Public Health Education and Promotion Commons^™

Predictors And Barriers To Vaccination Among Older Syrian Refugees In Lebanon: A Cross-Sectional Analysis Of A Multi-Wave Longitudinal Study, Berthe Abi Zeid, Tanya El Khoury, Hala Ghattas Ph.D., Marwan F. Alawieh, Zeinab Ramadan, Sirine Anouti, Sawsan Abdulrahim, Stephen J. Mccall

Faculty Publications

Background:

Vaccination is important to prevent morbidity and mortality due to COVID-19 among older Syrian refugees. We aimed to elucidate the predictors of COVID-19 vaccine uptake among Syrian refugees aged 50 years or older in Lebanon and to understand their main reasons for not receiving the vaccine.

Methods:

This was a cross-sectional analysis of a five-wave longitudinal study, conducted through telephone interviews between Sept 22, 2020, and March 14, 2022, in Lebanon. For this analysis, data were extracted from wave 3 (Jan 21–April 23, 2021), which included a question on vaccine safety and on whether participants intended to receive the …

Predicting Adolescent Intervention Non-Responsiveness For Precision Hiv Prevention Using Machine Learning, Bo Wang, Feifan Liu, Lynette Deveaux, Arlene Ash, Ben Gerber, Jeroan Allison, Carly Herbert, Maxwell Poitier, Karen Macdonell, Xiaoming Li Ph.D., Bonita Stanton

Faculty Publications

Interventions to teach protective behaviors may be differentially effective within an adolescent population. Identifying the characteristics of youth who are less likely to respond to an intervention can guide program modifications to improve its effectiveness. Using comprehensive longitudinal data on adolescent risk behaviors, perceptions, sensation-seeking, peer and family influence, and neighborhood risk factors from 2564 grade 10–12 students in The Bahamas, this study employs machine learning approaches (support vector machines, logistic regression, decision tree, and random forest) to identify important predictors of non-responsiveness for precision prevention. We used 80% of the data to train the models and the rest for …

A Process For Converting An In-Person Training To Increase Church Capacity To Implement Physical Activity And Healthy Eating Practices And Policies To An Online Format, Sara Wilcox Phd, Ruth P. Saunders Ph.D., Jessica Stucker, Andrew T. Kaczynski Ph.D., Kelsey R. Day, Deborah Kinnard, Lindsay Decker, John A. Bernhart Ph.D., Mph, Ches

Faculty Publications

The implementation of evidence-based public health programs into practice is critical for improving health, but trainings for organizational change agents are often not scalable. To describe the process of converting a training that targets faith-based organizational capacity development from an in-person to an online format. We engaged in an iterative process to convert the training delivery mode from in-person to online that included assessing stakeholder support, consulting the literature on best practices, seeking a design team, consolidating content, designing engaging lessons, and building an online site. Feedback from end-users and other audiences was incorporated throughout. Pilot participants with characteristics like …

Capturing Children Food Exposure Using Wearable Cameras And Deep Learning, Shady Elbassuoni, Hala Ghattas Ph.D., Jalila El Ati, Yorgo Zoughby, Aline Semaan, Christelle Akl, Tarek Trabelsi, Reem Talhouk, Houda Ben Gharbia, Zoulfikar Shmayssani, Aya Mourad

Faculty Publications

Children’s dietary habits are influenced by complex factors within their home, school and neighborhood environments. Identifying such influencers and assessing their effects is traditionally based on self-reported data which can be prone to recall bias. We developed a culturally acceptable machine-learning-based data-collection system to objectively capture school-children’s exposure to food (including food items, food advertisements, and food outlets) in two urban Arab centers: Greater Beirut, in Lebanon, and Greater Tunis, in Tunisia. Our machine-learning-based system consists of 1) a wearable camera that captures continuous footage of children’s environment during a typical school day, 2) a machine learning model that automatically …

Maternal And Infant Outcomes Of Syrian And Palestinian Refugees, Lebanese And Migrant Women Giving Birth In A Tertiary Public Hospital In Lebanon: A Secondary Analysis Of An Obstetric Database, Stephen J. Mccall, Tanya C. El Khoury, Hala Ghattas Ph.D., Shady Elbassuoni, Mhd Hussein Murtada, Zeina Jamaluddine, Christine Haddad, Aya Hussein, Amina Krounbi, Jocelyn Dejong, Janoub Khazaal, Rabih Chahine

Faculty Publications

Objectives This study aims to assess whether the characteristics, management and outcomes of women varied between Syrian and Palestinian refugees, migrant women of other nationalities and Lebanese women giving birth at a public tertiary centre in Beirut, Lebanon.

Methods This was a secondary data analysis of routinely collected data from the public Rafik Hariri University Hospital (RHUH) between January 2011 and July 2018. Data were extracted from medical notes using text mining machine learning methods. Nationality was categorised into Lebanese, Syrian, Palestinian and migrant women of other nationalities. The main outcomes were diabetes, pre-eclampsia, placenta accreta spectrum, hysterectomy, uterine rupture, …

Effect Of A Plant-Based Vs Omnivorous Soul Food Diet On Weight And Lipid Levels Among African American Adults: A Randomized Clinical Trial, Gabrielle M. Turner-Mcgrievy Ph.D., Rd, Sara Wilcox Phd, Edward A. Frongillo Jr. Ph.D., E. Angela Murphy, Brent Hutto Msph, Mary Wilson Phd, Mph, Marty Davey, John A. Bernhart Ph.D., Mph, Ches, Nkechi Okpara, Shiba Bailey, Emily Hu

Faculty Publications

Importance: More African American individuals die from cardiovascular disease (CVD) than any other chronic disease condition. Despite this disparity, African American individuals are underrepresented in nutrition and CVD interventions. Objective: To compare the effects of an entirely plant-based (vegan) or low-fat omnivorous (omni) diet on change in body weight and lipids during a 2-year intervention. Design, Setting, and Participants: The Nutritious Eating With Soul (NEW Soul) study was a 2-year, randomized clinical trial conducted in 2 cohorts (2018-2020 and 2019-2021) that took place in a university teaching kitchen in Columbia, South Carolina (before March 2020), and via online videoconference sessions …

Perspective: Food Environment Research Priorities For Africa-Lessons From The Africa Food Environment Research Network, Amos K. Laar, Phyllis Addo, Richmond Aryeetey, Charles Agyemang, Francis Zotor, Gershim Asiki, Krystal K. Ramapalli, Gideon S. Anevinya, Akua Tandoh, Silver Nanema, Akosua Pokua Adjei, Matlida E. Laar, Kobby Mensah, Dennis Laryea, Daniel Sellen, Stefanie Vandevijvere, Christopher Turner, Hibbah Osei-Kwasi, Mark Spires, Christine E. Blake, Dominic Rowland, Suneetha Kadiyala, Isabel Madzorera, Adama Diouf, Namukolo Covic, Isaac M. Dzudzor, Reginald Annan, Peiman Milani, John Nortey, Nicholas Bricas, Sukati Mphumuzi, Kenneth Yongabi Anchang, Ali Jafri, Meenal Dhall, Amanda Kee, Sally Mckay, Samuel O. Oti, Karen Hofman, Edward A. Frongillo Jr. Ph.D., Michelle Holdsworth

Faculty Publications

Over the last 2 decades, many African countries have undergone dietary and nutrition transitions fueled by globalization, rapid urbanization, and development. These changes have altered African food environments and, subsequently, dietary behaviors, including food acquisition and consumption. Dietary patterns associated with the nutrition transition have contributed to Africa's complex burden of malnutrition—obesity and other diet-related noncommunicable diseases (DR-NCDs)—along with persistent food insecurity and undernutrition. Available evidence links unhealthy or obesogenic food environments (including those that market and offer energy-dense, nutrient-poor foods and beverages) with suboptimal diets and associated adverse health outcomes. Elsewhere, governments have responded with policies to improve food …

How Perspectives On Food Safety Of Vendors And Consumers Translate Into Food-Choice Behaviors In 6 African And Asian Countries, Sejla Isanovic, Shilpa V. Constantinides, Edward A. Frongillo Ph.D., Shiva Bhandari, Sharraf Samin, Emma Kenney, Sigrid Wertheim-Heck, Stella Nordhagen, Michelle Holdsworth, Paula Dominguez-Salas, Ramya Ambikapathi, Amos Laar, Crystal L. Patil, Bharati Kulkarni, Salome A. Bukachi, Mariah Ngutu, Christine E. Blake Ph.D., Rd

Faculty Publications

Background: Consumption of unsafe foods increases morbidity and mortality and is currently an issue, particularly in low- and middle-income countries. Policy actions to ensure food safety are dominated by mitigation of biological and chemical hazards through supply-side risk management, lessening the degree to which consumer perspectives of food safety are considered. Objectives: This study aimed to provide an in-depth understanding, from vendor and consumer perspectives, of how food-safety concerns of consumers translate into their subsequent food-choice behaviors in 6 diverse low- and middle-income countries. Methods: Six Drivers of Food Choice projects (2016–2022) provided transcripts from 17 focus group discussions and …

Perceived Covid-19 Threat, Perceived Healthcare System Inequities, Personal Experiences Of Healthcare Discrimination And Their Associations With Covid-19 Preventive Behavioral Intentions Among College Students In The Us, Juliana S. Sherchan, Jessica R. Fernandez, Shan Qiao, Arie W. Kruglanski, Allana T. Forde

Faculty Publications

College students are often reluctant to follow U.S. preventive guidelines to lower their risk of COVID-19 infection, despite an increased risk of transmission in college settings. Prior research suggested that college students who perceived greater COVID-19 severity and susceptibility (i.e., COVID-19 threat) were more likely to engage in COVID-19 preventive behaviors, yet there is limited research examining whether perceived COVID-19 threat, perceived U.S. healthcare system inequities, and personal experiences of healthcare discrimination collectively influence college students’ COVID-19 preventive behaviors. This study identified latent classes of perceived COVID-19 threat, perceived U.S. healthcare system inequities, and personal experiences of healthcare discrimination, examined …

Relationship Between Live-In Grandparents And Grandchild’S Health And Well-Being In Palestinian Refugees In Lebanon, Olfat B. Sheikomar, Hala Ghattas Ph.D., Nadine R. Sahyoun

Faculty Publications

Grandparents (GP) play influential roles in grandchildren’s health, behavior, and life. However, this relationship has not been examined in the Arab region. This study assesses whether the presence of GP in the household is associated with grandchildren’s health and wellbeing. Health status was determined by a child experiencing chronic health conditions or an acute illness, and wellbeing was determined based on school attendance and child labor. Data were collected through surveys conducted in 2010 and 2015 of representative samples of Palestinian refugees living in Lebanon. Multivariate logistic regression showed that, even after controlling for potential confounders, including the presence of …

Investigating The Relationships Between Concentrated Disadvantage, Place Connectivity, And Covid-19 Fatality In The United States Over Time, Fengrui Jing, Zhenlong Liu, Shan Qiao, Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Background Concentrated disadvantaged areas have been disproportionately affected by COVID-19 outbreak in the United States (US). Meanwhile, highly connected areas may contribute to higher human movement, leading to higher COVID-19 cases and deaths. This study examined the associations between concentrated disadvantage, place connectivity, and COVID-19 fatality in the US over time. Methods Concentrated disadvantage was assessed based on the spatial concentration of residents with low socioeconomic status. Place connectivity was defined as the normalized number of shared Twitter users between the county and all other counties in the contiguous US in a year (Y = 2019). COVID-19 fatality was measured …

The Hypertension Cascade Of Care In The Midst Of Conflict: The Case Of The Gaza Strip, Bassam A. Abu Hamad, Zeina Jamaluddine, Gloria Safadi, Marie Elizabeth Ragi, Raeda El Sayed Ahmad, Eszter P. Vamos, Sanjay Basu, John S. Yudkin, Mohammed Jawad, Christopher Millett, Hala Ghattas Ph.D.

Faculty Publications

Although hypertension constitutes a substantial burden in conflict-affected areas, little is known about its prevalence, control, and management in Gaza. This study aims to estimate the prevalence and correlates of hypertension, its diagnosis and control among adults in Gaza. We conducted a representative, cross-sectional, anonymous, household survey of 4576 persons older than 40 years in Gaza in mid-2020. Data were collected through face-to-face interviews, anthropometric, and blood pressure measurements. Hypertension was defined in anyone with an average systolic blood pressure ≥140 mmHg or average diastolic blood pressure ≥90 mmHg from two consecutive readings or a hypertension diagnosis. The mean age …

The Fan Program Plan: Creating A Healthy Church Environment For Physical Activity And Healthy Eating, John A. Bernhart Ph.D., Mph, Ches, Caroline G. Dunn, Sara Wilcox Phd, Jessica Stucker, Deborah Kinnard

Faculty Publications

Background: Faith, Activity, & Nutrition (FAN) helps churches create a healthier environment for physical activity (PA) and healthy eating (HE) through policy, systems, and environmental changes. Objective: The purpose of this paper is to describe the implementation, evaluation, and revision of the FAN Program Plan across a two-phase study to help churches create guidelines and policies for PA and HE. Methods: In Phase 1, church committees attended trainings led by Community Health Advisors (CHA) where they assessed current practices to PA and HE. Committees used the FAN Program Plan to outline an implementation plan to increase opportunities, programs, messages, pastor …

Understanding Alcohol Use Discourse And Stigma Patterns In Perinatal Care On Twitter, Fritz Culp, Yuqi Wu, Dezhi Wu, Yang Ren, Phyllis Raynor, Peiyin Hung, Shan Qiao Ph.D., Xiaoming Li Ph.D., Kacey Eichelberger

Faculty Publications

(1) Background: perinatal alcohol use generates a variety of health risks. Social media platforms discuss fetal alcohol spectrum disorder (FASD) and other widespread outcomes, providing personalized user-generated content about the perceptions and behaviors related to alcohol use during pregnancy. Data collected from Twitter underscores various narrative structures and sentiments in tweets that reflect large-scale discourses and foster societal stigmas; (2) Methods: We extracted alcohol-related tweets from May 2019 to October 2021 using an official Twitter search API based on a set of keywords provided by our clinical team. Our exploratory study utilized thematic content analysis and inductive qualitative coding methods …

Resilience Resources And Coping Strategies Of Covid-19 Female Long Haulers: A Qualitative Study, Atefeh Aghaei, Abhishek Aggarwal, Ran Zhang, Xiaoming Li Ph.D., Shan Qiao Ph.D.

Faculty Publications

Background: Female long haulers deal with persistent post-acute COVID-19 symptoms that have serious health implications. This study aimed to identify resilience resources at multiple socio-ecological levels for female long haulers and describe how resilience resources affect their responses to long COVID. Methods: Purposive sampling was adopted to recruit participants through social media from April to June 2021 followed by 15 semi-structured interviews. An inductive analytical approach was adopted to categorize themes by open and axial coding that were verified by peer review. Results: Female long haulers relied on resources at various socio-ecological levels to foster their resilience in response to …

Determinants Of Egg Consumption By Infants And Young Children In Ethiopia, Bezawit E. Kase, Edward A. Frongillo Jr. Ph.D., Sejla Isanovic, Wendy Gonzalez, Hana Yemane Wodajo, Eric W. Djmeu

Faculty Publications

Objective:

To identify determinants of egg consumption in infants and young children aged 6–23·9 months in Ethiopia. Design and setting:

Data used were from the cross-sectional baseline survey of an egg campaign in Ethiopia implemented by the Global Alliance for Improved Nutrition. Participants:

Children aged 6–23·9 months (n 453) were sampled. Data on socio-demographic characteristics, economic resources, caregiver’s behaviour, child health and feeding practices, and egg consumption in the last 7 d were collected using interviewer-administered questionnaires. Multivariable ordinal logistic regression was used to examine the association between explanatory variables and egg consumption in the last 7 d. Results:

About …

Elements For Successful Implementation Of A Clinic-Based Health Literacy Intervention, Mark M. Macauda, Michelle Angelique Arent, Mayank Sakhuja, Brooks Yelton Ma, Lmsw, Samuel Noblet, Delores Fedrick, Diana Zona, Cyndi New, William D. Isenhower, Abraham Wandersman, Daniela B. Friedman Ph.D.

Faculty Publications

Improving health literacy is a national public health priority. Given the context of the COVID-19 pandemic, it is even more critical for health and medical information to be clear and understandable for patients and their families. Clinic-based programs to improve health literacy need to be pragmatic, feasible, and helpful for the implementing clinic and patients. This paper describes the development, implementation, and evaluation of a pragmatic, clinic-based health literacy intervention in a safety-net clinic that serves uninsured and indigent patients. Study methods are guided by a previous pilot study and components recommended for pragmatic interventions. An electronic readiness assessment was …

A Five-Country Study Of Front- And Back-Of-Package Nutrition Label Awareness And Use: Patterns And Correlates From The 2018 International Food Policy Study, Jasmin Bhawra, Sharon I. Kirkpatrick, Marissa G. Hall, Lana Vanderlee, Jim Thrasher Ph.D., Ma, Ms, Alejandra Jáuregui De La Mota, David Hammond

Faculty Publications

Objective:

This study aimed to identify correlates of nutrition label awareness and use, particularly subgroup differences among consumers. Two label types were assessed: (1) nutrition facts tables (NFt) in Australia, Canada, Mexico, UK, and USA and (2) front-of-package (FOP) labels, including mandatory Guideline Daily Amounts (Mexico), voluntary Health Star Ratings (Australia) and voluntary Traffic Lights (UK). Design:

Respondents were recruited using Nielsen Consumer Insights Global Panel (n 21 586) and completed online surveys in November–December 2018. Linear regression and generalised linear mixed models examined differences in label use and awareness between countries and label type based on sociodemographic, knowledge-related and …

Process Evaluation Methods And Results From The Health In Pregnancy And Postpartum (Hipp) Randomized Controlled Trial, Sarah Wilcox Phd, Alicia A. Dahl, Alycia K. Boutté, Jihong Liu Sc.D., Kelsey Day, Gabrielle Turner-Mcgrievy Ph.D., Rd, Ellen Wingard

Faculty Publications

Background

Excessive gestational weight gain has increased over time and is resistant to intervention, especially in women living with overweight or obesity. This study described the process evaluation methods and findings from a behavioral lifestyle intervention for African American and white women living with overweight and obesity that spanned pregnancy (≤ 16 weeks gestation) through 6 months postpartum.

Methods

The Health in Pregnancy and Postpartum (HIPP) study tested a theory-based behavioral intervention (vs. standard care) to help women (N = 219; 44% African American, 29.1 ± 4.8 years) living with overweight or obesity meet weight gain guidelines in pregnancy and …

Development Of A Prediction Model For The Management Of Noncommunicable Diseases Among Older Syrian Refugees Amidst The Covid-19 Pandemic In Lebanon, Stephen J. Mccall, Tanya El Khoury, Noura Salibi, Berthe Abi Zeid, Maria El Haddad, Marwan F. Alawieh, Sawsan Abdulrahim, Monique Chaaya, Hala Ghattas Ph.D., Abla M. Sibai

Faculty Publications

Importance: Older Syrian refugees have a high burden of noncommunicable diseases (NCDs) and economic vulnerability.

Objectives: To develop and internally validate a predictive model to estimate inability to manage NCDs in older Syrian refugees, and to describe barriers to NCD medication adherence.

Design, Setting, and Participants: This nested prognostic cross-sectional study was conducted through telephone surveys between September 2020 and January 2021. All households in Lebanon with Syrian refugees aged 50 years or older and who received humanitarian assistance from a nongovernmental organization were invited to participate. Refugees who self-reported having chronic respiratory disease (CRD), diabetes, history of cardiovascular disease …

Transitions Between Tobacco Products: Correlates Of Changes In Cigarette Smoking And E-Cigarette Use Among Exclusive Adult Smokers And Dual Users In Mexico, Katia Gallegos-Carrillo, Inti Barrientos-Gutiérrez, Edna Arillo-Santillán, Rosibel Rodríguez-Bolaños, Lizeth Cruz-Jiménez, Desirée Vidaña-Pérez, Yoo Jin Cho, Jim F. Thrasher Ph.D., Ma, Ms

Faculty Publications

This study examined transitions in tobacco products use among Mexican smokers and dual users. Data were analyzed from exclusive smokers (n = 2,946) and dual users (n = 1,643) recruited from an online consumer research panel and surveyed every-four months from November 2018 to April 2021. For exclusive smokers, estimated transitions were (time “t + 1” four months after prior survey): a) remain as exclusive smokers; b) dual use; c) exclusive e-cigarette use or quit both products. Among dual users, transitions analyzed were: a) remain as dual user; b) exclusive smoker; c) exclusive e-cigarette user or quit both products. Multinomial …

Association Between Socioeconomic Status And Mental Health Among China’S Migrant Workers: A Moderated Mediation Model, Yubo Shao, Huang Ying, Xiaoming Li Ph.D., Lian Tong

Faculty Publications

Mental health problems are prevalent among China’s internal migrant workers. However, research on the relationship between socioeconomic status (SES) and mental health is insufficient. Therefore, this study, utilizing the China’s National Dynamic Monitoring Survey data from a sample of 15,997 migrant workers aged 15–59 years to explore differences in the relationship between migrants’ objective and subjective SES and mental health status in 2015. Both the mediating effect of perceived interpersonal discrimination and the moderating effect of age were examined through structural equation modeling. The results indicated that subjective SES has a stronger direct relationship with mental health than objective SES. …

Curating A Knowledge Base For Individuals With Coinfection Of Hiv And Sars-Cov-2: A Study Protocol Of Ehr-Based Data Mining And Clinical Implementation, Chen Liang, Sharon Weissman, Bankole Olatosi, Eric G. Poon, Michael E. Yarrington, Xiaoming Li Ph.D.

Faculty Publications

Introduction Despite a higher risk of severe COVID-19 disease in individuals with HIV, the interactions between SARS-CoV-2 and HIV infections remain unclear. To delineate these interactions, multicentre Electronic Health Records (EHR) hold existing promise to provide fullspectrum and longitudinal clinical data, demographics and sociobehavioural data at individual level. Presently, a comprehensive EHR-based cohort for the HIV/SARS-CoV-2 coinfection has not been established; EHR integration and data mining methods tailored for studying the coinfection are urgently needed yet remain underdeveloped. Methods and analysis The overarching goal of this exploratory/developmental study is to establish an EHR-based cohort for individuals with HIV/SARS-CoV-2 coinfection and …

Validity Of An Abbreviated Individual Water Insecurity Experiences (Iwise-4) Scale For Measuring The Prevalence Of Water Insecurity In Low- And Middle-Income Countries, Hilary J. Bethanancourt, Edward A. Frongillo Jr. Ph.D., Sera L. Young

Faculty Publications

The 12-item Water Insecurity Experiences Scales provide high resolution, cross-context equivalent data on household and individual water insecurity. A 4-item, 1-minute version of the Household Water Insecurity Experiences (HWISE-4) Scale has proven useful for understanding the prevalence of household water insecurity experiences when limited resources preclude the use of the HWISE-12 Scale. Herein, we tested the validity of an analogous four-item version of the Individual Water Insecurity Experiences Scale (IWISE-4) for measuring the prevalence of individual water insecurity when limited resources prevent implementation of the IWISE-12 Scale. We used data from adults in 31 low- and middle-income countries (n …

Relationship Power, Antiretroviral Adherence, And Physical And Mental Health Among Women Living With Hiv In Rural Kenya, Rachel L. Burger, Craig R. Cohen, A. Rain Mocello, Shari L. Dworkin, Edward A. Frongillo Jr. Ph.D., Elly Weke, Lisa M. Butler, Harsha Thirumurthy, Elizabeth A. Bukusi, Sheri D. Weiser

Faculty Publications

Little is known about the association of gender-based power imbalances and health and health behaviors among women with HIV (WWH). We examined cross-sectional baseline data among WWH in a cluster-randomized control trial (NCT02815579) in rural Kenya. We assessed associations between the Sexual Relationship Power Scale (SRPS) and ART adherence, physical and mental health, adjusting for sociodemographic and social factors. SRPS consists of two subscales: relationship control (RC) and decision-making dominance. Women in the highest and middle tertiles for RC had a 7.49 point and 8.88 point greater Medical Outcomes Study-HIV mental health score, and a 0.27 and 0.29 lower odds …

Adolescent-Reported Household Food Insecurity And Adolescents' Poor Mental And Physical Health And Food Insufficiency In Kenya, Amanda S. Mcrell, Maryah S. Fram, Edward A. Frongillo Jr.

Faculty Publications

Background

Objectives

Methods

Mindfulness, Psychological Distress, And Somatic Symptoms Among Women Engaged In Sex Work In China, Cheuk Chi Tam, Yuejiao Zhao, Shan Qiao, Xiaoming Li, Zhiyong Shen

Faculty Publications

Women engaged in sex work (WSW) in China encounter numerous disadvantages (e.g., exposure to violence) and have substantial risk for psychological distress and somatic symptoms. Intervention literature has attended to mindfulness, which is a protective factor for psychological outcomes, and its influences can further improve physical health. However, mindfulness has not been well studied in WSW. We aimed to examine the association among mindfulness, psychological distress, and somatic symptoms among Chinese WSW. Data were collected from 410 WSW in Guangxi, China, using an anonymous, self-administered survey evaluating demographics, mindfulness, psychological distress (i.e., depression, loneliness, and perceived stress), and somatic symptoms …

Strengthening Causal Inference From Randomised Controlled Trials Of Complex Interventions, Jef L. Leroy, Edward A. Frongillo Jr. Ph.D., Bezawit E. Kase, Silvia Alonso, Mario Chen, Ian Dohoo, Lieven Huybregts, Suneetha Kadiyala, Naomi M. Saville

Faculty Publications

Researchers conducting randomised controlled trials (RCTs) of complex interventions face design and analytical challenges that are not fully addressed in existing guidelines. Further guidance is needed to help ensure that these trials of complex interventions are conducted to the highest scientific standards while maximising the evidence that can be extracted from each trial. The key challenge is how to manage the multiplicity of outcomes required for the trial while minimising false positive and false negative findings. To address this challenge, we formulate three principles to conduct RCTs: (1) outcomes chosen should be driven by the intent and programme theory of …

Association Of Body Mass Index And Plant-Based Diet With Cognitive Impairment Among Older Chinese Adults: A Prospective, Nationwide Cohort Study, Fang Liang, Jialin Fu, Gabrielle Turner-Mcgrievy Ph.D., Rd, Yechuang Wang, Nan Qiu, Kai Ding, Jing Zeng, Justin B. Moore, Rui Li

Faculty Publications

To examine the association of body mass index (BMI) and a plant-based diet (PBD) with cognitive impairment in older adults, this cohort study used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a national, community-based, longitudinal, prospective study in China. Cognitive function was evaluated via the Mini-Mental State Examination (MMSE). Diet was assessed using a simplified food frequency questionnaire (FFQ), and PBD patterns were estimated using the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI). BMI was measured objectively during the physical examination. Cox proportional hazard models and restricted …

Comparing Standard Versus Enhanced Implementation Of An Evidence-Based Hiv Prevention Program Among Bahamian Sixth Grade Students: Findings From Nationwide Implementation Trials, Bo Wang, Lynette Deveaux, Carly Herbert, Xiaoming Li Ph.D., Lesley Cottrell, Richard Adderley, Maxwell Poitier, Arvis Mortimer, Glenda Rolle, Sharon Marshall, Nikkiah Forbes, Bonita Stanton

Faculty Publications

Background Effective implementation strategies are needed to address the challenges encountered by teachers in implementation of evidence-based HV prevention programs in schools. The current study: 1) compares implementation fidelity of Focus on Youth in the Caribbean (FOYC) plus Caribbean Informed Parents and Children Together (CImPACT)intervention using enhanced implementation strategies (including biweekly monitoring/feedback and site-based mentoring) to those using more traditional approach (teacher training only); and 2) evaluates the impact of school coordinators’ and mentors’ performance on teachers’ implementation fidelity and student outcomes.

Methods

Data from an enhanced implementation trial in 2019–2020, involving 24 government primary schools, 79 teachers, and …