Public Health Education and Promotion Commons^™

Exploring Capacity For Future Sustainability Of Healthy Eating Policy, Systems, And Environmental Change Strategies Previously Implemented Through Snap-Ed Programming, Carrie L. Draper, Nicholas Younginer Ph.D.

Faculty Publications

Objective

Design

Setting

Participants

Phenomenon of Interest

Analysis

Results

Impact Of Suaahara, An At-Scale Multisectoral Nutrition Programme, On Health Workers’ Maternal And Child Health, And Nutrition Knowledge And Skills In Nepal, Deependra K. Thapa, Edward A. Frongillo Jr. Ph.D., Shalini Suresh, Ramesh P. Adhikari, Bhim Pun, Karuna L. Shakya, Raj Mandal, Subir K. Kole, Kenda Cunningham

Faculty Publications

Suaahara, an at-scale multisectoral nutrition programme in Nepal, aimed to advance knowledge and skills of frontline health workers to improve the quality of nutrition and health services at health facility and community levels. This study assessed the impact of Suaahara interventions on knowledge and skills of health facility workers and Female Community Health Volunteers (FCHVs). The study used a quasi-experimental design in which four Suaahara intervention districts were compared with pair-matched comparison districts. One health facility worker and three FCHVs from each survey cluster were included. Baseline survey consisted of 93 health facility workers (2015) and 118 FCHVs (2012), and …

Understanding Breastfeeding Practices In Tennessee: Goals, Duration, And Reasons For Discontinuation, Amir Alakaam, Chia-Lin Chang, Hannah Jeffery

Journal of Appalachian Health

Introduction: Breastfeeding is widely recognized as the optimal source of infant nutrition, offering many health benefits.

Purpose: The purpose of this study was to examine goals, exclusivity, and duration of breastfeeding and explore factors that influence breastfeeding practices among individuals in Tennessee (TN).

Methods: A cross-sectional study was conducted among individuals (N = 1,249). Participants were recruited and data were collected from June – September 2021. The data were entered and analyzed from September 2022 – March 2023. Descriptive statistics, chi-square test, and ANOVA were used to analyze the data and identify associations between variables.

Results: About 32% of the …

Understanding Garden Resource Use By Low-Income Families With Children, Mai Thao, Rita S. Stephenson, Katherine R. Arlinghaus, Abby L. Gold

Journal of Human Sciences and Extension

Home gardens are an important supplemental source of food for many families and provide multiple health benefits. However, the practice of gardening may be more challenging for low-income families with limited access to gardening resources. The University of Minnesota Extension offers gardening resources, but it is unclear how these resources are used by low-income families with children. Aim 1 of the project was to understand access to and use of Extension and other vegetable gardening resources by low-income families with children. Aim 2 of the project was to develop a set of recommendations for improving access to existing resources and …

Reaching Tomorrow’S Extension Customer: A Food And Health Needs Assessment, Morgan Szczepaniak, Sarah L. Francis, Ruth Litchfield, Ulrike Genschel, Shannon Coleman, Anirudh Naig

Journal of Extension

The food and health needs and preferences of Iowans (n=452) were examined. The leading food and health information sources were online platforms, social media, and print media. Program topics with high participation likelihood were cooking, food preservation, food safety, and gardening. Short, low-cost, online programs were preferred. Extension use was more likely among those who identified as persons of color, Hispanic/Latino, or were food insecure (p < 0.030). Those with less education and chronic disease were less likely to be interested in Extension programming (p < 0.040). These results provide valuable information regarding future directions for Extension programming.

Empowering Youth Through Cooking Classes, Jamiya C. Mason

Honors Theses

Chronic health issues and poor dietary habits continue to disproportionately impact rural communities in Mississippi, especially among children. Research has shown that early exposure to healthy foods and cooking practices can positively influence lifelong health behaviors. Cooking classes have also been linked to improved food literacy, culinary confidence, and willingness to try new foods. The purpose of this study was to assess the effects of a short-term culinary program on children’s cooking self-efficacy and food behaviors in Quitman County, Mississippi.

Four cooking classes were conducted with youth (grades 4–7) in a local after-school program. Lessons included vegetable-based recipes, including zucchini …

Building Community Through Food And Health: Student Initiatives To Address Food Insecurity In Mississippi, Sarah E. Sawaya

Honors Theses

This thesis explores food insecurity in Oxford and Lafayette County, Mississippi, within the broader context of state, national, and global challenges. Over a four-year period, student-led and community organizations collaborated to design programs that addressed both food access and chronic illness prevention through education, outreach, and direct service. Community input was gathered through health screenings, campus engagement, and informal interviews with residents, which guided the development of practical tools like recipe kits, QR code-based cookbooks, and on-site health education. These efforts were rooted in local partnerships and shaped by the lived experiences of those most affected. This project demonstrates that …

Maternal Health And Nutrition: Combating Maternal Mortality Through Proper Nutrition, Archna Mahendru, Yeisanai Cardona Torres, Maya Blayne Partee, Katarina Rusinak

Rowan-Virtua Research Day

Maternal mortality is an increasing concern in the United States. According to the WHO, from 2018-2022 the Maternal Mortality Rate (MMR) was 23.3 deaths per every 100,000 live births. New Jersey's MMR exceeded this average at 26 per 100,000 during the same period, with 91% of cases deemed preventable. While medical care plays a crucial role, research shows that non-medical determinants such as food insecurity, lack of nutritional education, limited access to transportation, and systemic barriers to health care contribute significantly to maternal health outcomes. Among these factors, proper nutrition plays a critical role before and during pregnancy, particularly in …

Examining The Relationship Between Nutritional Access And Childhood Obesity In Low-Resource South Jersey Communities, Anastasiya Matveyenko, Saul Madrid-Flores, Arleen Fortuna, Kirsten Marie Carlberg

Rowan-Virtua Research Day

BACKGROUND: Childhood obesity is defined as a child considered to have obesity when their body mass index falls in the top 5% compared to other children of the same age and gender. Unhealthy eating habits formed during childhood have been associated with diseases such as obesity and diabetes. We aim to examine the relationship between childhood obesity and barriers to optimal nutrition in our local South Jersey community.

METHODS: We conducted a literature review through Google, Google Scholar, and PubMed utilizing the key terms, “low socioeconomic status (SES),” “Childhood obesity in NJ,” “Nutritional Intervention,” and “Health Risks.”

RESULTS: Our study …

Analyzing The Association Of Competitive Food Policy On Competitive Food Content In U.S. Schools., Mary E. Curnutte

Electronic Theses and Dissertations

OBJECTIVES: School food can have a profound effect on the population’s health. Thirty million children receive food at school and consume half their daily calorie intake at school. Competitive foods are foods sold outside of school breakfast and lunch, such as those sold in vending machines. A new ruling for Smart Snacks Standards, a set of competitive food guidelines, started in the school year 2014-2015. It is known that competitive foods undermine school lunch participation, and a decrease in school lunch consumption is associated with poorer student health. Additionally, an increase in competitive foods tends to be of nutrient-poor …

Why A Healthy Diet Is Important For Women's Health, Halley Doster

Theses and Dissertations

Nutrition plays a critical role in women’s reproductive health, yet many women face barriers to maintaining a balanced diet. This study aimed to examine the relationship between nutritional intake and reproductive health outcomes among women of reproductive age, as well as to assess their knowledge and challenges related to healthy eating. Using a cross-sectional survey design, data were collected from 50 women at a community health center and analyzed using SPSS to generate descriptive statistics and explore patterns through chi-square and regression analyses. Findings revealed that most participants had moderate to low fruit and vegetable intake, and fewer than half …

Enhancing Nutrition Information Utilisation, Confidence, And Role Legitimacy And Adequacy Among Early Childhood Education Professionals Through Evidence-Based Online Training, Ruth Wallace, Ros Sambell, Shih Ching Fu, Johnny Lo, Elizabeth J. Cook, Amanda Devine

Research outputs 2022 to 2026

This study evaluated the effectiveness of an online short course based on the Health Promoting Schools Framework and specifically designed for Early Childhood Education and Care (ECEC) professionals. The short course aimed to enhance ECEC professionals’ nutrition knowledge, confidence, role legitimacy and adequacy to model healthy behaviours, teach healthy food habits and create health-promoting environments. Participants (n = 116) working at Australian ECEC services were assigned to control (n = 62) or intervention (n = 54) groups. Both groups completed a pre-intervention survey. The intervention group accessed the four-week course and completed the post-intervention survey. The control group completed a …

Integrated Child Nutrition, Parenting, And Health Intervention In Rural Liberia: A Mixed-Methods Feasibility Study, Sejla Isanovic, Musa Sanoe, Shelbie Wooten, Edward A. Frongillo Ph.D., Aisha K. Yousafzai, Christine E. Blake Ph.D., Rd, Mufaro Kanyangarara Ph.D., Melanie Swan, Nicole Rodger, Miriam Murray, Leila M. Larson Ph.D., Mph

Faculty Publications

In Liberia, children are exposed to multiple forms of adversity which can negatively impact their health and development. Research is needed to examine the feasibility and benefits of integrated interventions that can be incorporated into existing health delivery programs to simultaneously address low responsive stimulation, undernutrition, and infection. This study assessed the feasibility of an integrated intervention promoting psychosocial stimulation and improved child feeding by the provision of eggs and fish. The integrated intervention was incorporated into an existing government health program. Thirty female caregiver-child dyads were randomly selected from two rural communities in Liberia. Participants received fortnightly group parenting …

Obesity: Influencing Behavioral Consumption Through Meal Kit Distribution, Alejandro Hernandez

Capstone Projects and Master's Theses

Founded in 2002, Everyone’s Harvest is a grassroots nonprofit dedicated to providing access to healthy, affordable fruits and vegetables through certified farmers markets and community food programs. Its key initiatives—Fresh Rx, Market Match, Edible Education and Farms Together —focus on alleviating nutrition insecurity and combating diet-related health conditions by providing vulnerable populations the resources to purchase, or receive, fresh produce and gain nutritional knowledge. This study explores a new intervention: the distribution of farmers' market meal kits as a complementary strategy to the current Edible Education program. These meal kits, which feature seasonally available produce and pre-measured ingredients, aim to …

Household Food Expenditure Typology And Its Association With Child Stunting And Anemia In Indonesia, Ratu Ayu Dewi Sartika, Yusnita Yusnita, Winda M. Ningsih, Ririn Arminsih Wulandari, Siti A. Pujonarti, Fadila Wirawan

Kesmas

Stunting and anemia remain the coexisting nutritional problems among Indonesian children. However, evidence of household-level food expenditure and its association with child stunting and anemia is limited. This study aimed to observe the association between household food expenditure typology and child stunting and anemia in Indonesia. Data was obtained from the 2007 and 2014 Indonesia Family Life Survey (IFLS). The household food expenditure, child nutritional status, and anemia were observed in 2007 and 2014. Latent class analysis was taken to identify the food expenditure pattern. Binary logistic regression was applied to analyze the association between household food expenditure patterns and …

Nutrition Education Needs And Barriers Of Uninsured Clients Who Utilize Free Clinics In Western North Carolina, Manan Roy, Alisha Farris, Erin Loy, Lauren Sastre, Danielle L. Nunnery

Journal of Appalachian Health

Introduction: Many uninsured adults rely on free health clinics for prevention and treatment of chronic disease. Little is known about the nutrition education needs of adults served by free health clinics, especially those living in counties within the Western North Carolina Appalachian Mountain Region.

Methods: An in-person survey was distributed to 202 clients of two free health clinics in western North Carolina. Descriptive analyses were conducted to determine frequency distributions for food and physical activity practices, acceptable topics and strategies for nutrition education, and the acceptance and barriers for various modalities.

Results: Depending on the clinic, 49-58% of participants were …

Addressing Rural Food Insecurity: A Flexible Approach Using Evidence-Based Practices, Alison Clayshulte

Master's Projects and Capstones

Food insecurity is a major public health problem in the United States that can lead to worse physical and mental health outcomes for millions of Americans. Rural communities struggle with food insecurity at a higher rate, leading to disproportionately higher levels of chronic conditions, obesity, and stress. Food insecurity is a symptom of many factors including underlying social, economic, and institutional obstacles that affect the quantity and quality of available food. Examples of evidence-based programs implemented to address these factors abound, however rural communities have unique challenges that must be considered to ensure programmatic success. This paper explores these challenges …

Enriching The Pcos Lifestyle, Callie Coleman

Electronic Theses and Dissertations

Polycystic Ovary Syndrome (PCOS) is an endocrine disorder affecting approximately 4 – 20% of women worldwide. It is associated with insulin resistance, fertility problems, and an increased susceptibility to chronic conditions through multiple inflammatory pathways. Women with PCOS are also at increased risk for disordered eating. The Mediterranean diet is associated with decreased inflammation and risk of chronic conditions, and intuitive eating principles are associated with decreased disordered eating patterns. The purpose of this study was to determine if a six-week nutrition education workshop incorporating information and skills related to both the Mediterranean lifestyle and intuitive eating principles can improve …

Barriers And Facilitators To 24-Month Maintenance Of The Faith, Activity, And Nutrition Program In The U.S., Kelsey R. Day, John A. Bernhart Ph.D., Rd, Sara Wilcox Phd

Faculty Publications

Little is known about the barriers and facilitators to organizational maintenance of faith-based health promotion programs. This study used qualitative data (collected from 2016–2019) from pastors (n = 81) and program coordinators (n = 103) to identify barriers and facilitators to 24-month maintenance of a faith-based physical activity (PA) and healthy eating (HE) intervention in South Carolina. Barriers differed for PA versus HE: resistance to change impeded HE while church characteristics tended to impede PA. Similar themes emerged for PA and HE facilitators: healthy opportunities, church communication, and consistency. Future research should build upon this study to tailor faith-based health …

Development And Validity Of The 'Modified Mediterranean Prime Screen' To Assess Dietary Intake Among Women Of Reproductive Age In Lebanon, Mariam Assaad, Sara Ajjour, Maya Rahme, Laila Al-Shaar, May Sakr, Hala Ghattas Ph.D., Ghada El-Hajj Fuleihan, Jana Jabbour

Faculty Publications

The Mediterranean Region registers an increasing prevalence of obesity. The region lacks a diet screener to assess obesogenic nutrients. This study aimed to evaluate the reproducibility and validity of the Modified Mediterranean Prime Screen (MMPS) in estimating obesogenic nutrients' intake among women of reproductive age, as compared with a culturally validated Food Frequency Questionnaire (FFQ), in Lebanon. We developed the MMPS consisting of thirty-two food/beverage items specific to the Lebanese Mediterranean culture. The MMPS and FFQ were administered in two visits (2 weeks-6 months apart), face to face and via telephone during the coronavirus disease 2019 pandemic. The reproducibility and …

Development And Validity Of The ‘Modified Mediterranean Prime Screen’ To Assess Dietary Intake Among Women Of Reproductive Age In Lebanon, Mariam Assaad, Sara Ajjour, Maya Rahme, Laila Al-Shaar, Hala Ghattas Ph.D., Ghada El-Hajj Fuleihan, Jana Jabbour

Faculty Publications

The Mediterranean Region registers an increasing prevalence of obesity. The region lacks a diet screener to assess obesogenic nutrients. This study aimed to evaluate the reproducibility and validity of the Modified Mediterranean Prime Screen (MMPS) in estimating obesogenic nutrients’ intake among women of reproductive age, as compared with a culturally validated Food Frequency Questionnaire (FFQ), in Lebanon. We developed the MMPS consisting of thirty-two food/beverage items specific to the Lebanese Mediterranean culture. The MMPS and FFQ were administered in two visits (2 weeks–6 months apart), face to face and via telephone during the coronavirus disease 2019 pandemic. The reproducibility and …

Nutrition And Exercise Resources For Uninsured Patient Populations, Sabrina Marie Paparo, Samantha Plasner, Runi Patel, Wendy Briaguez

Rowan-Virtua Research Day

Proper nutrition and exercise is integral for the prevention and management of chronic diseases such as type two diabetes, hypertension, high cholesterol, and cardiovascular disease. However, health care disparities in the United States, such as lack of access to primary health care, has been an ever growing problem. The purpose of this study is to determine if there is a correlation between being uninsured and having worse health outcomes, and to determine if there is a need for accessible nutrition and/or exercise resources for this population. To conduct this research, a survey was distributed at the Cherry Hill Free Clinic …

Systematic Review On The Impacts Of Agricultural Interventions On Food Security And Nutrition In Complex Humanitarian Emergency Settings, Melodie Al Daccache, Berthe Abi Zeid, Leila Hojeij, Ghassan Baliki, Tilman Brück, Hala Ghattas Ph.D.

Faculty Publications

Complex humanitarian emergencies are a main driver of food and nutritional insecurity. Agricultural interventions are key to improving nutrition and food security, and their positive impacts are well-documented in stable developing countries. However, it is unclear if their positive effects on food security hold in complex emergency settings, too. In this paper, we systematically review empirical articles that apply rigorous designs to assess the causal impacts of agricultural interventions on food security, nutrition, or health outcomes in complex humanitarian emergencies. We only find six articles matching these criteria, which have mixed results on dietary diversity and food security, and little …

"Fueling For A Healthy Life:" A Cooking Class For Adolescent And Young Adult Childhood Cancer Survivors, Hope Dominique

Senior Theses

Following cancer treatment, childhood cancer survivors (CCS) are at an increased risk of developing chronic diseases and face an increased risk of health-related death during adulthood. Recent literature demonstrates that modifying lifestyle factors such as nutrition can reduce the risk of late mortality in survivors, suggesting that interventions promoting a healthy lifestyle may improve quality and quantity of life for CCS. However, many adolescent and young adult (AYA) CCS do not adhere to national dietary guidelines and face both real and perceived barriers to adopting healthier eating habits while in a critical period for establishing behaviors that contribute to lifelong …

Advancing School Nursing Practice: A Novel Approach To Screening For Gastrointestinal Disorders In Children, Ashley Bunting, Isabella Cavlan

Nursing | Senior Theses

Background: Currently, mandated health screenings in California schools are limited to vision, hearing, and scoliosis; this leaves several other body systems unmonitored during the crucial years of childhood development. One such system is the gastrointestinal (GI) system, which plays a vital role in the normal growth, nutrition status, development, and overall health of children. Objective: By developing and implementing a GI-specific screening tool in the outpatient school setting, this research aims to increase the detection of GI disorders in children. Not only that, but school nurses can use this novel screening tool to promote early diagnosis, intervention, and …

Examining The Feasibility Of Implementing Farm To School Programs In Rural Kentucky Schools: Barriers And Successes Of Initiating Programming As Identified Through Teacher’S Observations, Christina Wilson

Theses and Dissertations--Nutrition and Food Systems

Farm to School (FTS) programs provide experiential learning opportunities to children that have the potential to shape eating patterns and, in turn, improve health and learning outcomes. Participation in FTS programs in Kentucky is growing. However, programming varies widely across schools, and few have an edible school garden. This study examined the feasibility of establishing an edible school garden while incorporating FTS programming by evaluating teachers' observations and experiences. Six rural Kentucky schools were selected to receive a $5,000 grant to initiate an edible school garden and incorporate FTS programming. A Qualtrics survey measured six categories regarding implementation. The results …

Understanding Guardian Perceptions Of Whole-Foods Plant-Based Diets As Interventions In Pediatric Medicine, Vijay R. Luthra

Honors Undergraduate Theses

The obesity epidemic is widespread in American society, often affecting children who bear its consequences innocently. Due to a lack of nutrition knowledge, children rely on caregivers to meet their nutritional needs and instill healthy habits. This study examines parents' attitudes, knowledge, and behaviors, as well as perceived barriers to adopting a whole-foods plant-based diet (WFPD) for their children. Using a modified survey instrument by Morton et al., this study focused on parents and children regarding dietary choices. Participants were recruited from the waiting area of a pediatric clinic at the Medical College of Georgia between April and May 2023. …

Serum Metabolomic Markers Of Dairy Consumption: Results From The Atherosclerosis Risk In Communities Study And The Bogalusa Heart Study, Lauren Bernard, Jingsha Chen, Hyunju Kim, Zhijie Huang, Lydia Bazzano, Lu Qi, Jiang He, Varun S Rao, Kaitlin S Potts, Tanika N Kelly, Kari E Wong, Lyn M Steffen, Bing Yu, Eugene P Rhee, Casey M Rebholz

Faculty, Staff and Student Publications

BACKGROUND: Dairy consumption is related to chronic disease risk; however, the measurement of dairy consumption has largely relied upon self-report. Untargeted metabolomics allows for the identification of objective markers of dietary intake.

OBJECTIVES: We aimed to identify associations between dietary dairy intake (total dairy, low-fat dairy, and high-fat dairy) and serum metabolites in 2 independent study populations of United States adults.

METHODS: Dietary intake was assessed with food frequency questionnaires. Multivariable linear regression models were used to estimate cross-sectional associations between dietary intake of dairy and 360 serum metabolites analyzed in 2 subgroups of the Atherosclerosis Risk in Communities study …

Dietary Intake And Quality Among Stroke Survivors: Nhanes 1999-2018, Erika R Zoellner, Mindy A Patterson, Anjail Z Sharrief, Sean I Savitz, Wesley J Tucker, Derek C Miketinas

Faculty, Staff and Student Publications

Background: Nutrition is an important modifiable risk factor for prevention and treatment of stroke. However, examination of nutrient intake and diet quality in stroke survivors is limited.

Objectives: The aim of the study was to estimate usual nutrient intake and diet quality in US adults with and without a history of self-reported stroke.

Methods: Using US National Health and Nutrition Examination Survey (NHANES) 1999-2018, we analyzed demographics, health history, and dietary intake data in 1626 individuals with a history of stroke matched for age, gender, and survey cycle to respective controls (n=1621) with no history of stroke. A minimum of …

Revisiting The Master Food Volunteer Program: Examining How To Enhance Nutrition Education In The United States, Stacey Viera, Lindsey Haynes-Maslow

Journal of Extension

America’s diet-related illness crisis intersects with a lack of nutrition literacy, nutrition security, and systemic inequities. The Cooperative Extension Service’s (CES) national infrastructure could potentially provide equitable access to quality nutrition education in the US utilizing a Master Food Volunteer (MFV) model. This research brief examined preliminary evidence for the MFV model as a support for CES agents and paraprofessionals, and results show a paucity of evidence. Further research and a pilot program with pre-established measures for health-related knowledge and behaviors could elucidate the model’s potential to increase equitable access to evidence-based programming, nutrition, and implementation guidance.