Maternal and Child Health Commons^™

'I Did Not Know We Could Exercise This Small Premature Baby': Challenges Experienced By Parents While Implementing Early Intervention For Their Preterm Infants-A Qualitative Perspective, Manasa Kolibylu Raghupathy, Selim Jahangir, Sonia Khurana, Leslie Edward S. Lewis, Bhamini Krishna Rao

Rehabilitation Sciences Faculty Publications

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Background

Preterm birth is a highly stressful experience for both parents and infants. Parental participation in care enhances developmental outcomes, fosters parent-infant interactions and builds parental confidence. However, low parental adherence has always been a challenge in the successful implementation of intervention programs both in the NICU and at home. It is imperative to understand parents' perspectives and view the challenges that they experience through their lens while providing early intervention to their infants born preterm. This study is aimed at identifying new parents' challenges when implementing early intervention programs for their infants during the transition from hospital to home. …

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Racial Disparities In Maternal Mortality Before, During, And After The Covid-19 Pandemic In The United States: A Difference-In-Difference Analysis, Kyosuke Kamijo, Misa Hayasaka, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

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Background

This study aimed to examine changes in racial disparities in pregnancy-related and maternal mortality before, during, and after the COVID-19 pandemic in the United States.

Methodology

This was a cross-sectional study using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data from January 2018 to June 2024. We focused on pregnancy-related and maternal mortality among Black and White individuals to examine racial disparities. The study periods were defined as pre-pandemic (January 2018-March 2020), pandemic (April 2020-March 2022), and post-pandemic (April 2022-June 2024). We applied interrupted time series analysis and difference-in-difference (DID) models …

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Association Of Maternity Care Deserts With Maternal And Pregnancy-Related Mortality, Rula Atwani, Lindsay Robbins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

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OBJECTIVE:

To evaluate the association between the level of maternity care access and maternal and pregnancy-related mortality.

METHODS:

This was a cross-sectional analysis of county-level data in the United States from January 2018 to December 2021. Using the level of maternity care access, we categorized counties into desert, low access, moderate access, and full access. The primary outcome of interest was maternal mortality rate per 100,000 live births. A secondary outcome was pregnancy-related mortality rate per 100,000 live births. Absolute risk differences and adjusted incidence rate ratios were calculated for maternal mortality and pregnancy-related mortality with multivariable negative binomial mixed-effects …

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Association Of Mean Arterial, Systolic, And Diastolic Blood Pressure Trends In Early Pregnancy With Superimposed Preeclampsia With Severe Features In Pregnancies Complicated By Chronic Hypertension, Tetsuya Kawakita, Justin M. Leach, George R. Saade, Kim Boggess, Lorraine Dugoff, Brenna L. Hughes, Joseph Bell, Kjersti Aagaard, Rodney K. Edwards, Kelly Gibson, David M. Haas, Lauren Plante, Torri Metz, Brian Casey, Sherri Longo, Matthew K. Hoffman, Kara K. Hoppe, Methodius Tuuli, Michelle Y. Owens, Heather Frey, Todd Rosen, Uma M. Reddy, Wendy Kinzler, Emily Su, Iris Krishna, Mary E. Norton, Daniel Skupski, Yasser Y. El-Sayed, Ronald Librizzi, Mounira Habli, Shauna Williams, Gabriella Pridjian, David S. Mckenna, Sarah Osmundson, Joanne Quinones, Zorina Galis, Lorie Harper, Namasivayam Ambalavanan, Jeff M. Szychowski, Alan T.N. Tita

Department of Obstetrics & Gynecology Faculty Publications

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OBJECTIVE: To evaluate the association of longitudinal systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in early pregnancy with later development of superimposed preeclampsia with severe features in pregnancies complicated by mild chronic hypertension.

METHODS: This secondary analysis used data from the CHAP (Chronic Hypertension and Pregnancy) trial, a multicenter randomized controlled trial that involved pregnant individuals with chronic hypertension. Participants were categorized based on the development of superimposed preeclampsia with severe features. Longitudinal blood pressure measurements from enrollment to the development of superimposed preeclampsia with severe features or delivery were assessed using regression models. …

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Longitudinal Assessment Of Fetal Myocardial Performance Index In Normal Pregnancy Using Spectral Tissue Doppler, R. Horgan, E. Sinkovskaya, E. Kalafat, G. Saade, A. Abuhamad

Department of Obstetrics & Gynecology Faculty Publications

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Objective

Although spectral tissue Doppler imaging is recognized as the optimal method for assessing the fetal myocardial performance index (MPI), longitudinal reference ranges for fetal MPI measured using spectral tissue Doppler have not been established. Our objective was to use spectral tissue Doppler data to establish gestational-age-specific reference ranges from 12–33 weeks for left and right ventricular fetal MPI.

Methods

This was a prospective longitudinal study of women aged 18–35 years, with a body mass index below 30 kg/m² and a singleton pregnancy conceived spontaneously. Fetal MPI measurements were obtained in the first, second and third trimesters and MPI was …

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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

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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. …

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Mobile Health Intervention Tools Promoting Hiv Pre-Exposure Prophylaxis Among Adolescent Girls And Young Women In Sub-Saharan Africa: Scoping Review, Alex Emilio Fischer, Homaira Hanif, Jacob B. Stocks, Aimee E. Rochelle, Karen Dominguez, Eliana Gabriela Armora Langoni, H. Luz Mcnaughton Reyes, Gustavo F. Doncel, Kathryn E. Muessig

Department of Obstetrics & Gynecology Faculty Publications

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Background:

In 2022, 3100 adolescent girls and young women in sub-Saharan Africa experienced new HIV infections each week. HIV pre-exposure prophylaxis (PrEP) is effective at preventing HIV but has limited uptake and persistence. Mobile health (mHealth) interventions can improve medication adherence; however, their utility to improve PrEP adherence among adolescent girls and young women is not well established.

Objective:

This scoping review synthesizes evidence supporting mHealth for PrEP among adolescent girls and young women in sub-Saharan Africa and identifies strategies for further evaluation.

Methods:

We searched PubMed and Google Scholar databases, expert referrals, and reference lists using the following eligibility …

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Timing Of Delivery In Preeclampsia: Time To Reconsider?, Rebecca Horgan, Ahmed S. Z. Moustafa, Mackenzie Mchugh, Tetsuya Kawakita, Baha Sibai, George Saade

Department of Obstetrics & Gynecology Faculty Publications

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The article discusses the need to reassess the timing of delivery in cases of preeclampsia, a condition affecting 2%–8% of pregnancies and linked to significant maternal and neonatal risks. It highlights that existing guidelines, primarily based on older studies, may not adequately reflect current clinical practices and advancements in neonatal care. The authors suggest that planned delivery at 34–36 weeks of gestation may offer maternal benefits without increasing short-term neonatal morbidity, while also emphasizing the importance of considering long-term outcomes for both mothers and infants. They advocate for further research, including large-scale randomized trials, to better understand the implications of …

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Facilitated Group Care For Maternal And Child Health Model Fidelity: A Scoping Review, Ashley Gresh, Phoebe Parker, Anne Batchelder, Jalana Lazar, Christina X. Marea, Camilla Bjelland, Rohan D. Jeremiah, Giovanna Cristina Machado-Kayzuka, Hayden Geibel, Dhruvi R. Patel, Esnath Kapito, Kathleen F. Norr, Crystal L. Patil

Department of Pediatrics Faculty Publications

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Group care is a transformative model of prenatal, postnatal, and well-child care. The Centering-based group care model has three core components: health care, interactive learning, and community building. It has been implemented in 33 countries with associated improved maternal and child health outcomes. Maintaining fidelity to the model is essential for its effectiveness. However, to date no standardised measure of fidelity to the group care model exists. This review aimed to explore how fidelity is measured in group care and identify common themes to understand what is essential to maintain fidelity. We used the scoping review framework by Arksey & …

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Risk And Protective Factors For Sudden Infant Death Syndrome (Sids) In Low-Resource Communities In Kolkata India: A Mixed Methods Exploratory Study Of Semi-Structured Interviews And Survey Data, Susan Samreth, Alexandra Leader, Jillian Kiely, Turja Chakrabarti, Rupa Kapoor

Department of Pediatrics Faculty Publications

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Sudden Unexpected Infant Death (SUID), Sudden Infant Death Syndrome (SIDS) and infant sleep practices are widely documented and studied in high-resource countries. Knowledge of SUID/SIDS occurrence, risk factors and protective factors in low or middle-resource countries such as India is lacking. This was an exploratory study using a mixed methods (qualitative and quantitative) approach to better understand infant sleep practices and the various factors that may influence them amongst caregivers in 5 low-income communities in Kolkata, India. Twenty-eight and 22 caregivers of infants < 12 months old were recruited using a convenience sampling approach to participate in semi-structured interviews (phase 1) and a survey (phase 2), respectively. This research was conducted in partnership with Pratit International, a locally based NGO dedicated to providing comprehensive health care to disenfranchised communities in Kolkata. Analysis of qualitative and quantitative data found that infant caregivers frequently described risk factors (e.g., bedsharing, soft sleep surface, infant sleep position, objects in sleep area, environmental smoke exposure, low rates of pacifier use) and protective factors (e.g., breastfeeding, routine immunization/prenatal care, low rates of caregiver substance use) that have been associated with SIDS in high resource communities. Qualitative data revealed that certain caregivers' reasons for infant sleep position were rooted in cultural beliefs. Prenatal and postnatal sleep education given by a healthcare professional were limited and awareness of safer sleep advice in the community was low. These study findings suggest the need to provide safer sleep education resources in a culturally appropriate manner and can help guide future research on potential interventions such as the baby box.

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Unmeasured Confounding In Summary Estimates Of Maternal Periodontitis And Adverse Birth Outcomes: Meta-Analyses Of Observational Studies, May Salama, Abdullah Al-Taiar, Denise Mickenny

Graduate Student Government Association Research Conference

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Abstract

Importance Maternal periodontitis has been consistently linked to adverse birth outcomes. However, a causal relationship is not established due to potential unmeasured confounding factors in observational studies and inconclusive results from randomized controlled trials.

Objective To assess the impact of unmeasured confounding factors in meta-analyses examining associations between maternal periodontal disease and preterm birth or low birth weight.

Data Sources PubMed/Medline, the Cochrane database for systematic reviews, Embase, Google Scholar, and a manual search of the reported references between 2002 and 2023.

Study Selection Systematic reviews with meta-analyses of observational studies were included if either preterm birth or low …

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The Impact Of Scaling And Root Planning Combined With Mouthwash During Pregnancy On Preterm Birth And Low Birth Weight: A Systematic Review And Meta-Analysis, May Salama, Abdullah Al-Taiar, Denise C. Mckinney, Estiar Rahman, Anwar T. Merchant

Dental Hygiene Faculty Publications

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The effect of treating periodontal disease (PD) during pregnancy on adverse birth outcomes, such as preterm birth (PTB) and/or low birth weight (LBW), remains unclear. This is partially due to the fact that Randomized Controlled Trials (RCTs) have used different combinations of treatment approaches to test this hypothesis. In this meta-analysis of RCTs, we assessed the impact of treating PD during pregnancy with scaling and root planning (SRP) and mouthwash use on PTB and LBW.

Background

The effect of treating periodontal disease (PD) during pregnancy on adverse birth outcomes, such as preterm birth (PTB) and/or low birth weight (LBW), remains …

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Breastfeeding Perceptions And Decisions Among Hispanic Participants In The Special Supplemental Nutrition Program For Women, Infants, And Children: A Qualitative Study, Emily Fisher, Priyanka Patel, Kathryn G. Wouk, Bidusha Neupane, Futun Alkhalifah, Marilyn M. Bartholmae, Chuanyi Tang, Qi Zhang

Community & Environmental Health Faculty Publications

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The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the U.S. WIC served 2.5 million eligible Hispanic women, infants, and children under the age of five in 2021, which is WIC's largest racial/ethnic group. However, limited research has been conducted to understand Hispanic WIC participants' perceptions of WIC breastfeeding recommendations and their breastfeeding decisions. For this qualitative study, we interviewed 18 of these pregnant and postpartum WIC participants on their experiences and decision-making processes related to breastfeeding. Hispanic cultures and home country norms were identified as prominent influences on breastfeeding decisions, along …

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Leveraging Machine Learning To Study How Temperature Scores Predict Pre-Term Birth Status, Erich Seamon, Jennifer A. Mattera, Sarah A. Keim, Esther M. Leerkes, Jennifer L. Rennels, Andrea J. Kayl, Kristy M. Kulhanek, Darcia Narvaez, Sarah M. Sanborn, Jennifer B. Grandits, Christine Dunkel Schetter, Mary Coussons-Read, Amanda R. Tarullo, Sarah J. Schoppe-Sullivan, Mariah E. Thomason, Julie M. Braungart-Rieker, Julie C. Lumeng, Shannon N. Lenze, Lisa M. Christian, Darby E. Saxbe, Laura R. Stroud, Christina M. Rodriguez, Stephanie Anzaman-Frasca

Psychology Faculty Publications

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Background

Preterm birth (birth at <37 completed weeks gestation) is a significant public heatlh concern worldwide. Important health, and developmental consequences of preterm birth include altered temperament development, with greater dysregulation and distress proneness.

Aims

The present study leveraged advanced quantitative techniques, namely machine learning approaches, to discern the contribution of narrowly defined and broadband temperament dimensions to birth status classification (full-term vs. preterm). Along with contributing to the literature addressing temperament of infants born preterm, the present study serves as a methodological demonstration of these innovative statistical techniques.

Study design

This study represents a metanalysis conducted with multiple samples (N = 19) including preterm (n = 201) children and (n = 402) born at term, with data combined across investigations to perform classification analyses.

Subjects …

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Family Structure, Family Transitions, And Child Overweight And Obesity: Comparing Australia, The United Kingdom, And The United States, Sadie A. Slighting, Kirsten Rasmussen, Mikaela J. Dufur, Jonathan A. Jarvis, Shana Pribesh, Alyssa J. Alexander, Carolina Otero

STEMPS Faculty Publications

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Growing rates of childhood obesity globally create concern for individuals' health outcomes and demands on health systems. While many policy approaches focus on macro-level interventions, we examine how the type of stability of a family structure might provide opportunities for policy interventions at the micro level. We examine the association between family structure trajectories and childhood overweight and obesity across three Anglophone countries using an expanded set of eight family structure categories that capture biological relationships and instability, along with potential explanatory variables that might vary across family trajectories and provide opportunities for intervention, including access to resources, family stressors, …

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Teachers' Perception On Physical Activity Promotion In Kindergarten Children In China: A Qualitative Study Connecting Social Ecological Model, Yahan Liang, Fangyuan Ju, Yueran Hao, Jia Yang, Yang Liu

Human Movement Studies & Special Education Faculty Publications

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Background

Globally, the majority of kindergarten-aged children face obesity issues and insufficient physical activity (PA) engagement. Regular PA participation can provide various health benefits, including obesity reduction, for kindergarten-aged children. However, limited studies have investigated the factors influencing kindergarten-aged children's PA engagement from the perspective of their teachers. This qualitative study aimed to identify factors that could help promote PA among kindergarten-aged children from teachers' perspectives, including facilitators, barriers, and teachers' recommendations.

Methods

Fifteen kindergarten teachers (age range: 28-50 years; mean age: 38.53 years) with teaching experience ranging from 2 to 31 years (mean: 16.27 years) were recruited from Shanghai …

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Impact Of Treating Maternal Periodontal Disease On The Risk Of Preterm Birth And Low Birth Weight: An Umbrella Review Of Systematic Reviews, May Salama, Abdullah Al-Taiar

College of Health Sciences Posters

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Pregnancy involves complex physical and hormonal changes that significantly impact almost every organ system, including the oral cavity. The presence of oral disease in women has consequences for both their child and their health. The two main oral conditions linked to pregnancy are gingivitis and periodontal disease. Several studies have demonstrated that there is a positive association between periodontal disease and adverse pregnancy outcomes such as preterm birth (PTB) and low birth weight (LBW). PTB and LBW are among the leading causes of perinatal mortality and morbidity. It has been hypothesized that periodontal disease may cause PTB and/or LBW either …

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Forming The Perception Of Wic Infant Feeding Recommendations: A Qualitative Study, Emily Fisher, Kathryn Wouk, Priyanka Patel, Chuanyi Tang, Qi Zhang

Community & Environmental Health Faculty Publications

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Nearly half of newborns in the United States are enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Promoting breastfeeding is a programmatic priority, although formula vouchers are provided for those who do not exclusively breastfeed. Previous literature suggests that participant perception of WIC’s breastfeeding recommendations is a significant factor predicting breastfeeding initiation, duration, and exclusivity outcomes. However, little is known about how participants’ perceptions of WIC’s breastfeeding recommendations are formed. To address this knowledge gap, we conducted a qualitative pilot study in Nevada, interviewing 10 postpartum WIC mothers and 12 WIC staff who had interacted …

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Effect Of Positive Emotion Intervention During Late Pregnancy On Improving Colostrum Secretion: A Randomised Control Trial Protocol, Kechen Xu, Ying Xie, Xiujun Han, Ying Yu, Suqing Liu, Suliu Wu, Qian Yang, Qi Zhang

Community & Environmental Health Faculty Publications

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Introduction Though evidence has revealed the beneficial effects of cognitive improvement interventions on breastfeeding, the effect of psychological interventions has rarely been studied. This study aims to test whether promoting a positive emotion intervention, 'Three Good Things' intervention, during the last trimester of pregnancy can enhance early colostrum secretion and breastfeeding behaviours by modulating the hormones associated with lactation (prolactin and insulin-like growth factor I). We will attempt to promote exclusive breastfeeding by using physiological behavioural measures.

Methods and analysis This study is designed as a randomised controlled trial conducted in the Women's Hospital School of Medicine at Zhejiang University …

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Age-Related Differences In Accelerometer-Assessed Physical Activity And Sleep Parameters Among Children And Adolescents With And Without Autism Spectrum Disorder: A Meta-Analysis, Xiao Liang, Justin A. Haegele, Sean Healy, Andy Choi-Yeung Tse, Hui Qiu, Shi Zhao, Chunxiao Li

Human Movement Studies & Special Education Faculty Publications

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Importance: Physical inactivity and sleep disorders are health-related concerns of youth with autism spectrum disorder (ASD) that can persist from childhood and exacerbate core symptoms. However, evidence on group differences in accelerometer-assessed physical activity and sleep parameters among youth with and without ASD is inconclusive and age-specific effects remain unclear.

Objective: To synthesize evidence on group differences in accelerometer-assessed physical activity and sleep parameters and examine the moderating effects of age between children and adolescents with and without ASD.

Data Sources: American Psychological Association PsychInfo, CINAHL Ultimate, ERIC, MEDLINE, SPORTDiscus with Full Text, and Web of Science from inception to …

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Exposure To Pcb126 During The Nursing Period Reversibly Impacts Early-Life Glucose Tolerance, Brittany B. Rice, Keegan W. Sammons, Sara Y. Ngo Tenlep, Madeline T. Weltzer, Leryn J. Reynolds, Cetewayo S. Rashid, Hollie I. Swanson, Kevin J. Pearson

Human Movement Studies & Special Education Faculty Publications

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Polychlorinated biphenyls (PCBs) are persistent environmental organic pollutants known to have detrimental health effects. Using a mouse model, we previously demonstrated that PCB126 exposure before and during pregnancy and throughout the perinatal period adversely affected offspring glucose tolerance and/or body composition profiles. The purpose of this study was to investigate the glucose tolerance and body composition of offspring born to dams exposed to PCB126 during the nursing period only. Female ICR mice were bred, and half of the dams were exposed to either vehicle (safflower oil) or 1 µmole PCB126 per kg of body weight via oral gavage on postnatal …

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The Impact Of Oral Health On Low-Income Pregnant Women Living In The United States, Olivia Ward, Jill Jacobs Diss

College of Health Sciences Posters

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Introduction: Oral health has a significant impact on pregnancy outcomes. Inter-professional collaboration can assist in bridging the gap between oral and systemic health and assist in optimizing the health of low-income pregnant women, infants, and children.

Methods: A literature review was used to ascertain the impact of oral health on adverse pregnancy outcomes. Research sources used in this literature review were gathered from the U.S. National Library of Medicine at the National Institutes of Health, PubMed, The Centers for Disease Control and Prevention (CDC), Elsevier, Department of Medical Assistance Services (DMAS), the Office of the Surgeon General, and Google Scholars. …

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Prenatal Perception Of Wic Breastfeeding Recommendation Predicts Breastfeeding Outcomes In Infant's First Year, Joanne Guthrie, Qi Zhang, Kelin Li, Kathryn Wouk, Rajan Lamichhane

Community & Environmental Health Faculty Publications

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Objectives

Promoting breastfeeding (BF) is a priority of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Prior research found that pregnant mothers who believed WIC recommends BF only (versus BF and formula equally OK) were more likely to initiate BF and continue through 1 month postpartum. We examine whether such mothers are more likely to continue to exclusively BF through 5 months and BF at all through the infant's first year. Methods

Data are from the WIC Infant and Toddler Feeding Practices Study-2 (ITFPS-2), a longitudinal study that includes 2,649 mothers who completed prenatal interviews. Four BF …

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Disparities In Caregiver-Reported Dental Cavities And Toothaches Among Children In The Special Supplemental Nutrition For Women, Infants, And Children (Wic) Program, Denise M. Claiborne, Chun Chen, Qi Zhang

Dental Hygiene Faculty Publications

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Purpose: Dental caries is prevalent among low-income and minority children despite oral health promotion programs. The purpose of this study was to examine disparities associated with caregiver-reported cavities and toothaches among children in the United States aged 2-4 years by their eligibility for and participation in the Special Supplemental Nutrition for Women, Infants, and Children (WIC) program.

Methods: A secondary data analysis was performed using the 2016 National Survey of Children's Health (NSCH) data on children aged 2-4 years (n=7,719) with complete WIC participation information. Three groups were formed based on WIC eligibility and participation status: WIC participants, income-eligible non-participants, …

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Mothers' Perceptions Of Their Children's Weight: Opportunity For Health Promotion In Kuwait, Abdullah Al-Taiar, Nawal Alqaoud, Reem Sharaf-Alddin, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

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Background: Mothers’ perceptions of their children’s weight remain mostly unknown in oil-rich countries of the Middle East.

Aims: To compare maternal perceptions of their children’s weight with actual body weight.

Methods: We used the Kuwait nutritional surveillance data for 5 consecutive years (2015-2019) (N = 5119), which were collected through face-to-face interviews with mothers of children aged 2-5 years attending vaccination centres.

Results: Of the 5119 mothers in the study, 163 (3.18%) and 332 (6.48%) had obese or overweight children, respectively. Among 4624 mothers who had normal weight children, 1350 (29.20%) perceived their children’s weight as …

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Family Structure And Maternal Depressive Symptoms: A Cross-National Comparison Of Australia, The United Kingdom, And The United States, Kirsten Rasmussen, Elizabeth K. Sigler, Sadie A. Slighting, Jonathan A. Jarvis, Mikaela J. Dufur, Shana Pribesh

Educational Leadership & Workforce Development Faculty Publications

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The purpose of this study is to understand the relationship between family structure and maternal depressive symptoms (MDS) in Australia, the United Kingdom, and the United States. Family structures that involve transitions across life's course, such as divorce, can alter access to resources and introduce new stressors into family systems. Using the stress process model, we examine the links between family structure, stress, resources, and MDS. Using nationally representative data from Australia, the United Kingdom, and the United States and cross-sectional models for each country, we find that family structure may influence MDS differently in the UK than it does …

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The Online Ordering Behaviors Among Participants In The Oklahoma Women, Infants, And Children Program: A Cross-Sectional Analysis, Qi Zhang, Kayoung Park, Junzhou Zhang, Chuanyi Tang

Community & Environmental Health Faculty Publications

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The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the United States (U.S.). Participants in the program redeem their prescribed food benefits in WIC-authorized grocery stores. Online ordering is an innovative method being pilot-tested in some stores to facilitate WIC participants' food benefit redemption, which has become especially important in the COVID-19 pandemic. The present research aimed to examine the online ordering (OO) behaviors among 726 WIC households who adopted WIC OO in a grocery chain, XYZ (anonymous) store, in Oklahoma (OK). These households represented approximately 5% of WIC households who redeemed …

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Parents' Attitudes As Mediators Between Knowledge And Behaviours In Unintentional Injuries At Home Of Children Aged 0-3 In Shanghai, Eastern China: A Cross-Sectional Study, Xueqi Ma, Qi Zhang, Ruo Jiang, Jun Lu, Huiping Wang, Qinghua Xia, Jicui Zheng, Wei Deng, Fengshui Chang, Xiaohong Li

Community & Environmental Health Faculty Publications

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Objective: Parental behaviours are important in preventing unintentional injury at home among young children. Previous research showed an inconsistent relationship between knowledge and behaviours, indicating that the mechanisms may vary for different behaviours. This study aimed to examine the mediating roles of different attitudes in the mechanism of knowledge acting on different behaviours.

Design: Cross-sectional study.

Setting: Eastern China

Participants: Participants were recruited using stratified community-based sampling. A total of 488 parents of children aged 0–3 years participated in the study and 476 (97.5%) valid questionnaires were recovered.

Primary outcome measures: Parents’ knowledge, attitudes (including injury attribution, preventability and responsibility) …

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Data On Breastfeeding And State Policies In The United States, Chun Chen, Hong Xue, Qi Zhang

Community & Environmental Health Faculty Publications

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Breastfeeding is critically important to maternal and child health in the United States. Examining the relationship between breastfeeding outcomes and state policies requires multidisciplinary efforts to link data from various sources. This article describes an integrated dataset that was used to understand the relationship between participation in a nutrition assistance program and low-income children's breastfeeding outcomes [1]. This dataset merged public health information from the National Immunization Surveys Data from 2006 to 2016 and matching state policy data from the Correlates of State Policy Project (CSPP), the U.S. Department of Agriculture/Economic Research Services (USDA/ERS) Supplemental Nutrition Assistance Program (SNAP) Policy …

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Vitamin D Levels In Relation To Low Back Pain During Adolescence, Abdullah Al-Taiar, Abdur Rahman, Lemia Shaban, Anwar H. Albaloul, Sean Banaee, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

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This study aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D) level and low back pain (LBP) among adolescents while adjusting for potential confounders pertinent to this age group including the weight of school bags, BMI and physical activity. A cross-sectional study was conducted on 760 randomly selected adolescents in middle schools. Data on LBP and the risk factors for LBP were collected from parents by a self-administered questionnaire and from adolescents by face-to-face interview. Blood samples were tested in an accredited laboratory; and 25(OH)D was measured using liquid chromatography-tandem MS. The lifetime prevalence and the 6-month prevalence of LBP …

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