Public Health Education and Promotion Commons^™

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 …

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 …

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 …

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 …

The Individual Water Insecurity Experiences (Iwise) Scale: Reliability, Equivalence And Validity Of An Individual-Level Measure Of Water Security, Sera L. Young, Hilary J. Bethancourt, Zacchary R. Ritter, Edward A. Frongillo Jr.

Faculty Publications

Objective: The lack of a validated and cross-culturally equivalent scale for measuring individual-level water insecurity has prevented identification of those most vulnerable to it. Therefore, we developed the 12-item Individual Water InSecurity Experiences (IWISE) Scale to comparably measure individual experiences with access, use, and stability (reliability) of water. Here, we examine the reliability, cross-country equivalence, and cross-country and within-country validity of the scale in a cross-sectional sample.

Methods: IWISE items were implemented by the Gallup World Poll among nationally representative samples of 43 970 adults (15 y) in 31 low-income and middle-income countries (LMICs). Internal consistency was assessed …

Relation Of Breastfeeding Duration With Blood Pressure And Arterial Stiffness, Lohita Kollipara, Abbi Lane-Cordova, Xuewen Wang

Senior Theses

Background: The purpose of this analysis was to investigate the effects of differing breastfeeding duration on vascular function.

Methods: A study was designed to explore the breastfeeding patterns of 79 participants who delivered a singleton fetus 6 months-3 years ago and were aged 18-45 years old. Participant breastfeeding and dietary habits were self-reported using surveys. Breastfeeding groups were established by following the American Association of Pediatric guidelines on breastfeeding duration: Women who did versus did not breastfeeding for 6 months continuously. Blood pressure was measured using a standard oscillometric cuff, while SphygmoCor® technology was used to measure pulse wave velocity. …

Predictors Of Complementary Feeding Practices Among Children Aged 6–23 Months In Five Countries In The Middle East And North Africa Region, Linda Shaker-Berbari, Vilma Qahoush Tyler, Chaza Akik, Zeina Jamaluddine, Hala Ghattas Ph.D.

Faculty Publications

Ensuring diets of children aged 6–23 months meet recommended guidance is crucial for growth and development and for the prevention of malnutrition including stunting, wasting and micronutrient deficiencies. Despite some improvement, indicators related to undernutrition and overnutrition fall short of global targets in the Middle East and North Africa (MENA) region that consist of low- and middle-income countries witnessing political and social changes and a nutrition transition. This research aims at reviewing the situation related to the diets of children aged 6–23 months in five selected countries in the MENA region, examining factors affecting complementary feeding and providing recommendations for …

Prolonged Time From Diagnosis To Breast-Conserving Surgery Is Associated With Upstaging In Hormone Receptor-Positive Invasive Ductal Breast Carcinoma, Natalie Hills, Macall Leslie, Rachel Davis, Marielle Crowell, Hiroyasu Kameyama, Hallgeir Rui, Inna Chervoneva, William Dooley, Takemi Tanaka

Faculty Publications

BACKGROUND: Time to surgery (TTS) has been suggested to have an association with mortality in early-stage breast cancer. OBJECTIVE: This study aims to determine the association between TTS and preoperative disease progression in tumor size or nodal status among women diagnosed with clinical T1N0M0 ductal breast cancer. METHODS: Women diagnosed with clinical T1N0M0 ductal breast cancer who had breast-conserving surgery as their first definitive treatment between 2010 and 2016 (n = 90,405) were analyzed using the National Cancer Database. Separate multivariable logistic regression models for hormone receptor (HR)-positive and HR-negative patients, adjusted for clinical and demographic variables, were used to …

Evaluating The Health Impact Of Centeringpregnancy Program Versus Traditional Prenatal Care In Midland Obstetric Clinics And Validating Selected Item On Birth Certificate, Oluwatosin A. Momodu

Theses and Dissertations

The primary focus of this dissertation is to evaluate the health impact of the CenteringPregnancy (CP) program versus traditional prenatal care (TPNC) on important maternal outcomes of pregnancy. This is looked at in two outcomes-gestational weight gain (GWG) and pregnancy induced hypertension (PIH). The specific aims are to examine the: (1) effects of CenteringPregnancy program versus traditional prenatal care on gestational weight gain (GWG); (2) effects of CenteringPregnancy program versus traditional prenatal care on pregnancy induced hypertension (PIH).

Birth certificate (BC) data were linked to hospital discharge records of women who delivered in midland’s obstetric clinics of South Carolina between …

Food Choice Decision-Making Among School-Going Adolescents Amidst The Nutrition Transition In Urban Accra, Ghana, Krystal Krsna Rampalli

Theses and Dissertations

Like many countries of the world, Ghana is experiencing a nutrition transition and rising non-communicable diseases. Adolescents are susceptible to diet-related health risks as they experience significant physical and psychological changes, which are happening in tandem with food environment changes, including widespread proliferation of large portion and package sizes of energy-dense, nutrient-poor foods. Both local and multinational food and beverage companies have encouraged consumption of their products through various marketing tactics targeted directly to adolescents. Some of these tactics include the use of characters or celebrity endorsement, promotional discounts, and appeal to sociocultural values, including messages about body size preferences. …

Pre-Exposure Prophylaxis (Prep) Knowledge, Willingness To Use & Uptake Among Black Heterosexual Men, Akeen Lowell Hamilton

Theses and Dissertations

INTRODUCTION: Pre-exposure prophylaxis (PrEP) is a pill, taken orally, that has been shown to be effective at reducing the chance that someone who is HIV-negative and at-risk for HIV will contract the disease during sexual intercourse with someone who is living with HIV. One demographic group that has been under-researched is Black heterosexual men. This dissertation presents research on evaluating the heterosexual Black men’s awareness of, prior use, and network of friends/family’s perceived interest in learning more about PrEP.

METHODS: Two-hundred and six Black heterosexual men living in Brooklyn, New York City, were surveyed about their sexual behaviors and PrEP …

Estimated Prevalence Of Smoking And Smoking-Attributable Mortality Associated With Graphic Health Warnings On Cigarette Packages In The Us From 2022 To 2100, Jamie Tam, Jihyoun Jeon, Jim Thrasher Ph.D., Ma, Ms, David Hammond, Theodore R. Holford, David T. Levy, Rafael Meza

Faculty Publications

Question What are the estimated population health outcomes associated with implementation of graphic health warnings on cigarette packages in 2022 and with delayed implementation of the warnings since 2012, as originally planned, in the US?

Findings In this decision analytical model using simulation modeling of smoking prevalence and smoking-attributable mortality in the US from 2012 to 2100, graphic health warnings, if implemented from 2022 to 2100, would be associated with 539 000 smoking-attributable deaths averted and 7.9 million life-years gained, and if implemented in 2012, with 718 000 deaths averted and 11.2 million life-years gained through 2100.

Meaning These findings …

Facial Expression Processing Of Children Orphaned By Parental Hiv/Aids: A Cross-Sectional Erp Study With Rapid Serial Visual Presentation, Qiong Zhao, Hui He, Huang Gu, Junfeng Zhao, Peilian Chi, Xiaoming Li Ph.D.

Faculty Publications

Existing behavioral studies have suggested that individuals with early life stress usually show abnormal emotional processing. However, limited event-related brain potentials (ERPs) evidence was available to explore the emotional processes in children orphaned by parental HIV/AIDS (“AIDS orphans”). The current study aims to investigate whether there are behavioral and neurological obstacles in the recognition of emotional faces in AIDS orphans and also to further explore the processing stage at which the difference in facial emotion recognition exists. A total of 81 AIDS orphans and 60 non-orphan children were recruited through the local communities and school systems in Henan, China. Participants …

The Assessment Of An Extended Set Of Socio-Economic Determinants To Explain Anxiety And Uncertainty, Insufficient Quality And Food Intake Of Afghan Refugees, Mohammad Reza Pakravan-Charvadeh, Hassan Vatanparast, Edward A. Frongillo Jr., Mahasti Khakpour, Cornelia Flora

Faculty Publications

OBJECTIVES:

In this study, socio-economic factors associated with Afghan refugee households' food insecurity, anxiety and uncertainty, insufficient quality and food intake were determined.

DESIGN:

Household Food Insecurity Assess Scale measurement was applied to assess food insecurity, anxiety and uncertainty, insufficient quality and insufficient food intake. Descriptive analysis and multivariable regression models were used to determine the associated factors.

SETTING:

The study was carried out in urban areas of Tehran province in Iran. PARTICIPANTS: To collect data, interviews were conducted among 317 Afghan households. The questionnaire was administered via face-to-face interviews to either the breadwinner of the selected households or a …

Advancing Use Of Nutrition Knowledge To Improve Practice By Policy And Program Communities In India During A Political Transition, Edward A. Frongillo Jr., Jessica L. Escobar-Alegria

Faculty Publications

Models are needed for how to advance use of knowledge by programs and policy officials to make evidence-based decisions about nutrition. How to advance use of nutrition knowledge in India from 2011 to 2015 during a political transition was investigated through studying a knowledge initiative led by the International Food Policy Research Institute. Semistructured interviews were conducted with 37 diverse participants, and 1091 news articles, 318 Twitter and 175 Facebook posts, 12 YouTube events, 65 knowledge products, and 130 engaging events were assessed. Open-axial coding, content and themes analysis, triangulation, and process tracing were used. The knowledge initiative analyzed the …

A Structural Study Of The Cytoplasmic Chaperone Effect Of 14-3-3 Proteins On Ataxin-1, Seppe Leysen, Rebecca Jane Burnley, Elizabeth Rodriguez, Lech-Gustav Milroy, Lorenzo Soini, Carolyn J. Adamski, Larissa Nitschke, Rachel Davis, Tomas Obsil, Lucas Brunsveld, Tom Crabbe, Huda Yahya Zoghbi, Christian Ottmann, Jeremy Martin Davis

Faculty Publications

Expansion of the polyglutamine tract in the N terminus of Ataxin-1 is the main cause of the neurodegenerative disease, spinocerebellar ataxia type 1 (SCA1). However, the C-terminal part of the protein - including its AXH domain and a phosphorylation on residue serine 776 - also plays a crucial role in disease development. This phosphorylation event is known to be crucial for the interaction of Ataxin-1 with the 14-3-3 adaptor proteins and has been shown to indirectly contribute to Ataxin-1 stability. Here we show that 14-3-3 also has a direct anti-aggregation or "chaperone" effect on Ataxin-1. Furthermore, we provide structural and …

Pre-Exposure Prophylaxis (Prep) Uptake Among Black Men Who Have Sex With Men (Bmsm) In The Southern U.S, Oluwafemi Adeagbo, Sayward Elizabeth Harrison, Shan Qiao Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Black men who have sex with men (BMSM) living in the United States (U.S.) South are disproportionately affected by HIV and experience significant disparities in HIV incidence, access to HIV care, and prevention across ages and socio-economic statuses. The aim of this commentary is to critically review current literature on the state of PrEP use among BMSM in the U.S. South, including identifying barriers and facilitators to PrEP use in order to inform intervention development. Extant literature shows that despite the documented benefits of PrEP as an effective HIV-prevention method, its uptake among BMSM is limited across the U.S. South. …

Temporal Geospatial Analysis Of Covid-19 Pre-Infection Determinants Of Risk In South Carolina, Tianchu Lyu, Nicole Hair, Nicholas Yell, Zhenlong Li, Shan Qiao Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Disparities and their geospatial patterns exist in morbidity and mortality of COVID-19 patients. When it comes to the infection rate, there is a dearth of research with respect to the disparity structure, its geospatial characteristics, and the pre-infection determinants of risk (PIDRs). This work aimed to assess the temporal-geospatial associations between PIDRs and COVID-19 infection at the county level in South Carolina. We used the spatial error model (SEM), spatial lag model (SLM), and conditional autoregressive model (CAR) as global models and the geographically weighted regression model (GWR) as a local model. The data were retrieved from multiple sources including …

Maternal Resources For Care Are Associated With Child Growth And Early Childhood Development In Bangladesh And Vietnam, Sulochana Basnet, Edward A. Frongillo Jr., Phuong Hong Nguyen, Spencer Moore, Mandana Arabi

Faculty Publications

BACKGROUND:

Suboptimal child growth and development are significant problems in low- and middle-income countries. Maternal resources for care may help to improve growth and development. This study examined the association of maternal resources for care on child length, motor development and language development of children 12-23.9 months old.

METHODS:

We used baseline data from the Alive & Thrive household surveys collected in Bangladesh (n = 803) and Vietnam (n = 635). Resources for care were represented by maternal education, knowledge, height, well-nourishment, mental well-being, decision-making, employment, support in chores and perceived support. The regression analyses were adjusted for household wealth …

Relationship Between Food Insecurity And Smoking Status Among Women Living With And At Risk For Hiv In The Usa: A Cohort Study, Lila A. Sheira, Edward A. Frongillo Jr., Judith Hahn, Kartika Palar, Elise D. Riley, Tracey E. Wilson, Adebola Adedimeji, Daniel Merenstein, Mardge Cohen, Eryka L. Wentz, Adaora A. Adimora, Ighovwerha Ofotokun, Lisa Metsch, Janet M. Turan, Phyllis C. Tien, Sheri D. Weiser

Faculty Publications

Objectives People living with HIV (PLHIV) in the USA, particularly women, have a higher prevalence of food insecurity than the general population. Cigarette smoking among PLHIV is common (42%), and PLHIV are 6–13 times more likely to die from lung cancer than AIDS related causes. This study sought to investigate the associations between food security status and smoking status and severity among a cohort of predominantly low-income women of colour living with and without HIV in the USA.

Design Women enrolled in an ongoing longitudinal cohort study from 2013 to 2015.

Setting Nine participating sites across the USA.

Participants 2553 …

Suicide Attempts In Us Veterans With Chronic Headache Disorders: A 10-Year Retrospective Cohort Study, X. Michelle Androulakis, Siyuan Guo, Jiajia Zhang Ph.D., Jason Sico, Peter Warren, Alec Giakas, Xiaoming Li Ph.D., B Lee Peterlin, Roy Mathew, Deborah Reyes

Faculty Publications

Objectives: A large-scale retrospective analysis of veterans with chronic pain was con-ducted to examine (1) the annual incidence of suicide attempts (SA) in veterans with chronic headache and other chronic pain conditions, and (2) the risk of SA in men and women with chronic headache and chronic headache concurrent with traumatic brain injury (TBI) as compared to non-headache chronic pain.

Methods: This retrospective study (N=3,247,621) analyzed National Veterans Affair Health Administrative data of patients diagnosed with chronic head, neck, back and other chronic pain from 2000 to 2010. Multivariable Poisson regression was used to explore the relative risks of SA …

Drivers Of Food Choice Among Children And Caregivers In Post-Earthquake Nepal, Pepijn Schreinemachers, Rachana Manadhar Sherestha, Bishal Gole, Dhruba Raj Bhattarai, Puspa Lal Ghimire, Bhishm P. Subedi, Tilman Brück, Ghassan Baliki, Ishwori P. Gautam, Christine E. Blake

Faculty Publications

Food systems in many countries are experiencing a shift from traditional foods toward processed foods high in sugar, fat and salt, but low in dietary fiber and micronutrients. There is an urgent need to better understand drivers of changing food behavior, particularly for lower-income countries. This study analyzes drivers of food choice among children and parents in rural Nepal. It uses qualitative data collected through key informant interviews and focus group discussions with school children, parents and teachers. The study reveals substantial changes in food behavior during the past decade with increased consumption of rice, meat, and highly processed snack …

Adaptation Of The Agency For Healthcare Research And Quality’S ‘Hospital Survey On Patient Safety Culture’ To The Bosnia And Herzegovina Context, Šehad Draganović, Guido Offermanns, Rachel E. Davis

Faculty Publications

OBJECTIVES: Measuring staff perspectives on patient safety culture (PSC) can identify areas of concern that, if addressed, could lead to improvements in healthcare. To date, there is no validated measure to assess PSC that has been tested and adapted for use in Bosnia and Herzegovina (BiH). This research addresses the gap in the evidence through the psychometric assessment of the Agency for Healthcare Research and Quality's: 'Hospital Survey on Patient Safety Culture' (HSOPSC), to determine its suitability for the health system in BiH. SETTING: Nine hospitals. PARTICIPANTS: Healthcare professionals (n=1429); nurse (n=823), doctors (n=328), other clinical personnel (n=111), non-clinical personnel …

Water Insecurity Is Associated With Lack Of Viral Suppression And Greater Odds Of Aids-Defining Illnesses Among Adults With Hiv In Western Kenya, Jason M. Nagata, Joshua D. Miller, Craig R. Cohen, Edward A. Frongillo Jr., Elly Weke, Rachel Burger, Pauline Wekesa, Lila A. Sheira, A Rain Mocello, Phelgona Otieno, Lisa M. Butler, Elizabeth A. Bukusi, Sheri D. Weiser, Sera L. Young

Faculty Publications

Reliable access to safe and acceptable water in sufficient quantities (i.e., water security) is important for medication adherence and limiting pathogen exposure, yet prior studies have only considered the role of food security as a social determinant of HIV-related health. Therefore, the objective of this analysis was to assess the relationships between household water insecurity and HIV-related outcomes among adults living with HIV in western Kenya (N = 716). We conducted a cross-sectional analysis of baseline data from Shamba Maisha (NCT02815579), a cluster randomized controlled trial of a multisectoral agricultural and asset loan intervention. Baseline data were collected from June …

Covid-19 Disrupted Provision And Utilization Of Health And Nutrition Services In Uttar Pradesh, India: Insights From Service Providers, Household Phone Surveys, And Administrative Data, Phuong H. Nguyen, Shivani Kachwaha, Anjali Pant, Lan M. Tran, Monika Walia, Sebanti Ghosh, Praveen K. Sharma, Jessica Escobar-Alegria, Edward A. Frongillo Jr., Purnima Menon, Rasmi Avula

Faculty Publications

BACKGROUND: The coronavirus (COVID-19) pandemic may substantially affect health systems, but little primary evidence is available on disruption of health and nutrition services. OBJECTIVES: This study aimed to 1) determine the extent of disruption in provision and utilization of health and nutrition services induced by the pandemic in Uttar Pradesh, India; and 2) identify how adaptations were made to restore service provision in response to the pandemic. METHODS: We conducted longitudinal surveys with frontline workers (FLWs, n = 313) and mothers of children < 2 y old (n = 659) in December 2019 (in-person) and July 2020 (by phone). We also interviewed block-level managers and obtained administrative data. We examined changes in service provision and utilization using Wilcoxon matched-pairs signed-rank tests. RESULTS: Compared with prepandemic, service provision reduced substantially during lockdown (83-98 percentage points, pp), except for home visits and take-home rations (∼ 30%). Most FLWs (68%-90%) restored service provision in July 2020, except for immunization and hot cooked meals (< 10%). Administrative data showed similar patterns of disruption and restoration. FLW fears, increased workload, inadequate personal protective equipment (PPE), and manpower shortages challenged service provision. Key adaptations made to provide services were delivering services to beneficiary homes (∼ 40%-90%), social distancing (80%), and using PPE (40%-50%) and telephones for communication (∼ 20%). On the demand side, service utilization reduced substantially (40-80 pp) during the lockdown, but about half of mothers received home visits and food supplementation. Utilization for most services did not improve after the lockdown, bearing the challenges of limited travel (30%), nonavailability of services (26%), and fear of catching the virus when leaving the house (22%) or meeting service providers (14%). CONCLUSIONS: COVID-19 disrupted the provision and use of health and nutrition services in Uttar Pradesh, India, despite adaptations to restore services. Strengthening logistical support, capacity enhancement, performance management, and demand creation are needed to improve service provision and utilization during and post-COVID-19.

Exploring How Exposure To Truth And State-Sponsored Anti-Tobacco Media Campaigns Affect Smoking Disparities Among Young Adults Using A National Longitudinal Dataset, 2002-2017, David C. Colston, Yanmei Xie, Jim Thrasher Ph.D.,Ma. Ms, Sherry Emery, Megan E. Patrick, Andrea R. Titus, Micheal R. Elliot, Nancy L. Fleischer

Faculty Publications

Background. Little is known regarding long-term impacts of anti-tobacco media campaigns on youth smoking and related disparities in the United States. Methods. We examined longitudinal cohort data from Monitoring the Future (MTF) between 2000 and 2017 in modified Poisson regression models to understand the long-term impacts of televised Truth and state-sponsored ad campaign exposure at baseline (age 18) on first cigarette and daily smoking initiation 1 to 2 years later (at modal ages 19/20). We also used additive interactions to test for potential effect modification between campaign exposure and smoking outcomes by sex, race/ethnicity, and parental educational attainment. Results. We …

A Contextual Evaluation Of The Fresh Fruit And Vegetable Program In South Carolina And Related Child Health Behaviors, Kathryn Irene Hoy

Theses and Dissertations

Children in vulnerable communities are at increased risk for poor diet.1,2 The Fresh Fruit and Vegetable Program (FFVP) is a United States Department of Agriculture (USDA) child nutrition program that increases vulnerable children’s access to and consumption of fruits and vegetables.3,4 FFVP is inherently flexible,5 has few regulations, and helps identify and develop best practices for individual schools to increase fruit and vegetable consumption among low-resource children.6 Flexibility built into the FFVP at the federal level naturally results in a variation of program adoption and implementation at both the state and school-levels.7 These variations affect outcomes in complex health promotion …

Neighborhood Socioeconomic Status, Green Space, And Walkability And Risk For Falls And Fracture Among Postmenopausal Women: The Women’S Health Initiative, Marilyn Elizabeth Wende

Theses and Dissertations

The purpose of this study was to assess whether neighborhood socioeconomic status (SES), walkability, and green space impacts fall and fracture incidence among postmenopausal women, and to assess important modifiers for these relationships, such as fall history, physical activity, physical impairment, race/ethnicity, and rurality. Data from the Women’s Health Initiative study from 1993 to 2012 (N=161,808) was used.

SES had a significant relationship with falling after adjustment (intermediate vs low SES OR=0.99, p=0.0309; high vs low SES OR=0.99, p=0.1192). Study arm participation and fall frequency at baseline significantly modified this relationship. Walkability had a significant relationship with falling incidence after …

Applying Health Stigma Framework To Examine The Mechanisms Of Hiv-Related Stigma On Clinical Outcomes, Chengbo Zeng

Theses and Dissertations

Background: HIV clinical outcomes including CD4 count, viral suppression, and health-related quality of life (HRQoL), are important indicators reflecting immunologic functioning, treatment efficacy, and overall health quality. However, due, in part, to HIV-related stigma, many people living with HIV (PLWH) experience suboptimal clinical outcomes. The Health Stigma Framework introduced the potentially distinct mechanisms underlying internalized, anticipated, enacted stigma and health outcomes through psycho-behavioral pathways. Based on this framework, this dissertation investigated the impacts and mechanisms of HIV-related stigma on clinical outcomes among PLWH in Guangxi, China from a longitudinal perspective. Methods: Data at baseline, 6-, 12-, 18- month follow-ups …