Public Health Education and Promotion Commons^™

Development Of A Comprehensive Measure Of Organizational Readiness (Motivation × Capacity) For Implementation: A Study Protocol, Timothy J. Walker, Heather M. Brandt, Abraham Wandersman, Jonathan Scaccia, Andrea Lamont, Lauren Workman, Emanuelle Dias, Pamela M. Diamond, Derek W. Craig, Maria E. Fernandez

Faculty Publications

BACKGROUND: Organizational readiness is important for the implementation of evidence-based interventions. Currently, there is a critical need for a comprehensive, valid, reliable, and pragmatic measure of organizational readiness that can be used throughout the implementation process. This study aims to develop a readiness measure that can be used to support implementation in two critical public health settings: federally qualified health centers (FQHCs) and schools. The measure is informed by the Interactive Systems Framework for Dissemination and Implementation and R = MC heuristic (readiness = motivation × innovation-specific capacity × general capacity). The study aims are to adapt and further develop …

Impact Of Mass Distribution Of Long-Lasting Insecticidal Nets (Llins) In Mozambique, 2011 To 2025: Retrospective And Prospective Modelling Of Child Mortality And Lives Saved, Erica Wetzler, Jorge A. H. Arroz, Chulwoo Park, Marta Chande, Figueiredo Mussambala

Faculty Publications

No abstract provided.

A Community-Based School Nutrition Intervention Improves Diet Diversity And School Attendance In Palestinian Refugee Schoolchildren In Lebanon, Zeina Jamaluddine, Jowel Choufani, Amelia Reese Masterson, Reem Hoteit, Nadine R. Sahyoun, Hala Ghattas Ph.D.

Faculty Publications

Background:

School feeding programs have the potential to supply children with healthy school food, alleviate short-term hunger, and improve children's educational outcomes.

Objectives:

We linked community kitchens to a subsidized school snack intervention and assessed the impact of this intervention on nutritional (diet diversity, hemoglobin, and anthropometry) and educational (attendance and academic performance) outcomes of Palestinian refugee schoolchildren.

Methods:

We collected data from 1362 students (aged 5-15 y) and their parents at baseline, and at an 8-mo follow-up in 2 control and 2 intervention schools. We conducted linear, logistic, and negative binomial regression analyses to assess changes in outcomes of …

Building Capacity In Dissemination And Implementation Science: A Systematic Review Of The Academic Literature On Teaching And Training Initiatives, Rachel E. Davis, Danielle D'Lima

Faculty Publications

BACKGROUND: The field of dissemination and implementation (D&I) science has grown significantly over recent years. Alongside this, an increased demand for training in D&I from researchers and implementers has been seen. Research describing and evaluating D&I training opportunities, referred to here as 'capacity building initiatives' (CBIs), can help provide an understanding of different methods of training as well as training successes and challenges. However, to gain a more detailed understanding of the evidence-base and how D&I CBIs are being reported in publications, a field-wide examination of the academic literature is required. METHODS: Systematic review to identify the type and range …

Terminal Logic Behavior And Strategic Defection Of Governmental Officials During Presidential Transitions In Guatemala: Implications For The Sustainability Of Food And Nutrition Security Policy, Jessica L. Escobar-Alegria, Edward A. Frongillo Jr., Christine E. Blake

Faculty Publications

Background: Presidents with no possibility of re-election overvalue far-future rewards and succumb to terminal logic behavior (TLB), responding to end-of-tenure legacy concerns despite political context. Government authorities perceiving the outgoing government is losing power at the end of term behave under the logic of strategic defection (SD), dissociating from the outgoing government once it is perceived powerless. In countries where re-election is impossible and government turnover and inconstant political parties are concerns, governmental officials at all levels may show TLB and SD during transitions that affect policy sustainability. Objectives: This study aimed to understand the context during presidential transitions that …

African American Emerging Adult Perspectives On Unintended Pregnancy And Meeting Their Needs With Mobile Technology: Mixed Methods Qualitative Study, Lucy Annang Ingram, Crystal Stafford, Quentin Mccollum, Mckenzie Isreal

Faculty Publications

Background: In the United States, a disproportionate number of unintended pregnancies occur among African Americans, particularly those in their later teenage years and early 20s. Mobile technology is becoming more ubiquitous as a method for health promotion; however, relatively little research has been done with this population to determine their perspectives about unintended pregnancy, the potential of successfully using mobile technology to prevent unintended pregnancy, and the content of such programs.

Objective: The purpose of this study was to obtain the perspectives of African American emerging adults about unintended pregnancy and the use of mobile technology to reduce unintended pregnancy …

Sensor-Measured Physical Activity Is Associated With Decreased Cardiovascular Disease Risk In African Americans, John A. Bernhart Ph.D., Mph, Ches, Gabrielle M. Turner-Mcgrievy Ph.D., Rd, Sarah Eustis, Mary J. Wilson Phd, Mph, Brent Hutto Msph, Sara Wilcox Phd, Edward A. Frongillo Jr. Ph.D., E. Angela Murphy

Faculty Publications

Introduction: Few studies have examined relationships between sensor-measured physical activity (PA) and cardiovascular disease (CVD) risk among African Americans. This study described relationships between PA and CVD risk in NEW Soul study participants. Methods: Participants completed a dual X-ray absorptiometry scan and measures of blood pressure, waist and hip circumference, height, and weight. Actigraph GTM accelerometers measured moderate to vigorous physical activity (MVPA). We assessed relationships between minutes/day of MVPA and total body fat percent, total lean body mass, total fat mass, total bone mass, total fat distribution, body mass index (BMI), systolic and diastolic blood pressure, and waist-to-hip ratio, …

National Nutrition Strategies That Focus On Maternal, Infant, And Young Child Nutrition In Southeast Asia Do Not Consistently Align With Regional And International Recommendations, Tuan T. Nguyen, Ashley Darnell, Amy Weissman, Jennifer Cashin, Mellissa Withers, Roger Mathisen, Karin Lapping, Timothy D. Mastro, Edward A. Frongillo Jr.

Faculty Publications

We examined the consistency of national nutrition strategies and action plans (NNS) focusing on maternal, infant, and young child nutrition in Southeast Asia with regional and international recommendations. Between July and December 2017, we identified and extracted information on context, objectives, interventions, indicators, strategies, and coordination mechanisms from the most recent NNS in nine Southeast Asian countries. All NNS described context, objectives, and the following interventions: antenatal care, micronutrient supplementation during pregnancy, breastfeeding promotion, improved complementary feeding, nutrition in emergencies, and food fortification or dietary diversity. Micronutrient supplementation for young children was included in eight NNS; breastfeeding promotion during pregnancy …

Early Breastfeeding Practices Contribute To Exclusive Breastfeeding In Bangladesh, Vietnam And Ethiopia, Phuong Hong Nguyen, Sunny S. Kim, Lan Mai Tran, Purnima Menon, Edward A. Frongillo Jr.

Faculty Publications

Limited evidence exists on the complex relationship among interventions, early initiation of breastfeeding (EIBF), prelacteal feeding and exclusive breastfeeding (EBF). We examined whether early breastfeeding practices are associated with EBF and how much improving EIBF and non-prelacteal feeding contributes to increased prevalence of EBF. Survey data were collected in 2010 and 2014 as part of impact evaluations of Alive & Thrive (A&T) interventions to improve infant and young child feeding (IYCF) practices in Bangladesh, Vietnam and Ethiopia. Multivariable logistic regression analyses were used to examine effects of interventions and early breastfeeding practices on EBF. Structural equation modelling quantified the direct …

Intermittent Pneumatic Compression For Venous Thromboembolism Prevention: A Systematic Review On Factors Affecting Adherence, Richard Greenall, Rachel E. Davis

Faculty Publications

OBJECTIVE: Venous thromboembolism (VTE) is a potentially fatal complication of hospitalisation. Intermittent pneumatic compression (IPC) is one approach to reducing the likelihood of a VTE. Adherence to IPC is known to be inadequate though the reasons for this remain unclear. This systematic review explores factors that affect adherence to IPC in the inpatient context. METHODS: Information sources-EMBASE, MEDLINE and PsycINFO were searched for literature between January 1960 and May 2019. Eligibility criteria-studies were included if they focused on inpatient care and examined factors affecting adherence to IPC devices. RESULTS: Included studies-a total of 20 out of 1476 studies were included. …

Building Implementation Science In Nutrition, Andrea M. Warren, Edward A. Frongillo Jr., Rahul Rawat

Faculty Publications

The field of nutrition has been investing in the development of many nutrition-specific and -sensitive policies and programs aimed at improving population-level malnutrition in all its forms. When there is a need to learn about a new system, programmatic context, or target population to understand how to effectively deploy an intervention to help improve nutrition, it is important to be able to ask a broad range of questions, both in topic and in scope. Our aim is to provide a simple and conceptually clear definition and principles to elaborate the science of implementation for nutrition to distinguish it from other …

Men’S Vasectomy Knowledge, Attitudes, And Information-Seeking Behaviors In The Southern United States: Results From An Exploratory Survey, Ashley L. White, Rachel E. Davis, Deborah Lynn Billings Phd, Emily S. Mann

Faculty Publications

Vasectomy is one of the few options men have to manage their reproductive capacity and take on a more equitable role in pregnancy prevention. While the method is underused throughout the United States, the southern states have a lower prevalence rate compared to the rest of the country. Existing survey research does not assess what men know or think about the procedure as a means of understanding why this is the case. We created and conducted an exploratory survey to assess men’s knowledge, attitudes, and information-seeking behaviors about vasectomy in the Southern United States. We used targeted Facebook advertising to …

Can Children Catch Up From The Consequences Of Undernourishment? Evidence From Child Linear Growth, Developmental Epigenetics, And Brain And Neurocognitive Development, Jef L. Leroy, Edward A. Frongillo Jr., Pragya Dewan, Maureen M. Black, Robert A. Waterland

Faculty Publications

Recovery from nutritionally induced height deficits continues to garner attention. The current literature on catch-up growth, however, has 2 important limitations: wide-ranging definitions of catch-up growth are used, and it remains unclear whether children can recover from the broader consequences of undernutrition. We addressed these shortcomings by reviewing the literature on the criteria for catch-up in linear growth and on the potential to recover from undernutrition early in life in 3 domains: linear growth, developmental epigenetics, and child brain and neurocognitive development. Four criteria must be met to demonstrate catch-up growth in height: after a period in which a growth-inhibiting …

Nutrient Timing: A Garage Door Of Opportunity?, Shawn M. Arent, Harry P. Cintineo, Bridget A. Mcfadden, Alexa Jenny Chandler, Michelle Angelique Arent

Faculty Publications

Nutrient timing involves manipulation of nutrient consumption at specific times in and around exercise bouts in an effort to improve performance, recovery, and adaptation. Its historical perspective centered on ingestion during exercise and grew to include pre- and post-training periods. As research continued, translational focus remained primarily on the impact and outcomes related to nutrient consumption during one specific time period to the exclusion of all others. Additionally, there seemed to be increasing emphasis on outcomes related to hypertrophy and strength at the expense of other potentially more impactful performance measures. As consumption of nutrients does not occur at only …

Living Arrangements And Food Security Of A Sample Of Older Palestinian Refugees In Lebanon, Nadine R. Sahyoun, Anniebelle Sassine, Anna Vaudin, Fayrouz Sakr-Ashour, Hala Ghattas Ph.D.

Faculty Publications

Background

Although we know of the relationship between food insecurity, poor dietary intake and health outcomes, there are limited studies examining the determinants of food insecurity in older adults in developing countries. This study describes the living arrangement and characteristics of protracted Palestinian refugees in Lebanon aged 60 years and older and, the status and determinants of household food insecurity.

Methods

Two surveys, representative of Palestinian refugees in Lebanon (2010 and 2015), were appended and used to examine living arrangement of older adults and household food security. Our final pooled sample included 5412 households and 24,540 individuals. Of these individuals, …

Linking Activity, Nutrition, And Child Health (Launch): Protocol For A Longitudinal Cohort Study Of Children As They Develop From Infancy To Preschool Age, Russell R. Pate, Edward A. Frongillo Jr., Kerry Cordan, Marsha Dowda, Alexander C. Mclain, Myriam E. Torres, William H. Brown, Agnes Bucko, Emily R. Shull

Faculty Publications

Background

Physical activity is known to provide important health benefits in children ages 3 years and above, but little is known about the effects of physical activity on health in very young children under age 3. LAUNCH (Linking Activity, Nutrition, and Child Health) is a study designed to expand the body of knowledge on development of physical activity behavior and associations between physical activity and other health characteristics as children transition from infancy to preschool age.

Methods

Physical activity and sedentary behavior will be measured objectively in young children over a period of 30 months. Each child will complete a …

The Cascade Of Care In Managing Hypertension In The Arab World: A Systematic Assessment Of The Evidence On Awareness, Treatment And Control, Christelle Akl, Chaza Akik, Hala Ghattas Ph.D., Carla Makhlouf Obermeyer

Faculty Publications

Background:

Hypertension is a leading risk factor for mortality and morbidity globally and in the Arab world. We summarize the evidence on awareness, treatment, and control of hypertension, to assess the extent of gaps in the hypertension continuum of care. We also assess the influence of gender and other social determinants at each level of the cascade of care.

Methods:

We searched MEDLINE and SSCI databases for studies published between 2000 and 2017, reporting the rates of awareness, treatment or control of hypertension and/or their determinants in the Arab region. We included sources on both general populations and on clinical …

Responding To Health Needs Of Women, Children And Adolescents Within Syria During Conflict: Intervention Coverage, Challenges And Adaptations, Chaza Akik, Aline Semaan, Linda Shaker-Berbari, Zeina Jamaluddine, Ghada E. Saad, Katherine Lopes, Joanne Constantin, Abdulkarim Ekzayez, Neha S. Singh, Karl Blanchet, Jocelyn Dejong, Hala Ghattas Ph.D.

Faculty Publications

Background:

Women and children suffer disproportionately in armed-conflicts. Since 2011, the protracted Syrian crisis has fragmented the pre-existing healthcare system. Despite the massive health needs of women and children, the delivery of key reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH&N) interventions, and its underlying factors are not well-understood in Syria. Our objective was to document intervention coverage indicators and their implementation challenges inside Syria during conflict.

Methods:

We conducted 1) a desk review to extract RMNCAH&N intervention coverage indicators inside Syria during the conflict; and 2) qualitative interviews with decision makers and health program implementers to …

Effect Of Differences In Month And Location Of Measurement In Estimating Prevalence And Trend Of Wasting And Stunting In India In 2005-2006 And 2015-2016, Emily M. Madan, Edward A. Frongillo Jr., Sayeed Unisa, Laxmikant Dwivedi, Robert Johnston, Abner Daniel, Praween K. Agrawal, Sila Deb, Ajay Khera, Purnima Menon, Phuong H. Nguyen

Faculty Publications

Background: Child undernutrition in India remains widespread. Data from the National Family Health Survey 3 and 4 (NFHS-3 and NFHS-4) suggest that wasting prevalence has increased while stunting prevalence has declined. Objective: The objectives of this study were to do the following: ) describe wasting and stunting by month of measurement in India in children surveys, and ) test whether differences in the timing of anthropometric data collection and in states between survey years introduced bias in the comparison of estimates of wasting and stunting between NFHS-3 and NFHS-4. Methods: Data on wasting and stunting for 42,608 and 232,744 children …

Objective Church Environment Audits And Attendee Perceptions Of Healthy Eating And Physical Activity Supports Within The Church Setting, Marilyn E. Wende, Andrew T. Kaczynski, John A. Bernhart, Caroline G. Dunn, Sarah Wilcox

Faculty Publications

Interventions in faith-based settings are increasingly popular, due to their effectiveness for improving attendee health outcomes and behaviors. Little past research has examined the important role of the church environment in individual-level outcomes using objective environmental audits. This study examined associations between the objectively measured physical church environment and attendees’ perceptions of physical activity (PA) and healthy eating (HE) supports within the church environment, self-efficacy for PA and HE, and self-reported PA and HE behaviors. Data were collected via church audits and church attendee surveys in 54 churches in a rural, medically underserved county in South Carolina. Multi-level regression was …

2020 County Health Rankings Tennessee Data And Updated Substance Abuse 2005-2019, Kelsey L. Grabeel, Jenny Moore

Faculty Publications

No abstract provided.

Association Of Multisetting Community Programs And Policies With Child Body Mass Index: The Healthy Communities Study, Vicki L. Collie-Akers, Stephen B. Fawcett, Jerry A. Schultz, Kandace K. Fleming, Rebecca E. Swinburne Romine, Lorrene D. Ritchie, Edward A. Frongillo Jr., S Sonia Arteaga

Faculty Publications

INTRODUCTION:

Expert opinion suggests that efforts to address childhood obesity should seek to transform the environments in which children operate. The objective of this study was to describe the extent to which multisetting programs and policies interact with community and child predictors and are associated with child body mass index (BMI) in the 130 US communities participating in the Healthy Communities Study.

METHODS:

For 2 years beginning in fall 2013, we collected data through key informant interviews on community programs and policies related to healthy weight among children that occurred in the 10 years before the interview. We characterized community …

Associations Between Food Insecurity And Psychotropic Medication Use Among Women Living With Hiv In The United States, Henry J. Whittle, William R. Wolfe, Lila A. Sheira, Edward A. Frongillo Jr., Kartika Palar, Daniel Merenstein, Tracey E. Wilson, Adebola Adedimeji, Mardge H. Cohen, Eryka L. Wentz, Phyllis C. Tien, Sheri D. Weiser

Faculty Publications

AIMS: Psychotropic prescription rates continue to increase in the United States (USA). Few studies have investigated whether social-structural factors may play a role in psychotropic medication use independent of mental illness. Food insecurity is prevalent among people living with HIV in the USA and has been associated with poor mental health. We investigated whether food insecurity was associated with psychotropic medication use independent of the symptoms of depression and anxiety among women living with HIV in the USA. METHODS: We used cross-sectional data from the Women's Interagency HIV Study (WIHS), a nationwide cohort study. Food security (FS) was the primary …

Associations Of Maternal Resources With Care Behaviours Differ By Resource And Behaviour, Sulochana Basnet, Edward A. Frongillo Jr., Phuong Hong Nguyen, Spencer Moore, Mandana Arabi

Faculty Publications

Care is important for children's growth and development, but lack or inadequacy of resources for care can constrain appropriate caregiving. The objectives of this study were to examine whether maternal resources for care are associated with care behaviours specifically infant and young child feeding, hygiene, health-seeking, and family care behaviours. The study also examined if some resources for care are more important than others. This study used baseline Alive & Thrive household surveys from Bangladesh, Vietnam, and Ethiopia. Measures of resources for care were maternal education, knowledge, height, nourishment, mental well-being, decision-making autonomy, employment, support in chores, and perceived instrumental …

Adult Smokers’ Awareness And Interest In Trying Heated Tobacco Products: Perspectives From Mexico, Where Htps And E-Cigarettes Are Banned, Lizeth Cruz-Jiménez, Inti Barrientos-Gutiérrez, Liliana Coutiño-Escamilla, Katia Gallegos-Carrillo, Edna Arillo-Santillán, Jim Thrasher

Faculty Publications

Background: We evaluated smokers’ perceptions of heated tobacco products (HTPs) in Mexico, where industry publically lobbied to introduce HTPs into this country that banned both HTPs and e-cigarettes. Methods: Online surveys (November 2018 to July 2019) were analyzed from adults who only smoked cigarettes (n = 2091) or who smoked and used e-cigarettes (“dual users” n = 1128). Logistic models regressed HTP awareness, interest to trying HTPs, and having seen HTPs for sale (only among aware participants) on sociodemographics and tobacco-related variables. Results: Of the 17.1% who were aware of HTPs, 52.7% reported having seen HTPs for sale. Of all …

Functional Blockade Of E-Selectin In Tumor-Associated Vessels Enhances Anti-Tumor Effect Of Doxorubicin In Breast Cancer, Yoshihiro Morita, Macall Leslie, Hiroyasu Kameyama, Ganesh L. Lokesh, Norihisa Ichimura, Rachel Davis, Natalie Hills, Nafis Hasan, Roy Zhang, Yuji Kondo, David G. Gorenstein, David E. Volk, Inna Chervoneva, Hallgeir Rui, Takemi Tanaka

Faculty Publications

Chemotherapy is a mainstay of treatment for solid tumors. However, little is known about how therapy-induced immune cell infiltration may affect therapy response. We found substantial CD45 immune cell density adjacent to E-selectin expressing inflamed vessels in doxorubicin (DOX)-treated residual human breast tumors. While CD45 level was significantly elevated in DOX-treated wildtype mice, it remained unchanged in DOX-treated tumors from E-selectin null mice. Similarly, intravenous administration of anti-E-selectin aptamer (ESTA) resulted in a significant reduction in CD45 immune cell density in DOX-treated residual tumors, which coincided with a delay in tumor growth and lung metastasis in MMTV-pyMT mice. Additionally, both …

Comparing Self-Reported Medication Adherence Measures With Hair Antiretroviral Concentration Among People Living With Hiv In Guangxi, China, Quan Zhang, Xiaoming Li Ph.D., Shan Qiao Ph.D., Zhiyong Shen, Yuejiao Zhou

Faculty Publications

Background: Antiretroviral adherence is essential to HIV treatment efcacy. Various self-reported measures are commonly used for assessing antiretroviral adherence. Limited data are available regarding the validity of those selfreported measures in comparison with long-term objective biomarkers of adherence measures such as hair measures.

Methods: Self-reported adherence (frequency, percentage, and visual analog scale [VAS]) and hair tenofovir concentration were evaluated at a single time point from 268 people living with HIV in China. The responses to each of three self-reported measures were converted into percentage and then dichotomized as “optimal” (100%) vs. “suboptimal” (less than 100%) adherence. Two composite adherence scores …

Icope A Multi-Level, Cluster Randomized, 36-Month, Parallel-Group Study To Assess The Efficacy Of Hiv Disclosure Intervention In Hiv Parental Disclosure Among Parents Living With Hiv In China, Xiaoming Li Ph.D., Shan Qiao Ph.D., Yuejiao Zhou

Faculty Publications

Objectives: Parents living with HIV who disclose their HIV status to their children could benefit from the parental HIV disclosure. However, it is also very challenging because of persistent stigma and discrimination against HIV. This report describes the study design and protocol of the “Interactive Communication with Openness, Passion, and Empowerment (iCOPE)” randomized controlled trial aimed at assisting parents living with HIV in conducting culturally and developmentally appropriate disclosure to their uninfected children in China through trainings among both parents living with HIV and healthcare providers.

Methods: A total of 791 parents living with HIV with children aged between 6 …

Agricultural And Finance Intervention Increased Dietary Intake And Weight Of Children Living In Hiv-Affected Households In Western Kenya, Lisa M. Butler, Shiva Bhandari, Phelgona Otieno, Sheri D. Weiser, Craig R. Cohen, Edward A. Frongillo Jr.

Faculty Publications

We tested whether a multisectoral household agricultural and finance intervention increased the dietary intake and improved the nutritional status of HIV-affected children. Two hospitals in rural Kenya were randomly assigned to be either the intervention or the control arm. The intervention comprised a human-powered water pump, microfinance loan for farm commodities, and training in sustainable farming practices and financial management. In each arm, 100 children (0-59 mo of age) were enrolled from households with HIV-infected adults 18-49 y old. Children were assessed beginning in April 2012 and every 3 mo for 1 y for dietary intake and anthropometry. Children in …

Social, Economic, And Political Events Affect Gender Equity In China, Nepal, And Nicaragua: A Matched, Interrupted Time-Series Study, Tuan T. Nguyen, Ashley Darnell, Amy Weissman, Edward A. Frongillo Jr., Roger Mathisen, Karin Lapping, Timothy D. Mastro, Mellissa Withers

Faculty Publications

: Progress in gender equity can improve health at the individual and country levels.: This study's objective was to analyze recent trends in gender equity and identify historical and contextual factors that contributed to changes in gender equity in three countries: China, Nepal, and Nicaragua.: To assess gender equity trends, we used the Gender Gap Index (GGI) from the World Economic Forum's Global Gender Gap Report (2006-2017). The GGI incorporated data on economic participation, educational attainment, health, and political empowerment for almost 150 countries. We selected China, Nepal, and Nicaragua because of their major changes in GGI and diversity in …