Molly Sears Rosenberg

Indiana University Bloomington | IUB · Department of Epidemiology and Biostatistics

Background Postoperative delirium (POD) is a common complication after major surgery and is associated with poor outcomes in older adults. Early identification of patients at high risk of POD can enable targeted prevention efforts. However, existing POD prediction models require inpatient data collected during the hospital stay, which delays predic...

Evidence on cash transfers as a population-level intervention to support healthy cognitive aging in low-income settings is sparse. We assessed the effect of a cash transfer intervention on cognitive aging outcomes in older South African adults. We leveraged the overlap in the sampling frames of a Phase 3 randomized cash transfer trial [HIV Preventi...

Household food and water insecurity has been previously associated with adverse health consequences in children. However, these relationships are understudied in middle‐income Latin American populations such as in Ecuador, where a high prevalence of food and water insecurity has been reported. Using cross‐sectional data from 2018 Ecuadorian Nationa...

Retrospective alcohol use data are prone to recall bias, a limitation that could be addressed with real-time ecological momentary assessment (EMA) tools. We aimed to (1) introduce a simple (single-click) EMA methodology for collecting real-time alcohol use data, and (2) investigate the EMA methodology’s performance relative to established alcohol u...

BACKGROUND Postoperative delirium (POD) is a common complication after major surgery and is associated with poor outcomes in older adults. Early identification of patients at high risk of POD can enable targeted prevention efforts. However, existing POD prediction models require inpatient data collected during the hospital stay, which delays predic...

Background Cash transfers are a promising but understudied intervention that may protect cognitive function in adults. Although South Africa has a rapidly ageing population, little is known about the nature of association between cash transfers and cognitive function in this setting. Objectives We leveraged age-eligibility expansions to South Afri...

Background and Objectives Alcohol causes more than 3 million deaths a year globally and contributes to over 5% of global disease and injury. Heavy drinking and alcohol use disorders among older adults have increased in the last 10–15 years. For individuals living in low-income countries, where wages are low and unemployment is high, old age pension...

Background Studies from rural South Africa indicate that people living with HIV (PLHIV) may have better health outcomes than those without, potentially due to the frequent healthcare visits necessitated by infection. Here, we examined the association between HIV status and healthcare utilization, using diabetes as an illustrative comparator of anot...

Background: Cognitive impairment is projected to rise substantially by 2050, particularly in low- and middle-income countries with aging populations. Reproductive life history may be associated with later-life cognitive function. We aim to estimate the association between number of children and mid- to later-life cognitive performance. Method: Data...

Objective: We assessed the feasibility and acceptability of using BACtrack Skyn wearable alcohol monitors for alcohol research in a college student population. Methods: We enrolled n=5 (Sample 1) and n=84 (Sample 2) Indiana University undergraduate students to wear BACTrack Skyn devices continuously over a five-day to seven-day study period. We...

Introduction Being choked/strangled during partnered sex is an emerging sexual behavior, particularly prevalent among young adult women. Using a multiparameter morphometric imaging approach, we aimed to characterize neuroanatomical differences between young adult women (18–30 years old) who were exposed to frequent sexual choking and their choking...

Background and aims: Transdermal alcohol content (TAC) data collected by wearable alcohol monitors could potentially contribute to alcohol research, but raw data from the devices are challenging to interpret. We aimed to develop and validate a model using TAC data to detect alcohol drinking. Design: Model development and validation SETTING: Indi...

Two-thirds of people living with Alzheimer's disease and related dementias (ADRD) live in low- and middle-income countries, and this figure is expected to rise as these populations are rapidly aging. Since evidence demonstrates links between socioeconomic status and slower rates of cognitive decline, protecting older adults' cognitive function in r...

Background: Increasing socioeconomic resources through cash transfer payments could help promote healthy longevity. However, research in this area is limited due to endogeneity in cash transfer exposures and limited geographic representation. Methods: We leveraged the HPTN 068 randomized cash transfer trial, conducted from 2011 to 2015 in a rura...

Cash transfers are a promising but understudied intervention that may protect cognitive function in adults by promoting their cognitive reserve. South Africa has a rapidly ageing population, however, less is known about the nature of association between cash transfers and cognitive function in this setting. We leveraged natural experiments from Chi...

Background: Research trial participation may influence health outcomes regardless of the intervention assigned but is often not assessed. Setting: We investigated how participation in an HIV prevention trial (the HIV Prevention Trials Network (HPTN) 068 study) affected health outcomes four years after the study in adolescent girls and young wome...

The impact of improved socioeconomic welfare after retirement on cardiovascular health among older men in low-income settings is unknown. Using natural experiment, we investigated the impact of eligibility for additional Old Age Pension (OAP) income on systolic blood pressure (SBP) among older men in rural South Africa using data from 1,208 men age...

Material resources that affect daily living conditions may be salient for cognitive aging in low-income settings, but evidence is limited on this topic. We investigated relationships between long-term trends in household material resources and subsequent cognitive function among 4,580 adults aged ≥40 in a population-representative cohort in Agincou...

Purpose The aim of this cross-sectional study was to examine the relationship between social factors and COVID-19 protective behaviors and two outcomes: depressive and perceived stress symptoms. Methods In September 2020, 1,064 randomly selected undergraduate students from a large midwestern university completed an online survey and provided infor...

Background The burden of cognitive decline is projected to rise over the next decades, particularly in low‐ and middle‐income countries, contributing to economic hardship, morbidity, and mortality. Reproductive life‐history, including parity, may be associated with later‐life cognitive ability. Using data from the population‐representative “Health...

Background Studies from rural South Africa indicate that people living with HIV (PLHIV) may have better health outcomes than those without, potentially due to the frequent healthcare visits necessitated by infection. Here, we examined the association between HIV status and healthcare utilization, using diabetes as an illustrative comparator of anot...

To understand how household context factors impacted self-reported changes in solo and sexual behaviors in U.S. adults during early stages of the COVID- 19 pandemic, we conducted an online, nationally representative, cross-sectional survey of U.S. adults (N = 1010; aged 18–94 years; 62% response rate) from April 10–20, 2020. We used weighted descri...

Objectives: To examine changes over time in event-level condom/contraceptive use and the association between past year penile-vaginal intercourse frequency and event-level condom/contraceptive use. Methods: Data were from the 2009 and 2018 National Survey of Sexual Health and Behavior, an online probability survey of U.S. adolescents and adults....

Background The aim of this study was to test whether two SARS-CoV-2 experiences, knowing someone who had died of SARS-CoV-2 infection and having received a positive SARS-CoV-2 test result, were associated with shorter sleep duration among undergraduate students. Methods An online cross-sectional study was conducted at a large public Midwestern uni...

Although sexual choking is now prevalent, little is known about how people engage in choking in terms of frequency, intensity, method, or potential health sequelae. In a campus-representative survey of undergraduate and graduate students, we aimed to: (1) describe the prevalence of ever having choked/been choked as part of sex; (2) examine the char...

Objective: This longitudinal study tested the relationship between cigarette and e-cigarette use and SARS-CoV-2 seroconversion among US college students. Participants: Undergraduate students (n = 764), drawn from a randomly selected invitation-only pool from a large Midwestern university, that were initially negative for SARS-CoV-2 antibodies an...

Solo and partnered sexual behaviors are relevant to health, well-being, and relationships. Recent research shows that sexual frequency has declined in the U.S. and in other countries; however, measurement has been imprecise. We used data from 14- to 49-year-old participants in the 2009 and 2018 waves of the National Survey of Sexual Health and Beha...

Aims: To estimate the associations between high-risk alcohol consumption and (1) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroconversion, (2) self-reported new SARS-CoV-2 infection, and (3) symptomatic COVID-19. Design: Prospective cohort study SETTING: Indiana University Bloomington (IUB), Indiana, USA. Participants: N=1,0...

The purpose of this study was to investigate how various subgroups based on gender, sexual identity, and political ideology conceptualize rough sex. We used available data from a 2020 survey of randomly sampled undergraduate students at a large public university in the Midwestern U.S. (n = 4,989). The dichotomous responses to 13 items on the rough...

In the wake of the COVID-19 pandemic, most U.S. colleges closed their campuses—including residence halls—causing significant disruption to students’ lives. Two waves of data were collected from undergraduate students enrolled at a large U.S. Midwestern university: Wave 1 was a confidential online survey of 4989 randomly sampled undergraduate studen...

Objective:Explore how perceptions of the sex ratio in Black communities’ impact heterosexual Black women’s confidence in negotiating condom use with sex partners and condom use at last sex. Methods: Using log-binomial regression models, we estimated the association between perception of the sex ratio and condom negotiation self-efficacy and condom...

IntroductionHigh childhood vaccine adherence is critical for disease prevention, and poverty is a key barrier to vaccine uptake. Interventions like microfinance programs that aim to lift individuals out of poverty could thus improve vaccine adherence of the children in the household. BIGPIC Family Program in rural Western Kenya provides group-based...

Choking/strangulation during sex is prevalent among young adults in the United States. We examined associations between having ever been choked and participants’ current mental health symptoms (e.g., feeling depressed, anxious, sad, lonely) in the prior 30 days and in the prior year. Participants were 4352 randomly sampled undergraduates who comple...

Natural disaster and food insecurity are prevalent in Haiti. Natural disasters may cause long-term food insecurity. Microfinance programs may provide resilience against this outcome. The objectives of this study were 1) to assess the association between the impact of Hurricane Matthew and long-term food insecurity and 2) to understand whether this...

Background Randomized controlled trials (RCT) are considered the ideal design for evaluating the efficacy of interventions. However, conducting a successful RCT has technological and logistical challenges. Defects in randomization processes (e.g., allocation sequence concealment) and flawed masking could bias an RCT’s findings. Moreover, investigat...

Aims: To estimate the associations between high-risk alcohol consumption and (1) SARS-CoV-2 seroconversion, (2) self-reported new SARS-CoV-2 infection, and (3) symptomatic COVID-19. Design: Prospective cohort Setting: Indiana University Bloomington (IUB), a public university of 34,660 students in southern Indiana. Participants: At the beginning of...

Objective: In a random sample of undergraduate students, we aimed to: (1) establish the prevalence of choking and being choked; (2) examine demographic and situational predictors of being choked, and (3) examine demographic and situational predictors of choking someone. Participants: 4168 randomly sampled undergraduates at a large public U.S. univ...

Purpose To estimate the prevalence of depression and loneliness during the US COVID-19 response, and examine their associations with frequency of social and sexual connections. Methods We conducted an online cross-sectional survey of a nationally representative sample of American adults (n = 1010), aged 18–94, running from April 10–20, 2020. We as...

Objective: To measure associations between participation in community-based microfinance groups, retention in HIV care, and death among people living with HIV (PLHIV) in low-resource settings. Design and methods: We prospectively analyzed data from 3,609 patients enrolled in an HIV care program in western Kenya. HIV patients who were eligible an...

Purpose Colleges and universities across the United States are developing and implementing data-driven prevention and containment measures against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Identifying risk factors for SARS-CoV-2 seropositivity could help to direct these efforts. This study aimed to estimate the associa...

Background Probability-based surveys of college students typically assess sexual behaviors such as oral, vaginal, and anal sex. Little is known about the broader range of sexual behaviors in which students engage. Aims In a random sample survey of undergraduate students, we aimed to: (1) describe how recently participants had engaged in solo and p...

Using data from an undergraduate probability sample, we aimed to: (1) describe the prevalence and demographic characteristics of students who reported having engaged in rough sex with their current partner; (2) assess which sexual behaviors students consider to be rough sex; (3) describe the frequency with which participants report engaging in roug...

Background: Randomized controlled trials (RCT) are considered the ideal design for evaluating the efficacy of interventions. However, conducting a successful RCT has technological and logistical challenges. Defects in randomization processes (e.g., allocation sequence concealment) and flawed masking could bias an RCT’s findings. Moreover, investiga...

Objective: To assess the feasibility and acceptability of using BACtrack Skyn wearable alcohol monitors in a college student population. Method: In September 2019, we enrolled n=5 Indiana University undergraduate students in a study to wear alcohol monitor wristbands continuously over a 5-day period. Concurrently, participants completed daily surve...

Background: During the COVID-19 outbreak, facility capacity for HIV testing has been limited. Further, people may have opted against HIV testing during this period to avoid COVID-19 exposure. We investigated the influence of the COVID-19 pandemic on HIV testing and the number of reported HIV cases in Japan. Methods: We analyzed quarterly HIV/AID...

Background: Colleges and universities across the United States are developing and implementing data-driven prevention and containment measures against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Identifying risk factors for SARS-CoV-2 seropositivity could help to direct these efforts. Objective: To estimate the associati...

In November 2020, we conducted a cross sectional study to implement and test the method of acquaintance sampling (randomly sampling friends of randomly sampled individuals) in detecting students with higher probability of COVID-19 positivity. Overall, 879 students were randomly sampled and participated in this study. In an online survey, the random...

Background During the COVID-19 outbreak, medical resources were primarily allocated to COVID-19, which might have reduced facility capacity for HIV testing. Further, people may have opted against HIV testing during this period to avoid COVID-19 exposure. We investigate the influence of the COVID-19 pandemic on HIV testing and its consequences in Ja...

Research dedicated to understanding the sexual experiences of Black women has historically been framed around adverse outcomes. There are limited data that can be used to understand the lived experiences of Black women related to sexual health care. Twenty-five Black women aged 18- 35 from across nine US states were interviewed to gain insight into...

Background: Structural barriers often prevent rural Kenyans from receiving healthcare and diagnostic testing. The Bridging Income Generation through grouP Integrated Care (BIGPIC) Family intervention facilitates microfinance groups, provides health screenings and treatment, and delivers education about health insurance coverage to address some of...

In early 2020, the novel coronavirus 2019 (COVID-19) spread across the United States and mitigation measures drastically affected the daily lives of Americans. In this study, we assessed the association between COVID-related relationship conflict and changes in intimate and sexual behaviors and experiences. Using data from an online nationally repr...

Background Few studies have assessed the association between e-cigarette use and sleep deprivation. This is an important question given the rapid increase in e-cigarette use among young adults in recent years. Purpose To determine whether e-cigarette use is associated with sleep deprivation in a sample of young (18–24 years-old) American adults....

Background: Household food insecurity (HFI) and gestational diabetes mellitus (GDM) are both common during pregnancy, yet it is unknown if these two factors are related. We aimed to determine the independent and joint associations between HFI, gestational weight gain (GWG) and GDM among pregnant women in the USA. Methods: We used data from 592 w...

Objective: Assess the impact of survey non-response and non-completion for a campus climate survey. Participants: Intended for all degree-seeking students at a large, public, midwestern university, November 2014. Methods: The survey covered sexual assault experiences and related attitudes. We identify the magnitude and potential impact of survey no...

Background In the United States, efforts to achieve health equity and reduce sexual health disparities remain a national priority; however, limited research has focused on understanding racial differences in patient/provider discussions about sexual health. Aim To quantify racial differences between black and white women (aged 18–49 years) in the...

Microfinance interventions may have differential effects on relationship dynamics among subpopulations of women. We estimated the association between microfinance participation duration and physical abuse, relationship power, and transactional sex in a sample of Haitian women ( n = 304). Furthermore, we tested for moderation by age. In older women,...

Background: Research demonstrates that pandemics adversely impact sexual and reproductive health (SRH), but few have examined their impact on participation in sex. We examined self-reported changes in solo and sexual behaviors in U.S. adults during early stages of the public health response to COVID-19. Methods: We conducted an online, nationally r...

Introduction: In South Africa evidence shows high HIV prevalence in older populations, with sexual behavior consistent with high HIV acquisition and transmission risk. However, there is a dearth of evidence on older people's HIV incidence. Methods: We used a 2010-11 cohort of HIV negative adults in rural South Africa who were 40 years or older a...

Purpose: To estimate the prevalence of depression and loneliness during the US COVID-19 response, and examine their associations with frequency of social and sexual connections. Methods: We conducted an online cross-sectional survey of a nationally representative sample of American adults (n=1010), aged 18-94, running from April 10-20, 2020. We ass...

Introduction Although HIV prevalence is exceptionally high in South Africa, HIV testing rates remain below targeted guidelines. Older adults living with HIV are substantially more likely to remain undiagnosed than younger people. Cognitive function and literacy could play key roles in HIV status knowledge due to the decision‐making processes requir...

Introduction Structural barriers often prevent rural Kenyans from receiving healthcare and diagnostic testing. The Bridging Income Generation through grouP Integrated Care (BIGPIC) Family intervention facilitates microfinance groups, provides health screenings and treatment, and delivers education about health insurance coverage to address some of...

Background: Structural barriers often prevent rural Kenyans from receiving healthcare and diagnostic testing. The Bridging Income Generation through grouP Integrated Care (BIGPIC) Family intervention facilitates microfinance groups, provides health screenings and treatment, and delivers education about health insurance coverage to address some of t...

Background: Structural barriers often prevent rural Kenyans from receiving healthcare and diagnostic testing. The Bridging Income Generation through grouP Integrated Care (BIGPIC) Family intervention facilitates microfinance groups, provides health screenings and treatment, and delivers education about health insurance coverage to address some of t...

Background: Structural barriers often prevent rural Kenyans from receiving healthcare and diagnostic testing. The Bridging Income Generation through grouP Integrated Care (BIGPIC) Family intervention facilitates microfinance groups, provides health screenings and treatment, and delivers education about health insurance coverage to address some of t...

Objective The purpose of this study was to determine the association between HFI and EADS in the National Children’s Study, 2009-2014, as well as standardize our results to the US pregnant population. Methods HFI was collected at participants’ baseline visits using the US Household Food Security Survey Module; antepartum depression symptoms were c...

Limited research has examined sexual victimization among U.S. college men, and particularly fraternity men. We report the prevalence of sexual assault (SA) victimization among a sample of college fraternity members and the sociodemographic variables associated with this victimization. In April 2018, we conducted a web-based survey study among a ran...

Bias may be introduced in survey data collection when participants answer questions differently depending on interviewer gender. This could affect the validity of collected data, especially sensitive data. Using sexual behavior data collected in a 2017–2018 cross-sectional survey of Haitian women (n = 304), we evaluated the associations between int...

Sexual health education interventions have generally yielded modest impact, but may be more successful when integrated into programs designed to alleviate poverty and empower women. Between December 2017 and February 2018, we interviewed 304 Haitian female microfinance clients, 75 of whom had received health education training delivered within thei...

Objectives The HIV treatment cascade is a powerful framework for understanding progress from initial diagnosis to successful treatment. Data sources for cascades vary and often are based on clinical cohorts, population cohorts linked to clinics, or self-reported information. We use both biomarkers and self-reported data from a large population-base...

Background Zika virus is associated with increased cases of both microcephaly and Guillain-Barré syndrome. Community knowledge, perceptions and practices to prevent infection with the Zika virus are not well understood, particularly among high risk populations living in resource-poor and Zika-endemic areas. Our objective was to assess knowledge of...

Introduction The real-world association between male circumcision and HIV status has important implications for policy and intervention practice. For instance, women may assume that circumcised men are safer sex partners than non-circumcised men and adjust sexual partnering and behavior according to these beliefs. Voluntary medical male circumcisio...

Logistic regression sensitivity analysis of the relationship between circumcision status and HIV status among HAALSI men with laboratory-confirmed HIV status (n = 1945). (DOCX)