Eunjung Lim - Academia.edu (original) (raw)

Papers by Eunjung Lim

Archives of Psychiatric Nursing, 2017

As adoptive parents create a new family, they face myriad changes both pre-and post-placement of ... more As adoptive parents create a new family, they face myriad changes both pre-and post-placement of their child. The aim of this study was to describe parent perceptions and depressive symptoms during this transition via reports collected with an online survey. Using content analysis, we analyzed a total of 110 responses from 64 parents at three time points: 4-6 weeks pre-placement, and 4-6 weeks and 5-6 months post-placement. Five main themes were revealed: Transition from uncertainty to a new normal; unique experiences related to adoption; rest/fatigue: out of balance; life stressors; and faith/spirituality. Two subthemes were also identified: previous losses (pre-placement) and joy and love (post-placement). During the transition from pre-to post-placement, adoptive parents experience a unique passage, with both challenges and strengths exclusive to this group of parents. While acknowledging the commonalities of some parenting experiences, healthcare and adoption professionals should recognize the unique dynamics that adoption brings to families.

Understanding of behavioral factors associated with obesity is of importance in addressing this i... more Understanding of behavioral factors associated with obesity is of importance in addressing this issue. This study examined the association between cognitive restraint, uncontrolled eating, emotional eating and body mass index (BMI) and amount of food plated, consumed, leftovers, and leftover food thrown into the trash (food wasted) in early adolescent girls nine to 13 years in O'ahu, Hawai'i (n = 93). Food plated, consumed, leftovers, and food wasted were estimated using a three-day mobile food record™ (mFR). Weight and height were measured to compute BMI (kg/m 2). The three-factor eating questionnaire provided a score from 0 to 100 for cognitive restraint, uncontrolled eating, and emotional eating. Higher scores are indicative of greater cognitive restraint, uncontrolled eating, and emotional eating. Pearson's correlations were computed to examine the relationship between three factor eating scores and BMI. General linear models were conducted to examine the effect of each of three-factor eating scores on food plated, consumed, leftovers, and food wasted. Cognitive restraint was positively correlated with BMI (r = 0.36, p < 0.001) and with BMI z-score (r = 0.40, p < 0.001). There were no associations between three-factor eating scores and food plated, consumed, leftovers, and food wasted at lunch. However, at dinner, total energy plated, left over, and food wasted increased by 4.24 kcal/day (p = 0.030), 1.67 kcal/day (p = 0.002), and 0.93 kcal/day (p = 0.031), respectively, with a unit increase in uncontrolled eating score. Similarly, total energy plated and energy left over at dinner increased by 3.40 kcal/day (p = 0.045) and 1.51 kcal/day (p = 0.001), respectively, with a unit increase in emotional eating score. Additional research should examine the specific roles of cognitive restraint, uncontrolled eating, emotional eating and food waste in the development of obesity in adolescents.

Journal of Nutrition Education and Behavior, Dec 1, 2020

OBJECTIVE Test a dietary sodium survey in a US adult population of college students using a surve... more OBJECTIVE Test a dietary sodium survey in a US adult population of college students using a survey previously validated in a non-US adult population. METHODS Cross-sectional study of a convenience sample of college students from a Midwest (n = 168) and Pacific Island (n = 152) university. Main outcome measures were knowledge, attitudes, and practices regarding dietary sodium (38 items). Sum scores and percentages for constructs were calculated. A score <75% was considered unfavorable; t test or ANOVA were used to examine group differences. RESULTS Midwest students were primarily non-Hispanic White individuals (81%) and 65% female. Pacific Island students were predominantly Asian (51%) and 66% female. Mean ± SD construct scores (percentage) for knowledge, attitudes, and practices were 58.69 ± 10.62, 63.96 ± 16.18, 66.00 ± 12.34 (Midwest) and 57.54 ± 10.93, 64.84 ± 14.96, 64.94 ± 13.18 (Pacific Island), respectively; there were no significant differences between schools or race. CONCLUSIONS AND IMPLICATIONS College students scored low in knowledge, attitudes, and practices regarding sodium. Results from this formative study may inform assessment strategies in future dietary sodium interventions.

The FASEB Journal, Apr 1, 2016

BackgroundStudies have reported that the proportion of food that is plated, uneaten and thrown aw... more BackgroundStudies have reported that the proportion of food that is plated, uneaten and thrown away is high among youth in the school environment. To our knowledge, no studies have collected data on food waste over a 24‐hr period in early adolescents in the U.S. Further, few studies have investigated differences in food waste according to demographic characteristics. The mobile food record (mFR) has been found to be a feasible and acceptable method for measuring dietary intake in youth and may be used to collect data on food waste over the course of a day in real time.PurposeTo examine differences in food waste according to age, race/ethnicity, total household income and mother's education level in early adolescent girls 9 to 13 years in Oahu, Hawaii using the mFR.MethodsParticipants (n=72) used the mFR for 3 days to capture food eaten and any leftovers. A trained analyst met with each girl to review images from the mFR to classify the outcome of food remaining after each eating occasion. Participants’ mothers provided demographic information. The amount of food wasted was estimated. Data were entered into the RapidCalc nutrition database to quantify amount of food waste by food groups. Differences in the proportion of each food group wasted according to demographics were examined using Wilcoxon or Kruskal‐Wallis nonparametric tests.ResultsAll participants’ mothers completed at least 4 years of college. Participants whose mothers only completed college had at least twice the amount of waste with regards to total energy (p=0.008), dairy (p=0.033) and grains (p=0.029) than those whose mothers had a higher level of education. Compared to girls who identified as white or Asian, girls in the other race category (Native Hawaiian or Other Pacific Islander, American Indian or Alaska Native, Black or African American, Some Other Race) had at least twice the amount of waste with regards to total energy (p=0.018), grains (p=0.012) and dairy (p=0.006). No differences in waste according to age and total household income were found.ConclusionDifferences were observed in food waste over 3 days among the girls according to mother's education level and race/ethnicity. No differences were found with regards to age and total household income. Findings suggest that educational campaigns to reduce food waste may benefit from tailoring to specific groups.Support or Funding InformationSupported by the USDA National Institute of Food and Agriculture, Hatch project, HAW02026‐H, Accession no. 1000090. Also supported by NIH grant U54MD007584.

Journal of Nutrition Education and Behavior, Jul 1, 2017

Objective-To examine factorial validity, test-retest reliability, and internal consistency of a T... more Objective-To examine factorial validity, test-retest reliability, and internal consistency of a Tagalog-language food behavior checklist (FBC) for a low-income Filipino population. Methods-Participants (n = 160) completed the FBC on 2 occasions 3 weeks apart. Factor structure was examined using principal component analysis. For internal consistency, Cronbach α was calculated. For test-retest reliability, Spearman correlation or intraclass correlation coefficient (ICC) was calculated between scores at the 2 points. Results-All but 1 item loaded on 6 factors: fruit and vegetable quantity, fruit and vegetable variety, fast food, sweetened beverage, healthy fat, and diet quality. Cronbach α was .75 for the total scale (range, .39-.76 for subscales). Spearman correlation was 0.78 (ICC, 0.79) for the total scale (range, 0.66-0.80 [ICC, 0.68-0.80] for subscales). Conclusions and Implications-The FBC demonstrated adequate factorial validity, test-retest reliability, and internal consistency. With additional testing, the FBC may be used to evaluate the US Department of Agriculture's nutrition education programs for Tagalog speakers.

Healthcare

This study used the American Time Use Survey (ATUS) to examine socialization, relaxation, and lei... more This study used the American Time Use Survey (ATUS) to examine socialization, relaxation, and leisure activities throughout the day as related to social determinants of health (SDOH). The study population was adults aged 25 years and older who participated in the ATUS in 2014–2016, the most recent years for collecting SDOH. Descriptive analyses provide characteristics of the study population. Graphical analyses display socialization by SDOH across the hours of the day based on adjusted regression models. Quasi-binomial models analyzed the association between the numbers of minutes of various activities and SDOH. Associations between SDOH and sleeplessness (yes or no) were explored using logistic regression. For much of the day, being female, having less education, living in poverty, and having food insecurity were associated with more time socializing and relaxing. The major activities under socializing and relaxation are watching television and movies. Having a college degree was s...

International Journal of Environmental Research and Public Health

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

BMC Public Health

Background To date, little is known about cardiovascular disease risks among older adults with no... more Background To date, little is known about cardiovascular disease risks among older adults with non-valvular atrial fibrillation by their association with diabetes and osteoarthritis status, based on longitudinal data with substantial amounts of non-white individuals. The objective of this study was to examine the risks for three cardiovascular diseases: stroke, acute myocardial infarction (AMI), and heart failure (HF), by diabetes and osteoarthritis status among older adults with non-valvular atrial fibrillation in Hawaii. Methods We conducted a retrospective observational cohort study for older adults (65 years and older) with non-valvular atrial fibrillation using the Hawaii Medicare data 2009–2017. Their risks for the three cardiovascular diseases by diabetes and osteoarthritis status (diabetes, osteoarthritis, diabetes and osteoarthritis, and without diabetes and osteoarthritis) were examined by multivariable Cox proportional hazard regression models. Results The analysis includ...

Nutrients

Background: To date, few studies have compared the dietary quality of US adults with diabetes mel... more Background: To date, few studies have compared the dietary quality of US adults with diabetes mellitus (DM), osteoarthritis (OA), and rheumatoid arthritis (RA) by age groups. Methods: This study used cross-sectional data from adult participants from National Health and Nutrition Examination Survey 2011–2016 to identify dietary quality measured by Healthy Eating Index (HEI)-2015 total and component scores and self-reported disease status for DM, OA, and RA. Associations between the disease status and HEI-2015 total/component scores among younger adults aged 20–59 years (n = 7988) and older adults aged 60 years and older (n = 3780) were examined using logistic regression models. These accounted for the complex survey design and were adjusted for self-reported disease status, sex, race/ethnicity, education levels, income status, weight status, physical activity levels, and smoking status. Results: Among younger adults, 7% had DM, 7% had OA, and 3% had RA. Among older adults, 20% had DM...

PLOS ONE, 2021

Introduction In December 2020, the first two COVID-19 vaccines were approved in the United States... more Introduction In December 2020, the first two COVID-19 vaccines were approved in the United States (U.S.) and recommended for distribution to front-line personnel, including nurses. Nursing students are being prepared to fill critical gaps in the health care workforce and have played important supportive roles during the current pandemic. Research has focused on vaccine intentions of current health care providers and less is known about students’ intentions to vaccinate for COVID-19. Methods A national sample of undergraduate nursing students were recruited across five nursing schools in five U.S. regions in December 2020. The survey measured perceived risk/threat of COVID-19, COVID-19 vaccine attitudes, perceived safety and efficacy of COVID-19 vaccines, sources for vaccine information and level of intention to become vaccinated [primary, secondary (i.e., delayed), or no intention to vaccinate]. Results The final sample consisted of 772 students. The majority (83.6%) had intentions ...

Journal of School Health, 2019

ABSTRACTBACKGROUNDFrom 5 to 7.5 million schoolchildren are chronically absent, defined as missing... more ABSTRACTBACKGROUNDFrom 5 to 7.5 million schoolchildren are chronically absent, defined as missing ≥15 days of school within a year. Students miss schools due to various reasons such as health, socioeconomic status, and environmental factors. We examined child's health and behavior, family structure, and sociodemographics to understand chronic absenteeism.METHODSThe population included children ages 6 to 17 years from the Medical Expenditure Panel Survey years 2008‐2013. Multivariable logistic regressions were used to identify the risk factors of chronic absenteeism, adjusting for the complex sampling design.RESULTSAmong sociodemographic variables, age ≥14 years, race/ethnicity, lower‐income family, public health insurance, US born, and speaking English at home were associated with absenteeism. Asians, Mexican Hispanics, and blacks have lower absenteeism than whites. Among health‐related variables, children using an inhaler for asthma, having behavioral problems, and less healthy...

Understanding behavioral factors associated with obesity is of importance in addressing this issu... more Understanding behavioral factors associated with obesity is of importance in addressing this issue. This study examined the association between cognitive restraint, uncontrolled eating, emotional eating and body mass index (BMI) and amount of food plated, consumed, leftovers, and leftover food thrown into the trash (food wasted) in early adolescent girls nine to 13 years in O’ahu, Hawai’i (n = 93). Food plated, consumed, leftovers, and food wasted were estimated using a three-day mobile food record (mFR). Weight and height were measured to compute BMI (kg/m2). The three-factor eating questionnaire provided a score from 0 to 100 for cognitive restraint, uncontrolled eating, and emotional eating. Higher scores are indicative of greater cognitive restraint, uncontrolled eating, and emotional eating. Pearson’s correlation and general linear models were computed to examine the relationship between three factor eating scores, BMI, and food plated, consumed, leftover...

Maternal and child health journal, Jan 13, 2018

Objectives This study investigated the association between maternal pregravid body mass index (BM... more Objectives This study investigated the association between maternal pregravid body mass index (BMI) and breastfeeding discontinuation at 4-6 months postpartum in Hawaii and Puerto Rico participants from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Methods A secondary data analysis was conducted from a text message-based intervention in WIC participants in Hawaii and Puerto Rico. The analysis included 87 women from the control group who initiated breastfeeding and whose breastfeeding status was known at the end of the study when infants were 4-6 months old. Pregravid BMI and breastfeeding discontinuation were assessed using questionnaires. Results The association between pregravid BMI and breastfeeding discontinuation was not significant in the unadjusted model or in the adjusted model. Native Hawaiian or Other Pacific Islander (NHOPI) participants showed significantly increased odds of discontinuing breastfeeding (adjusted odds ratio [AOR] 7.12;...

Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health, 2018

We investigated racial/ethnic and county-level disparities in inpatient utilization for 15 clinic... more We investigated racial/ethnic and county-level disparities in inpatient utilization for 15 clinical conditions among Hawaii's Medicaid population. The study was conducted using inpatient claims data from more than 200,000 Hawai'i Medicaid beneficiaries, reported in the year 2010. The analysis was performed by stratifying the Medicaid population into three age groups: children and adolescent group (1-20 years), adult group (21-64 years), and elderly group (65 years and above). Among the differences found, Asians had a low probability of inpatient admissions compared to Whites for many disease categories, while Native Hawaiian/Pacific Islanders had higher probabilities than Whites, across all age groups. Pediatric and adult groups from Hawai'i County (Big Island) had lower probabilities for inpatient admissions compared to Honolulu County (O'ahu) for most disease conditions, but higher probabilities were observed for several conditions in the elderly group. Notably, th...

Asia Pacific journal of clinical nutrition, 2018

In investigating diet-disease relationships, examination of dietary patterns allows for conclusio... more In investigating diet-disease relationships, examination of dietary patterns allows for conclusions to be drawn based on overall intake. This study characterized dietary patterns of early adolescent girls over a two-year period and examined the relationship between dietary patterns and body mass index (BMI). Cross-sectional analyses were performed using longitudinal data from food records of early adolescent girls (n=148) 9 to 14 years in Hawai'i from the Female Adolescent Maturation (FAM) study. Dietary patterns were identified using principal component analysis (PCA). Pearson's correlations between BMI percentile and z-score and dietary pattern factor scores at Times 1 (2001-2002) and 2 (2002-2003) were calculated. For each dietary pattern, participants were divided into low, intermediate, and high scorers. Mean BMI percentiles and z-scores were compared between groups using analysis of covariance. At Time 1, three patterns were identified, characterized by: (1) whole grai...

Nutrients, Jan 26, 2017

This study aimed to assess the amount of plate waste and how plate waste was disposed by early ad... more This study aimed to assess the amount of plate waste and how plate waste was disposed by early adolescent girls using a mobile food record (mFR). Participants were girls nine to thirteen years residing in O'ahu, Hawai'i (n = 93). Foods selected and leftover were estimated using a three day mFR. Each leftover food was then classified as thrown into the trash, fed to a pet, eaten later, or other (e.g., composted). Repeated measures analyses of variance (ANOVA) were conducted and Tukey's post-hoc test were used to adjust for multiple comparisons between times (breakfast, lunch, dinner, and snack) on leftover food and leftover food thrown into the trash. The percentage of food leftover and thrown into the trash was highest at lunch. The percentage of protein, grain, vegetables, fruit, and dairy leftover at lunch were unexpectedly low compared to previous studies. The median for percentage of food thrown into the trash at lunch was <5% for all food groups, and was consiste...

Journal of Affective Disorders, 2016

Background-Approximately 10%-15% of birth mothers and fathers experience postpartum depression, b... more Background-Approximately 10%-15% of birth mothers and fathers experience postpartum depression, but reports of depressive symptoms in adoptive parents are more variable. Findings from investigators range from 10%-32%, which may mask the experiences of distinct groups of adoptive parents from pre-to post-placement of a child. Methods-We performed latent class growth analysis using the Center for Epidemiologic Studies-Depression scores of 129 primarily heterosexual, adoptive parents (50% females) for three time points: 4-6 weeks pre-placement of the child, 4-6 weeks post-placement, and 5-6 months post-placement. Mixed effects models by parent depressive trajectories were also conducted for three types of variables: interpersonal, psychological symptoms, and life orientation. Results-Five classes of depressive symptom trajectories were found. The majority of parents (71%) belonged to a class with low levels of depressive symptoms across time. However, two classes of parents were above the threshold for depressive symptoms at placement, and three classes of parents were above the threshold at 6 months post-placement. The majority of interpersonal, psychological symptom, and life orientation variables were significant across classes and by time. Limitations-The homogeneity of the sample calls for replication of study findings.

The journal of trauma and acute care surgery, Jul 7, 2016

Briefing of the trauma team prior to patient arrival is unstructured in many centers. We surveyed... more Briefing of the trauma team prior to patient arrival is unstructured in many centers. We surveyed trauma teams regarding agreement on patient care priorities, and evaluated the impact of a structured, physician-led briefing on concordance during simulated resuscitations. Trauma nurses at our Level II center were surveyed, and participated in four resuscitation scenarios, randomized to "Briefed" or "Non-briefed." For Non-briefed scenarios, nurses independently reviewed triage sheets with written information. Briefed scenarios had a structured, four-minute physician-led briefing reviewing triage sheets identical to Non-briefed scenarios. Teams included 3-4 nurses (subjects) and 2-4 confederates (physicians, respiratory therapists). Each team served as their own control group. Confederates were blinded to nurses' Briefed or Non-briefed status. Immediately before, and at the midpoint of each scenario, nurses estimated patient morbidity and mortality and ranked th...

The American Journal of Surgery, 2016

Background-Trauma care requires coordinating an interprofessional team, with formative feedback o... more Background-Trauma care requires coordinating an interprofessional team, with formative feedback on teamwork skills. We hypothesized nurses and surgeons have different perceptions regarding roles during resuscitation; that nurses' teamwork self-assessment differs from experts', and that video debriefing might improve accuracy of self-assessment. Methods-Trauma nurses and surgeons were surveyed regarding resuscitation responsibilities. Subsequently, nurses joined interprofessional teams in simulated trauma resuscitations. Following each resuscitation, nurses and teamwork experts independently scored teamwork (T-NOTECHS). After video debriefing, nurses repeated T-NOTECHS self-assessment. Results-Nurses and surgeons assumed significantly more responsibility by their own profession for 71% of resuscitation tasks. Nurses' overall T-NOTECHS ratings were slightly higher than experts'. This was evident in all T-NOTECHS subdomains except "leadership," but despite statistical significance the difference was small and clinically irrelevant. Video debriefing did not improve the accuracy of self-assessment. Conclusions-Nurses and physicians demonstrated discordant perceptions of responsibilities. Nurses' self-assessment of teamwork was statistically, but not clinically significantly, higher than experts' in all domains except physician leadership.

Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health, 2015

Reference intervals (RIs) for common clinical laboratory tests are usually not developed separate... more Reference intervals (RIs) for common clinical laboratory tests are usually not developed separately for different subpopulations. The aim of this study was to investigate racial/ethnic differences in RIs of common biochemical and hematological laboratory tests using the National Health and Nutrition Examination Survey (NHANES) 2011-2012 data. This current study included 3,077 participants aged 18-65 years who reported their health status as "Excellent," "Very good," or "Good," with known race/ethnicity as white, black, Hispanic, or Asian. Quantile regression analyses adjusted for sex were conducted to evaluate racial/ethnic differences in the normal ranges of 38 laboratory tests. Significant racial/ethnic differences were found in almost all laboratory tests. Compared to whites, the normal range for Asians significantly shifted to higher values in globulin and total protein and to lower values in creatinine, hematocrit, hemoglobin, mean cell hemoglobin,...