Helen Bland’s research while affiliated with Georgia Southern University and other places

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Publications (32)


Knowledge of pregnancy care behaviors, complications, and urgent maternal warning signs up to one year postpartum among Georgia residents
  • Article
  • Full-text available

September 2024

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22 Reads

BMC Public Health

Evelyn F. Fagan

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Ana M. Palacios

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Helen W. Bland

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[...]

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Objectives Maternal mortality in the U.S. continues to increase, and the State of Georgia has one of the highest maternal mortality rates among the 50 states at 33.9 deaths per 100,000 live births, disproportionately affecting Black and rural populations. This study sought to ascertain knowledge of adults living in Georgia about proper pregnancy care behaviors and their ability to identify warning signs and symptoms (WSS) of life-threatening complications during pregnancy and up to 1-year postpartum. Methods In 2022, using a cross-sectional study design, a questionnaire including items from validated instruments was distributed to adults residing in Georgia through social media and email. Questions were grouped into categories: total pregnancy knowledge, general pregnancy care behaviors, and pregnancy and postpartum WSS. Based on correct answer choices, scores were created for each of the four categories and compared by gender, age, education, race, and ethnicity using multiple linear regressions. Results Participants (n = 588) ranged from 18 to 76 years old and were primarily female (80%). The vast majority (83.3%) failed to identify important pregnancy care behaviors. More than half of all participants were unable to recognize pregnancy and postpartum WSS of complications, 52% and 56% respectively. Male, Black, and Hispanic self-identified adults exhibited lower recognition of pregnancy care behaviors and WSS of pregnancy and postpartum complications, relative to other genders, races, and ethnic groups, respectively (p < 0.001). Conclusions This research identified important gaps in maternal health knowledge among adults living in the State of Georgia, highlighting specific opportunities for intervention and offering evidence-based information that can help improve health literacy for better maternal outcomes.

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The Association Between Body Composition and Performance on Military Fitness Tests

September 2024

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19 Reads

The Journal of Strength and Conditioning Research

Feeney, KA, Melton, BF, Ryan, GA, Bland, HW, and Butler, CR. The association between body composition and performance on military fitness tests. J Strength Cond Res 39(1): 94-98, 2025-Body composition and physical testing are important considerations for military personnel. However, limited research exists on the potential relationship between these 2 factors. The purpose of this retrospective cohort study was to examine the correlations between several body composition measures and performance on the components of 2 separate fitness tests in Air Force special warfare candidates. Within the cohort of candidates, 1,036 completed body composition testing, 1,002 completed a calisthenic-based fitness test, and 562 completed a fitness test designed to mimic occupational tasks. Analysis of Pearson correlations indicated that the calisthenic-based test weakly favored candidates with lower body mass and body fat levels on the lower end of that found within the cohort studied, while a higher score on the occupational-based test was linked to higher body mass index (BMI) and skeletal muscle mass (SMM) and lower absolute and relative body fat levels. Individual components of the occupational-based test favored different body composition relationships. A large negative association was seen between the farmer's carry time and SMM (r = -0.53) and a moderate negative association between farmer's carry time and body mass (r = -0.46), p < 0.01. The weight lifted during 3-RM deadlift demonstrated moderate positive associations with body mass (r = 0.49), BMI (r = 0.50), and SMM (r = 0.49), p < 0.01. These results suggest that individuals in physically active military roles should maximize SMM while managing body fat levels.


Multinomial multivariable logistic regression model showing the association between the socio-structural and demographic determinants of health and COVID-19 vaccine hesitancy among older adults.
Social and Structural Determinants of Health Associated with COVID-19 Vaccine Hesitancy among Older Adults in the United States

May 2024

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35 Reads

State-level COVID-19 vaccination rates among older adults have been uneven in the United States. Due to the immunocompromised nature of older adults, vaccine hesitancy increases the risk of morbidity and mortality. This study aims to determine the association between the social determinants of health, the structural determinants of health, and COVID-19 vaccine hesitancy among older adults in the United States. Secondary data from the Health and Retirement Study (HRS) dataset were used. A descriptive analysis and multinomial multivariable logistic regression were performed to examine the association of the independent variables—gender, age, race, immigration status, marital status, broadband internet access, social security income, Medicare coverage, education, and frequency of religious service—with the dependent variable, vaccine hesitancy. Compared to the respondents with no vaccine hesitancy and without the specific predictor, the respondents who reported religious attendance at least once/week were more likely to be “somewhat hesitant”, divorced respondents had higher odds of being “somewhat hesitant”, and older adults aged 65–74 years were more likely to be “very hesitant” or “somewhat hesitant” about the COVID-19 vaccine. Compared to the respondents with no vaccine hesitancy and without the specific predictor, females had higher odds of being “very hesitant”, “somewhat hesitant”, or a “little hesitant”, and African Americans were more likely to be “very hesitant”, “somewhat hesitant”, or a “little hesitant” about the COVID-19 vaccine. Addressing these factors may limit the barriers to vaccine uptake reported among older adults and improve herd immunity among the immunocompromised population.


Evaluation of the Craniovertebral Angle in Standing versus Sitting Positions in Young Adults with and without Severe Forward Head Posture

January 2024

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79 Reads

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3 Citations

The purpose of this study was to examine the effects of standing versus sitting body position on the craniovertebral angle (CVA) in young adults without pathology; and to investigate whether mean differences between positional CVA measures in subjects with severe forward head posture (FHP) are distinct from age-matched controls with normal head posture. Ninety-eight young adults (68 women, 30 men) without pathology (OVERALL; n = 98) volunteered for the study; those with CVA > 53° were also included in a normal posture group (NORM; n = 14); those with CVA < 45° were also included in a severe FHP group (SEV; n = 15). CVA assessments were conducted in standing and sitting. Mean difference comparison of change in mean CVA between conditions revealed significantly (p < 0.05) higher CVA values in standing condition (OVERALL: 50.0 ± 5.2°; NORM: 56.6 ± 2.7°; SEV: 41.2 ± 3.2°) compared to sitting condition (OVERALL: 47.8 ± 5.7°; NORM: 55.9 ± 2.8°; SEV: 39.0 ± 4.0°). Mean difference comparison of between-group change in mean CVA between conditions revealed greater CVA change (p < 0.05) in the SEV group (2.2 ± 2.1°) versus the NORM group (0.8 ± 1.2°). Sitting CVA values may be lower (indicating greater FHP) than standing CVA values in young adults. Differences between standing and sitting CVA measures may be greater in young adults with severe FHP compared to peers with normal head posture. Study findings support standing as a standardized body position for CVA assessment in young adults without pathology.


Figure 1. Percentage of injuries by anatomical location.
Running-related injuries and resistance-training status across sex, age, and run-distance categories.
Cont.
Resistance-training characteristics by running-related injury status.
Running-Related Overuse Injuries and Their Relationship with Run and Resistance Training Characteristics in Adult Recreational Runners: A Cross-Sectional Study

September 2023

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164 Reads

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6 Citations

Journal of Functional Morphology and Kinesiology

This study aimed to characterize running-related injuries (RRIs), explore their relationship with run and resistance training (RT) parameters, and identify perceived prevention measures among adult recreational runners. An anonymous online survey was designed and distributed via social media and email. Data were analyzed with chi-square, t-test, or analysis of variance (ANOVA), with significance accepted at p ≤ 0.05. Data from 616 participants (76.8% female, age: 42.3 ± 10.5 y) were analyzed. Most runners (84.4%) had an injury history, with 44.6% experiencing one in the past year. The most common RRI sites included the foot/ankle (30.9%) and knee (22.2%). RRI prevalence was higher in those running >19 miles weekly (48.4%, p = 0.05), but there were no differences based on RT participation status. Among those using RT, relatively more RRIs were observed in runners who trained the hip musculature (50.3%, p = 0.005) and did not include the upper body (61.6%, p < 0.001). A disproportionately high RRI prevalence was found for several of the other risk-reduction strategies. RRIs remain a substantial problem, particularly around the ankle/foot and knee. Higher run volume and performance motives were positively associated with RRIs. Most runners incorporated RRI risk-reduction techniques, with over half using RT. The current study did not determine whether preventative strategies were implemented before or after injury; therefore, prospective studies controlling for previous injuries are required to evaluate the effectiveness of RT in preventing future RRIs.


The Effects of Postural Education or Corrective Exercise on the Craniovertebral Angle in Young Adults with Forward Head Posture: A Randomized Controlled Trial

August 2023

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62 Reads

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3 Citations

The purpose of this study was to compare the effects of three different intervention strategies, postural education (PE) and two corrective exercise programs (CEPs), on the craniovertebral angle (CVA) in young adults with forward head posture (FHP). A prospective four-arm parallel randomized controlled trial with repeated measures was performed. Seventy-nine healthy young adults (55 women, 24 men; mean age: 20.08 ± 2.19 years) with FHP were randomized into four groups: PE group, self-myofascial release + stretching group (SMRS), self-myofascial release + stretching + strengthening group (SMRSS), and a control group (CG). Participant CVA (°) was assessed before and after a 4-week intervention. Seventy-two participants completed the trial. Mean difference comparisons of within-group change in mean CVA revealed an increase in the PE (MD = 3.1, p < .01), SMRS (MD = 3.8, p < .01), and SMRSS (MD = 4.4, p < .01) groups. Mean difference comparison of between-group change in mean CVA supported greater CVA change in the SMRS and SMRSS groups compared to the CG (F(3, 68) = 5.26, p < .01, η2 = .188). All three interventions appear to be effective techniques for improving FHP in young adults, however CEPs may provide superior outcomes than PE alone. A 4-week CEP consisting of self-myofascial release + stretching may yield similar CVA enhancements as a CEP consisting of self-myofascial release + stretching + strengthening. Study findings can assist fitness professionals in designing evidence-based FHP intervention programs for young adults.


Physical Profile of Air Force Special Warfare Trainees

July 2023

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18 Reads

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3 Citations

Physical fitness testing in the military is commonly used to assess whether service members are physically capable of performing the diverse physical tasks that may be required for their job. Body composition can influence an individual's ability to physically perform. This study aimed to analyze the general physical profile of U.S. Air Force (USAF) special warfare candidates by assessing body composition results and physical assessment scores collected over the past four years. Male candidates (n = 1036) were 18.2 years to 39.5 years of age (M = 23.5, SD = 3.9) and weighed 78.8 kg (SD = 8.3) with a BMI of 25.0 (SD = 2.0) at 11.8% body fat (SD = 3.3) as measured using bioelectrical impedance. Body composition and fitness scores were similar to those noted in U.S. Navy special warfare candidates as well as individuals in other elite tactical units. These results highlight the normative body composition profile of individuals assessing for advanced military career fields.


Physical Activity Solutions to Decrease Occupational Stress

May 2023

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19 Reads

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2 Citations

ACSMʼs Health & Fitness Journal

Apply It! After reading this article, fitness professionals will be able to: • Understand the impact of occupational stress on employees. • Understand how physical activity impacts occupational stress. • Implement suggestions for on-site physical activity solutions and off-site physical activity promotion to impact occupational stress.



Physical activity and health characteristics of a sample of 218 long-term care employees.Table 1.3 One-Way Analysis of Variance Summary Table Comparing the Effects of Demographic and Health Information on Total Physical Activity Score. * p < .05.
Physical Activity Levels among American Long-Term Care Employees during the COVID-19 Pandemic

November 2022

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29 Reads

Journal of Long-Term Care

Context: Physical activity has been shown to have physiological and psychological benefits in adults worldwide. Those in the healthcare industry, including long-term care employees, face unique occupational stressors that could be barriers to initiating and maintaining a physically active lifestyle.Objectives: 1) to describe the physical activity level of a group of long-term care employees; and 2) examined demographic and self-efficacy influences on physical activity level.Methods: The cross-sectional study included an online questionnaire with demographics, the Godin Leisure-Time Exercise Questionnaire (GLTEQ), and the Self-Efficacy for Exercise Scale, in a convenience sample of 218 participants.Findings: Results found 71.5% of the sample were classified as active, the percentage of participants who indicated they were highly active in their youth compared to adulthood decreased from 40.3% to 16.0%, and 37.3% of the sample decreased their physical activity level during COVID-19. Additionally, the GLTEQ score was significantly higher for those with high exercise self-efficacy (M = 65.97, SD = 30.78) compared to those with moderate exercise self-efficacy (M = 37.14, SD = 27.07, p = .000) and low exercise self-efficacy (M = 16.00, SD = 15.11, p = .000).Implications: Although the majority of the long-term care employees were considered active even during the COVID-19 pandemic, strategies to promote physical activity in the occupation setting are needed. Additional research is warranted to better understand if the nature of healthcare and occupational physical activity may have impacted this value.


Citations (22)


... The craniovertebral angle was measured in a standing position by using an imaginary horizontal line passing through the C7 spinous process, as well as anothe line from the C7 spinous process to the tragus of the ear, as shown in Figure 1. The stand ing posture position was used to measure the CVA as recent evidence indicates a signifi cant difference in sitting vs. standing postures where sitting overestimates the amount o FHP (reduces the CVA) [32] and our study focused on upright gait kinematics such tha the standing CVA seemed more appropriate for our analysis. The angle was determined at the point where these two lines intersected. ...

Reference:

Cognitive Load and Dual-Task Performance in Individuals with and without Forward Head Posture
Evaluation of the Craniovertebral Angle in Standing versus Sitting Positions in Young Adults with and without Severe Forward Head Posture

... Abb. 1 und stehende Tätigkeit angeführt werden [21,62]. Häufig stellt ein schneller Anstieg des Trainingsumfangs in kurzer Zeit eine Ursache dar [77]. Leitsymptom ist der Schmerz. ...

Running-Related Overuse Injuries and Their Relationship with Run and Resistance Training Characteristics in Adult Recreational Runners: A Cross-Sectional Study

Journal of Functional Morphology and Kinesiology

... Vijayan et al. [25] and Suvarnnato et al. [26] demonstrated increased neck muscle strength and pain reduction with corrective posture exercises. Suwaidi et al. [17] and Titcomb et al. [27] found dynamic postural exercises and CEPs techniques effective in improving FHP in young adults. Finally, Yousef et al. [28] reported significant improvements in CVA and neck disability following corrective exercises. ...

The Effects of Postural Education or Corrective Exercise on the Craniovertebral Angle in Young Adults with Forward Head Posture: A Randomized Controlled Trial
  • Citing Article
  • August 2023

... They are expert ground combat personnel who specialize in delivering precision air power, command and control, emergency personnel recovery, trauma and field medical care, and multidomain reconnaissance across a full spectrum of military operations in any environmental conditions [2]. Exceptional physical fitness is vital for an AFSPECWAR operator to complete their unique mission [3]. Integrity, drive, problem-solving, stress tolerance, trainability, communication skills, and teamwork are also essential. ...

Physical Profile of Air Force Special Warfare Trainees
  • Citing Article
  • July 2023

... That is why it is possible to conclude that the presence of a recreation center can help reduce stress. Recreation centers offer different activities, for instance, games, exercises, gym, saunas, etc, which can enable one to relax and reduce stress (Racu, 2023;Aslakson et al., 2023). It can also stimulate socialization and help use the body, thus enhancing proper mental and physical health (Figueira et al., 2022;Lagunes-Co rdoba et al., 2022). ...

Physical Activity Solutions to Decrease Occupational Stress
  • Citing Article
  • May 2023

ACSMʼs Health & Fitness Journal

... Prior studies have established the importance of early intervention and continuous monitoring in mitigating the effects of childhood malnutrition, with stunting being a significant concern worldwide (Beal et al., 2019;Huriah et al., 2021). Research has also emphasized the role of maternal factors, environmental conditions, and early nutritional interventions in preventing stunting and improving child health outcomes (Ekholuenetale et al., 2020;Palacios et al., 2022;Yafie, 2019). This study builds on this foundation by introducing a novel technological solution to address these challenges comprehensively. ...

Children Receiving a Nutrition and High-Quality Early Childhood Education Intervention Are Associated with Greater Math and Fluid Intelligence Scores: The Guatemala City Municipal Nurseries

... Scapular exercise therapy has now been added to head forward posture training as level 1b evidence [43]. Our study also reconfirmed that scapular therapy could change head forward posture through the limited available literature. ...

Evidence-Based Corrective Exercise Intervention for Forward Head Posture in Adolescents and Young Adults Without Musculoskeletal Pathology: A Critically Appraised Topic
  • Citing Article
  • February 2022

Journal of Sport Rehabilitation

... Powerful guides can also be found in the experiences of plant-based athletes who have successfully negotiated their dietary trajectory. The case studies, which include strength trainers and marathon runners, show how a plant-based diet combined with targeted supplementation and expert nutritional advice may support intense training needs [310,311]. These real-world examples not only show that it is possible to achieve athletic success on a plant-based diet, but they also offer others a useful guide that demonstrates how customized dietary approaches can effectively address the intricate nutritional requirements of athletes [275,312]; (Fig. 4). ...

Associations Between Health Status, Training Level, Motivations For Exercise, And Supplement Use Among Recreational Runners: 839
  • Citing Article
  • August 2021

Medicine and Science in Sports and Exercise

... There are also other supplements described as 'herbal', 'botanical', or 'functional' that are claimed to optimise health; however, the safety and efficacy of such supplements is questionable for athletes given that their production methods and active ingredients are often unclear [3]. Nonetheless, supplements from each of these categories offer practical benefits that are attractive to athletes, resulting in widespread use across sports at the elite [4], junior [5], and recreational levels [6]. Supplement use generally increases with age and training status, but the total number and type of supplements that are consumed may also be influenced by a sport's cultural norms [1]. ...

Associations Between Health Status, Training Level, Motivations for Exercise, and Supplement Use Among Recreational Runners
  • Citing Article
  • April 2021

Journal of Dietary Supplements

... These estimates of sleep are similar to the average sleep time reported among other middle-aged recreational exercise participants. 18 When this is considered alongside evidence that regular exercise is known to promote healthy sleep in middle-aged populations. 19 It may be considered that the TST and efficiency had already been optimised in this cohort (i.e. ...

The Effect of Timing and Type of Exercise on the Quality of Sleep in Trained Individuals
  • Citing Article
  • August 2020