Public Health Education and Promotion Commons^™

The Effect Of School-Based Educational Session On Knowledge, Attitudes, And Beliefs Of Cervical Cancer Among Adolescents In Mixed Day High Schools In Embu County: A Quasi-Experimental Study, Lucy W. Kivuti-Bitok, Mugo, Dorothy Mituki, Christine Marete, Irene Ngune, Jessica Wells

Research outputs 2022 to 2026

Background: School-based interventions have proven effective in enhancing knowledge and altering attitudes toward cervical cancer among adolescents. This study aimed to evaluate the effect of a school-based educational intervention on the attitudes, beliefs, and knowledge of cervical cancer among adolescents in mixed-day high schools in Embu County. Methods: This study used a single-group, repeated cross-sectional design to assess the effect of a structured health education session on cervical cancer among adolescent boys and girls in mixed-gender secondary schools. A self-administered anonymous questionnaire was administered before and immediately after the post-intervention. The education session lasted 30–45 min, and the study population …

Slushies Before School: Exploring How Nearby Food Outlets Impact The Eating Behaviours Of Secondary Students In Perth, Western Australia, Sharonna Mossenson, Klug, Joelie Mandzufas, Jacinta Francis, Siobhan Hickling, Lukar Thornton, Gina Trapp

Research outputs 2022 to 2026

The external school food environment, comprising food outlets and marketing near schools, shapes what young people eat. Yet little is known about how Australian adolescents perceive and navigate these environments. Focus groups were conducted with 31 school students (Years 7–12) from Perth, Western Australia, to explore their experiences of the external school food environment and its influence on their food-related behaviours. Transcripts were thematically analysed and six themes were identified. Accessibility emphasised proximity, transport links, opening hours and speed of service, with older students using outlets as social spaces. Availability of slushies, energy drinks, snacks and fast-food meal deals influenced …

Temptation At The School Fence: A Qualitative Exploration Of The Impact Of External Food Outlets On The School Community, Sharonna Mossenson, Klug, Jacinta Francis, Siobhan Hickling, Lukar Thornton, Gina Trapp

Research outputs 2022 to 2026

Retail food outlets are commonly located in close proximity to schools, providing students with opportunities to purchase and consume food enroute to or from school. These outlets are typically unhealthy and disproportionately clustered near schools, and this trend has been increasing over time. While quantitative studies have established associations between school food environments and adolescent dietary behaviours, little is known about how school personnel perceive and experience their impacts. This qualitative study explored perspectives of school personnel (n = 9) from a secondary school in Perth, Western Australia, located 150 m from two retail food precincts (areas with a high …

What Drives Schoolchildren's Food Choices? Insights From A Gamified Stated-Preference Choice Experiment In Tunisia, Ali Chalak, Christelle Akl, Joanne Haddad, Nehmat El Helou, Sonia Sassi, Houda Ben Gharbia, Rawan Traboulsi, Marc Haber, Jalila El Ati, Hala Ghattas Ph.D.

Faculty Publications

This paper models the drivers of schoolchildren's food choices in urban Tunisia using a gamified Stated-Preference Choice Experiment (SPCE), which includes scenario attributes (food placement, preparation, and price) and contextual factors (parental/peer modeling eating behaviors). A representative sample of 2465 schoolchildren aged 8 to 12 years in Greater Tunis participated in a SPCE, which simulates real-life food choice scenarios on a typical school day. The game includes six nodes (breakfast, recess, lunch, snack on the road to/from school, afternoon snack, dinner) in various locations (home, school, neighborhood). Each choice task includes nine items to choose from (3 beverages, 3 side-meals, …

Urban-Rural Differences In The Association Between Physical Activity And Overweight/Obesity Among Indonesian Adolescents: A Cross-Sectional Study, Wahyu Wulandari, Mufti As Siddiq M. Irzal, Lady Farah Fatmawati

Jurnal Epidemiologi Kesehatan Indonesia

Adolescent overweight/obesity is an increasing public health concern and contributes to the risk of non-communicable diseases later in life. Physical activity plays an important role in weight regulation. However, its association with overweight/obesity may vary according to residential setting. This study aimed to examine the association between physical activity and overweight/obesity among adolescents living in rural and urban areas of Indonesia. A cross-sectional study was conducted using data from the 2023 Indonesian Health Survey. The study included 115,372 adolescents aged 10–18 years. Physical activity was classified based on total Metabolic Equivalent of Task (MET)-minutes per week (≥600 MET-minutes/week), while nutritional …

Staff Educational Impact On School-Based Mental Health Services: A Scoping Review, Daniel J. Kim, Di'yana Fisher, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap

Doctor of Nursing Practice Projects

Purpose/Background

            Trends are consistently increasing among adolescents in regard to mental health diagnoses and suicide risks, which emphasizes the necessity for early identification via school-based psychiatric screenings. The Patient Health Questionnaire-9 (PHQ-9) has proven effective in uncovering symptoms of depression; variable application and limited staff knowledge continue to be substantial hurdles. This scoping review examined the influence of staff education and training on the efficacy of school-based psychiatric screening.

Methods

            PubMed, CINAHL, Medline, Elsevier, Google Scholar, and JAMA were utilized to conduct this scoping review. Peer-reviewed studies published between 2020 and 2025 were included if they involved adolescents aged 13-18, …

Psychosocial Determinants Of Hand Hygiene Practices Among Children And Adolescents Living With Hiv In The Northern City Of Malawi, Balwani Chingatichifwe Mbakaya, Maggie Zgambo, Richard Moyo, Paul Uchizi Kaseka, Obed Nkhata, Fatch Kalembo

Research outputs 2022 to 2026

Background: The common cause of death in HIV and AIDS patients are opportunistic infections such as diarrhoea, acute respiratory infections, and skin conditions. Many of these infections are spread through contaminated hands. Therefore, this study aimed at exploring hand hygiene practices among HIV positive children and adolescents in Mzuzu City, Malawi. Methodology: A cross-sectional study was used to collect data from children and adolescents living with HIV (aged between 9 and 18 years) WHO were attending teen clubs in Mzuzu City. Data were analysed using Stata 17. Chi-Square and logistic regression analysis were used to examine the association among multiple …

Increasing Hpv Vaccination Among Early Adolescents Using A Game-Based Digital Intervention: A Randomized Controlled Trial, Angela Chia-Chen Chen, Lihong Ou, Elizabeth Reifsnider, Kimberly Arcoleo, Ashish Amresh, Michael Todd

Ellmer School of Nursing Faculty Publications

Background/Objectives: Human papillomavirus (HPV) vaccination coverage among adolescents remains below public health targets despite strong evidence of vaccine effectiveness in preventing HPV-related cancers. Digital interventions (e.g., serious games) may improve HPV vaccine uptake, but evidence for effects on vaccination behavior remains limited. Methods: This secondary analysis of a randomized controlled trial evaluated a co-designed, game-based digital intervention to increase HPV vaccine initiation among unvaccinated youth aged 11-14 years and their parents. The sample included 64 parent-adolescent dyads (33 intervention and 31 usual care dyads). The primary outcome was HPV vaccine initiation at 2-month follow-up. Results: A significantly greater proportion of …

Academic Stress Among Jss High School Students In Mysuru And Chamarajanagar Districts: A Cross-Sectional Study, Lathika R, Dr Sunil Kumar D, Krishnamurthy K V, Dr Rakshitha J

Digital Journal of Clinical Medicine

Background

In today's world, students face academic stress which leading to anxiety, poor performance in academics and many other issues like nervousness, panic attacks and depression mainly derived from grades, parental pressure, and competition between the students. With the above background study aims to estimate the prevalence and assess the associated factors of academic stress among high school adolescents.

Method

A cross-sectional study was conducted to explore the academic stress among JSS high school students of Mysuru and Chamarajanagar districts. A total of 379 were selected through Probability proportional to size (PPS) sampling. Structured questionnaire was used to assess the …

Help-Seeking Behavior And Related Mental Health Promotion Programs In Southeast Asian Youth: A Systematic Literature Review, Gladys Octavia, James A. Doorbar, Kallista Chan

Kesmas

Mental health issues are a prominent burden among adolescents and young adults in Southeast Asia, compounded by reluctance to seek help and low treatment rates. This mixed-method systematic review analyzed help-seeking profiles (preference, facilitators, and barriers) and evaluated implemented help-seeking programs. Data were sourced from electronic databases, hand-searched local databases, conference proceedings, and grey literature. Study selection followed PRISMA 2020 guidelines, focusing on 1) adolescents (10–19 years) and young adults (18–26 years) in Southeast Asia who were not receiving mental health care, 2) assessing help-seeking behavior, and 3) evaluating programs to increase help-seeking. A total of 16 articles were identified. …

Associations Between County-Level E-Cigarette-Inclusive Tobacco 21 Law Population Coverage And E-Cigarette Use Behaviors Among United States Adolescents In Monitoring The Future, James H. Buszkiewicz, Catherine A. Vander Woude, Yanmei Xie, Steven Cook, Bukola Usidame Peters, Megan E. Patrick, Michael R. Elliott, James F. Thrasher Ph.D., Ma, Ms, Nancy L. Fleischer

Faculty Publications

Background and aims: In the United States (US), Tobacco 21 (T21) laws set the minimum legal sale age for all tobacco products to 21 years. This study aimed to examine whether e-cigarette-inclusive T21 laws were associated with e-cigarette use behaviors and related disparities among US adolescents. Design: We used nationally representative, repeated cross-sectional Monitoring the Future data to compare self-reported current e-cigarette use (2014–2022) and first e-cigarette initiation (2015–2022) among adolescents in counties with 100% ('full') versus < 100% ('partial or no') e-cigarette-inclusive T21 law population coverage using modified Poisson regression, examining differences by sex, race and ethnicity, parental educational attainment and college educational expectations through interactions. Setting: United States. Participants: 8th, 10th and 12th graders. Measurements: County-level e-cigarette-inclusive T21 law population coverage was determined using Tobacco 21 Population Coverage Database and US Census Bureau population data. Current e-cigarette …

Evaluating The Efficacy Of A Serious Game To Deliver Health Education About Invasive Meningococcal Disease: Clustered Randomized Controlled Equivalence Trial, Lauren Bloomfield, Julie Boston, Martin Masek, Lesley Andrew, Donna Barwood, Amanda Devine

Research outputs 2022 to 2026

Background: Invasive meningococcal disease (IMD) is a serious, vaccine-preventable infectious disease that can be life-threatening. Teaching adolescents about the early detection and prevention of IMD can be challenging in a school environment, with educators reporting they lack confidence or expertise to cover this in the classroom environment. Professional guest educators are an alternative to cover specialist topics such as IMD; however, time and resourcing constraints can mean that these educators are not always available. Serious games may be an alternative to face-to-face education, where complex health information may be delivered via self-directed gameplay. Objective: This study aims to develop a …

Emotional Eating In Adolescents With Obesity: Case Series, Paula Dayan

Electronic Theses, Projects, and Dissertations

Childhood obesity remains a significant public health concern, with substantial implications for physical and mental well-being. This thesis aims to explore the intricate relationship between emotional eating and obesity among adolescents, with a focus on identifying emotional triggers and assessing their psychological impact. Utilizing a cross-sectional study design at a university in southern California, data were collected from two adolescents aged 13-18 years. Through surveys and body composition measurements, participants' emotional barriers to weight loss and readiness for change were assessed. The findings underscore the presence of varying degrees of emotional hurdles among adolescents with obesity, including depression, frustration, and …

Trends In Substance Use And Mental Health Among Adolescents In Georgia, 2002-2022, Saumya S. Palipudi, Bangaru Talli Palipudi, Murty Komanduri

Georgia Public Health Association Annual Meeting & Conference

Background: While substance use and absence of mental health disorders among youth in the United States (US) have declined over the past two decades, post COVID-19 pandemic, these conditions have increased significantly with notable disparities, and witnessed a crisis in public health. In 2022, 24.7% or 6.1 million adolescents aged 12 to 17 in the US had either Major Depressive Episodes (MDE) or Substance Use Disorder (SUD) and 3.7 percent had both in the prior year². Increased stress, lack of peer connections, parental abuse, and poor mental health conditions were attributed to this increase in substance use^{3-7 …}

Investigating The Factors That Lead To Sports Related Injuries In Children, Kinjal Shah, Shawna Rotoli

Rowan-Virtua Research Day

This project’s focus is to investigate if playing contact versus non-contact sports at a young age leads to more sports related injuries and to identify which factors correlate with increased injury rate in order to develop the most effective prevention and treatment methods. Data was collected through a survey including questions that delve deeper to quantify the amount of strain being put on the youth athlete’s body such as hours played a week, level of competitiveness, weeks played in a year, contact versus non-contact sport, and number of sports played. The following set of questions then addressed the actual injury …

Traditional And Emerging Modifiable Lifestyle Risk Behaviors For Non-Communicable Diseases In A Sample Of Hispanic/Latino American Adolescents Living In The U.S.-Mexico Border Region, Silvia Salinas Lopez

Open Access Theses & Dissertations

Background: Non-communicable diseases (NCDs) pose a significant global health threat, with modifiable lifestyle risk behaviors (mLRBs) contributing substantially to their onset. This study examined traditional and emerging mLRBs and their distribution on cross-sectional health outcomes among Hispanic/Latino in-school adolescents living on the U.S.-Mexico border. Methods: This secondary data analysis used information from the cross-sectional 2019 El Paso YHBS obtained through online surveys. The secondary data analyzed the prevalence, clustering, and co-occurrence of mLRBs of 539 Hispanic/Latino high school students. Results were compared to mLRBs findings corresponding to Hispanic/Latino adolescents who participated in the national and state 2019 CDC YRBSS. An …

Impact Of Preparing Nursing Students To Deliver A Parent-Based Sexual Health Intervention On Attitudes And Intentions For Sexual Health Education And Parent Communication Counseling: A Mixed Methods Study, Deidra Carroll Coleman, Anitra Frederick, Stanley Cron, Christine Markham, Vincent Guilamo-Ramos, Diane Santa Maria

Faculty, Staff and Student Publications

BACKGROUND: Nurses are well positioned to promote sexual health but are not adequately prepared in their nursing programs to engage families on this topic and often lack the knowledge and confidence necessary to counsel families about sexual health communication. The purpose of this study was to determine how facilitating a parent-based sexual health intervention would impact nursing students' attitudes and intentions about sexual health education and parent communication counseling.

METHODS: Using an embedded mixed-methods design, which integrated a quasi-experimental framework, we examined the impact of participation in a parent-based sexual health intervention among 126 baccalaureate nursing students enrolled in a …

Understanding Cultural Perceptions Of Health In Middle School Females For Obesity Prevention: A Case Study, Tien Vo, Egenia Dorsan, J. Mitchell Vaterlaus, Lori A. Spruance

Journal of Social, Behavioral, and Health Sciences

The purpose of this study was to understand acculturation and race/ethnicity influences in the home and school environment that affect physical activity and nutrition in female adolescents attending middle school. A convenience sample of eight female adolescents (n = 2 Asian American, n = 2 Black, n =2 Latinx/Hispanic, and n = 2 White) was interviewed individually via Zoom. Responses regarding acculturation, physical activity, and nutrition in the home and school environment were analyzed using qualitative case study analysis. Three themes were identified: 1) experiences related to home, health, and culture, 2) the intersection between school meals and personal …

Association Of Physical Activity And Screen Time Usage Of Adolescents In Rural Areas Of Mysore., Aakash Pavan Kumar, Nayanabai Shabadi, Bikram Sinha Roy, Anchu R. Nath, Arun Gopi

Digital Journal of Clinical Medicine

Introduction:

In these changing times there have been increased usage of screen device due to more accessibility to both device and the internet and a greater number of children are having reduced physical activity. The purpose of the current study was to determine if screen usage among adolescents (11-17yrs) who live in supportive environments is associated with decreased levels of moderate to vigorous physical activity.

Methods & materials:

A school-based cross-sectional study was conducted in two rural schools of Mysore, Karnataka in February 2023, in 176 students between the age group of 11 – 17yrs. Physical activity and screen …

Comparative Study Of Risky Sexual Behaviors In African American Adolescents Who Use Drugs And Alcohol, Angela Matthew

Walden Dissertations and Doctoral Studies

Sexually transmitted infections (STIs) are a major public health problem in the United States. Adolescents are a high majority of these cases, with African American adolescents being affected disproportionally. Previous research has shown that risky sexual behaviors, such as non-condom use, multiple sexual partners, early initiation of sexual intercourse, and alcohol or marijuana use before sexual intercourse put adolescents at a higher risk of contracting an STI when they are sexually active. These behaviors can be observed through the theoretical framework of the problem behavior theory that describes the constructs of why individuals engage certain behaviors. How alcohol and drug …

Comparative Study Of Risky Sexual Behaviors In African American Adolescents Who Use Drugs And Alcohol, Angela Matthew

Walden Dissertations and Doctoral Studies

Sexually transmitted infections (STIs) are a major public health problem in the United States. Adolescents are a high majority of these cases, with African American adolescents being affected disproportionally. Previous research has shown that risky sexual behaviors, such as non-condom use, multiple sexual partners, early initiation of sexual intercourse, and alcohol or marijuana use before sexual intercourse put adolescents at a higher risk of contracting an STI when they are sexually active. These behaviors can be observed through the theoretical framework of the problem behavior theory that describes the constructs of why individuals engage certain behaviors. How alcohol and drug …

An Evaluation Of The Enjoyment Levels Of Participants Of Lifelab, A Health Literacy Intervention For Socially Disadvantaged Adolescents., Lorna Burke, Dr. Hannah Goss, Craig Smith, Dr. Johann Issartel, Dr. Sarahjane Belton

SURE Journal: Science Undergraduate Research Experience Journal

Aim: LifeLab is co-designed by and for Junior Cycle students from social disadvantage in Ireland, with the hope to improve health literacy and subsequent health outcomes in this cohort. The aim of this study was to evaluate the enjoyment levels of students participating in the pilot of LifeLab, with a view to informing future development of the intervention.

Method: As part of the process evaluation of the pilot of LifeLab, a series of focus groups and purposively designed enjoyment scales were completed by 80 adolescents, from one disadvantaged school in Dublin, Ireland. Inductive thematic analysis was carried out to analyse …

Nutrition Facts Label Use Among U.S. Adolescents, Jennifer Beth Mandelbaum

Theses and Dissertations

Despite the promise of Nutrition Facts label (NFL) use as a population-level intervention with broad reach, few studies have examined determinants of adolescents’ NFL use, and how this label use may be associated with nutrition behaviors. This study used data from the International Food Policy Study, an online cross-sectional survey of trends in dietary patterns and policy-relevant behaviors in the U.S. and five other countries. First, this study examined 1) whether NFL use was associated with healthy eating efforts and 2) whether there were sociodemographic differences in NFL use among U.S. adolescents. Results demonstrated that NFL use was positively associated …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Save The Date: An Analysis Of Interventions On Teen Dating Violence, Elizabeth Maestretti

Master's Projects and Capstones

Domestic violence or interpersonal violence (IPV) is a serious public health issue in the United States. IPV is commonly considered to be an issue that occurs in adult relationships. However, most victims of IPV first experience some form of IPV during adolescence, which is known as teen dating violence (TDV). In the United States, TDV impacts about 26% of female and 15% of male adolescents. In Southern California (Orange County) approximately two thirds of adolescents have experienced some form of TDV. This paper examined the literature on existing interventions and strategies which focused on TDV prevention at individual, interpersonal, community/organizational, …

Development, Validity, And Cross-Context Equivalence Of The Child Food Insecurity Experiences Scale For Assessing Food Insecurity Of School-Age Children And Adolescents, Edward A. Frongillo Jr., Maryah S. Fram, Hala Ghattas Ph.D., Jennifer Bernal, Zeina Jamaluddine, Sharon I. Kirkpatrick, David Hammond, Elisabetta Aurino, Sharon Wolf, Sophie M. Goudet, Mara Nyawo, Chika Hayashi

Faculty Publications

Background: Children ages 6 to 17 years can accurately assess their own food insecurity, whereas parents are inaccurate reporters of their children's experiences of food insecurity. No globally applicable scale to assess the food insecurity of children has been developed and validated.

Objectives: We aimed to develop a globally applicable, experience-based measure of child and adolescent food insecurity and establish the validity and cross-contextual equivalence of the measure.

Methods: The 10-item Child Food Insecurity Experiences Scale (CFIES) was based on items previously validated from questionnaires from the United States, Venezuela, and Lebanon. Cognitive interviews were conducted to check understanding of …

The Impact Of Outcomes On Depression Literacy In School-Age Children Who Received Depression Education, Loretta Q. Smith Aprn, Pnp-Bc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background Recognizing mental illness is crucial in adolescence. It is the second leading cause of suicide and death in children 10-19 years of age. Early identification and recognition of signs and symptoms could prevent progressive mental health illness in early childhood and adulthood. We are seeking to answer the PICO question: In adolescents between 10 and 19 years of age who are enrolled in school (P), how does receiving education on depression awareness (I) compared to not receiving education on depression awareness (C) affect depression scores (O)?

Methods This review was conducted on articles about adolescent children. These articles were …

The Age Of E-Cigarette Initiation And Association With Frequency Of Use And Risk Of Combustible Tobacco Cigarette Smoking Initiation, Andy Hu

Senior Theses

Background - Studies have shown that electronic nicotine delivery systems (ENDS) are unsafe for consumption. However, the prevalence of e-cigarette use among adolescents and young adults continues to increase, which is being addressed by research. Little attention has been paid to the effects of earlier age of ENDS initiation.

Purpose - This paper examined published research studies on the topic of the age of initiation of e-cigarette use in relation to 1) frequency of e-cigarette use and 2) risk of combustible tobacco cigarette smoking initiation. This research tested the hypothesis that an earlier age of e-cigarette initiation was associated with …

Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett

DNP Projects

Background: Most adolescents spend a great deal of their time using various social media platforms. However, excessive and maladaptive social media use is correlated with worsening symptoms of depression and anxiety among adolescents.

Objective: This project aimed to determine whether an educational intervention could help decrease overall time spent using social media and improve mood and mental health outcomes among adolescents with depression or anxiety disorders.

Methods: This was a quasi-experiment with a pretest and posttest design. An educational intervention about the relationship between social media use and symptoms of depression and anxiety among adolescents and strategies to minimize risk …

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …