2025
Disparities in Prenatal Care Utilization in the United States
McElfish P, Caldwell A, Selig J, Watson D, Langner J, Callaghan-Koru J, Porter A, Willis D, Andersen J, Hawley N, Mendoza-Kabua P, Brown C. Disparities in Prenatal Care Utilization in the United States. Maternal And Child Health Journal 2025, 1-9. PMID: 40986172, DOI: 10.1007/s10995-025-04150-2.Peer-Reviewed Original ResearchPrenatal care utilizationPrenatal care visitsInitiation of prenatal careCare utilizationPrenatal careCare visitsInadequate prenatal care utilizationNational Center for Health StatisticsCenter for Health StatisticsMedicaid-covered deliveriesPrenatal care accessInadequate prenatal careLate initiationSingleton live birthsDistrict of ColumbiaPerinatal healthCare accessAIAN womenHealth StatisticsPrenatal visitRacial/ethnic groupsCareMedicaid policiesResultsThe average numberWhite populationStudy protocol for the Health Outcomes in Pregnancy and Early Childhood (HOPE) Study: A mother-infant study in American Samoa
Heinsberg L, Loia M, Tasele S, Faasalele-Savusa K, Carlson J, Anesi S, Desobry K, Yuchongco E, Guevara B, Sesaga A, Iloilo A, Tofaeono V, Bryan K, Tauasosi-Posiulai T, Kershaw E, Conley Y, Weeks D, Hawley N, Muasau-Howard B. Study protocol for the Health Outcomes in Pregnancy and Early Childhood (HOPE) Study: A mother-infant study in American Samoa. PLOS ONE 2025, 20: e0326644. PMID: 40952996, PMCID: PMC12435730, DOI: 10.1371/journal.pone.0326644.Peer-Reviewed Original ResearchConceptsGestational diabetes mellitusBody mass indexHealth outcomesBurden of gestational diabetes mellitusLower risk of type 2 diabetesAmerican Samoa Department of HealthAssociated with higher body mass indexLow riskGestational diabetes statusRisk of type 2 diabetesHigher Body Mass IndexCord blood DNA methylationLongitudinal cohort studyDepartment of HealthInfant body sizePacific IslandersPeer-reviewed publicationsType 2 diabetesBlood DNA methylationInstitutional review boardAmerican SamoaPregnant womenInfant growthFollow-upMass indexSeasonal and community size-related patterns of population dietary energy, macronutrients, and fiber purchased in grocery stores across Nunavut, Canada
Gilbert S, Jessri M, Turner L, Fawehinmi T, Caughey A, Stadnyk S, Kaminsky L, Ford J, Pérez-Escamilla R, Hawley N, Dubrow R. Seasonal and community size-related patterns of population dietary energy, macronutrients, and fiber purchased in grocery stores across Nunavut, Canada. Current Developments In Nutrition 2025, 107558. DOI: 10.1016/j.cdnut.2025.107558.Peer-Reviewed Original ResearchNutrition transitionEnergy-denseStatistical significanceFood energy densityCanadian Nutrient FileStatistical significance of differencesNunavut communitiesDaily energy densitySignificance of differencesNutritional patternsNutritional insightGrocery storesAnalysis of varianceHigh-carbohydrateCensus dataMacronutrient valuesSales dataTerritory of NunavutLow proteinCommunityPer capita standardDietary energyMacronutrientsCanadaQuartileExcessive gestational weight gain associated with higher risk of cesarean delivery across body mass index categories in the United States
Mcelfish P, Hawley N, Caldwell A, Selig J, Watson D, Gomez-Pomar E, Andersen J, Kraleti S, White L, Willis D, Langston K, Manning N, Callaghan-Koru J, Porter A, Brown C. Excessive gestational weight gain associated with higher risk of cesarean delivery across body mass index categories in the United States. Journal Of Gynecology Obstetrics And Human Reproduction 2025, 54: 103010. PMID: 40796020, PMCID: PMC12434902, DOI: 10.1016/j.jogoh.2025.103010.Peer-Reviewed Original ResearchRisk of cesarean deliveryPre-pregnancy body mass indexHigher risk of cesarean deliveryBody mass indexBody mass index categoriesCesarean deliveryGestational weight gainExcessive GWGAssociated with higher riskPre-pregnancyNational Center for Health StatisticsExcessive gestational weight gainCenter for Health StatisticsCesarean delivery riskHigher pre-pregnancy body mass indexRate of gestational weight gainMode of birthVital records dataRate of GWGSingleton term birthsJ-shaped relationshipHigh riskCephalic presentationProvider levelHealth StatisticsAssociations between maternal and infant body composition, feeding practices, and perceived infant eating behaviour in Samoan mother–infant dyads aged 1–4 months
Bertacchi V, Daiy K, Vesi L, Faaselele-Savusa K, Duckham R, Naseri T, Soti-Ulberg C, Abraham J, Bribiescas R, Hawley N. Associations between maternal and infant body composition, feeding practices, and perceived infant eating behaviour in Samoan mother–infant dyads aged 1–4 months. Annals Of Human Biology 2025, 52: 2534349. PMID: 40762381, DOI: 10.1080/03014460.2025.2534349.Peer-Reviewed Original ResearchConceptsBaby Eating Behaviour QuestionnaireInfant body compositionFood responsivenessSatiety responsivenessInfant appetiteBody compositionMaternal perceptionProportion of infantsBMI-for-ageAged 1General appetiteInfants aged 1Initiation of breastfeedingBody composition measurementsDevelopment of obesityInfant eating behaviorsMaternal educational statusMaternal BMIBreastfed infantsInfant characteristicsInfant sexBreastfeeding patternsBreastfeeding practicesMaternal confidenceInfantsMaternal Obesity and Neonatal Death in Preterm US Pacific Islander Neonates Using 2 Analytic Approaches
Wu B, Taylor S, Hawley N, Shabanova V. Maternal Obesity and Neonatal Death in Preterm US Pacific Islander Neonates Using 2 Analytic Approaches. JAMA Network Open 2025, 8: e2528924. PMID: 40856998, PMCID: PMC12381668, DOI: 10.1001/jamanetworkopen.2025.28924.Peer-Reviewed Original ResearchConceptsFetuses-at-risk approachFetuses-at-riskPrepregnancy body mass indexBody mass indexPreterm birthGestational ageNeonatal deathPacific Islander individualsObesity class ICohort studyWeeks GAPrepregnancy obesityStratification biasIslander individualsNational Center for Health StatisticsRate of neonatal deathPopulation-based cohort studyCenter for Health StatisticsClass IDegree of prematurityMother-neonate dyadsPrevalence of obesityCox proportional hazards modelsNeonatal mortality ratePreterm birth prevalenceA Genome-Wide Association Study of Anti-Müllerian Hormone (AMH) Levels in Samoan Women
Erdogan-Yildirim Z, Carlson J, Krishnan M, Zhang J, Lambert-Messerlian G, Naseri T, Viali S, Hawley N, McGarvey S, Weeks D, Minster R. A Genome-Wide Association Study of Anti-Müllerian Hormone (AMH) Levels in Samoan Women. Genes 2025, 16: 793. PMID: 40725450, PMCID: PMC12294779, DOI: 10.3390/genes16070793.Peer-Reviewed Original ResearchConceptsGenome-wide association studiesTranscriptome-wide association analysisAssociation studiesGenome-wide suggestive lociExpression quantitative trait lociGene-based testsQuantitative trait lociBiologically plausible candidate genesCox mixed-effects modelsWomen of European ancestryAnti-Mullerian hormoneLead variantsSuggestive lociGenetic lociTrait lociAnti-Mullerian hormone levelsCandidate genesReproductive phenotypesSignificant genesAssociation analysisGenetic determinantsEuropean ancestryLociGenesRegulation of ovarian follicle developmentCorrigendum to “Sociodemographic factors associated with prenatal care utilization in Arkansas, United States” [Prev. Med. Rep. 51(2025) 102983]
McElfish P, Caldwell A, Watson D, Langner J, Callaghan-Koru J, Porter A, Willis D, Andersen J, Hawley N, Selig J, Forati A, Alcala M, White L, Gomez-Pomar E, Brown C. Corrigendum to “Sociodemographic factors associated with prenatal care utilization in Arkansas, United States” [Prev. Med. Rep. 51(2025) 102983]. Preventive Medicine Reports 2025, 55: 103122. PMID: 40589551, PMCID: PMC12207217, DOI: 10.1016/j.pmedr.2025.103122.Peer-Reviewed Original ResearchGut microbial composition and diversity varies by CREBRF genotype among Samoan infants
Oyama S, Arslanian K, Savo Sardaro M, Duckham R, Kershaw E, Wood A, Fidow U, Naseri T, Reupena M, Amato K, Hawley N. Gut microbial composition and diversity varies by CREBRF genotype among Samoan infants. Physiological Genomics 2025, 57: 473-484. PMID: 40366801, PMCID: PMC12276851, DOI: 10.1152/physiolgenomics.00014.2024.Peer-Reviewed Original ResearchGut microbiotaMicrobiome compositionBacterial gene sequencesDifferentially abundant taxaGut microbial compositionGut microbial diversityMicrobiota community structureOverall microbiome compositionGut microbiome compositionGenotypic differencesDifferential abundance analysisImmune signaling pathwaysEscherichia-Shigella,Low relative abundanceAbundant taxaGene sequencesGut microbiomeMicrobial diversityMicrobial compositionAssociated with functional differencesCommunity structureAssociated with lower relative abundanceMinor A alleleRelative abundanceMicrobiotaValidation of the Latin American and Caribbean Food Security Scale (ELCSA) for use in Samoa
Tanawattanacharoen V, Choy C, Anesi T, Hromi-Fiedler A, Naseri T, Reupena M, Duckham R, Wang D, Hawley N, Soti-Ulberg C. Validation of the Latin American and Caribbean Food Security Scale (ELCSA) for use in Samoa. Journal Of Nutrition 2025, 155: 1474-1484. PMID: 40127734, PMCID: PMC12121424, DOI: 10.1016/j.tjnut.2025.03.023.Peer-Reviewed Original ResearchCaribbean Food Security ScaleFood Security ScaleFood insecurityInternal consistencySecurity ScaleDegree of food insecurityChildren's dietary intakeLongitudinal cohort studyRasch modelProtective factorsItem infit statisticsFocus group discussionsObesity riskInfit statisticsContent validityMaternal educationConstruct validityHealthy foodSamoan mothersSamoan womenCohort studyDietary intakeHousehold incomeGroup discussionsCohort characteristicsSerum anti-mullerian hormone levels and age among Samoan women
O’Brien G, Lambert-Messerlian G, Hawley N, Fidow U, Naseri T, Reupena M, Kershaw E, Azar M, Pangburn M, McGarvey S. Serum anti-mullerian hormone levels and age among Samoan women. Reproductive Biology And Endocrinology 2025, 23: 45. PMID: 40108611, PMCID: PMC11921511, DOI: 10.1186/s12958-025-01379-y.Peer-Reviewed Original ResearchConceptsPCOS prevalencePolycystic ovary syndromeSerum anti-Mullerian hormoneAnti-Mullerian hormoneAnti-Mullerian hormone levelsSamoan womenAssociation of anti-Mullerian hormoneContraceptive useBody mass indexSerum anti-mullerian hormone levelsEthnic minority populationsHormonal contraceptive useAMH levelsAssociated with ageFree androgen indexMinority populationsSex hormone binding globulinReproductive healthAssociated with body mass indexSerum total testosteroneAndrogen indexPrevalence of obesityRelated declineTobacco useAdult womenEquity, ethics and the promise of partnership in genomic medicine
Hawley N, Viali S. Equity, ethics and the promise of partnership in genomic medicine. Nature Genetics 2025, 57: 765-766. PMID: 40065167, DOI: 10.1038/s41588-025-02131-3.Peer-Reviewed Original ResearchPsychosocial correlates of HbA1c among adult Samoans without diabetes
Rivara A, Heinsberg L, Carlson J, Pomer A, Naseri T, Reupena M, Choy C, Wang D, Kershaw E, Viali S, McGarvey S, Hawley N. Psychosocial correlates of HbA1c among adult Samoans without diabetes. PLOS Mental Health 2025, 2: e0000196. DOI: 10.1371/journal.pmen.0000196.Peer-Reviewed Original ResearchPsychosocial factorsSocial supportMental health awarenessHealth promotion materialsAssociated with lower HbA1cBehavioral risk factorsFactors associated with HbA1cHigh social supportHigh-risk populationPsychosocial healthDiabetes careDiabetes prevalencePsychosocial determinantsHealth outcomesDiabetes preventionAdult SamoansPsychosocial variablesParticipant demographicsCorrelation of HbA1cPsychosocial correlatesHealth awarenessSamoan adultsRs373863828 genotypeSelf-EfficacyLower HbA1cCross-cultural adaptation of mental health screening instruments for Samoan adolescents
Mew E, Lowe S, Galea’i A, Iopu F, Anderson J, Naseri J, Hunt L, Mulitalo-Cheung T, Fauolo-Manila O, Soliai-Lemusu S, Hawley N, McCutchan-Tofaeono J. Cross-cultural adaptation of mental health screening instruments for Samoan adolescents. PLOS Mental Health 2025, 2: e0000106. DOI: 10.1371/journal.pmen.0000106.Peer-Reviewed Original ResearchMental health screening instrumentCPSS-5Screening instrumentPTSD Symptom Scale-Self-ReportDeliberate Self-Harm QuestionnaireGeneralized Anxiety Disorder 7Measure symptoms of depressionSelf-injurious thoughtsSymptoms of depressionSamoan adolescentsPost-traumatic stressSelf-Harm QuestionnaireAvon Longitudinal Study of ParentsCross-cultural validityLongitudinal Study of ParentsMental health problemsAvon Longitudinal StudyStudy of parentsGAD-7English language wordsAdolescent focus groupsMeasure symptomsMeasurement equivalenceSelf-ReportFocus groupsSociodemographic factors associated with prenatal care utilization in Arkansas, United States
McElfish P, Caldwell A, Watson D, Langner J, Callaghan-Koru J, Porter A, Willis D, Andersen J, Hawley N, Selig J, Forati A, Alcala M, White L, Gomez-Pomar E, Brown C. Sociodemographic factors associated with prenatal care utilization in Arkansas, United States. Preventive Medicine Reports 2025, 51: 102983. PMID: 39990201, PMCID: PMC11847520, DOI: 10.1016/j.pmedr.2025.102983.Peer-Reviewed Original ResearchPrenatal care visitsPrenatal carePrenatal visitCare visitsRural/Urban ResidenceNational Center for Health StatisticsCenter for Health StatisticsPrenatal care utilizationBirth record dataSingleton live birthsMedicaid-covered birthsCare utilizationHealth StatisticsResults MothersMaternal educationRacial/ethnic groupsRate ratiosCareRecord dataMaternal ageWhite mothersPrimary outcomeUtilization differencesRural areasStudy populationGestational weight gain and increased risk of cesarean delivery across body mass index categories
MCELFISH P, AYERS B, HAWLEY N, CALDWELL A, PORTER A, MACECHKO M, WATSON D, CALLAGHAN-KORU J, SELIG J, ANDERSEN J, MANNING N, WHITE L, GOMEZ-POMAR E, BROWN C. Gestational weight gain and increased risk of cesarean delivery across body mass index categories. AJOG Global Reports 2025, 5: 100445. PMID: 40027475, PMCID: PMC11869019, DOI: 10.1016/j.xagr.2025.100445.Peer-Reviewed Original ResearchRisk of cesarean deliveryGestational weight gainRate of gestational weight gainHealthy pre-pregnancy BMIIncreased risk of cesarean deliveryPre-pregnancy BMIExcessive rate of gestational weight gainExcessive gestational weight gainCesarean deliveryBMI categoriesAssociated with increased risk of cesarean deliveryCesarean delivery riskPre-pregnancy BMI categoriesLow-risk birthsAmerican College of Obstetricians and GynecologistsReduce cesarean deliveryIncreased GWGVital records dataIncreased riskObstetricians and GynecologistsStudy design analysisAssociated with increased riskProportion of womenMaternal healthExcess rateBehavioral and sociodemographic correlates of sleep duration among children in Samoa
von Ash T, Choy C, Dunsiger S, Soti-Ulberg C, Wang D, Reupena M, Duckham R, Naseri T, Hawley N. Behavioral and sociodemographic correlates of sleep duration among children in Samoa. Sleep Health 2025, 11: 57-64. PMID: 39753399, PMCID: PMC11805616, DOI: 10.1016/j.sleh.2024.10.009.Peer-Reviewed Original ResearchConceptsSchool-aged childrenSociodemographic correlatesPrimary caregiversSleep durationSleep recommendationsAssociated with longer sleepCorrelates of sleepCorrelates of sleep durationLongitudinal cohort studyShort sleepDietary pattern adherenceAged 2Total carbohydrate intakeData collection wavesNighttime sleepSamoan childrenChildren Aged 2Physical activityChild healthSociodemographic characteristicsAdequate sleepCarbohydrate intakeCollection wavesInsufficient sleepRisk factors
2024
Prediction of neonatal survival among Pacific Islander preterm births in the US
Wu B, Taylor S, Shabanova V, Hawley N. Prediction of neonatal survival among Pacific Islander preterm births in the US. PLOS ONE 2024, 19: e0316048. PMID: 39739767, PMCID: PMC11687717, DOI: 10.1371/journal.pone.0316048.Peer-Reviewed Original ResearchConceptsGestational ageNeonatal sexBirth weightNeonatal mortalityNeonatal survivalPreterm birthBorn large-for-gestational ageLarge-for-gestational ageObesity-related risk factorsPrediction of neonatal survivalPre-pregnancy obesityGroup of neonatesMortality rateNeonatal mortality rateUnited States National Center for Health StatisticsDeath data filesPacific Islander mothersPredicted survival ratesGestational weeksPre-pregnancyNeonatal deathCongenital anomaliesGestationSurvival rateRisk factorsShaping childhood obesity: behavioral and environmental risk factors associated with body mass index trajectories between 2 and 9 years in Samoan children
Choy C, Johnson W, Naseri T, Filipo V, Arorae M, Tafunaina F, Unasa F, Savusa K, Reupena M, Braun J, Duckham R, Soti-Ulberg C, McGarvey S, Hawley N. Shaping childhood obesity: behavioral and environmental risk factors associated with body mass index trajectories between 2 and 9 years in Samoan children. International Journal Of Obesity 2024, 49: 322-331. PMID: 39472691, PMCID: PMC11805637, DOI: 10.1038/s41366-024-01665-6.Peer-Reviewed Original ResearchBody mass indexDietary pattern adherenceHigher Body Mass IndexPhysical activityNetherlands Physical Activity QuestionnaireRisk factorsBody mass index trajectoriesFood frequency questionnaire dataPhysical Activity QuestionnaireHigh physical activityBody mass index gainBehavioral risk factorsHousehold asset scoreLow household assetsCubic spline regressionAged 2 to 4 yearsAged 2Public health solutionsChildhood risk factorsSamoan childrenActivity QuestionnaireObesity preventionBMI trajectoriesObesity riskHealth solutionsCommunity perspectives on adolescent mental health stigma in American Samoa
Blas V, Mew E, Winschel J, Hunt L, Soliai Lemusu S, Lowe S, Naseri J, Toelupe R, Hawley N, McCutchan-Tofaeono J. Community perspectives on adolescent mental health stigma in American Samoa. PLOS Mental Health 2024, 1: e0000080. DOI: 10.1371/journal.pmen.0000080.Peer-Reviewed Original ResearchMental health stigmaHealth stigmaSelf-stigma of mental illnessLevels of mental health stigmaMental illness-related stigmaMental health care accessIllness-related stigmaHealth care accessMental health burdenMental health servicesStigmatization of mental healthMental health needsSocio-ecological modelMental health challengesMental health concernsMental health stigmatizationOnline focus groupsAmerican SamoaCare accessSelf-StigmaPerceived stigmatizationHealth needsHealth servicesMental illnessMental health
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