A5034409005- Obesity, Physical Activity, Diet
- Birth, Development, and Health
- Genetic Associations and Epidemiology
- Nutritional Studies and Diet
- Disaster Response and Management
- Global Public Health Policies and Epidemiology
- Adipose Tissue and Metabolism
- COVID-19 and healthcare impacts
- Primary Care and Health Outcomes
- Nutrition, Genetics, and Disease
- Cardiovascular Health and Risk Factors
- Metabolism, Diabetes, and Cancer
- Adipokines, Inflammation, and Metabolic Diseases
- Chronic Disease Management Strategies
- Sleep and related disorders
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Healthcare Policy and Management
- Sleep and Work-Related Fatigue
- Health and Conflict Studies
- Diet and metabolism studies
- Maternal Mental Health During Pregnancy and Postpartum
- Nutrition and Health in Aging
- Sleep and Wakefulness Research
- Obstructive Sleep Apnea Research
- Diabetes Management and Education
Brigham and Women's Hospital
2022-2025
Lewis University
2024
Wellcome / EPSRC Centre for Interventional and Surgical Sciences
2024
Yale University
2018-2022
Harvard University
2022
Providence College
2021
Binghamton University
2015-2017
Understanding psychosocial determinants of health is critical in understudied, high-risk populations, where such knowledge could have a major impact on outcomes. In Samoa, diabetes prevalence has rapidly increased over 30 years, associations between factors and remain poorly understood. The purpose our study was to identify associated with HbA1c among Samoan adults while accounting for established correlates including age, body composition, genetic behavioral risk factors. Participants (n =...
Objective The Republic of Vanuatu, similar to other South Pacific island nations, is undergoing a rapid health transition as consequence modernization. pace modernization uneven across Vanuatu's 63 inhabited islands, resulting in differential impacts on overall body composition and prevalence obesity among between men women. In this study, we investigated (1) how adult male female Melanesians living four islands varying economic development (2) differs Polynesians rural Vanuatu. Methods...
Background The prevalence of obesity and diabetes in Samoa, like many other Pacific Island nations, has reached epidemic proportions. Although the etiology these conditions can be largely attributed to rapidly changing economic nutritional environment, a recently identified genetic variant, rs373863828 (CREB 3 regulatory factor, CREBRF: c.1370G>A p.[R457Q]) is associated with increased odds obesity, but paradoxically, decreased diabetes. Objective overarching goal Soifua Manuia (Good...
Hospital equity officers have become critical leaders in the effort to address determinants of health care disparities, including structural racism. In this mixed-methods study, we surveyed a national sample and interviewed subset respondents provide additional perspective. About one-half survey reported at least some obstacles achieving their objectives, racist beliefs among people working hospitals systems, policies that perpetuate racism, lack staff diversity. To these challenges, are...
Abstract Objective The present study evaluates the use of multiple correspondence analysis (MCA), a type exploratory factor designed to reduce dimensionality large categorical data sets, in identifying behaviours associated with measures overweight/obesity Vanuatu, rapidly modernizing Pacific Island country. Design Starting seventy-three true/false questions regarding variety behaviours, MCA identified twelve most significantly modernization status and transformed aggregate binary responses...
COVID-19 is known to have altered the capacity perform surgical procedures in numerous health care settings. The impact of this change within direct and private-sector settings Military Health System has not been effectively explored, particularly as it pertains disparities access shifting services between sectors. We sought characterize how pandemic influenced for System.
The Republic of Vanuatu, like many developing nations, is undergoing a rapid health transition. Our previous study identified several behavioral risk factors for the rising prevalence obesity. Unexpectedly, daily time spent using television and radio was revealed as protective factor obesity in 2007. In this study, we sought to explore associations between ownership consumer electronics (CE) measures adiposity Vanuatu 2011.We surveyed 873 adults from five islands varying level economic...
SUMMARY The risk of malaria outbreak surfaced in Vanuatu after Tropical Cyclone (TC) Pam March 2015. In June and July 2015 we conducted malariometric surveys on the islands Tanna, Aneityum, Erromango Tafea Province, where elimination had been targeted, to determine if incidence increased TC Pam. No Plasmodium infection was detected by microscopy PCR 3009 survey participants. Only 6·3% (190/3007) participants fever. Spleen rates children aged ⩽12 years from Aneityum Tanna were low, at 3·6%...
Samoa needs to intensify the response growing non-communicable disease burden. This study aimed assess bottlenecks in care continuum and identify possible solutions.The mixed-methods used cascade framework as an analysis tool hypertension a tracer condition for chronic diseases. Household survey data were integrated with medical record of patients results from focus group discussions healthcare providers.Hypertension prevalence was 38.1% but only 4.7% hypertensive individuals had controlled...
To describe daytime sleepiness and insomnia among adults in Samoa identify modifiable factors associated with these measures.Cross-sectional analysis of data from the Soifua Manuia ("Good Health") study (n = 519, 55.1% female); Upolu island, Samoa.Daytime were assessed Epworth Sleepiness Scale (ESS) Women's Health Initiative Insomnia Rating (WHIIRS), respectively. Detailed physical, sociodemographic, behavioral collected. Sleep measures characterized using multiple linear regression...
The prevalence of obesity-related cardiometabolic disease in Samoa is among the highest globally. While physical activity a modifiable risk factor for disease, little known about levels adult Samoans. Using wrist-worn accelerometer-based devices, this study aimed to characterize Samoan adults. adults (n = 385; 55% female, mean [SD] age 52 [10] y) wore Actigraph GT3X+ devices 7 10 days. General linear models were used examine daily minutes sedentary time, light activity, and moderate vigorous...
Context: Recent national guidelines aimed at addressing equity in health care settings have contributed to an increase officer positions, yet little is known about their roles, responsibilities, or strategies for engaging work. Objective: To understand the roles and responsibilities of officers, as well facilitators barriers success. Design: In-depth semi-structured interviews with selected respondents from Equity Officer National Study. Setting: Hospitals systems across United States....
Maternal stress during pregnancy is associated with birth outcomes, including birthweight. Exposure to natural disasters provides a model study these relationships. However, few studies assess both and diet, which might have interactive effects. Furthermore, most are conducted in high-income countries. Patterns differ low- middle-income countries (LMICs).To relationships between diet pregnancy, infant birthweight, following disaster lower-middle income country.In 2015, the island nation of...
The coronavirus disease 2019 (COVID-19) pandemic caused significant global disruptions to the healthcare system, which was forced make rapid changes in delivery. necessitated closer collaboration between US civilian sector and military health system (MHS), resulting new strengthened partnerships that can ultimately benefit public for nation. In this study, we sought understand full range of MHS engaged with during COVID-19 elicit lessons future. We conducted key informant interviews...
Abstract Objective The aim of this study was to understand whether the paradoxical association missense variant rs373863828 in CREB3 regulatory factor ( CREBRF ) with higher BMI but lower odds diabetes is explained by either metabolically favorable body fat distribution or greater fat‐free mass. Methods This explored minor allele dual‐energy x‐ray absorptiometry‐derived composition n = 421 Samoans and used path analysis examine mediating role mass on relationship between fasting glucose....
Abstract Poor maternal mental health during pregnancy is associated with adverse birth outcomes, including lower birthweight and gestational age. However, few studies assess both diet, which might have interactive effects. Furthermore, most are in high‐income countries, though patterns differ low‐ middle‐income countries (LMICs). Objectives To analyze relationships between diet outcomes Vanuatu, a lower‐middle income country. Methods We assessed negative emotional symptoms of depression,...
In addition to the widespread availability of packaged cigarettes, inhabitants island nations Southwest Pacific frequently smoke commercially available loose tobacco using manufactured rolling papers, as well locally grown rolled in paper or wrapped leaves, copybook paper, and newspaper. this study, Vanuatu men who smoked local newspaper showed significantly lower forced vital capacity (FVC), expiratory volume 1 second (FEV1), FEV1/FVC ratios than store-bought papers. The toxins from these...
Abstract Introduction In 1999, a set of highly accurate Polynesian‐specific equations to estimate adult body fat from non‐invasive field measures age, sex, height, and weight (Equation 1), weight, bioelectrical impedance analysis (BIA) resistance 2), the sum two skinfold thicknesses 3) were published. The purpose this study was evaluate performance equation‐based estimators in sample Samoan adults recruited 20 years later between 2017 2019. Methods Age, BIA resistance, thickness, mass as...
Introduction:As a result of the COVID-19 pandemic, telehealth use became widespread, allowing for continued health care while minimizing transmission risk patients and providers. This rapid scale-up highlighted shortcomings current infrastructure in many systems. We aimed to identify address gaps United States Military Health System (MHS) response pandemic related implementation utilization telehealth. Methods:We conducted semistructured key informant interviews MHS stakeholders, including...