Delaware journal of public health最新文献

{"title":"Bridging the Gaps between Aspirin Guidelines and Pregnancy Outcomes.","authors":"Matthew K Hoffman","doi":"10.32481/djph.2025.12.07","DOIUrl":"10.32481/djph.2025.12.07","url":null,"abstract":"<p><p>Currently birth outcomes in the United States lag other industrialized countries and are driven predominantly by adverse pregnancy outcomes including preeclampsia, spontaneous preterm birth, stillbirth and fetal growth restriction. In aggregate these conditions are termed adverse pregnancy outcomes (APOs) and are complex in their origin, but largely reflect placentally mediated conditions that begin in early pregnancy. Low-dose aspirin (LDA) has been shown to lower the risk of APOs, but questions about the optimal dose, patient population to receive it, and barriers to prescribing and adherence have limited the impact of LDA on a population level. Multiple investigations unfortunately have shown that uptake is low and often biased in its provision. To address these inequities in care, the Delaware Perinatal Quality Collaborative (DPQC) organized efforts around standardizing screening all patients, providing hospital level feedback and enhanced patient education. With this effort, the rate of appropriate LDA prescription increased from 10% to 65%. Further studies and thoughtful conversations around additional barriers to care must be addressed jointly by researchers, providers, public health officials, patients and the community at large if the full promise shown in randomized controlled trials is to be realized.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"11 5","pages":"38-41"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12890020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstetric Triage as a Gateway to Social Care: Social Needs, Disparities, and Implications for Advancing Equity.","authors":"Alicia L Salvatore, Michelle Axe, Matthew K Hoffman","doi":"10.32481/djph.2025.12.05","DOIUrl":"10.32481/djph.2025.12.05","url":null,"abstract":"<p><strong>Objectives: </strong>To estimate the prevalence and distribution of social needs among obstetric triage patients at ChristianaCare; examine associations with patient characteristics and insurance status; and identify implementation and policy implications for integrating social determinants of health (SDOH) screening into obstetric care in Delaware.</p><p><strong>Methods: </strong>We conducted cross-sectional SDOH screening among patients aged ≥18 years presenting to the obstetric triage unit at Christiana Hospital (November 2019-February 2020). An 11-item tool covering 10 social-need domains was administered; 326 (82%) patients participated, and 317 unique patients were analyzed. Descriptive statistics estimated social-need prevalence. Age-adjusted logistic regression assessed associations of race/ethnicity and insurance (Medicaid/self-pay vs other) with each domain and with cumulative needs. Screeners completed brief debriefs on feasibility and workflow.</p><p><strong>Results: </strong>Participants had a mean age of 30.2 years; 49.5% were White, 38.4% Black, and 10.7% Hispanic/Latine; 39.1% had Medicaid or were self-pay. Overall, 46.1% reported ≥1 social need and 7.0% reported ≥4 needs. Financial strain, food insecurity, and housing and transportation challenges were among the most frequently endorsed domains. Black and Hispanic/Latine patients and those with Medicaid or self-pay coverage experienced significantly higher odds of multiple social-need domains and ≥4 needs (all p<0.05). Screening was feasible and acceptable but required attention to privacy, timing, and referral pathways.</p><p><strong>Conclusions: </strong>Nearly half of obstetric triage patients reported unmet social needs, with marked inequities by race/ethnicity and insurance. Triage-based SDOH screening is feasible and can connect patients to social, legal, and community supports. <b>Public Health and Policy Implications:</b> Integrating SDOH and food insecurity screening into obstetric triage, linking patients to social, legal, and Food is Medicine supports, and advancing upstream policies on wages, housing, and racism may narrow racial and socioeconomic gaps in maternal and infant outcomes and advance reproductive justice in Delaware.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"11 5","pages":"22-31"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12798935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Health Education in Maternal and Infant Health.","authors":"Adrienne Palmer","doi":"10.32481/djph.2025.12.08","DOIUrl":"10.32481/djph.2025.12.08","url":null,"abstract":"<p><p>Maternal and infant health outcomes in the United States remain concerning despite advances in medicine, with persistent disparities in underserved communities. This article highlights the role of health education as a preventive strategy to improve outcomes for mothers and babies. By providing expectant and new parents with knowledge on prenatal care, nutrition, breastfeeding, infant safety, and postpartum wellness, health education programs empower families to make informed decisions and adopt healthier practices. Drawing on professional experience in maternal and infant nutrition and health education, the article introduces Healthy from the Bump, a tailored program designed to provide culturally relevant, accessible, and practical education for parents and their support partners. While immediate results may be difficult to measure, health education's long-term benefits include reducing risks, fostering healthier habits, and strengthening caregiver confidence. Investing in maternal and infant health education is an essential step toward closing health gaps and building healthier generations from the very start.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"11 5","pages":"42-43"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12798934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Historical Claims Literature Review Paper: Black Maternal Health.","authors":"Jasmine R Hilliard","doi":"10.32481/djph.2025.12.04","DOIUrl":"10.32481/djph.2025.12.04","url":null,"abstract":"<p><p>Mistrust among Black women toward the medical system is evident across many eras of reproductive history, and the generational mistreatment of their reproductive health continues to harm their mental well-being and family health in the 21st century. Even with the advancement of modern medicine, Black women and babies are dying at a higher rate than other ethnic groups. Medicine has long been used to stereotype Black women's physical and emotional resilience, sexuality, and capacity for motherhood. The interplay of race, socioeconomic power, and institutional knowledge has worked to preserve an inequitable and oppressive framework governing Black women's reproductive rights. This article reviews literature on the history of reproduction as it relates to Black women, as well as studies examining culturally sensitive approaches aimed at improving provider-patient interactions and reducing maternal and infant mortality. The results indicate that historical constructions of race and the persistence of racial stereotypes continue to shape the practices of today's medical professionals. By understanding how these stereotypes developed and how they intersect with race and socioeconomic status, we can foster new frameworks that improve outcomes for Black women and their families.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"11 5","pages":"16-20"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12798944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Prenatal and Postpartum Exercise.","authors":"Julia Olsen","doi":"10.32481/djph.2025.12.06","DOIUrl":"10.32481/djph.2025.12.06","url":null,"abstract":"<p><p>Regular physical activity and structured exercise during pregnancy and postpartum are strongly associated with improved maternal and infant health outcomes; however, confusion persists among clinicians, fitness professionals, and patients regarding the safety, intensity, and appropriate modes of exercise across the perinatal period. The objective of this paper is to synthesize current evidence on aerobic training, resistance training, flexibility and mobility work, and high-intensity training (HIT) to provide clear, practical, and mode-specific recommendations that support safe, enjoyable, and effective movement during pregnancy and postpartum.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"11 5","pages":"32-36"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12798931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Mapping of Evidence on Vaccination Related Education Through School Based Curriculum: A Systematic Scoping Review.","authors":"Bhupender Singh Khanuja, Palak Badhwar, Kapil Singh, Shipra Verma, Anjori Agrawal, Ashwani Verma","doi":"10.32481/djph.2025.12.09","DOIUrl":"10.32481/djph.2025.12.09","url":null,"abstract":"<p><strong>Background: </strong>Educating school children about vaccination as a part of health promotion intervention is one of the strategies to improve vaccination acceptance. The aim of this scoping review is to describe the range of school-based education interventions related to vaccination and particularly about efforts to include such education in school curricula.</p><p><strong>Methods: </strong>This systematic scoping review was conducted based on the methodological framework proposed by Arskey and O'Malley. Searches were performed in four databases from Nov 1, 2004 to Nov 30, 2024. Databases were systematically searched for published articles on school education on vaccination. Two independent authors screened the articles followed by data extraction using MS-Excel tool.</p><p><strong>Results: </strong>Out of total identified 18,706 articles, only six articles met the inclusion criteria. All studies were focused on developed countries and most were experimental studies. Interventions were delivered by teachers or researchers and reported general improvements in vaccine knowledge as well as of vaccine-specific interventions. This review documented the outcomes on a curriculum based on immunity and vaccine related concept in school education. The review also highlights the ad hoc approach of health promotion during the vaccine specific knowledge dissemination in school.</p><p><strong>Conclusion: </strong>Formalizing health education could be a long-term strategy for better public health outcomes which face numerous challenges due to vaccine hesitancy or denial. Structured school curriculum on vaccination is warranted to sustain the knowledge on vaccination and its effect on community.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"11 5","pages":"44-52"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12798945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigating Food Insecurity-Related Stigma: A Review of Intervention Strategies.","authors":"Evyn Y Appel, McKenna M Halverson, Valerie A Earnshaw, Tania Cruz Cordero, Maya Rozin, Raquelle Powell, Grace Sands, Nithila Chrisostam, Sarah E Katz, Shreela V Sharma, Allison Karpyn","doi":"10.32481/djph.2025.11.04","DOIUrl":"10.32481/djph.2025.11.04","url":null,"abstract":"<p><strong>Objective: </strong>To characterize intervention strategies addressing food insecurity-related stigma implemented in federal nutrition programs (e.g. SNAP, WIC) and emergency food programs (e.g. food pantries, food cupboards) within high income countries.</p><p><strong>Methods: </strong>Six databases (PubMed, PsychINFO, Web of Science, CINAHL, Sociological Abstracts, Dissertations and Theses Global) and the Internet were searched through September 2024. Data on study characteristics and stigma intervention characteristics were extracted with a structured template. Descriptive statistics and thematic analysis were used.</p><p><strong>Results: </strong>The review found 46 intervention strategies across 18 articles. The majority of articles were based in the United States (89.9%) with the remaining portion from the United Kingdom (11.1%). Interventions most frequently targeted emergency food (44.4% of articles, 70.3% of interventions). Interventions were most often operating at the structural level (89.1%).</p><p><strong>Conclusion: </strong>This review demonstrates the frequency of structural level interventions, particularly within the emergency food setting, and the need to implement strategies that address the everyday interactions between staff/volunteers and those seeking food assistance.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"11 4","pages":"8-21"},"PeriodicalIF":0.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Food Security as a Social Determinant of Mental Health in College Students.","authors":"Amy Gootee-Ash","doi":"10.32481/djph.2025.11.06","DOIUrl":"10.32481/djph.2025.11.06","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the prevalence of food insecurity and its association with anxiety and depression among students at Delaware State University (DSU).</p><p><strong>Methods: </strong>A cross-sectional survey was administered to 117 students via classroom distribution, social media, campus events, and within the campus food pantry. Food insecurity was assessed using the USDA Six-Item Short Form, anxiety levels were determined using the GAD-7 survey tool, and depression scored with the PHQ-9 survey tool. Descriptive statistics were used to describe the population and the chi square test to analyze relationships between food security status and mental health outcomes.</p><p><strong>Results: </strong>Among respondents <i>(n</i> = 117), 97% were classified as food insecure (<i>n</i> = 113), and of those, 17% (<i>n</i> = 20) reported moderate-to-severe anxiety and 32% (<i>n</i> = 37) reporting moderate-to-severe depression. Only 37% (<i>n</i> = 43) of the students surveyed (<i>n</i> = 117) accessed mental health services within the past year and only 6% (<i>n</i> = 7) participated in food assistance programs. Although notable proportions of students experiencing food insecurity presented with elevated mental health symptoms, there was no statistically significant association between food security status and levels of depression or anxiety.</p><p><strong>Conclusions: </strong>The lack of statistical significance does not rule out a meaningful relationship between food and psychological distress. Larger sample sizes, longitudinal studies, and the inclusion of impacting variables such as financial supports are warranted to get an accurate assessment of our current student needs. Developing targeted interventions addressing both nutrition and mental health are essential to improve student well-being at a critical \"gateway\" period-habits and health challenges that emerge in this life stage often influence lifelong health trajectories.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"11 4","pages":"32-36"},"PeriodicalIF":0.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Culinary Medicine: A Necessary Public Health Intervention.","authors":"Katelyn Fritzges","doi":"10.32481/djph.2025.11.03","DOIUrl":"10.32481/djph.2025.11.03","url":null,"abstract":"","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"11 4","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Food and Care: Evaluating Impacts of Delaware Food Farmacy, a Food is Medicine Pilot for Maternal Health.","authors":"Allison Karpyn, Vandeka Eze, Michelle Axe","doi":"10.32481/djph.2025.11.09","DOIUrl":"10.32481/djph.2025.11.09","url":null,"abstract":"<p><strong>Objective: </strong>The study examined participant experiences in a community-based Food is Medicine (FIM) program for pregnant women in Delaware, focusing on program structure, support services, health impacts, and perceived dignity and respect.</p><p><strong>Methods: </strong>Using a qualitative design, 7 postpartum participants who completed the FIM pilot during pregnancy participated in semi-structured interviews that were transcribed and analyzed using thematic analysis, generating five conceptual categories and 25 themes.</p><p><strong>Results: </strong>Participants described substantial benefits, including improved food security, healthier eating behaviors, and emotional well-being supported through Community Health Workers and Case Management. They valued the program's respectful delivery, high food quality, convenient home delivery, and personalized dietary guidance. Reported challenges included limited program duration, restricted snack variety, and communication gaps related to goal-setting and resource navigation.</p><p><strong>Conclusions: </strong>Findings suggest that FIM programs tailored to pregnant women can have multidimensional effects that extend beyond nutrition to encompass economic stability, mental health, and access to social supports. The integration of Community Health Workers and participant-centered service delivery emerged as key strengths, underscoring the potential of FIM models to enhance perinatal health outcomes and equity.</p>","PeriodicalId":72774,"journal":{"name":"Delaware journal of public health","volume":"11 4","pages":"74-83"},"PeriodicalIF":0.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}