Digital Health

Why is the “freshmen 15” phenomenon so common?

Taylor Thomas — Tue, 04 Nov 2025 14:49:18 +0000

Why is the “freshmen 15” phenomenon so common? Taylor Thomas Tue, 11/04/2025 - 09:49

In This Story

Do not schedule eight AM classes. Communicate with your roommate. Wash your bedding regularly. Incoming college students are offered numerous pieces of advice before stepping onto campus. Arguably, one of the most common is to beware of the “freshman 15.” But why is weight gain among first-year students so universal that it has earned such a notorious reputation?

An �� interdisciplinary research team led by Y. Alicia Hong, professor in the Department of Health Administration and Policy who studies mobile and wearable technologies, found that the college environment lends itself to habits that increase food intake and subsequent weight gain.

“Social and environmental factors are key determinants of eating behavior,” said Hong. "College students are affected by the eating environment, especially where they eat and whom they eat with. Our research found that they consume more calories when eating in groups or formal dining settings."

Over the course of four weeks, college students self-recorded daily eating behaviors, environment, and mood and stress levels using a mobile app. App-logged responses indicated participants eat more when in groups of two or more and in locations such as dining halls or restaurants. Conversely, food intake was less when alone or at home.

College students are unaware of their eating habits, findings suggest. Analysis revealed that students’ perceptions of their food consumption did not align with the caloric intake logged. Factors related to gender and emotion also contributed to the complex nature of dietary behavior.

“College students’ eating behaviors are complex, with individual, interpersonal, and environmental factors interacting to influence dietary intake. This research underscores the importance of context in dietary intervention and incorporating digital tools for dietary assessment,” said Hong.

The research team included Distinguished University Professor Larry Cheskin in the Department of Nutrition and Food Studies, Associate Professor in the Department of Health Administration and Policy Hong Xue, and George Mason alumna Jo-Vivian Yu, BS Health Adminstration '21, MS Health Informatics '22.

The Dynamics of Eating Behaviors and Eating Environment in College Students: Discrepancies Between App-Tracked Dietary Intake and Self-Perceived Food Consumption was published in mHealth on October 29, 2025. The study was funded by the �� College of Public Health Pilot Grant (PI: YAH).

About the researchers

Y. Alicia Hong is a professor in the Department of Health Administration and Policy at ��. She is an expert in behavioral interventions with a research interest in the intersection of health services delivery and consumer informatics. Her work primarily explores chronic care and self-care solutions through innovative digital technologies, aiming to improve patient-centered outcomes and enhance healthcare accessibility. Hong’s research focuses on implementation and dissemination science, and leveraging digital technologies to enhance health services delivery.

Larry Cheskin is a distinguished university professor in the Department of Nutrition and Food Studies and adjunct professor of medicine at Johns Hopkins School of Medicine. Cheskin has dedicated his career to research, education, and program building to enhance people’s diets and combat obesity. He founded the Johns Hopkins Weight Management Center, a multidisciplinary clinical research and treatment program. His work has impacted the problem of obesity through innovative treatment programs, and in community-based participatory research among the underserved in urban areas. He also developed mHealth tailored to the behavioral characteristics of the recipient to combat obesity.

Hong Xue is an associate professor in the Department of Health Administration and Policy. He currently serves as the Chair of the Tobacco Free Alliance of Virginia. Xue conducts interdisciplinary research in public health and in particular, integrates economics, nutrition, epidemiology, systems science, health informatics and machine learning in studying multilevel mechanisms and factors (e.g., from policy to behavior) related to obesity and non-communicable chronic diseases (NCDs), and tobacco use. Dr. Xue's research has been widely published in top journals and featured in national media, contributing significantly to both domestic and global NCD control efforts.

Jo-Vivian Yu holds a Master of Science in Data Analytics and a Bachelor of Science in Health Informatics from ��. Her academic and research background reflects a strong interdisciplinary foundation at the intersection of data science, technology, and public health. She has contributed to multiple peer-reviewed studies focused on health behavior and population health, using digital tools and data analytics to investigate the impact of social and environmental factors on health outcomes.

Thumbnail photo by Rosalind Chang via unsplash.

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College of Public Health

New program reduces burnout in dementia caregivers, novel research evaluation proves

Taylor Thomas — Wed, 29 Oct 2025 12:41:27 +0000

New program reduces burnout in dementia caregivers, novel research evaluation proves Taylor Thomas Wed, 10/29/2025 - 08:41

In This Story

Y. Alicia Hong, PhD

As the old saying goes, you cannot pour from an empty cup. To give time and energy to others, it is vital to attend to one’s own well-being. As the U.S. population ages, there is a growing demand for tools that support the more than 19 million people who serve as caregivers of family members with Alzheimer’s Disease and related dementias (ADRD). Family caregivers of individuals with ADRD are vulnerable to poor mental and physical health due to long-term, strenuous caregiving and lack of support.

Kang Shen. Photo provided

A novel process (i.e., delivery and functionality) evaluation developed by Kang Shen, PhD health services research student at ��’s College of Public Health, establishes that user-friendly digital interventions are the solution. WECARE 2.0, a culturally tailored digital health program, is proof as it has enhanced caregivers’ physical and mental health.

“WECARE’s approach—combining cultural relevance with an accessible, widely used technology app—proved to be highly effective and well-accepted by users. High user satisfaction, participant retention, and significant improvements in caregiving skills and positive aspects of caregiving all point to WECARE’s promising early results,” said Shen, who is a first-generation student and also has a bachelor's and master's degrees in health informatics from George Mason.

The study, Process evaluation of a digital health intervention for dementia caregivers: Integrating active and passive measurements, was published in September 2025 in Alzheimer’s & Dementia, the premier journal of the Alzheimer’s Association and the leading journal in the field.

Participants became more knowledgeable about ADRD, learned problem-solving strategies, improved their personal caregiving skills, reduced stress, increased social support, while being user-friendly.

“This program [WECARE] is so good, easy to understand, even for a 70-year-old. I don’t like reading text and can play the recording instead. I like your how-to videos; I can open them whenever I want and watch them multiple times,” one program participant shared.

WECARE, which was originally designed by Y. Alicia Hong, a Department of Health Administration professor and digital technologies intervention researcher and specialist, was delivered through the social media app WeChat. Through the platform, researchers provide easily accessible educational articles and videos, tips on practicing self-care, and opportunities for social connection with other caregivers.

Innovative Evaluation Methods

Shen’s process evaluation of WECARE 2.0 is the first to employ multiple—qualitative and quantitative—data collection methods. With data from surveys, interviews, self-reported reviews, and website engagement, Shen measured how often participants opened the app and its accompanying resources, how long they spent using the resources, and feedback of the program at the intervention’s conclusion.

Shen’s approach also highlights the importance of creating tools that do not simply exist but are observable to implementers for timely improvement. Unlike previous evaluative methods, her use of short surveys (active measurement) and tracking user activities on the backend (passive measurement) offers program developers comprehensive insight into what works, what doesn’t work, and why throughout the intervention process.

This innovative process evaluation method can facilitate developing more effective digital health interventions for underserved dementia caregivers. Results are being integrated into the next version of WECARE and can inspire future interventions.

“This study serves as a framework for creating and evaluating digital health tools that are culturally grounded and genuinely accessible for diverse, underserved caregiving communities. Our goal is to inspire a shift toward more inclusive and effective support systems that meet caregivers where they are, leveraging familiar technologies to overcome access barriers,” said Shen.

Her research was supported by Hong. Additional co-authors include Yixuan (Janice) Zhang from the College of William and Mary Department of Computer Science, Hae-Ra Han from the Johns Hopkins University School of Nursing, Jessica Lin from the George Mason's Department of Computer Science, and Kenneth Hepburn from the Emory University School of Nursing.

Topics

PhD in Health Services Research

Digital Health

Research

GCI-Grand Challenge Initiative

Alumni