Epidemiology Commons^™

Knowledge, Attitudes, And Practices (Kap) Of Parents Regarding The Prevention And Control Of Childhood Iron Deficiency Anemia In Egypt: A Cross-Sectional Study, Omnia Soliman

Theses and Dissertations

Childhood Iron Deficiency Anemia (IDA) remains a major public health challenge in Egypt, where its persistently high and rising prevalence carries substantial consequences for child growth, cognitive development, immunity, and long-term health outcomes. Globally, approximately 40% of children aged 6–59 months are affected by anemia (World Health Organization, 2025), and Egypt mirrors this burden, with national data showing a worsening trend in recent years. In Egypt, national strategies have traditionally focused on biomedical interventions such as iron supplementation and food fortification, while less attention has been directed toward behavioral and household-level determinants, particularly parental knowledge, attitudes, and practices (KAP) related …

Weathering The Divide: Social Determinants, Neighborhood Context, And Systemic Lupus Erythematosus Among African American Women, Vanessa Cl Morman

Electronic Theses and Dissertations

Background: Systemic lupus erythematosus (SLE) disproportionately affects African American women and contributes to racial health disparities in the United States. Although genetic susceptibility influences disease risk, growing evidence suggests that social determinants of health (SDOH), including neighborhood conditions, structural racism, and socioeconomic disadvantage, contribute to disease development and progression. Epigenetic mechanisms may provide a biological pathway linking adverse social conditions to chronic disease disparities. This dissertation examined the influence of SDOH on SLE disparities through evidence synthesis and empirical investigation to inform public health practice and policy.

Methods: This integrated learning experience consisted of three complementary manuscripts. Aim 1 was …

Progression Of Non-Radiographic To Radiographic Axial Spondyloarthritis: A Risk Model Based On A Chinese Cohort Study, Rui Ying Deng, Xiaojia Xu, Jian Hua Peng, Feng Cai Shen, Yao Gong, Dan Min Wang, Hong Jin Liang, Shu Xin Huang, Zhao Peng Chen, Wen Long Wu, Ze Xin Zheng, Ling Lin, Zhi Duo Hou

Research outputs 2022 to 2026

Objectives: To evaluate the progression from non-radiographic axial spondyloarthritis (nr-axSpA) to radiographic axial spondyloarthritis (r-axSpA) in a Chinese cohort, identify associated risk factors in both clinical and imaging arms, and enable risk stratification based on these factors. Methods: Overall, 572 patients with nr-axSpA were enrolled with a median follow-up of 5 years. Cox proportional hazard regression analyses were conducted to identify potential risk factors associated with the progression from nr-axSpA to r-axSpA in both clinical and imaging arms. A risk-scoring system was then developed by assigning each independent predictor a weight based on its regression coefficient. Patients were subsequently categorized …

Pola Rujukan Penyakit Saluran Pernapasan Di Fasilitas Kesehatan Tingkat Pertama: Tantangan Gatekeeper Program Jaminan Kesehatan Nasional Di Jakarta, Syarif Rahman Hasibuan, Melrose Holy Natasha, Fatih Jihadi Ramadan

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Program Jaminan Kesehatan Nasional yang diselenggarakan oleh Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan mewajibkan Fasilitas Kesehatan Tingkat Pertama (FKTP) untuk menyeleksi kasus yang memerlukan rujukan. Penyakit saluran pernapasan yang menjadi penyebab utama kunjungan ke FKTP memiliki pola rujukan yang masih belum banyak diteliti. Oleh karena itu, dilakukan penelitian untuk melihat pola rujukan penyakit saluran pernapasan di FKTP dan mengetahui faktor yang berasosiasi dengan keputusan rujukan. Penelitian potong lintang ini dilakukan terhadap 89.225 klaim FKTP di Jakarta pada periode 2017-2023, dengan kriteria inklusi semua kunjungan dengan diagnosis ICD-10 diseases of the respiratory system. Uji regresi logistik dilakukan untuk mengidentifikasi faktor …

Precision Approaches Improve Community Health, Roger A. Rennekamp, David Buys

Journal of Extension

Recent advances in data science provide Extension practitioners with access to data sorted by zip code, census tract, or neighborhood. Such hyper-local data now allows Extension personnel to assess community needs and assets at a more granular level and focus their work on the people and communities of greatest need. In this article, we introduce an approach we refer to as precision public health. Using such a precision approach to community assessment and, ultimately, programming can save money, increase the likelihood of producing measurable results, and create more manageable workloads for county-based Extension personnel.

Cardiovascular Disease Incidence And Cancer Risk In Two Large European Prospective Cohorts, Emma Fontvieille, Vivian Viallon, Laia Peruchet-Noray, Quan Gan, N. Charlotte Onland-Moret, Yvonne Koop, Anne Tjønneland, Nicola Bondonno, Verena Katzke, Rudolf Kaaks, Matthias B. Schulze, Catarina Schiborn, Calogero Saieva, Vittorio Simeon, Claudia Agnoli, Rosario Tumino, Fulvio Ricceri, Leila Luján-Barroso, Maria José Sánchez, Conchi Moreno-Iribas, Konstantinos K. Tsilidis, Marc J. Gunter, Adam Butterworth, Elio Riboli, Heinz Freisling, Pietro Ferrari

Research outputs 2022 to 2026

Our study investigated the association between incident cardiovascular disease (CVD) and subsequent cancer risk in two large European prospective cohorts. We included 568,926 adults from the European Prospective Investigation into Cancer and Nutrition and United Kingdom Biobank, all of whom were free of CVD, cancer and type 2 diabetes at baseline. Multivariable Cox proportional hazards regression models were used to estimate cancer hazard ratios (HRs) and 95% confidence intervals (CIs) in relation to incident CVD events. CVD was treated as a time-varying exposure, and models accounted for time since CVD diagnosis and other lifestyle factors. Study-specific estimates were pooled using …

Provincial Disparities In Adolescent Fertility In Indonesia: An Ecological Analysis Of Child Marriage, Median Age At First Marriage, And Family Development Index, Andi Nisa Fathimiyah Afidah, Milla Herdayati

Kesmas

Adolescent fertility remains a public health concern in Indonesia, with substantial variations across provinces. However, the evidence explaining provincial disparities using population-level indicators remains limited. This study aimed to examine provincial disparities in adolescent fertility and assess the association of child marriage, median age at first marriage among women, and the Family Development Index called iBangga with adolescent fertility across Indonesia. This ecological, cross-sectional study used aggregated data from 34 Indonesian provinces. Descriptive statistics, spatial visualization, Pearson’s correlation, and multiple linear regression analyses were performed. The mean adolescent fertility rate was 25.0 births per 1,000 female adolescents aged 15–19 years, …

Spatial Association Of Acute Respiratory Infection, Diarrhea, And Low Birth Weight With Stunting Prevalence In Indonesia, 2024, Dian Rosadi, Husaini Husaini, Triawanti Triawanti, Musafaah Musafaah

Kesmas

Stunting remains unevenly distributed across Indonesia, but national evidence integrating spatial analysis and spatial regression is limited. This study examined the spatial distribution of stunting and its associations with acute respiratory infection (ARI), diarrhea, and low birth weight (LBW) across Indonesian provinces. An ecological cross-sectional study used data from the 2024 Indonesian Nutritional Status Survey. Stunting-only analyses included all 38 provinces, whereas analyses involving ARI, diarrhea, and LBW included 37 provinces with complete data. Spatial analyses used a row-standardized symmetric four-nearest-neighbor spatial weights matrix and included Global Moran’s I, bivariate spatial analysis, Local Indicators of Spatial Association, ordinary least squares, …

Self-Management Interventions For Adults With Type 2 Diabetes Mellitus In Thai Primary Care And Community Settings: A Scoping Review, Sansanee Seetangkham, Supaluk Seetunya, Subhawan Yodprong

Kesmas

Diabetes mellitus is a leading cause of mortality and economic burden, with significant impacts on health outcomes and quality of life. Effective self-management is crucial for controlling Type 2 Diabetes Mellitus (T2DM). Thailand has implemented diverse self-management interventions for adults with T2DM in primary care and community settings, but the components, delivery, duration, and outcomes of these interventions have not been synthesized. Following the Arksey and O’Malley framework, Joanna Briggs Institute guidance, and PRISMA-ScR, five databases were searched from inception to June 2025. Eligible English-language intervention studies involved Thai adults with T2DM in primary care or community settings. Study characteristics …

Environmental Perspective For System Dynamics Modeling Of Stunting Mitigation To Achieve The Sustainable Development Goals In West Sumatra, Indonesia, Elsa Yuniarti, Nabila Azzahra, Yulhendri Yulhendri, Heldi Heldi, Mery Delvina, Saskia Putri Azeli

Kesmas

This study developed a system dynamics model to simulate stunting reduction in West Sumatra Province, Indonesia, by integrating infant and toddler health, maternal health, and environmental determinants. Secondary data from 2020–2024 on low birth weight, immunization, malnutrition, exclusive breastfeeding, maternal chronic energy deficiency, iron and folic acid supplement distribution, sanitation, and safe drinking water access were compiled from West Sumatra Provincial Health Office and Statistics Indonesia, and validated through consultation with five stakeholder institutions. Causal Loop Diagrams mapped feedback relationships among determinants and were translated into Stock Flow Diagrams using Powersim Studio 10. The model was validated through structural verification, …

Determinants Of Multimorbidity Among Stroke Patients For Epidemiological Management In Indonesia's Agro-Coastal Communities, Krish Naufal Anugrah Robby, Isa Ma'rufi, Farida Wahyu Ningtyias, Latifatul Izzah, Nurjazuli Nurjazuli, Suhartono Suhartono, Muchlis Achsan Udji Sofro, Ida Srisurani Wiji Astuti, Olivia Listiowati Prawoto, Dedek Sutinbuk, Taufik Kurrohman, Elhoussin Ouassou

Kesmas

Multimorbidity remains a major public health challenge among stroke patients, particularly in agro-coastal communities characterized by socioeconomic vulnerability, limited healthcare access, and lifestyle changes. This study aimed to analyze the determinants of multimorbidity among stroke patients in agro-coastal communities. A quantitative observational analytical design was employed, involving 45 stroke patients selected through total sampling in Jember District, Indonesia. Data were collected through structured interviews, anthropometric measurements, and secondary health records. The model included biological, socioeconomic, healthcare access, and lifestyle as exogenous variables, with multimorbidity as the endogenous variable. Data were analyzed using PLS-SEM, including evaluation of measurement and structural models …

Relationship Between Sociodemographic Factors And Opioid Overdose Mortality In Milwaukee County, 2020-2021, Elizabeth David

Walden Dissertations and Doctoral Studies

Opioid overdose deaths increased significantly from 2020 to 2021, with Milwaukee County experiencing higher rates than the national and state averages. African American and Hispanic residents faced disproportionately high fatal overdose rates. The purpose of this quantitative retrospective cross-sectional study was to examine the associations among socioeconomic status, race, age, access to treatment (measured by emergency medical services [EMS] naloxone administration), and opioid overdose mortality among underserved minority populations in Milwaukee County. Guided by the social-ecological model, the study analyzed data from the Milwaukee Health Department and the Milwaukee County Medical Examiner's Office across 34 ZIP codes. Inclusion criteria for …

Self-Care Behavior And Diabetes Knowledge In African American Women With Type 2 Diabetes, Rena Renee Barron

Walden Dissertations and Doctoral Studies

African American women experience a disproportionate burden of Type 2 diabetes, and limited evidence exists regarding the relationship between diabetes knowledge and self-care behaviors, particularly among African American female veterans. The purpose of this quantitative, cross-sectional study was to examine the relationship between diabetes knowledge and diabetes self-care among African American women with Type 2 diabetes, including a subsample of African American female veterans, and to evaluate whether the COVID-19 pandemic (2017–2019 vs. 2021–2023) moderated this relationship. Additional variables included age, marital status, physical health, and mental health. Guided by the social-ecological model, de-identified data from the Behavioral Risk Factor …

Race And Ethnicity And Overall Survival In Pediatric Acute Myeloid Leukemia, Daniel J. Zheng, Long Khuong, Catherine Aftandilian, Kira Bona, Emi H. Caywood, Caitlin W. Elgarten, Brian T. Fisher, Cody-Aaron L. Gathers, Taumoha Ghosh, M. Monica Gramatges, Gary Hettinger, Meret R. Henry, Yuan-Shung V Huang, Yimei Li, Kelly Maloney, Amir Mian, Tamara P Miller, Arunkumar Modi, Rajen Mody, Regina M. Myers, Haley Newman, Jose Ortiz, Alix E. Seif, Caroline Smith, Jamie Stokke, Naomi Winick, Jennifer J. Wilkes, Victor Wong, Richard Aplenc, Kelly D. Getz

Department of Pediatrics Faculty Papers

IMPORTANCE: Hispanic and non-Hispanic Black (hereafter, Black) children with acute myeloid leukemia (AML) have historically experienced worse survival outcomes compared with non-Hispanic White (hereafter, White) children. Understanding specific intermediate pathways underlying these outcome disparities is a critical step to directing interventional efforts and resources.

OBJECTIVE: To compare survival outcomes by race and ethnicity in a large contemporary cohort of pediatric patients with AML and to examine presentation acuity, frontline organ toxic effects, and relapse as potential mediators of any observed outcome disparities.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study was analyzed from April 2025 to January 2026 and included …

School-Centered Tobacco Retailer Exposure And Neighborhood Opportunity Across Urban And Rural Tennessee, Sima Namin Dr, Jacob Black, Jennifer Ferris, Robert E. Heidel Dr

Journal of Appalachian Health

Introduction: Tobacco retailer availability contributes to youth tobacco use, and retailers are concentrated in socioeconomically disadvantaged communities. However, few studies have examined how school-centered retailer exposure intersects with neighborhood opportunity in a predominantly rural Appalachian state.

Purpose: The purpose of this study is to assess the association between neighborhood opportunity and school-centered tobacco retailer exposure across Tennessee (TN), including differences by rurality and Appalachian status.

Methods: We constructed a tract-level, school-centered youth tobacco exposure index for TN using tobacco retailer locations and public and private K-12 school data. The index incorporated retailer proximity, density, and distance-decay accessibility measures. Child Opportunity …

Deaths Of Despair Among Cancer Survivors In Rural/Urban Appalachia (2000-2022), Jason Semprini, Anders Erickson, Nosa Osazuwa-Peters

Journal of Appalachian Health

Introduction: Rising deaths of despair (premature deaths from suicide, overdose, alcohol, and violence) in adults under age 65 persist across the United States, especially in Appalachia. People diagnosed with cancer may face elevated risks of such deaths due to pain, psychosocial distress, and financial hardship.

Purpose: Deaths of despair trends were compared among adults with cancer across Appalachian and non-Appalachian regions, stratified by sex and rurality.

Methods: Analyzing SEER-21 Incidence-Based Mortality data (2000–2022), deaths caused by suicide, cirrhosis of the liver, or accidents (includes overdose) were identified among adults aged 20–64 years. Annual mortality rates per 100,000 total population were …

Numerical Analysis Of The Sir Model For Predicting Disease Spread, Victoria Gaibor, Isabel Tejada, Kate Moore

Discovery Day - Daytona Beach

This project, Numerical Solutions of the SIR Model for Predicting Disease Spread, investigates the application of numerical methods to analyze the dynamics of infectious diseases using the classical Susceptible–Infected–Recovered (SIR) model. The SIR model, a system of nonlinear ordinary differential equations, is widely used to describe how diseases such as COVID-19 propagate through a population. The primary objective of this study is to solve the SIR initial value problem using multiple numerical techniques, including Euler’s method, Runge–Kutta methods, and multistep methods, and to compare their accuracy and efficiency. The model is implemented using given initial conditions and parameters, and additional …

Immigration Status And Lung Cancer Diagnosis In U.S. First-Generation Immigrants, Valeriya Lockwood

Walden Dissertations and Doctoral Studies

The healthy immigrant effect (HIE) is an observed phenomenon in which immigrants exhibit better health outcomes than native-born residents, though relatively few studies have examined its role in chronic diseases in the United States. The purpose of this quantitative cross-sectional study was to assess the associations between immigration status, age, sex, race/ethnicity, median household income, and geographic location and lung cancer diagnosis in first-generation immigrant adults aged 18 or older. The subsequent health trajectory model provided the theoretical framework for the study. Data were obtained from the SEER*Stat Database 1975-2022 (N = 1,993). Binomial regression analysis showed that immigrants were …

How Recent Medicaid Defunding Has Impacted San Bernardino County Residents Access To Health Care Services, Samantha I. Rios

Electronic Theses, Projects, and Dissertations

Background: Medicaid is a critical source of health insurance for low-income populations in the United States, providing access to essential preventative, primary, and reproductive health care services (Donohue et al., 2022). The Medicaid defunding of 2025 and policy changes that follow have raised concerns regarding increased barriers to care, particularly among low-income and vulnerable populations who rely on safety-net providers such as Planned Parenthood (Planned Parenthood, 2025). The purpose of this study was to examine how the 2025 Medicaid defunding has impacted access to general and reproductive health care services among residents of San Bernardino County, California.

Conclusion: The research …

Updating The Prisma Reporting Guideline For Scoping Reviews: A Scoping Review, Andrea C. Tricco, Emily Robinson, Sharon E. Straus, Heather Colquhoun, Christina M. Godfrey, David Moher, Zachary Munn, Danielle Pollock, Sherrie Logan, Ellen B.M. Elsman, Sabira Hasanoff, Yonda Lai, James Mcmahon, Jasmeen Dourka, Dipika Neupane, Hanan Khalil, Micah D.J. Peters, Lyndsay Alexander, Romy M. Jia, Ashrita Saran, Catrin Evans, Dawid Pieper

Research outputs 2022 to 2026

Background and Objectives The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) extension for scoping reviews (ScRs) (PRISMA-ScR) was published in 2018 to provide reporting guidance. A substantial increase in published ScRs in recent years coupled with the omission or lack of engagement of interest-holders, including patients and public partners, as research partners throughout its development necessitate updating PRISMA-ScR. Important methodological advancements have emerged since PRISMA-ScR 2018, including automation and data extraction, which need to be incorporated into this update and reflected in new reporting items. Aligned with PRISMA 2020, this ScR underpins the update by identifying potential new …