Delaware journal of public health最新文献

Objective: 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.

Methods: 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.

Results: 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%).

Conclusion: 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.

Objective: This study examined the prevalence of food insecurity and its association with anxiety and depression among students at Delaware State University (DSU).

Methods: 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.

Results: Among respondents (n = 117), 97% were classified as food insecure (n = 113), and of those, 17% (n = 20) reported moderate-to-severe anxiety and 32% (n = 37) reporting moderate-to-severe depression. Only 37% (n = 43) of the students surveyed (n = 117) accessed mental health services within the past year and only 6% (n = 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.

Conclusions: 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.

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Objective: This study evaluates whether a medically tailored grocery intervention supported by community health workers improves clinical, behavioral, and social outcomes among patients with diet-related chronic conditions. The Delaware Food Farmacy (DFF), a six-month program implemented by ChristianaCare, targeted adults with diabetes, hypertension, or heart failure.

Methods: This retrospective pre-post quasi-experimental study analyzed intake and six-month data for 185 participants enrolled between 2021 and 2024. Participants received weekly home deliveries of groceries aligned with the DASH diet, cooking tools, and ongoing support from community health workers (CHWs). Outcomes included food security, depression (PHQ-9), anxiety (GAD-7), BMI, blood pressure, and HbA1c.

Results: Results indicated significant improvements in food security (p = 0.008), depression (-2.19 points, p < 0.001), anxiety (-1.76 points, p = 0.001), BMI (-1.44 kg/m², p = 0.020), and HbA1c (-0.52%, p = 0.027). Goal completion averaged 84%, and satisfaction exceeded 90% across all program components.

Conclusions: Findings demonstrate that medically tailored grocery programs supported by community health workers can produce measurable improvements in health and social outcomes among medically complex, low-income adults, offering a scalable, equity-oriented model to address chronic disease and inform value-based reimbursement pathways.

Nutrition and malnutrition are highly influential yet often under recognized determinants in the development, progression, and survivorship of cancer. Poor dietary patterns and nutritional deficiencies are leading modifiable risk factors for several types of cancers. These issues disproportionately affect vulnerable populations, intensifying existing health disparities. In Delaware, the Bureau of Cancer Prevention and Control addresses cancer across the continuum from education and prevention to screening, diagnosis, treatment, and survivorship. This is done through integrated programs such as the Delaware Comprehensive Cancer Control Program, Screening for Life, the Physical Activity, Nutrition and Obesity Prevention Program, and the Delaware Cancer Treatment Program. This article explores the complex interplay between nutrition and malnutrition, and their impact on cancer. Highlighted are both the biological mechanisms linking dietary patterns to carcinogenesis and the socioeconomic factors that drive nutritional inequities. It also presents Delaware-specific cancer and nutrition data, highlighting how state-led efforts are evolving to incorporate nutrition education, food access partnerships, and community-based interventions into cancer prevention and control strategies. By aligning clinical, public health, and community resources, Delaware is creating a more holistic and equitable approach to reducing cancer incidence and improving outcomes. This article underscores the urgent need to treat nutrition as a foundational element of cancer prevention and presents opportunities for policy and practice to address malnutrition across the cancer care continuum.

: To characterize the ways in which structural stigma manifests within emergency food program settings. Methods : We conducted 30-minute semi-structured interviews with 18 emergency food program clients in Pennsylvania and Delaware between August and December of 2024. The discussion guide included open-ended questions regarding client experiences of structural stigma, with an emphasis on issues of access and quality. Demographic data and household food insecurity (Hunger Vital Sign) were also captured. A hybrid inductive and deductive coding approach was used to analyze the data. Results : Structural stigma is a persistent issue within emergency food program environments, impacting both participant access and quality. Access constraints included long wait times, limited agency over food choice, and accessibility challenges for individuals with physical disabilities, whereas quality constraints included receiving expired/spoiled foods or foods not aligned with participants' nutritional needs. These issues led to the erosion of autonomy and dignity and perpetuated clients' feelings of shame, frustration, and discomfort. Conclusions : Intervention strategies such as routinely assessing structural stigma, implementing and monitoring quality standards, increasing infrastructure funding for pantries, creating direct distribution channels with local growers, and revising tax incentive policies show promise for reducing structural stigma within emergency food program settings. Implications : Findings indicate the importance of addressing structural barriers related to accessibility and quality to reduce stigma and create more equitable and inclusive food assistance systems.

Objective: This report summarizes the findings from a comprehensive study conducted by The Delaware Academy of Medicine & Public Health's Delaware Health Force program on the educational pathways of Delaware dentists from 1939-2024.

Methods: Delaware undergraduate education, dental school attendance, residency hospital training, and stage transition records were stratified by gender and license activity status for practicing Delaware dentists, and trends based on Delaware proximity and regional movements were identified. Shifts in the Delaware dental pipeline were also identified.

Results: The most common educational pathway for Delaware dentists was to complete their undergraduate education in Delaware, move to Pennsylvania for dental school, and then return to Delaware for residency and training. Most Delaware dentists remained in the Northeast for their entire training pathway.

Conclusion: There is subtle regional diversity in the pathways of Delaware dentists, with an overwhelming leaning towards educational training at all levels in the Northeast and Mid-Atlantic regions of the country.