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Background: Campus behavioral intervention teams (BITs) provide early identification of students and/or situations that may be a risk to the community, as well as determine and implement intervention plans for a safe resolution. Methods: An evaluation of 529 faculty and staff was conducted at a large urban, southeastern research university to assess BIT knowledge, triggers for referral, referral self-efficacy, referrals, and satisfaction regarding said university's BIT (Students of Concern Assistance Team, otherwise known as SOCAT). Results: Findings revealed low levels of knowledge, self-efficacy, and referrals among faculty and staff. Utilization of SOCAT resulted in high levels of satisfaction among the process and follow-up outcomes. Discussion: Findings from this study will guide future implementation by highlighting strategies to enhance the referrals to and utility of BITs on college campuses and identifying best practices in improving faculty and staff satisfaction with the referral system process for BITs.

College students experience food insecurity at higher rates than the general population, which has been found to be directly and indirectly associated with poor mental and physical health in addition to academic success. Since the rise of the COVID-19 pandemic, mounting evidence has demonstrated an increase in food insecurity rates in the U.S. The current study assessed food insecurity and its associated impacts on health and academic success among college students at a large urban university (n = 1743). Results revealed 46.8% of students as food insecure with statistically significant differences in race/ethnicity, GPA, and hours worked per week. Students who were observed with any level of food insecurity were more likely to also experience challenges with academics, careers, procrastination, and faculty as compared to their food secure counterparts. Analysis of differences in well-being indicators by food insecurity status revealed that students with any level of food insecurity were observed with statistically significantly higher mean scores for psychological distress, loneliness, and suicide behavior, with reduced scores for flourishing and resiliency as compared to their food secure counterparts. Implications for post-COVID-19 programming to mitigate food insecurity and associated public health issues associated with the COVID-19 and future pandemics are discussed.

RE-AIM is an implementation science framework that provides a structure to promote data collection and analysis in the domains of Reach, Efficacy/ Effectiveness, Adoption, Implementation, and Maintenance. The RE-AIM approach promotes more data collection and reporting than typical evaluations so potential adopters can determine the potential program fit for their setting. RE-AIM has been used to evaluate a variety of programs; however, there are few resources that provide strategies for conducting a RE-AIM evaluation in the school setting. The purpose of this article is to inform future studies by elucidating experiences conducting a large, complex, multisite, longitudinal RE-AIM evaluation in schools in partnership with the state’s Departments of Education and Health, and to share strategies for overcoming obstacles. With the long-term goal of facilitating the translation of school-based intervention research into practice, we provide key considerations and recommend strategies for school-based RE-AIM evaluation success.

Male college students have been observed to have low mental health literacy and help-seeking behaviors. The purpose of this study was to apply social marketing theory to address mental health literacy among male undergraduate students in order to improve both mental health literacy and help-seeking behaviors. The current study employed qualitative methods involving key informant interviews among male undergraduate university students (n = 26). Participants were provided three vignettes representing a male college student presenting with anxiety, depression, or stress during the key informant interviews. The concepts from the key informant interviews were mapped onto the social marketing theory marketing mix (product, price, place, promotion). The social marketing mix identified methods to improve professional help-seeking behaviors (product) among male undergraduate students by reducing stigma, both perceived social stigma and self-stigma, as well as addressing masculine norms (price) in locations where students are comfortable, such as the university health center or the Internet (place), by connecting the physical signs and symptoms (promotion) to mental health concerns. Findings were translated into a targeted and tailored social marketing campaign implemented in male restrooms in the campus recreation center. Social marketing theory is a valuable tool for developing targeted and tailored social marketing programs for mental well-being among college students.

There is evidence to suggest the level of caregiver strain experienced by parents and other caregivers may have implications for engagement in their child’s mental health and education services. This is particularly important for caregivers of youth with emotional and behavioral disorders in special education, as these caregivers tend to be less involved than other caregivers. The purpose of this study was to understand caregiver strain and theoretically-related constructs in caregivers of youth with emotional and behavioral disorders. The sample included 112 caregivers of youth receiving special education services for Emotional Disturbance (ED). Using structural equation modeling and the Modified Double ABCX Model as a theoretical framework, the relationships among caregiver strain, stressors, resources, and perceptions were examined. Consistent with findings from previous studies, results indicated that more problems with youth functioning were related to higher levels of caregiver strain. Resources were found to be positively related to both perceptions and caregiver strain. The strongest relationship was observed between caregiver perceptions and caregiver strain, with more negative perceptions associated with higher levels of caregiver strain. Findings reveal the nature of the relationships among caregiver strain and related constructs, as well as the potential importance of perceptions as a target for interventions for families and youth. An understanding of caregiver strain as it relates to stressors, resources, and perceptions provides insight into how we might leverage these factors in order to increase caregiver engagement in services, ultimately improving outcomes for youth and their families.

The study aims to evaluate the enforcement, opinions, and effectiveness of the University of South Florida's tobacco free policy one year following implementation. By assessing readiness to change and using geographic information system (GIS) mapping this study sought to introduce a unique and effective way of evaluating college tobacco free policies. A cross-sectional survey was administered to students, faculty, and staff to assess knowledge of policy and resources, tobacco use observations, stage change regarding policy enforcement, self-efficacy to enforce, and policy impact on perceived campus tobacco use (n = 5242). Additionally, using ArcGIS Collector (in: ESRI, ArcGIS desktop: release 10, Environmental Systems Research Institute, Redlands, 2011) volunteers collected geospatial data on tobacco use continuing to occur on campus following policy implementation. Overall there was moderate knowledge of the current policy and low beliefs for policy enforcement. Majority of respondents were not approaching violators to remind them of the policy and did not plan to do so in the future. There were statistically significant differences between smokers and non-smokers as well as between students and faculty and staff. The mapping of observed violations revealed continued tobacco use on campus with 158 data points. From both the geospatial results as well as the survey findings, the current policy is ineffective in reducing tobacco use across campus. With rapidly increasing numbers of smoke and tobacco free universities, new and innovative evaluation tools are needed so institution leaders can efficiently evaluate their implementation.

Background. Oral health is a significant public health issue; yet barriers to implementing the prenatal oral health guidelines into practice remain. This formative research aimed to identify key implementation science characteristics to inform the development of an eHealth application (app) to assist providers in implementing the prenatal oral health guidelines during prenatal visits. Method. Guided by the Consolidated Framework for Implementation Research, the clinic’s infrastructure, workflow, and contextual factors were assessed via clinic observation, technology assessment, prenatal provider interviews ( n = 4), clinic staff interviews ( n = 8), and two focus groups with oral health providers ( n = 16). Results. System-level factors influencing future implementation were identified regarding structural characteristic, networks/communication, culture, external policy/incentives, relative advantage, complexity, design quality/packaging, knowledge/beliefs, and personal attributes. Discussion. Findings provided vital information and will directly inform the design and implementation of an eHealth app that aims to facilitate the translation of the interprofessional prenatal oral health guidelines into clinical prenatal oral health practices.

Considered a public health issue, the prevalence and severity of poor mental well-being on college campuses has continued to rise. While many college campuses offer mental health counseling services, and utilization rates are increasing, their proportional usage is low especially among males, who often deal with poor mental well-being by adopting unhealthy coping strategies. The purpose of this study was to use the Information-Motivation-Behavioral Skills (IMB) model to assess the relationship between the determinants as factors that may impact help-seeking behaviors in a large sample ( n = 1,242) of male college students. Employing a cross-sectional study design, a 71-item online survey assessed information via total mental health literacy (MHL), motivation via attitudes toward mental health and subjective norms regarding mental health, and behavioral skills via intentions regarding help-seeking behaviors, and stigma. Results revealed correlations between information and motivation ( r = .363, p < .01), information and behavioral skills ( r = .166, p < .01), and motivation and behavioral skills ( r = .399, p < .01). Multiple regression was used to determine stigma is a mediator for all relationships. These findings represent an opportunity to take a public health approach to male mental health through developing multilayered interventions that address information, motivation, behavioral skills, and stigma.

Mental health literacy (MHL) is low in college-aged men potentially resulting in impaired mental wellbeing. This study assessed MHL, psychosocial determinants, and help-seeking behaviors among male university students.Male undergraduate and graduate students were surveyed in Spring 2017 (n = 1,242) at a large southeastern university in the United States.Preexisting validated scales for MHL, psychosocial determinants, and help-seeking intention were used in measurement and demographic variables were collected. T-tests and one-way ANOVA were performed to measure differences between groups.Participants showed low scores for all constructs with statistically significant differences between undergraduate and graduate students, as well as between races and major classifications. Undergraduate men had moderate MHL and low intentions to seek professional care.Interventions focusing on increasing mental health knowledge and improving beliefs can improve MHL among male college students. Further, interventions should be tailored for racial groups and major classifications.

The rise in HPV-related oropharyngeal cancer incidence necessitates novel prevention efforts including multiple provider types. Although dental providers screen for HPV-related oropharyngeal cancers, little is known about their needs to advance “primordial prevention,” or interventions at the earliest possible stage, to prevent HPV-related cancers. This study assessed dentists' and dental hygienists’ perceived roles and needs regarding HPV-related primordial prevention.We conducted a mixed-method study with data from focus groups with dentists (n= 33) and dental hygienists (n= 48) and surveys from both provider types (n= 203) among providers from a diverse set of practice settings and geographic communities. Data were analyzed using qualitative thematic analysis and chi square tests.Participants affirmed dental professionals’ roles in preventing HPV-related cancers and identified needs to overcome barriers to fulfilling prevention objectives. Barriers included: (1) practice environment and patient characteristics, and (2) the sensitive topic of HPV. Further, participants identified needs to improve HPV-related cancer prevention.Findings from this study suggest that dental providers may become the next line of prevention for HPV-related cancers. Dental providers’ professional associations have provided guidance on HPV and oropharyngeal cancers, but our study reveals dental providers’ needs for following professional organizations’ guidance to advance prevention efforts and reduce HPV-related cancer incidence. Keywords: Oropharyngeal cancer, Human papillomavirus, Dental providers, Prevention

Background Little is known about the factors that may influence women's adherence to moderate-to-vigorous physical activity (MVPA) using longitudinal data. The purpose of this study was to examine the correlates of long-term physical activity (PA) participation among women. Methods Female data from Waves I, III, and IV (n = 5381) of the National Longitudinal Study of Adolescent to Adult Health (Add Health) were used for the analysis. The outcome of PA adherence was operationalized as (1) consistently physically active (at least 5 instances during the week) in both Waves III and IV (during adulthood), and (2) consistently not physically active or only physically active in either Wave III or IV. Predictor variables from Wave I (during adolescence) included race/ethnicity, PA level, self-perception of being physically fit, general health status, attempt to change weight, parents' income level, parents' education, well-being, depression, access to PA resources, days of physical education (PE), and grade level. Crude and adjusted logistic regression models were utilized to estimate the adjusted odds ratio (aOR) and 95% confidence interval (95%CI) for the outcome variable. Results PA levels during adolescence significantly predicted PA adherence (aOR = 1.67, 95%CI: 1.35–2.05). Additionally, wanting to lose weight (aOR = 1.49, 95%CI: 1.20–1.85), using fitness center in the neighborhood (aOR = 1.29, 95%CI: 1.05–1.58), and having 5 days of PE a week (aOR = 1.48, 95%CI: 1.09–2.02) were significant predictors. Women who did not perceive being physically fit (aOR = 0.65, 95%CI: 0.44–0.95) and Black, non-Hispanics (aOR = 0.60, 95%CI: 0.44–0.82) were less likely to adhere to PA. Conclusion The findings suggested that physically active adolescents were more likely to become active adults. Future research should address interventions (e.g., PE program, community resources) that may promote lifetime PA in women, with the goal of decreasing morbidity and mortality.

Poor maternal oral health during pregnancy is associated with adverse maternal and child outcomes, including preterm birth and early childhood caries. Subsequently, professional associations have developed prenatal oral health guidelines, but significant gaps exist in implementing guidelines into clinical practice. The purpose of this study was to develop and test the usability of an innovative, theory-driven, eHealth application ("app") to facilitate prenatal providers' (nurse practitioners and midwives) implementation of oral health promotion during prenatal care visits. App development was guided by previous research, an integrated conceptual framework, Scientific Advisory Board input, and consumer-engaged iterative processes utilizing mixed-methods (observations, surveys, in-depth interviews) among providers (n = 4) during 10 unique prenatal care visits at a federally qualified health care center. Triangulation of quantitative and qualitative data analysis produced descriptive frequencies and salient themes. Concepts and principles from the following theoretical frameworks informed intervention development and testing: Consolidated Framework for Implementation Research; Information-Motivation-Behavioral Skills Model; Health Literacy; and Brief Motivational Interviewing. Overall, providers reported the app was effective at providing the information, motivation, and behavioral skills needed to integrate oral health promotion (e.g., easy to use; provided cues to action via scripts and tailored education; and documented findings into the patient's record). Although providers reported high usability, time constraints and detailed patient counseling scripts were identified areas for improvement. Findings suggest that the eHealth app could serve as an innovative mechanism to assist providers in implementing the prenatal oral health guidelines into practice. Future research is needed to continue app development efforts and to determine efficacy and effectiveness in practice settings.

Purpose We evaluated the impact of a positive youth development program on adolescent pregnancy, sexual behavior, risky sex, and intentions in nonmetropolitan Florida high schools. Methods Between 2012 and 2014, the Teen Outreach Program (TOP) was compared to standard school curriculum content using a cluster randomized controlled trial design with 7,976 youth in two cohorts. The majority of youth were 14 years old and in the ninth grade at baseline. Treatment group youth received TOP in health-related classes. After using multiple imputation to account for missing data, we analyzed baseline and follow-up survey data using generalized linear mixed-effects models with logit link function. Results In the cohort 1 sample, compared to the control condition, males and females receiving TOP showed lower odds of engaging in recent sex (odds ratio [OR], .71; 95% confidence interval [CI]: .58–.86) compared to control males and females. Cohort 1 treatment females who did engage in recent sex were less likely to have risky sex (OR, .54; 95% CI: .32–.89). There were fewer significant findings in cohort 2, though TOP females and combined gender had lower odds of risky sex intentions (OR, .53; 95% CI: .33–.84 and OR, .65; 95% CI: .44–.96, respectively). Overall, cohort 1 females in the TOP condition were the group most likely to benefit from TOP. Conclusions Consistent with previous research, TOP was more effective regarding sexual health outcomes among female versus male youth; this was especially true for the outcome of risky sex. However, results were not consistent across cohorts, prompting questions for future research.

Objectives We aimed to examine scholarly collaboration between oral health and prenatal providers. Oral disease is a silent epidemic with significant public health implications for pregnant women. Evidence linking poor oral health during pregnancy to adverse pregnancy and birth outcomes requires oral health and prenatal providers to communicate on the prevention, treatment and co-management matters pertaining to oral health issues among their pregnant patients. The need for inter-professional collaboration is highlighted by guidelines co-endorsed by the American College of Obstetricians and Gynecologists and the American Dental Association, stressing the importance of oral health care during pregnancy. Methods To assess if interdisciplinary communication occurs between oral health and prenatal disciplines, we conducted a network analysis of research on pregnancy-related periodontal disease. Results Social Network analysis allowed us to identify communication patterns between communities of oral health and prenatal professionals via scientific journals. Analysis of networks of citations linking journals in different fields reveals a core-periphery pattern dominated by oral health journals with some participation from medicine journals. However, an analysis of dyadic ties of citation reveals statistically significant "inbreeding" tendencies in the citation patterns: both medical and oral health journals tend to cite their own kind at greater-than-chance levels. Conclusions Despite evidence suggesting that professional collaboration benefits patients' overall health, findings from this research imply that little collaboration occurs between these two professional groups. More collaboration may be useful in addressing women's oral-systemic health concerns that result in adverse pregnancy outcomes.

Despite the numerous benefits of physical activity on mental, cognitive, social, and physical health, females are less active than males. Sport-based positive youth development (PYD) programs designed for girls may offer the unique blend of sport and life skills that address girl-specific physical activity determinants. The purpose of this study was to assess the short-term outcomes of a girl-focused sport-based PYD among 3rd–5th grade girls. A secondary analysis of pre- and post-intervention evaluation data was conducted to assess developmental assets, overall PYD, and physical activity among intervention participants (n = 384). Data analyses included descriptive statistics and paired sample t-tests to determine pre- to post-intervention changes. Results revealed statistically significant improvements in competence (p = .001), confidence (p

Associations between Hormonal Contraception (HC) and Depression have been previously reported, and indicate increased risk to younger women. These relationships need be explored and expanded to include measures of impact on Academic Performance (AP). Data was acquired from the National College Health Assessment (NCHA), administered from Fall 2008 to Spring 2015 across 370 schools nationwide. The most popular HC method was oral, followed by an IUD, and vaginal ring. HC use increased across all ages groups 18-29, and then decreased in the 30-34 age group. HC use significantly increased the odds of ever being diagnosed with depression in all age groups. HC use was found to have significantly increased odds of reporting AP issues in the 18-19 age group and to have significantly decreased odds of reporting AP issues in the 25-29 age group. Adding depression as a moderator, HC use continued to significantly increase the odds of AP issues. Women and their providers should balance the risks and benefits of initiating HC. Specifically, younger women, and be advised of the risks that HC presents in terms of a potential association with depression. Efforts to develop standardized protocols for discussing the risk-benefits for HC therapy should be pursued.

ADHD and eating disorders are both significant public health issues. Emerging evidence suggests that ADHD and eating disorders may be comorbid resulting in increased severity of associated health issues. Although several hypotheses have been proposed with respect to the underlying mechanisms of the comorbidity, there is a need for a conceptual model, which presents the simultaneous investigation of the trajectory of onset and multiple hypotheses. The current paper proposes an innovative conceptual model that can be used to simultaneously explore hypothesized underlying mechanisms by triangulating current literature with aspects of the biopsychosocial model, life course approach, Risk Regulator Framework, research domain criteria matrix, and the person-environment transaction theory. Designated within the model are proposed pathways that serve to describe how various psychosocial and psychiatric risk regulators and genetic risk factors combine to influence the comorbidity across the lifespan. The proposed conceptual model can provide the foundation for further research regarding comorbid ADHD and eating disorders in addition to translation for use among other comorbid conditions.

Twenty-first century advances have significantly altered the functions of public health professionals, resulting in a need for advanced level training in community health leadership and practice-oriented research without interruption of professional careers. We present an example of an innovative Doctor of Public Health (DrPH) program developed at the University of South Florida College of Public Health. This program incorporates 21st century public health competencies within a competency-based curricular model, delivered in a hybrid format (fall or spring online delivery and a 1-week face-to-face summer institute) in collaboration between academic and practice-based public health professionals at local and national levels. This revised competency-based program is an example of how to meet the needs of the 21st century public health practitioners while maintaining their connections to the practice world.

Although physical activity is a key behavior targeted during the preconception period given its significant impact on pregnancy/birth outcomes and psychological well-being, few women meet national guidelines. While intrapersonal factors influencing physical activity among this population have been studied, community factors remain unexplored. The objective of this study was to examine community level predictors of physical activity among preconception women. Data from Add Health were limited to women (Wave III; age 18-28; n = 7,596) and excluded respondents who were pregnant, physically disabled, and missing data. The outcome variable was ≥5 instances of moderate-vigorous physical activity (MVPA) in 1 week. Community predictor variables included neighborhood-level structural and social determinants (e.g., socio-demographic composition; landscape diversity; urbanization; access to resources; crime; vehicle availability). Multilevel logistic regression modeling was used to estimate the odds of engaging in ≥5 instances of MVPA. Few women (26 %) reported ≥5 instances of MVPA in 1 week. Adjusted multilevel analysis revealed women in the preconception period were more likely to report high MVPA when living in communities with larger population densities (OR 1.34, 95 % CI 1.02-1.77) and median household income greater than $50,000 (OR 1.33, 95 % CI 1.06-1.66). Additionally, a significant inverse trend was found between high MVPA and proportion of the community without a high school diploma. Findings suggest that neighborhood composition may have an impact on preconception physical activity status. Implications include increased efforts targeting community conditions for facilitating physical activity; ultimately, improving health among women and subsequent offspring.

Public health professionals have been challenged to radically reform public health training to meet evolving demands of twenty-first century public health. Such a transformation requires a systems thinking approach with an interdisciplinary focus on problem solving, leadership, management and teamwork, technology and information, budgeting and finance, and communication. This article presents processes for implementing and evaluating a revised public health curriculum and outlines lessons learned from this initiative. To date, more than 200 students have participated in the initial pilot testing of this program. A rigorous process and outcome evaluation plan was developed and employed. Results from the evaluation were used to enhance the resulting curriculum. Specifically, all instructional materials were evaluated by both the students who received the materials and the faculty who presented the materials. As each successive pilot is delivered, both enrollment and faculty involvement has increased. Through this process, the value of committed faculty, the importance of engaging learners in the evaluation of an education program, and the need to implement curriculum that has been carefully evaluated and evidence-informed in nature has emerged. We credit our successful transformation of the Masters in Public Health core to the challenge provided by the Framing the Future task force, the commitment of our College of Public Health leadership, the engagement of our faculty, and the time we allowed for the process to unfold. Ultimately, we believe this transformed curriculum will result in better trained public health professionals, interdisciplinary practitioners who can see public health challenges in new and different ways.

In the twenty-first century, the dynamics of health and health care are changing, necessitating a commitment to revising traditional public health curricula to better meet present day challenges. This article describes how the College of Public Health at the University of South Florida utilized the Intervention Mapping framework to translate revised core competencies into an integrated, theory-driven core curriculum to meet the training needs of the twenty-first century public health scholar and practitioner. This process resulted in the development of four sequenced courses: History and Systems of Public Health and Population Assessment I delivered in the first semester and Population Assessment II and Translation to Practice delivered in the second semester. While the transformation process, moving from traditional public health core content to an integrated and innovative curriculum, is a challenging and daunting task, Intervention Mapping provides the ideal framework for guiding this process. Intervention mapping walks the curriculum developers from the broad goals and objectives to the finite details of a lesson plan. Throughout this process, critical lessons were learned, including the importance of being open to new ideologies and frameworks and the critical need to involve key-stakeholders in every step of the decision-making process to ensure the sustainability of the resulting integrated and theory-based curriculum. Ultimately, as a stronger curriculum emerged, the developers and instructors themselves were changed, fostering a stronger public health workforce from within.

Twenty-first century health challenges have significantly altered the expanding role and functions of public health professionals. Guided by a call from the Association of Schools and Programs of Public Health’s (ASPPH) and the Framing the Future: The Second 100 Years of Education for Public Health report to adopt new and innovative approaches to prepare public health leaders, the University of South Florida College of Public Health aimed to self-assess the current Masters of Public Health (MPH) core curriculum with regard to preparing students to meet twenty-first century public health challenges. This paper describes how Intervention Mapping was employed as a framework to increase readiness and mobilize the COPH community for curricular change. Intervention Mapping provides an ideal framework, allowing organizations to access capacity, specify goals, and guide the change process from curriculum development to implementation and evaluation of competency-driven programs. The steps outlined in this paper resulted in a final set of revised MPH core competencies that are interdisciplinary in nature and fulfill the emergent needs to address changing trends in both public health education and challenges in population health approaches. Ultimately, the competencies developed through this process were agreed upon by the entire College of Public Health faculty, signaling one college’s readiness for change, while providing the impetus to revolutionize the delivery of public health education at the University of South Florida.

Pregnancy is identified as a sensitive period of increased risk for poor oral health among mothers and offspring. Subsequently, both medical and dental associations have re-endorsed consolidated, inter-professional guidelines promoting oral health during pregnancy. The objective was to explore prenatal and oral health providers' information, motivation and practice behaviors related to oral health during pregnancy. Twenty-two in-depth interviews were conducted with prenatal and oral health providers based on the Information-Motivation-Behavioral Skills Model. Data were analyzed using the constant comparative method in NVivo 10. Providers held variable knowledge with regards to identified oral-systemic connections and implications. Most providers were unaware of the guidelines; however, some oral health providers reported avoiding specific treatment behaviors during this period. Motivation to address oral-systemic health during pregnancy included: prevention; healthy pregnancy/birth outcomes; patient's complaint/question as cue to action; comprehensive, patient-centered, and family-centered care; ethical duty; and professional governing body. Oral health providers reported assessing, educating, and communicating with patients about oral health issues; whereas prenatal providers rarely addressed oral health but reported signing approval forms to receive such care. A few oral health providers highlighted lifecourse implications and the need for family-centered care when addressing poor oral health among pregnant patients. Findings suggest gaps in oral health prevention information and behaviors among prenatal and oral health providers. Future efforts should examine effective dissemination and implementation strategies that translate evidence-based guidelines into clinical practice, with the ultimate goal of improve oral-systemic health among women and their offspring across the lifecourse.

Various women's health concerns (e.g., hormonal changes, cardiovascular disease, diabetes mellitus, osteoporosis, immune deficiencies, respiratory diseases, eating disorders, substance use/abuse, sexually transmitted infections, stress, poverty, poor nutrition, and early childhood caries) are associated with oral-systemic etiologies that can either cause or form as a result of poor oral health. Nonetheless, the intersections of biological, social-behavioral, and structural factors that impact women's oral-systemic health are rarely examined. We argue for the need for transdisciplinary research, grounded in team science, for incorporating and transcending multiple discipline-specific frameworks and models to examine the complexity of women's health issues holistically across the lifespan.

The impact of dietary behaviors and food consumption and their relation to oral health are significant public health issues. Women and men exhibit different dietary behaviors. Understanding the influences of dietary behaviors on oral health from the perspective of gender disparities, however, is limited. This article provides the intersections of dietary factors and oral-systemic health for which women are at greater risk than men. Topics include the effect of dietary choices on oral health disparities seen in female patients. Interventional strategies at the local and community level that are designed to influence the balance between dietary habits and oral-systemic health are discussed.

The content for this chapter comes out of collaborative workshops at a two-day conference focused on after-school programs, hosted by Youth Nex at the University of Virginia in October of 2014. The goal of this paper is to look across these discussions, and highlight important strategies that apply across after-school programs, as well as discuss specific challenges that each type of program may face. The bulleted lists of opportunities and challenges that grew out of each workshop are also presented. Examples from the research literature are provided for each section. Focal questions include: How can looking at different types of after-school programs highlight specific challenges and opportunities? What does the lens of these specific programs show us about after-school programming in general?

Purpose: The purpose of this study was to describe the interactions between mothers in a methadone treatment program and their infants during a bottle feeding and compare the findings with normed data.Design: A comparative-descriptive design was used.Sample: Data from 12 opiate-exposed mother–infant dyads were compared with normed data.Main outcome variable: Nursing Child Assessment Satellite-Training Scale scores.Results: The opiate-exposed dyads scored significantly lower than the normed dyads in the infant subscales of clarity of cues (p < .001, 95% confidence interval [CI], 1.56–4.08) and responsiveness to caregiver (p < .01, 95% CI, 0.27–2.5), as well as the total score (p < .001, 95% CI, 2.42–6.15). Parent sensitivity to infant cues subscale (p < .01, 95% CI, 0.42–2.37) and parent contingency score (p < .01, 95% CI, 0.55–3.81) were also significantly lower. The cognitive growth fostering subscale scores were significantly higher in the neonatal abstinence syndrome (NAS) group (p < .01, 95% CI, −2.94 to −0.7).

Preventing oral-systemic health issues relies on evidence-based interventions across various system-level target groups. Although the use of theory- and evidence-based approaches has been encouraged in developing oral health behavior change programs, the translation of theoretical constructs and principles to behavior change interventions has not been well described. Based on a series of six systematic steps, Intervention Mapping provides a framework for effective decision making with regard to developing, implementing, and evaluating theory- and evidence-informed, system-based behavior change programs. This article describes the application of the Intervention Mapping framework to develop the EAT (evaluating, assessing, and treating) evidence-based intervention with the goal of increasing the capacity of oral health providers to engage in secondary prevention of oral-systemic issues associated with disordered eating behaviors. Examples of data and deliverables for each step are described. In addition, results from evaluation of the intervention via randomized control trial are described, with statistically significant differences observed in behavioral outcomes in the intervention group with effect sizes ranging from r=0.62 to 0.83. These results suggest that intervention mapping, via the six systematic steps, can be useful as a framework for continued development of preventive interventions.

BACKGROUND: The prevalence of obesity among high school students has risen in recent decades. Many high school students report trying to lose weight and some engage in disordered eating to do so. The obesity proneness model suggests that parents may influence their offspring's development of disordered eating. This study examined the viability of a modified obesity proneness model in a high school population. METHODS: Cross-sectional survey data from a random cluster sample of 1533 students in grades 9–12 from a Florida school district were analyzed using structural equation modeling. Variables included adolescents' weight concerns; inability to self-regulate eating; and perceptions about maternal comments about adolescents' weight, restrictive feeding practices, and maternal weight-related concern and values. RESULTS: All the model's originally proposed relationships were statistically significant, for example perceived maternal weight comments were associated with adolescents' weight concerns (β = 0.64; p < .0001), and perceived maternal restrictive feeding practices were associated with adolescents' inability to self-regulate eating (β = 0.22; p < .001). CONCLUSION: Some points of intervention should be subjected to empirical study. These interventions should give mothers guidance about appropriate feeding practices and discourage mothers from making weight-related comments to their offspring. Together, as 1 component of a multilevel intervention, these behaviors may help prevent disordered eating and obesity.

Case-based learning offers exposure to clinical situations that health professions students may not encounter in their training. The purposes of this study were to apply the Diffusion of Innovations conceptual framework to 1) identify characteristics of case studies that would increase their adoption among dental and dental hygiene faculty members and 2) develop and pretest interactive web-based case studies on sensitive oral-systemic health issues. The formative study spanned two phases using mixed methods (Phase 1: eight focus groups and four interviews; Phase 2: ten interviews and satisfaction surveys). Triangulation of quantitative and qualitative data revealed the following positive attributes of the developed case studies: relative advantage of active learning and modeling; compatibility with a variety of courses; observability of case-related knowledge and skills; independent learning; and modifiability for use with other oral-systemic health issues. These positive attributes are expected to increase the likelihood that dental and dental hygiene faculty members will adopt the developed case study once it is available for use. The themes identified in this study could be applied to the development of future case studies and may provide broader insight that might prove useful for exploring differences in case study use across dental and dental hygiene curricula.

Oral healthcare providers are likely to encounter a number of sensitive oral/systemic health issues whilst interacting with patients. The purpose of the current study was to develop and evaluate a framework aimed at oral healthcare providers to engage in active secondary prevention of eating disorders (i.e. early detection of oral manifestations of disordered eating behaviours, patient approach and communication, patient-specific oral treatment, and referral to care) for patients presenting with signs of disordered eating behaviours. The EAT Framework was developed based on the Brief Motivational Interviewing (B-MI) conceptual framework and comprises three continuous steps: Evaluating, Assessing, and Treating. Using a group-randomized control design, 11 dental hygiene (DH) and seven dental (D) classes from eight institutions were randomized to either the intervention or control conditions. Both groups completed pre- and post-intervention assessments. Hierarchical linear models were conducted to measure the effects of the intervention whilst controlling for baseline levels. Statistically significant improvements from pre- to post-intervention were observed in the Intervention group compared with the Control group on knowledge of eating disorders and oral findings, skills-based knowledge, and self-efficacy (all P < 0.01). Effect sizes ranged from 0.57 to 0.95. No statistically significant differences in outcomes were observed by type of student. Although the EAT Framework was developed as part of a larger study on secondary prevention of eating disorders, the procedures and skills presented can be applied to other sensitive oral/systemic health issues. Because the EAT Framework was developed by translating B-MI principles and procedures, the framework can be easily adopted as a non-confrontational method for patient communication.

Media use is associated with an increased risk of chronic disease and reduced quality of life among children. This study examined the relationship between media use during discretionary hours after school and psychological and physical assets among preadolescent girls.A cross-sectional analysis was conducted using data from a larger quasi-experimental evaluation of a positive youth development program through sport for third- to fifth-grade girls. Indicators of media use were the number of hours per school day spent watching television and videos and using computers. Psychological assets included global self-esteem, body size satisfaction, and commitment to physical activity; physical assets included physical activity. Nested random effects analysis of variance (ANOVA) models were used to examine the relationship between media use and psychological and physical assets controlling for relevant confounding factors.The analytic sample included 1027 participants; most were ≥10 years old, non-White; 27% self-reported ≥4 hours of media use on school days. In adjusted results, media use was inversely associated with self-esteem (p = .008) and commitment to physical activity (p.001). Time spent using media was not associated with body size satisfaction or physical activity in this age group.Media use was negatively associated with self-esteem and commitment to physical activity. It may be useful for school professionals to encourage after-school programs that offer opportunities for girls to reduce sedentary pursuits and improve important psychological and physical assets.

Background:Evidence supporting the effectiveness of a developmental-focused youth sport (DYS) program designed exclusively for elementary school aged girls is mounting. The purpose of this study was to evaluate the impact of on the Girls on the Run program on psychological and physical assets among 3rd- to 5th-grade girls.Methods:A longitudinal quasi-experimental study was conducted to evaluate intervention effects among 877 participants categorized into 1 of 3 groups (never, newly, and previously exposed). A 64-item self-report survey measured developmental assets at 3 time-points. Nested random effects ANOVA models were used to compare demographic factors and psychological and physical assets between exposure groups and to compare longitudinal differences in these assets.Results:After adjustment for multiple comparisons, previous program participants had significantly higher physical activity commitment (P = .006) and physical activity levels (P = .047) at preintervention than never exposed. From pre- to postintervention body image improved in newly exposed participants (P = .03). Physical activity increased from preintervention to follow-up among never and newly exposed participants (all P < .05).Conclusions:Although we were unable to fully confirm the study hypotheses, the results of the current study provide new evidence to support future long-term studies examining the effectiveness of an innovative DYS program for 3rd- to 5th-grade girls.

The incorporation of web-based learning into the dental curriculum has been consistently recommended in the literature on reform in dental education. There has been growing support for web-based learning in dental and dental hygiene education as demonstrated by deans’ identifying this as a planned curricular innovation. The purpose of our study was to explore characteristics of e-courses that may serve to increase adoption among dental and dental hygiene faculty members. Eight ninety-minute focus groups (three dental; five dental hygiene) were conducted with dental (n=27) and dental hygiene (n=23) faculty members from six academic institutions. The resulting data were analyzed to identify two overarching themes and associated subthemes with regard to benefits and barriers influencing adoption of e-courses. A working conceptual framework, based on the Diffusion of Innovations, was developed from these themes to understand the characteristics that may influence the rate of adoption of e-courses among dental and dental hygiene faculty members. Analysis of the data revealed four main adoption barriers: 1) low perceived relative advantage to faculty members; 2) low compatibility with current curriculum; 3) high perceived time commitment; and 4) complexity of e-course development. This exploratory assessment identifies leverage points for facilitating the adoption and sustainability of e-courses in dental and dental hygiene education.

Objectives: Human Papillomavirus (HPV), the most common STI in the United States, is increasingly being associated with a number of cancers, including oral cancers (OC). This may change the approach of oral health providers (OHP) towards screening and identifying OC in their patients. Methods: Five focus groups were conducted in February and March 2009 with dentists and dental hygienists. Participants were recruited via presentations at monthly meetings of local dental and dental hygiene professional associations, and through association mailing and telephone lists. Results: A total of 38 OHP participated in the focus groups (17 dentists and 21 hygienists). Analysis of focus group data was framed by three general content areas regarding HPV-related OC and the HPV vaccine, including: a) knowledge; b) attitudes; and c) perceived roles. Sub-themes that emerged included issues related to the HPV vaccine, the role of professional organizations, and concerns with gender roles and confidentiality. Conclusions: As public awareness of the link between HPV and OC increases, OHP play an important role in addressing this issue with their patients. The current study clearly identified areas that must be addressed among OHP in order for effective and comfortable communication regarding the HPV-OC link and the potential uses of the HPV vaccines to take place, including: a) increasing knowledge of the HPV-OC link and HPV vaccine; and b) clarifying screening procedures, role, and expectations.

The family dinner is a valued tradition that affords opportunities for social interaction and attachment, as well as sharing events of the day, role modeling, connectedness, and problem solving. Guided by the social-marketing framework, this study explored factors associated with the frequency of the family dinner among working mothers with children ages 8-11 years. A qualitative design was used, employing focus groups and Atlas-ti software for thematic analysis. Lack of time, cost, and exhaustion/lack of energy emerged as barriers. Working mothers indicated that a youth-based organization operating as a community partner could increase the frequency of the family dinner by helping with homework completion during after-school care, thereby providing mothers with the time necessary to prepare dinner. This research identified both community partners and working mothers as valued resources for prevention strategies. Interventions developed to increase family dinner frequency should emphasize the perceived value while decreasing the costs/barriers.

Children's physical activity (PA) may be determined, in part, by environmental influences such as access to diverse and safe places to play. As part of the development of a community-based PA program, a PA asset assessment was conducted in two low-income urban neighborhoods that support elementary schools serving minority youth. Resources were rated using an adapted version of the Physical Activity Resource Assessment (PARA), a multi-dimensional instrument that rates various venues on their features, amenities, and incivilities. Seventy-one child-centric venues (e.g., parks, playgrounds, community centers, sports facilities, fitness centers, etc.) were assessed within a three-mile radius of each school. Community member feedback via interviews with parent-child dyads revealed issues (e.g., bullying) not captured by the PARA that can influence venue use. Whereas the PARA can be a useful needs assessment and program planning tool for community-based PA programs, supplementing PARA data with community-based input may reduce contextual error in program development.

BACKGROUND: Community-based prevention marketing (CBPM) is a program planning framework that blends community-organizing principles with a social marketing mind-set to design, implement, and evaluate public health interventions. A community coalition used CBPM to create a physical activity promotion program for tweens (youth 9 -1 3 years of age) called VERB ™ Summer Scorecard. Based on the national VERB ™ media campaign, the program offered opportunities for tweens to try new types of physical activity during the summer months. METHODS: The VERB TM Summer Scorecard was implemented and monitored between 2004 and 2007 using the 9 -step CBPM framework. Program performance was assessed through in-depth interviews and a school-based survey of youth. RESULTS: The CBPM process and principles used by school and community personnel to promote physical activity among tweens are presented. Observed declines may become less steep if school officials adopt a marketing mind-set to encourage youth physical activity: deemphasizing health benefits but promoting activity as something fun that fosters spending time with friends while trying and mastering new skills. CONCLUSIONS: Community-based programs can augment and provide continuity to school-based prevention programs to increase physical activity among tweens.

Night eating syndrome criteria include skipping breakfast, night eating, and sleep difficulties. It is associated with mood disturbances, particularly depression, and may contribute to later obesity development. Most research on night eating syndrome has focused on obese persons seeking weight loss treatment, and little is known about night eating syndrome in other populations; therefore, the purpose of this exploratory study was to examine night eating and depression among college-age students. A paper-pencil survey was completed by 270 students at a southeastern university that included demographic information, self-reported heights and weights, Night Eating Questionnaire (NEQ), and Beck Depression Inventory (mean age = 21.05, 64.1% female, 78.5% White). A significant correlation was found between total scores for the Beck Depression Inventory and NEQ (r = .35, p < .0001). Health professionals should be aware of characteristics of the syndrome to better diagnose and treat those students who exhibit trai...

Although oral health care providers (OHP) are key in the secondary prevention of eating disorders (ED), the majority are not engaged in assessment, referral, and case management. This innovative pilot project developed and evaluated a web-based training program for dental and dental hygiene students and providers on the secondary prevention of ED. The intervention combined didactic and skill-based objectives to train OHP on ED and its oral health effects, OHP roles, skills in identifying the oral signs of ED, communication, treatment, and referral. Using a convenience sample of OHP (n=66), a pre-/post-test evaluated short-term outcomes and user satisfaction. Results revealed statistically significant improvements in self-efficacy (p

Background: Participation in free-time play, including individual and group activities, is important during youth as patterns of physical activity established then persist into adulthood. The VERB Summer Scorecard (VSS) intervention is an innovative physical activity promotion initiative that offers tweens (8-13 year-olds) opportunities to be active during the summer months when increased sedentariness can occur, leading to weight gain and a predisposition for further inactivity. Purpose: This study identified factors associated with intentions to participate in VSS among tweens previously exposed to the intervention. Methods: We conducted a cross-sectional study of 1,063 middle school youth using a 39-item survey and performed a multi-level analysis. Results: Being female (OR=1.43), having tried a new physical activity (OR=1.59), not currently participating in out-of-school activities but wanting to (OR=2.60), and self-monitoring of physical activity (OR=4.42 to 7.50) were associated with future...

Background: Despite findings that support physical activity (PA) as an effective means of improving health and quality of life, PA levels among girls tend to decline with age. Purpose: The purpose of this study was to assess changes pertaining to PA commitment following a curriculum-based running program designed for 3rd-to-5th-grade girls. Methods: Participants (n=196) were given paper-and-pencil surveys containing an adaptation of the "Feelings about Physical Activity Scale" in addition to items related to demographics, PA behaviors, and curriculum content. Results: Paired-sample t-tests revealed statistically significant differences in overall commitment to PA (p=.006) and attitudes regarding PA (p=.001) from pre-intervention to post-intervention. Results also suggest increases in value of PA. Discussion: The study's findings have important implications for those public health education professionals who develop PA programs for female children and adolescents. Prior to initiating programs to p...

Due to the oral/systemic nature of eating disorders, this serious health issue requires comprehensive patient assessment and coordinated health treatment. The purpose of this study was to assess the breadth and depth of eating disorder and comprehensive care within the dental and dental hygiene curriculum. Survey data were collected from deans of U.S. dental programs (n=24) and dental hygiene program directors (n=94). Statistically significant differences were observed between dental programs (DP) and dental hygiene programs (DHP) as more DHP reported including anorexia nervosa (p

Introduction. Based on internal and external assets, the positive youth development approach aims to increase the capacity among adolescents to overcome challenges as they transition to adulthood. Developmental assets have been found to be positively associated with academic achievement, a variety of health promoting behaviors, and improved physical and mental health. The purpose of this exploratory study was to assess the long-term association between positive youth developmental assets with health risk and promoting behaviors. Method. A continuous scale of developmental assets was created using 30 items from Wave I of the National Longitudinal Study of Adolescent to Adult Health, when participants were in 7th to 12th grades. Health behavior outcomes including cigarette use, substance use, fast food consumption, and physical activity were measured at both Wave III (age 18-26) and Wave IV (age 24-32). Path analysis was employed to assess the relationship between these observed measures. Results. The well-fitted path model revealed associations between developmental assets with each health behavior at Wave III. Developmental assets indirectly influenced each health behavior and direct associations were observed between assets with substance use and physical activity at Wave IV. Conclusion. Findings provide additional support for the developmental assets approach to adolescent health. Implications include Healthy People 2020 objectives related to tobacco and alcohol use and nutrition and physical activity.

The significant impact of physical activity during, or immediately prior to pregnancy on a range of pregnancy and birth outcomes has been established. However, lifecourse theory posits that the antecedents of poor outcomes occur across a larger trajectory of time. The objective of this study was to examine whether physical activity patterns over the lifecourse impact birth outcomes. The sample (n = 1,713) was derived from Waves I, III, and IV of the National Longitudinal Study of Adolescent Health and limited to women who had their first, singleton live birth between Waves III and IV; respondents who had missing data were excluded. Outcome variables included preterm birth (

Qualitative comparative analysis (QCA) was developed over 25 years ago to bridge the qualitative and quantitative research gap. On searching PubMed and the Journal of Mixed Methods Research, this review identified 30 original research studies that used QCA. Perceptions that QCA is complex and provides few relative advantages over other methods may be limiting QCA adoption. Thus, to overcome these perceptions, this article demonstrates how to perform QCA using data from 15 institutions that implemented universal tumor screening programs to identify patients at high risk for hereditary colorectal cancer. In this example, QCA revealed a combination of conditions unique to effective universal tumor screening programs. Results informed additional research and provided a model for improving patient follow-through after a positive screen.

Summary Objective To evaluate the effectiveness of a 10 min chair massage on the stress perception of hospital nurses in comparison to a routine “coffee break” during a working shift. Methods Eighty-two bedside nurses, ( M = 4 ; F = 7 8 ), mean age of 34.77±9.32, within a small, suburban hospital, participated in this study to determine the effect a 10-min on-site chair massage ( n = 4 1 ) had on their stress perception in comparison to a 10-min “coffee break” ( n = 4 1 ). The feasibility of incorporating a massage into their workload during a shift was also considered. Using the Perceived Stress Scale (PSS), stress perception was assessed in an experimental pre-test–post-test design and analyzed using t-tests for dependent samples. Results Stress perception was significantly lower in the massage group ( P . 0 5 ) and was not significantly changed in the control group. Also, 86% of the nurses scheduled to participate in the study were able to do so within their normal workday. Conclusion Incorporating chair massage into a nurse's hospital shift is feasible and a 10 min session reduces the stress perception of the nurse more so than the standard “coffee break”. This study focused on a one-time intervention for the 82 nurses enrolled. Further study on the longer term feasibility and effects of chair massage on this population and others in high stress professions is warranted.