pain, improve maternal mental health, and improve delivery outcomes. While there are many well-established benefits of yoga, the mechanism by which yoga elicits these improvements is unclear. One potential mechanism that has not been studied is through improvements in hip mobility. PURPOSE: The purpose of this study was to test the effect of prenatal yoga on hip mobility. The secondary aim was to determine the relationship between hip mobility and pregnancy outcomes. METHODS: Hip mobility via hip internal and external range of motion and hip flexor muscle length was measured in pregnant females …

A Comprehensive Literature Review Of Barriers To Hormone Therapy Utilization: Strategies For Improving Menopause Management In Women Aged 40-60, Suhan Lee

Capstone Experience: Master of Public Health

Menopause is a natural transition marked by the cessation of ovarian activity, often accompanied by vasomotor symptoms (VMS), genitourinary syndrome of menopause (GSM), and psychological changes that significantly impact women’s quality of life. Hormone therapy (HT) has been the primary treatment for managing menopausal symptoms, particularly VMS, providing substantial relief when initiated within 10 years of menopause. Despite its effectiveness, HT usage has declined dramatically over the past two decades primarily due to barriers such as stigma, safety, misinformation, provider hesitancy, financial barriers, and cultural beliefs. This comprehensive literature review explores key factors influencing HT decision-making, including the media’s role …

The Influence Of Scientific, Genetic, And Health Literacy On Carrier Screening Decision-Making, Brenna D. Albracht

Dissertations and Theses (Open Access)

For those wishing to assess their reproductive risks and make informed decisions in their reproductive planning, carrier screening for autosomal recessive and X-linked conditions, as well as cell-free DNA (cfDNA) screening for aneuploidy, are recommended during pregnancy. Despite similarities in purpose, sample requirements, insurance coverage, and safety, a lower percentage of individuals elect carrier screening than cfDNA screening, suggesting there may be a disconnect in what patients perceive as valuable information for their pregnancy. Previous studies have attempted to explain the factors associated with carrier screening uptake or decline; however, no models have yet accounted for a patient’s literacy level …

Maternal Dietary, Nutritional Status, And Its Association With Low-Birth Weight: A Scoping Review, Tri Siswati, Devi Septia Ningrum, Adinda Safitri, Almira Sitasari

Indonesian Journal of Public Health Nutrition (IJPHN)

Maternal diet and nutritional status during pregnancy influence birth outcomes. This review article aims to synthesize key studies examining the relationship between maternal dietary intake, nutritional status, and the occurrence of low birth weight (LBW). This study applies a scoping review from PubMed and Google Scholar (2018–2023). Observational and experimental studies were included. Articles met the criteria if they involved pregnant women aged 17+, human studies, full-text availability, and were in English or Indonesian. Fourteen studies met the inclusion criteria and were analyzed. The findings revealed that maternal intake of essential macronutrients, including energy and protein, along with key micronutrients …

Michelle Obama: Moving Towards Childhood Obesity Solutions, Ian Gallagher

Osmosis Magazine

Throughout the Obamas' time in office, approval ratings made it clear the most popular Obama was not the man in the Oval Office. First Lady Michelle Obama consistently received higher approval ratings than her husband during his time in office. This could be attributed to her strong devotion to her family and her appearance as a genuinely good and caring person. During her time in office she drew the attention of the public by shedding light on one of the worst health epidemics currently afflicting the country: childhood obesity.

Congenital Rickets, Melissa Intriago

Mako: NSU Undergraduate Student Journal

No abstract provided.

Racial Health Disparities Among Pregnant Women Of Color In New York City: Biological And Systemic Impacts, Kaylin Peña

Pitzer Senior Theses

Racial Health Disparities Among Pregnant Women of Color in New York City: Biological and Systemic Impacts

Abstract

This thesis aims to explore how racial health disparities, underrepresentation in gynecology, and socioeconomic barriers contribute to adverse pregnancy outcomes among women of color in New York City. Through an interdisciplinary approach that combines resources from medical anthropology and human biology, this research will examine the biological implications of chronic stress, specifically HPA axis dysregulation, and its role in maternal health outcomes. With the idea of intersectionality, as conceptualized by Kimberlé Crenshaw, the study analyzes the various effects of systemic inequities and social …

Consumption Of The Food Groups With The Revised Benefits In The New Wic Food Package: A Scoping Review, Qi Zhang, Priyanka T. Patel, Bidusha Neupane, Caitlin M. Lowery, Futun Alkhalifah, Faezeh Mahdavi, Esther May Sarino

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background: On 18 April 2024, the United States Department of Agriculture (USDA) published the first food package changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in over a decade, which reduced some food benefits (juice, milk, canned fish, and infant fruits and vegetables) and offered substitutes (cash-value vouchers (CVVs) or cash-value benefits (CVBs) to redeem for fruits and vegetables, cheese, soymilk, or other dairy products). Methods: To assess the impact of the changes on the consumption and redemption of these food groups, a systematic search was conducted, identifying 23 peer-reviewed publications between 2010 and 2024. …

Amniotic Fluid-Derived Stem Cells: Potential Factories Of Natural And Mimetic Strategies For Congenital Malformations, Cristiane S R Fonteles, Julia Enterria-Rosales, Ying Lin, John W Steele, Ramiro A Villarreal-Leal, Jing Xiao, Daniel I Idowu, Beck Burgelin, Bogdan J Wlodarczyk, Richard H Finnell, Bruna Corradetti

Faculty, Staff and Students Publications

BACKGROUND: Mesenchymal stem cells (MSCs) derived from gestational tissues offer a promising avenue for prenatal intervention in congenital malformations although their application is hampered by concerns related to cellular plasticity and the need for invasive, high-risk surgical procedures. Here, we present naturally occurring exosomes (EXOs) isolated from amniotic fluid-derived MSCs (AF-MSCs) and their mimetic analogs (MIMs) as viable, reproducible, and stable alternatives. These nanovesicles present a minimally invasive therapeutic option, addressing the limitations of MSC-based treatments while retaining therapeutic efficacy.

METHODS: MIMs were generated from AF-MSCs by combining sequential filtration steps through filter membranes with different porosity and size exclusion …