College of Health Sciences

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Adolescent suicidal behaviors, self rated health and multiple health risk behaviors: Exploring new perspectives in suicide prevention research
(Academic Journals (Journal of Public Health and Epidemiology), 2010) Nkansah-Amankra, Stephen; Diedhiou, Abdoulaye; Walker, Ashley Dawn; Agbanu, Harry; Clark, Alena
We sought to evaluate the extent to which self-rating of health, gender, and the co-occurrence of other health risk behaviors were related to suicidal behaviors among adolescents. Cross-sectional survey data of Colorado middle and high school students aged 12 to 18 years were analyzed using logistic regression. Main outcome variables were suicide ideation, suicide planning, and suicide attempt. Predictors included self-rated health, self-reported health behaviors, perception of body image, expression of sadness and hopelessness, self-reported sexual abuse, self-reported access to lethal weapon, and expression of school safety concerns. Adjusted results showed respondents with poor health rating had significantly higher odds of suicidal ideation (OR: 2.22), suicidal planning (OR: 1.35), and suicide attempt (OR: 2.23). Reporting of hopelessness was the most consistent predictor of suicidal behaviors with odds ratios ranging from 5.57 (for suicidal ideation) to 17.40 (for suicidal attempt). Factors associated with different adolescents’ suicidal behaviors were different for boys and girls. Findings suggest the need to consider gender differences as regards self assessment of health in order to improve the effectiveness of suicide interventions among adolescents.
Age Differences and Changes in Resources Essential to Aging Well: A Comparison of Sexagenarians, Octogenarians, and Centenarians
(Current Gerontology and Geriatrics Research, 2011-08-05) Randall, G. Kevin; Martin, Peter; Bishop, Alex J.; Poon, Leonard W.; Johnson, Mary Ann
This study examined change over time in five resources assessed by the Duke OARS Multidisciplinary Functional Assessment Questionnaire: social, economic, mental, physical, and functional resources. Two hundred and one participants in the Georgia Centenarian Study provided data for this longitudinal study: 70 sexagenarians, 63 octogenarians, and 68 centenarians. Those in their 60s and 80s were followed up within 60 months; due to mortality attrition, centenarians were followed up within 20 months. Centenarians experienced the lowest levels of resources relative to those in their 80s and 60s. Over time they primarily experienced loss in activities of daily living, highlighting that the ability to maximize gains and mitigate losses over time for older adults is highly associated with various resources essential to well-being. Findings suggest that older adults’—especially the very old—resources should be concurrently assessed in a multidimensional analysis by researchers and practitioners who work with older adults in various settings.
Association between depressive symptoms in adolescence and birth outcomes in early adulthood using a population-based sample
(Elsevier (Preventive Medicine Reports), 2015) Nkansah-Amankra, Stephen; Tettey, Grace
Background Adolescent female depressive symptomatology is an unrecognized mood disorder that impairs health in adolescence or adulthood. However, the long-term effects of pre-pregnancy depressive symptoms on birth outcomes in adulthood have not been given adequate empirical assessments. Results Exposure to elevated depressive symptoms in late adolescence, but not in adulthood, was associated with increased odds of LBW by more than 2-fold in early and young adulthoods (adjusted odds ratio [aOR]=2.19; 95% confidence interval, CI: 1.56, 3.08). Depressive symptoms in early adulthood were independently associated with increased odds of PTB and were higher for black mothers. Maternal race modified the relationship between consistent reporting of depressive symptoms in adolescence and LBW or PTB in adulthood. Conclusion This study provides compelling evidence that effects of elevated depressive symptomatology on LBW or PTB appear to be linked to a specific development period in adolescence. National policies to address social inequalities and stratification particularly in health at all stages of human development, will provide an important step in reducing depressive symptoms prior to early adulthood and in pregnancy and childbirth.
Association between Handwashing Behavior and Infectious Diseases among Low-Income Community Children in Urban New Delhi, India: A Cross-Sectional Study
(International Journal of Environmental Research and Public Health, 2021-11) Khan, Khalid M.; Chakraborty, Rishika; Brown, Stephen L.; Sultana, Rasheda; Colon, Alec; Toor, Devinder; Upreti, Pooja; Sen, Banalata
Diarrheal diseases and respiratory infections (RI) are two leading causes of childhood mortality in low and middle-income countries. Effective handwashing at critical time-points may mitigate these diseases. However, there is a lack of published data investigating this association in school-aged children in India. This study is part of a larger prospective handwashing intervention study in a low-income community in New Delhi, India examining the associations between handwashing behavior and diarrhea and RI in schoolchildren. This current study reports the findings of the baseline survey administered to 272 mother–child dyads. Children aged 8–12 years, and their mothers, were recruited from six schools. A baseline questionnaire was used to collect sociodemographic data, handwash behavior, and mother-reported recent diarrhea and RI incidence among the children. Handwashing before and after preparing food, after defecation, and after cleaning dishes significantly reduced the odds of diarrhea by over 70%, and of RI by over 56%. Using a clean cloth after handwashing lowered odds of diarrhea and RI by 72% and 63% respectively. Around 60% of the participants believed that handwashing could prevent diarrhea and RI in their children. There was a low prevalence of handwashing at critical time-points and a poor perception regarding handwashing benefits. To improve handwashing behavior, hygiene promotion programs need to understand what motivates and hinders handwashing in vulnerable populations.
Beverage Consumption of College Students: Factors that Influence Their Choices
(Undergraduate Research Journal for the Human Sciences, 2011) Randall, G. Kevin; Collins, Nina; Mills, Ellen; Grumbine, Rachel
Beverage consumption is a major source of energy; intake varies depending on demographics, availability, and personal and behavioral influences (Storey, Forshee, & Anderson, 2006). To date no studies were found investigating the milk and soda consumption behavior of college students and the factors influencing their choices relative to such consumption. Based on Martin and Martin’s (2002) Developmental Adaptation Model, this study employed hierarchical regression and path mediation analyses to examine distal (family consumption) and proximal factors that influenced beverage consumption among college students. The results of this research found the three most influential factors that affect amount of milk consumption by college students are taste, family consumption, and perceived nutritional value; the most influential factors for soda consumption was taste, frequency of eating out, and perceived negative effect on dental caries.
College Student Snacking Behaviour Pilot Study
(International Journal of Home Economics, 2012) Dallmeyer, Martha A.; Davidson, Jeanette; Randall, Kevin; Newell, Amanda
This study examined the snacking behaviour of undergraduate college students using a comprehensive survey that included a Healthy Snacking Knowledge Test (HSKT), a Snack Frequency Questionnaire, a survey of psychosocial correlates related to snacking behaviour (Situational Self-Efficacy, Barriers to Healthy Eating, and Transtheoretical Model of Behavior Change), and demographic information. There were 105 student participants from two Midwestern universities. Results show 2.6 mean snacking occasions per day, and the snack food selections tended to be high in nutrient density. Upper classmen had more knowledge about healthful snack options than freshmen. These students were most confident about healthful snack choices in difficult or inconvenient settings. The main predictors of healthful snack consumption were the academic year, the higher level of stage of change, and the difficult/inconvenient subscale of snacking self-efficacy
Comparing the Support-Efficacy Model among Centenarians Living in Private Homes, Assisted Living Facilities, and Nursing Homes
(Journal of Aging Research, 2011) Randall, G. Kevin; Bishop, Alex J.; Martin, Peter; Poon, Leonard W.; McDonald, Maurice; Margrett, Jennifer
We investigated the influence of social relations on health outcomes in very late life by examining the support-efficacy convoy model among older adults who resided in three different residential environments (centenarians in private homes, n = 126; centenarians in assisted living facilities, n = 55 ; centenarians in nursing homes, n = 105). For each group, path analytic models were employed to test our hypotheses; analyses controlled for sex, mental status, education, perceived economic sufficiency, and activities of daily living. The hypothesized relationships among the models’ variables were unique to each of the three groups; three different models fit the data depending upon residential environment. The direct and indirect effects of social relations assessments were positive for the mental and physical health of very old adults, suggesting that participants welcomed the support. However, residential status moderated the associations between the assessments of social relations, self-efficacy, and both outcomes, physical and mental health.
Correlates of Protein Intake among Community Dwelling Older Adults
(Undergraduate Research Journal for the Human Sciences, 2010) Sargent, Meredith E.; Evola, Kelly L.; Davidson, Jeanette; Randall, G. Kevin
Nutritional recommendations, BMI, and quality of life may be uniquely related in a population of older adults. The current recommended dietary allowance (RDA) for dietary protein in older adults is 0.8 g/ kg of body weight per day, but controversy exists as to whether this amount is adequate. Research findings suggest that the protein turnover rate decreases by the age of 70, resulting in a greater need for protein by older adults. In addition, nutritional studies have suggested a lower mortality rate is associated with overweight BMI ranges in older adults. Last, a relationship between nutritional risk and quality of life has been found in community living elderly adults. To date no studies have been found investigating the relationship between protein intake and various physical and mental health correlates, such as quality of life among community dwelling older adults. Using data collected from a convenience sample of this population, who indicated protein intake of 0.8 -1.6 g/kg and BMIs of 25 and over, we investigated the relationship between protein intake, self-rated physical health, and life regard; analyses controlled for age, sex, and marital status. Results from a hierarchical regression analysis showed that a measure of life regard significantly and positively contributed to Protein Intake. This final model explained 49 percent of the variance.
Developing an evidence-based public health informatics course
(Medical Library Association (Journal of the Medical Library Association), 2015) Yu, Xinyu; Xie, Yue; Pan, Xuequn; Mayfield-Johnson, Susan; Whipple, Jessica; Azadbakht, Elena
Objectives: This study assessed the need to develop a public health informatics (PHI) introductory course and determine contents of such a course. Methods: Community assessments employing focus group interviews and an online survey were utilized to determine course need and content. Results: Results revealed a need to provide PHI training to graduate public health students and suggested broad course content requirements. Results indicated lack of awareness of libraries and librarians as sources of public health information. Conclusions: A graduate PHI course was developed and delivered. Additionally, implementation of a subject guide increased the library's profile.
Efficacy of Individual Nutrition Counseling on Resting Energy Expenditure, Oxygen Consumption, Fat-Free Mass and Percentage Fat of Body Weight
(Undergraduate Research Journal for the Human Sciences, 2013) Kechter, Afton; Davidson, Jeanette; Randall, G. Kevin
There is agreement that optimizing intake of calories, protein, and carbohydrates to fuel muscle will enable athletes to train harder, but translating nutrition knowledge into nutrition behavior is problematic. The efficacy of individual nutrition counseling (INC) on nutrition behavior using objective measurements in competitive athletes has not been investigated. We therefore evaluated the influence of INC on the objective outcomes: oxygen consumption (VO2) at rest, resting energy expenditure (REE) measured by indirect calorimetry, fat-free mass (FFM), and percentage fat of body weight (PF) measured by tetra-polar bioelectrical impedance in varsity cross-country athletes at three-time points of pre-during-& post-season.
Elaborating on Population Health Inequalities in the United States: Maternity Care in the Era of Free Market System of Neoliberalization
(MedCrave (International Journal of Pregnancy and Child Birth), 2018) Nkansah-Amankra, Stephen; Diedhiou, Abdoulaye; Mendoza, Justin
While there is an extensive array of literature examining the impacts of neoliberal markets on population health and social outcomes, few studies have focused on the impact of neoliberalism on maternity care and women’s health in the United States. We provided a critical review of the literature by examining mechanisms linking the emergent neoliberal market systems to maternity care, infant health and women’s health outcomes while assessing the population-wide shifts in risk exposures associated with contexts of emergent neoliberalized markets in the country over the last thirty years. The findings from studies showed a correlated pattern of increasing poor health outcomes among women in the United States compared with other industrialized countries over the past three decades. Overall, the health system in the country does not make provisions for some of the most important determinants occurring prior to pregnancy, and often fails to place these concerns in the context of women’s health across the life course. Increasing medicalization of pregnancy and birthing processes reflect a dominance of the market-oriented approach of the country’s health system. We conclude that many aspects of the emergent neoliberal market influences bear greatly on maternity care and women’s health in particular. We further propose that it is only the collective decisions of society (particularly governments at different levels) that can consciously redirect and modify policy interventions to benefit women over the life course rather than on specific periods of pregnancy and childbirth.
Evaluating Pre-Service Teacher Workforce: Environmental Health Knowledge, Attitude, and Behavior
(Southern Illinois University (Online Journal for Workforce Education and Development), 2011) Ratnapradipa, Dhititnut; Rhodes, Darson L.; Brown, Stephen L.
Research has shown that personal health behaviors and actions established early in life are often carried through adulthood. Thus, working with children to increase environmental health literacy may improve the environmental health literacy of future adults, potentially improving the health of the Nation. Given the amount of time children spend in school, this setting could be an ideal place to address environmental health with children. According to social cognitive theory, observation is one way in which learning takes place. Consequently, the environmental behaviors and attitudes modeled by teachers would likely impact the environmental behaviors and attitudes learned by students. A research study including 101 pre-service teachers from a large Midwestern university was conducted to determine participants’ knowledge, attitudes, and behaviors regarding environmental health. Results indicated major deficiencies in basic knowledge as well as many unfavorable environmental behaviors. On average, participants answered only 49.7% of knowledge items correctly. Less than half (46.0%) recycle bottles or cans “often” or “almost always.” Given these results, pre-service teachers are likely ill-prepared to address environmental health literacy in their classrooms. Teacher education programs need to address this deficiency in pre-service teachers through the implementation of new courses focused on environmental health or the redesign of current courses to include environmental health content.
Evaluation of Waterless Cookware on an Induction Cooktop
(Undergraduate Research Journal for the Human Sciences, 2008) Coyle, Michelle; Fontana, Michelle; Knaak, Alaina; Lynch, Rachael; Zannis, Maria-Kanella; Collins, Nina; Randall, G. Kevin
This student-faculty collaborative study compared the effects of different cookware using induction and electric cooktops on overall qualities of chicken breasts including shrinkage, palatability, and consumer acceptability. Four trials of cooking boneless, skinless, chicken breasts on each of these various cooktops were conducted to get an average shrink loss (i.e., weight and length change), taste, texture, and appearance. Objective tests resulted in lowest shrink loss and highest texture and appearance score for the high-end stainless steel cookware on an induction cooktop.
Exploring the Experience of Older Adults Volunteering with an Intergenerational Program to Prevent Childhood Obesity
(Californian Journal of Health Promotion, 2011) Werner, Danilea; Teufel, James; Brown, Stephen L.
Over the past three decades, obesity rates in the United States have increased dramatically among both children and adults. A variety of programs have been created to prevent and intervene in the obesity epidemic but few are intergenerational. This article explores volunteers' experience with an innovative childhood obesity prevention program called Active Generations. Active Generations benefits both children and seniors by utilizing older adult volunteers to implement a version of the evidence-based childhood obesity prevention program, CATCH (Coordinated Approach To Child Health) in out-of-school settings. Understanding that social and civic engagement maintains or improves the health of older adults, this article reviews the stories and preliminary experiences of older adults volunteering to help reverse the trend of childhood obesity.
Family and Personal Predictors of Early Adolescent Eating Patterns
(Californian Journal of Health Promotion, 2012) Brown, Stephen L.; Gautam, Yuba R.; Norrick, Christie; Birch, David; Teufel, James
Many early adolescents report consuming less than the recommended five servings of fruits and vegetables a day, and up to one-third report skipping breakfast. Recent research suggests that children consider parents to be the gatekeepers of food choices, and that parents are important role models for children's eating behaviors. This study examined perceived control over food choices, familial communication regarding healthy eating, and preferred sources of information about healthy eating in relation to eating behaviors. Data were obtained from 959 early adolescents attending health programs in the Midwest. Early adolescents who reported more frequent family discussions were more likely to report eating two or more vegetables per day (AOR=1.4, p<.05), three or more fruits per day (AOR=1.6, p<.05), and five or more vegetables and/or fruits per day (AOR=1.9, p<.05) than early adolescents who reported less family discussions. Those exposed to more frequent family discussions were also more likely to report usually eating breakfast (AOR=1.8, p<.05). Older children were less likely to report eating breakfast (AOR=0.2 for ages 12 and13 compared to age 9, p<.05). Although healthy eating behaviors decline with age, children and adolescents whose families reinforce healthy eating patterns appear more likely to maintain healthy patterns.
Food Portion Sizes Consumed by College Students
(Undergraduate Research Journal for the Human Sciences, 2008) Cloyd, Brooke N.; Collins, Nina; Randall, G. Kevin
Obesity is on the rise in the United States, and causes of such an epidemic have become the basis of research in many scientific studies. Researchers are looking at portion control or distortion as one part of the problem. This portion control problem can put people who often eat in a cafeteria setting at high risk for obesity. This study examined a Midwestern University’s students’ eating habits and compared their eating habits to the USDA guidelines. The purpose of this study was to compare the estimated portion sizes of fruits, vegetables, and french fries consumed by college students with the USDA suggested serving size. "Serving Size Screener ” was administered to a volunteer sample consisting of 67 college students (45 females) in general education classes during the 2008 spring semester. Participants were given a portion guide to use as they completed the personal food frequency questionnaire. Single sample t-tests were performed comparing the study sample's perceived average portion size consumed relative to the USDA suggested size for the three categories. Results indicated that students consumed significantly larger servings of each item than the USDA recommendations.
“Gateway hypothesis” and early drug use: Additional findings from tracking a population-based sample of adolescents to adulthood
(Elsevier (Preventive Medicine Reports), 2016) Nkansah-Amankra, Stephen; Minelli, Mark
To evaluate the consistency of the relationship between early drug use in adolescence and illegal drug use in adulthood as proposed in the“gateway theory”and to determine whether pre-existing depressive symptoms modifies this relationship. We used contractual data from the National Longitudinal Study of Adolescent to Adult health data spanning a 14 year period. We assessed the relationship between gateway drugs at baseline(age 11–20 years) and drug use in adulthood using generalized estimating equation (GEE) regression models.Gateways drugs used in early adolescence were significantly associated with marijuana use, illegal drugs and cocaine in older adolescence, but over time these relationships were not consistent in adulthood. Changes in the pattern of psychoactive drug use were important predictors of drug use in adulthood. A history of higher depressive symptoms was associated with higher frequencies of psychoactive drug use over time. Users of mental health services in adolescence were less likely to use drugs in older adolescence and in adulthood. Relation-ships between early drug use and later drug use in adulthood cannot be solely explained by the gateway hypothesis. Collectively, adolescent drug prevention and treatment programs should apply theory-based and evidence-proven multisectoral intervention strategies rather than providing a brief counseling on individual's behaviors. This evidence should include understanding that changes in behavior should involve broader analyses of the underlying social context for drug use and in particular the role of the community social norms in driving a group's behaviors.
Healthy Tazewell County Initiative: Implementation of the MAPP Process and Survey Findings
(Undergraduate Research Journal for the Human Sciences, 2014) Oates, Erin N.; Cluskey, Maureen; Randall, G. Kevin
The Mobilizing for Action through Planning and Partnerships (MAPP) process, provides a way for communities to collaboratively prioritize and improve public health issues by determining gaps as well as strengths in public health services (McClellan, 2005). Results from the four assessments in step three of MAPP identify quality of life issues, efficiency of current services, observation of community health status, as well as forces of technology, laws, and other ever-developing facets that may affect how public health systems function (“National Association of City and County Health Officials,” 2012). To date no studies have been found investigating the MAPP process relative to which factors citizens perceive most important to quality of life within a community. Thus, as a research question, we investigated the most important features of a healthy community listed by residents of Tazewell County, then used the quality of life questions to predict a multi-item outcome applying hierarchical regression analysis. The results of this research found that when the Tazewell Public Health Department is seeking to implement positive change in the community they should aim to focus on living in a community that (a) has a strong overall quality of life, (b) is a good place to grow old, (c) has clean air and water, (d) has an active sense that citizens can make the community a better place individually and corporately, and (e) has pride in shared accomplishments.
Healthy Tazewell County Initiative: Variations in Community Quality of Life, Health Problems, and Risky Behaviors by Age Category
(Undergraduate Research Journal of for the Human Sciences, 2014) Carlson, Alyssa; Stegmaier, Angela; Cluskey, Maureen; Randall, G. Kevin
The MAPP process, a strategic planning tool that allows communities to prioritize their public health issues, was employed by the Tazewell County Health Department to assess what factors residents perceived to be (a) the most important for community quality of life, (b) the greatest health problems, and (c) the top risky behaviors impacting community health. Data, collected through an online survey, were provided by 456 participants residing in the county and at least 18 years of age. First, we conducted a frequency analysis on the top three factors for community quality of life, health problems, and risky behaviors as nominated by participants. Second, we assessed whether or not the factors differed by age groups/cohorts: 25-34, 35-44, 45-55, 55-64, and those over 65. Although the top factors for community quality of life did not vary much by age cohort, 38 percent of those 65+ listed religious or spiritual values as one of their top three. Heart disease and stroke were common health concerns, but the youngest group listed teen pregnancy as a top health concern (35.6%), whereas the three older groups cited health problems associated with aging as a concern. The groups agreed consistently on the top three risky behaviors. Thus for these survey respondents, the top factors for community quality of life, and the top health problems varied by age category. Implications for public policy are discussed, including how age cohort related issues such as religiosity and health problems impact constituency preferences.
Home Economics in Higher Education: Enhancing Student Learning and Promoting Responsible Student Behavior
(International Journal of Home Economics, 2008) Randall, Kevin G.; Dallmeyer, Martha A.; Collins, Nina
Numerous challenges exist for Home Economics/Family and Consumer Sciences Departments and their universities. For universities, one challenge is the promotion of responsible social behavior by students, especially in light of the abuse and overconsumption of alcohol so often associated with the new found freedoms on campus. For HE/FCS Departments, high construction costs and maintenance expenses associated with a quantity foods laboratory often result in food service students working at various sites off campus to gain needed experience, leading to lack of consistency in student experience and reduced oversight by faculty. This paper illustrates how HE/FCS food service courses can benefit not only the department and its majors, but also can support and strengthen the university’s comprehensive alcohol action plan—ultimately enhancing the educational experience for students university wide.

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