Laura M Nicholson | DePaul University (original) (raw)

Papers by Laura M Nicholson

Research paper thumbnail of Spina bifida

Research paper thumbnail of Green schoolyard renovations in low‐income urban neighborhoods: Benefits to students, schools, and the surrounding community

American Journal of Community Psychology, 2021

Green schoolyards may buffer against the effects of urbanization through increasing access to nat... more Green schoolyards may buffer against the effects of urbanization through increasing access to nature and its benefits. The present study was a community-academic partnership that examined the effects of green schoolyard renovations on utilization, physical activity (PA), and social interactions as well as perceptions of safety, neighborhood climate, and social cohesion among those living in low-income, urban neighborhoods. Utilizing behavioral mapping techniques and multi-informant surveys (i.e., caregivers, teachers, and community members), changes from pre- to postrenovation were assessed at two low-income, urban schools. Behavioral mapping results demonstrated increases in utilization and prosocial interactions among youth from pre- to postrenovation. Levels of moderate-to-vigorous PA also increased from pre- to postrenovation at one school. Survey data from community stakeholders revealed improvements in the perception of schoolyard safety and school-community relationships as well as reductions in bullying postrenovation. Green schoolyards may offer a safe space for children and adults to engage in social, outdoor activities, particularly in low-income, urban neighborhoods.

Research paper thumbnail of Life Interrupted: Family Routines Buffer Stress during the COVID-19 Pandemic

Journal of Child and Family Studies, 2021

Adoption of certain behavioral and social routines that organize and structure the home environme... more Adoption of certain behavioral and social routines that organize and structure the home environment may help families navigate the challenges presented by the COVID-19 pandemic. The current cross-sectional study aimed to assess family routines prior to and during the COVID-19 pandemic and examine associations with individual and family well-being. Using a national sample, 300 caregivers of children ages 6-18 were surveyed using Amazon Mechanical Turk platform during the first three months of COVID-19 pandemic in the United States. Caregivers reported on family demographics, COVID-19related stress, engagement in family routines (prior to and during the COVID-19 pandemic), stress mindset, self-efficacy, and family resiliency. Overall, families reported engaging in fewer routines during the COVID-19 pandemic compared to prior to the pandemic. COVID-19-related stress was highest in low-income families, families of healthcare workers, and among caregivers who had experienced the COVID-19 virus. Moreover, COVID-19-related stress was negatively related to self-efficacy, positively related to an enhancing stress mindset, and negatively related to family resilience. Engagement in family routines buffered relations between COVID-19-related stress and family resilience, such that COVID-19-related stress was not associated with lower family resilience among families that engaged in high levels of family routines. Results suggest that family routines were challenging to maintain in the context of the COVID-19 pandemic, but were associated with better individual and family well-being during this period of acute health, economic, and social stress. Keywords COVID-19 • Family • Routines • Resilience • Stress • Stress mindset Highlights • Families reported engaging in fewer routines during the COVID-19 pandemic, when compared to prior to the pandemic. • Families reported significant reductions in child bedtime routines and screen time limitations during the COVID-19 pandemic, when compared to prior to the pandemic. • Engagement in family routines buffered the impact of stress on family resilience during the COVID-19 pandemic. The onset of the COVID-19 (coronavirus) pandemic was a major public health event characterized by unprecedented disruptions to daily life in the United States and around the world. By April of 2020, 48/50 states enacted statewide school/school district closures for the entire academic year (Education Week, 2020) and 45/50 states issued local or statewide stay-at-home orders (NBC News, 2020). These dramatic changes to daily life, occurring in the context of economic and health uncertainty, posed notable challenges to the psychological well-being of individuals of all ages. Negative effects may include post-traumatic stress symptoms, confusion, and anger (Brooks et al., 2020). Indeed, a preliminary poll of US adults in March 2020 found that nearly half of respondents endorsed that their life had changed in a "major way" due to the COVID-19 pandemic, and by May of 2020, one third of poll respondents reported high levels of psychological distress (Pew Research Center, 2020). Despite emerging information of the impact of the COVID-19 pandemic on mental health, the impact on

Research paper thumbnail of Links between the organization of the family home environment and child obesity: a systematic review

Obesity Reviews, 2018

Due to increasingly high rates of child overweight and obesity, it is important to identify risk ... more Due to increasingly high rates of child overweight and obesity, it is important to identify risk and protective factors that may inform more effective prevention and intervention. The degree of organization in the family home environment is a studied, but not well-specified, factor that may impact child weight. Prior research on household organization has examined an array of constructs, including family routines, limit setting, household chaos, crowding and the broad home environment. This study systematically reviews literature on organization within the family home environment and weight among children ages 2-12. Six hundred thirty-seven studies were reviewed by four coders for eligibility, and 32 studies were included in the final synthesis. Overall, 84% of studies provided evidence for relations between at least one indicator of organization within the family home environment and child weight. Studies provided compelling evidence across several constructs, suggesting that the relevance of household organization to child weight extends beyond a single indicator. Directions for future work include (i) examining the mediating role of health behaviours, (ii) examining the moderating role of socioeconomic factors, (iii) broadening this evidence base across cultures and nationalities and (iv) integrating constructs to develop a comprehensive model of organization within the home environment.

Research paper thumbnail of Delicious and difficult to resist?: Inhibitory control differs in young women after exposure to food and non-food commercials

Research paper thumbnail of Variability of Sleep and Relations to Body Weight Among First-Year College Students

International Journal of Behavioral Medicine

Research paper thumbnail of School as a Protective Setting for Excess Weight Gain and Child Obesity: A Meta‐Analysis

Research paper thumbnail of Activity measurement in pediatric chronic fatigue syndrome

Chronic Illness

Objectives Individuals with myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) exp... more Objectives Individuals with myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) experience debilitating symptoms, including post-exertional malaise, an intensification of symptoms after physical or cognitive exertion. Previous studies found differences in the activity levels and patterns of activity among individuals with ME and CFS, compared to healthy controls; however, limited research exists on the activity levels of pediatric patients. The objective of this study was to examine differences in activity between healthy children and youth with ME and CFS. Methods The present study examines the objective (i.e., ActiGraphy) and self-reported levels of activity among children (ages 5 to 17) enrolled in a community-based study of pediatric CFS. Results Children with ME and CFS evidenced lower activity levels than healthy control children. Moreover, participants with ME and CFS evidenced increased nighttime activity and delayed initiation of daytime activity. Participants...

Research paper thumbnail of Validation of a financial toxicity (FT) grading system

Journal of Clinical Oncology

6615 Background: FT is an important adverse event (AE) that should be objectively measured in cli... more 6615 Background: FT is an important adverse event (AE) that should be objectively measured in clinical practice. We previously developed an evidence-based FT grading system based on differences in HRQoL, analogous to the NCI-Common Terminology Criteria for Adverse Events (grade 1, mild AE; grade 2, moderate AE; grade 3, severe AE ,de Souza et al - ASCO 2015). We aimed to validate this grading system using a new sample of cancer patients (pts) and report its association with bankruptcy. Methods: FT was assessed by the COST (COmprehensive Score for financial Toxicity) in 2 sets of cancer pts. In the previously reported Development Set (DS), gradations of FT were determined by ROC analyses based on conventions for clinically meaningful small (0.2), medium (0.5) and large (0.8) effect sizes (e.s.) for independent FACT-G differences attributable to FT in pts with Stage IV cancers on chemotherapy. In the Validation Set (VS), differences in HRQoL and the odds ratio for a pt to have declare...

Research paper thumbnail of Evaluating financial toxicity (FT) interventions

Journal of Clinical Oncology

e21673 Background: FT has been defined as an adverse event of cancer treatments. Several patient ... more e21673 Background: FT has been defined as an adverse event of cancer treatments. Several patient (pt)-level interventions have been developed to mitigate FT. However, due to the lack of longitudinal studies, the impact of these interventions has not been established. Methods: Pts with cancer receiving Co-Pay Assistance (CPA) from the Patient Access Network Foundation were approached at baseline, 1 and 3 months post-CPA. We assessed the use of pt navigators, social workers, financial counselors, support groups, and transportation vouchers by pts. The outcomes were improvements in disease-specific HRQoL measures, global HRQoL measure (FACTG, lower values are worse) and improvement in FT, as measured by the COST (lower values are worse). Multivariable regression was used to identify whether these interventions were associated with the outcomes. Results: 308 pts with cancer were assessed at baseline (prior to CPA) and at 1 and 3 months after. 275 pts (89%) had an improvement in their FT...

Research paper thumbnail of Energy envelope maintenance among patients with myalgic encephalomyelitis and chronic fatigue syndrome: Implications of limited energy reserves

Chronic illness, 2017

Objective The Energy Envelope Theory of myalgic encephalomyelitis and chronic fatigue syndrome po... more Objective The Energy Envelope Theory of myalgic encephalomyelitis and chronic fatigue syndrome postulates that individuals with myalgic encephalomyelitis and chronic fatigue syndrome may experience some increase in functioning if their level of exertion consistently remains within the limits of their available energy. Findings of several studies support this theory; however, the current study is the first to explore how an individual's initial level of available energy may influence the relation between energy envelope maintenance and level of functioning. Method The functioning, activity, and symptomatology of six groups of individuals with myalgic encephalomyelitis and chronic fatigue syndrome were compared. Groups were created based upon level of available energy (higher or lower) and energy envelope adherence (underextended, within, overextended). Results Results indicate that, as expected, individuals with myalgic encephalomyelitis and chronic fatigue syndrome who had highe...

Research paper thumbnail of Access to Medical Care for Individuals with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome: A Call for Centers of Excellence

Modern Clinical Medicine Research

The current study sought to better understand the experience of individuals with myalgic encephal... more The current study sought to better understand the experience of individuals with myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) in accessing care for their debilitating illness. Of 898 participants, less than half had ever seen an ME or CFS specialist, though 99% of participants were interested in specialist care. Participants cited geographic and financial barriers as most frequently precluding access to specialists. Furthermore, satisfaction with specialist care greatly exceeded satisfaction with non-specialist care. These findings suggested that individuals with ME and CFS represent a medically-underserved population, due to lack of available care. The CFS Advisory Committee and NIH Pathways to Prevention Working Group recommended the creation of ME and CFS Centers of Excellence to improve the healthcare access of patients with ME and CFS. The current study documents the need for these centers, as they would ameliorate geographic and financial barriers to quality care.

Research paper thumbnail of Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

Neurology (E-Cronicon), 2016

It is unclear what key symptoms differentiate Myalgic Encephalomyelitis (ME) and Chronic Fatigue ... more It is unclear what key symptoms differentiate Myalgic Encephalomyelitis (ME) and Chronic Fatigue syndrome (CFS) from Multiple Sclerosis (MS). The current study compared self-report symptom data of patients with ME or CFS with those with MS. The self-report data is from the DePaul Symptom Questionnaire, and participants were recruited to take the questionnaire online. Data were analyzed using a machine learning technique called decision trees. Five symptoms best differentiated the groups. The best discriminating symptoms were from the immune domain (i.e., flu-like symptoms and tender lymph nodes), and the trees correctly categorized MS from ME or CFS 81.2% of the time, with those with ME or CFS having more severe symptoms. Our findings support the use of machine learning to further explore the unique nature of these different chronic diseases.

Research paper thumbnail of Factor Analysis of the DePaul Symptom Questionnaire: Identifying Core Domains

Journal of Neurology and Neurobiology, 2015

The present study attempted to identify critical symptom domains of individuals with Myalgic Ence... more The present study attempted to identify critical symptom domains of individuals with Myalgic Encephalomyelitis (ME) and chronic fatigue syndrome (CFS). Using patient and control samples collected in the United States, Great Britain, and Norway, exploratory factor analysis (EFA) was used to establish the underlying factor structure of ME and CFS symptoms. The EFA suggested a four-factor solution: post-exertional malaise, cognitive dysfunction, sleep difficulties, and a combined factor consisting of neuroendocrine, autonomic, and immune dysfunction symptoms. The use of empirical methods could help better understand the fundamental symptom domains of this illness.

Research paper thumbnail of Spina bifida

Research paper thumbnail of Green schoolyard renovations in low‐income urban neighborhoods: Benefits to students, schools, and the surrounding community

American Journal of Community Psychology, 2021

Green schoolyards may buffer against the effects of urbanization through increasing access to nat... more Green schoolyards may buffer against the effects of urbanization through increasing access to nature and its benefits. The present study was a community-academic partnership that examined the effects of green schoolyard renovations on utilization, physical activity (PA), and social interactions as well as perceptions of safety, neighborhood climate, and social cohesion among those living in low-income, urban neighborhoods. Utilizing behavioral mapping techniques and multi-informant surveys (i.e., caregivers, teachers, and community members), changes from pre- to postrenovation were assessed at two low-income, urban schools. Behavioral mapping results demonstrated increases in utilization and prosocial interactions among youth from pre- to postrenovation. Levels of moderate-to-vigorous PA also increased from pre- to postrenovation at one school. Survey data from community stakeholders revealed improvements in the perception of schoolyard safety and school-community relationships as well as reductions in bullying postrenovation. Green schoolyards may offer a safe space for children and adults to engage in social, outdoor activities, particularly in low-income, urban neighborhoods.

Research paper thumbnail of Life Interrupted: Family Routines Buffer Stress during the COVID-19 Pandemic

Journal of Child and Family Studies, 2021

Adoption of certain behavioral and social routines that organize and structure the home environme... more Adoption of certain behavioral and social routines that organize and structure the home environment may help families navigate the challenges presented by the COVID-19 pandemic. The current cross-sectional study aimed to assess family routines prior to and during the COVID-19 pandemic and examine associations with individual and family well-being. Using a national sample, 300 caregivers of children ages 6-18 were surveyed using Amazon Mechanical Turk platform during the first three months of COVID-19 pandemic in the United States. Caregivers reported on family demographics, COVID-19related stress, engagement in family routines (prior to and during the COVID-19 pandemic), stress mindset, self-efficacy, and family resiliency. Overall, families reported engaging in fewer routines during the COVID-19 pandemic compared to prior to the pandemic. COVID-19-related stress was highest in low-income families, families of healthcare workers, and among caregivers who had experienced the COVID-19 virus. Moreover, COVID-19-related stress was negatively related to self-efficacy, positively related to an enhancing stress mindset, and negatively related to family resilience. Engagement in family routines buffered relations between COVID-19-related stress and family resilience, such that COVID-19-related stress was not associated with lower family resilience among families that engaged in high levels of family routines. Results suggest that family routines were challenging to maintain in the context of the COVID-19 pandemic, but were associated with better individual and family well-being during this period of acute health, economic, and social stress. Keywords COVID-19 • Family • Routines • Resilience • Stress • Stress mindset Highlights • Families reported engaging in fewer routines during the COVID-19 pandemic, when compared to prior to the pandemic. • Families reported significant reductions in child bedtime routines and screen time limitations during the COVID-19 pandemic, when compared to prior to the pandemic. • Engagement in family routines buffered the impact of stress on family resilience during the COVID-19 pandemic. The onset of the COVID-19 (coronavirus) pandemic was a major public health event characterized by unprecedented disruptions to daily life in the United States and around the world. By April of 2020, 48/50 states enacted statewide school/school district closures for the entire academic year (Education Week, 2020) and 45/50 states issued local or statewide stay-at-home orders (NBC News, 2020). These dramatic changes to daily life, occurring in the context of economic and health uncertainty, posed notable challenges to the psychological well-being of individuals of all ages. Negative effects may include post-traumatic stress symptoms, confusion, and anger (Brooks et al., 2020). Indeed, a preliminary poll of US adults in March 2020 found that nearly half of respondents endorsed that their life had changed in a "major way" due to the COVID-19 pandemic, and by May of 2020, one third of poll respondents reported high levels of psychological distress (Pew Research Center, 2020). Despite emerging information of the impact of the COVID-19 pandemic on mental health, the impact on

Research paper thumbnail of Links between the organization of the family home environment and child obesity: a systematic review

Obesity Reviews, 2018

Due to increasingly high rates of child overweight and obesity, it is important to identify risk ... more Due to increasingly high rates of child overweight and obesity, it is important to identify risk and protective factors that may inform more effective prevention and intervention. The degree of organization in the family home environment is a studied, but not well-specified, factor that may impact child weight. Prior research on household organization has examined an array of constructs, including family routines, limit setting, household chaos, crowding and the broad home environment. This study systematically reviews literature on organization within the family home environment and weight among children ages 2-12. Six hundred thirty-seven studies were reviewed by four coders for eligibility, and 32 studies were included in the final synthesis. Overall, 84% of studies provided evidence for relations between at least one indicator of organization within the family home environment and child weight. Studies provided compelling evidence across several constructs, suggesting that the relevance of household organization to child weight extends beyond a single indicator. Directions for future work include (i) examining the mediating role of health behaviours, (ii) examining the moderating role of socioeconomic factors, (iii) broadening this evidence base across cultures and nationalities and (iv) integrating constructs to develop a comprehensive model of organization within the home environment.

Research paper thumbnail of Delicious and difficult to resist?: Inhibitory control differs in young women after exposure to food and non-food commercials

Research paper thumbnail of Variability of Sleep and Relations to Body Weight Among First-Year College Students

International Journal of Behavioral Medicine

Research paper thumbnail of School as a Protective Setting for Excess Weight Gain and Child Obesity: A Meta‐Analysis

Research paper thumbnail of Activity measurement in pediatric chronic fatigue syndrome

Chronic Illness

Objectives Individuals with myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) exp... more Objectives Individuals with myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) experience debilitating symptoms, including post-exertional malaise, an intensification of symptoms after physical or cognitive exertion. Previous studies found differences in the activity levels and patterns of activity among individuals with ME and CFS, compared to healthy controls; however, limited research exists on the activity levels of pediatric patients. The objective of this study was to examine differences in activity between healthy children and youth with ME and CFS. Methods The present study examines the objective (i.e., ActiGraphy) and self-reported levels of activity among children (ages 5 to 17) enrolled in a community-based study of pediatric CFS. Results Children with ME and CFS evidenced lower activity levels than healthy control children. Moreover, participants with ME and CFS evidenced increased nighttime activity and delayed initiation of daytime activity. Participants...

Research paper thumbnail of Validation of a financial toxicity (FT) grading system

Journal of Clinical Oncology

6615 Background: FT is an important adverse event (AE) that should be objectively measured in cli... more 6615 Background: FT is an important adverse event (AE) that should be objectively measured in clinical practice. We previously developed an evidence-based FT grading system based on differences in HRQoL, analogous to the NCI-Common Terminology Criteria for Adverse Events (grade 1, mild AE; grade 2, moderate AE; grade 3, severe AE ,de Souza et al - ASCO 2015). We aimed to validate this grading system using a new sample of cancer patients (pts) and report its association with bankruptcy. Methods: FT was assessed by the COST (COmprehensive Score for financial Toxicity) in 2 sets of cancer pts. In the previously reported Development Set (DS), gradations of FT were determined by ROC analyses based on conventions for clinically meaningful small (0.2), medium (0.5) and large (0.8) effect sizes (e.s.) for independent FACT-G differences attributable to FT in pts with Stage IV cancers on chemotherapy. In the Validation Set (VS), differences in HRQoL and the odds ratio for a pt to have declare...

Research paper thumbnail of Evaluating financial toxicity (FT) interventions

Journal of Clinical Oncology

e21673 Background: FT has been defined as an adverse event of cancer treatments. Several patient ... more e21673 Background: FT has been defined as an adverse event of cancer treatments. Several patient (pt)-level interventions have been developed to mitigate FT. However, due to the lack of longitudinal studies, the impact of these interventions has not been established. Methods: Pts with cancer receiving Co-Pay Assistance (CPA) from the Patient Access Network Foundation were approached at baseline, 1 and 3 months post-CPA. We assessed the use of pt navigators, social workers, financial counselors, support groups, and transportation vouchers by pts. The outcomes were improvements in disease-specific HRQoL measures, global HRQoL measure (FACTG, lower values are worse) and improvement in FT, as measured by the COST (lower values are worse). Multivariable regression was used to identify whether these interventions were associated with the outcomes. Results: 308 pts with cancer were assessed at baseline (prior to CPA) and at 1 and 3 months after. 275 pts (89%) had an improvement in their FT...

Research paper thumbnail of Energy envelope maintenance among patients with myalgic encephalomyelitis and chronic fatigue syndrome: Implications of limited energy reserves

Chronic illness, 2017

Objective The Energy Envelope Theory of myalgic encephalomyelitis and chronic fatigue syndrome po... more Objective The Energy Envelope Theory of myalgic encephalomyelitis and chronic fatigue syndrome postulates that individuals with myalgic encephalomyelitis and chronic fatigue syndrome may experience some increase in functioning if their level of exertion consistently remains within the limits of their available energy. Findings of several studies support this theory; however, the current study is the first to explore how an individual's initial level of available energy may influence the relation between energy envelope maintenance and level of functioning. Method The functioning, activity, and symptomatology of six groups of individuals with myalgic encephalomyelitis and chronic fatigue syndrome were compared. Groups were created based upon level of available energy (higher or lower) and energy envelope adherence (underextended, within, overextended). Results Results indicate that, as expected, individuals with myalgic encephalomyelitis and chronic fatigue syndrome who had highe...

Research paper thumbnail of Access to Medical Care for Individuals with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome: A Call for Centers of Excellence

Modern Clinical Medicine Research

The current study sought to better understand the experience of individuals with myalgic encephal... more The current study sought to better understand the experience of individuals with myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) in accessing care for their debilitating illness. Of 898 participants, less than half had ever seen an ME or CFS specialist, though 99% of participants were interested in specialist care. Participants cited geographic and financial barriers as most frequently precluding access to specialists. Furthermore, satisfaction with specialist care greatly exceeded satisfaction with non-specialist care. These findings suggested that individuals with ME and CFS represent a medically-underserved population, due to lack of available care. The CFS Advisory Committee and NIH Pathways to Prevention Working Group recommended the creation of ME and CFS Centers of Excellence to improve the healthcare access of patients with ME and CFS. The current study documents the need for these centers, as they would ameliorate geographic and financial barriers to quality care.

Research paper thumbnail of Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

Neurology (E-Cronicon), 2016

It is unclear what key symptoms differentiate Myalgic Encephalomyelitis (ME) and Chronic Fatigue ... more It is unclear what key symptoms differentiate Myalgic Encephalomyelitis (ME) and Chronic Fatigue syndrome (CFS) from Multiple Sclerosis (MS). The current study compared self-report symptom data of patients with ME or CFS with those with MS. The self-report data is from the DePaul Symptom Questionnaire, and participants were recruited to take the questionnaire online. Data were analyzed using a machine learning technique called decision trees. Five symptoms best differentiated the groups. The best discriminating symptoms were from the immune domain (i.e., flu-like symptoms and tender lymph nodes), and the trees correctly categorized MS from ME or CFS 81.2% of the time, with those with ME or CFS having more severe symptoms. Our findings support the use of machine learning to further explore the unique nature of these different chronic diseases.

Research paper thumbnail of Factor Analysis of the DePaul Symptom Questionnaire: Identifying Core Domains

Journal of Neurology and Neurobiology, 2015

The present study attempted to identify critical symptom domains of individuals with Myalgic Ence... more The present study attempted to identify critical symptom domains of individuals with Myalgic Encephalomyelitis (ME) and chronic fatigue syndrome (CFS). Using patient and control samples collected in the United States, Great Britain, and Norway, exploratory factor analysis (EFA) was used to establish the underlying factor structure of ME and CFS symptoms. The EFA suggested a four-factor solution: post-exertional malaise, cognitive dysfunction, sleep difficulties, and a combined factor consisting of neuroendocrine, autonomic, and immune dysfunction symptoms. The use of empirical methods could help better understand the fundamental symptom domains of this illness.