Monica Stanton Koko

Dr. Monica Stanton Koko


Research Focus & Metrics

Academic Career Length

9Years (2018-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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22 March 2019 in JMIR Pediatrics and Parenting
Verified
Journal Article
Open access
ACAlicia Chung
Alicia Chung
BWBarbara Wallace
Barbara Wallace
Monica Stanton KokoMonica Stanton Koko
Monica Stanton Koko
Azizi SeixasAzizi Seixas
Azizi Seixas
GJGirardin Jean-Louis
Girardin Jean-Louis
Background: African American youth (aged 8-14 years) do not adhere to national dietary and physical activity guidelines. Nonadherence to these recommendations contributes to disproportionate rates of obesity compared with their white counterparts. Culturally tailored electronic health (eHealth) solutions are needed to communicate nutrition and physical activity messages that resonate with this target population. Methods: Statistical analysis included paired sample t tests to evaluate knowledge gains, self-efficacy, and readiness to change. Adapted items from Prochaska’s Stages of Change toward the following 4 behaviors were assessed with pre- and posttest surveys: (1) fruit and vegetable selection on my plate, (2) meal preparation, (3) fruit and vegetable selection outside of home, and (4) physical activity. Open-ended comments on videos from mother-child dyads were used to determine user acceptance. Observations of repeated responses during content analysis informed coding and development of key themes. Results: A final sample size of 93 mother-child dyads completed the study. Mothers reported significant improvement from precontemplation or contemplation stages to preparation or action stages for (1) fruit and vegetable selection on her plate (P=.03), (2) meal preparation for her family (P=.01), (3) fruit and vegetable selection outside the home (P<.001), and (4) physical activity (P<.001). Significant improvements were found in knowledge, stage of change, and self-efficacy for the 4 target behaviors of interest (P<.001). Children’s open-ended commentary reported vicarious learning and positive character identification with brown-skinned cartoons exhibiting healthful food and exercise behaviors. Mothers commented on the lack of accessible produce in their neighborhoods not depicted in the cartoon videos. Conclusions: Culturally adapted cartoons that incorporate tailored preferences by African American families, such as race or demography, may help increase adherence to target health behaviors when developing eHealth behavior solutions.

5 November 2025 in Children
Verified
Journal Article
Open access
PDF file
ACAlicia Chung
Alicia Chung
SCStella Chong
Stella Chong
DCDebbie Chung
Debbie Chung
AGAmira Gee
Amira Gee
Monica Stanton KokoMonica Stanton Koko
Monica Stanton Koko
KHKeng-Yen Huang
Keng-Yen Huang
Background/Objectives: This study aims to understand gaps and strategies in Chinese Americans’ utilization of SDOH services in the pediatric primary care context in Sunset Park, Brooklyn, from a patient–provider partnership perspective. Methods: The study was guided by an integrated Patient–Provider Partnership, Engagement, and Collaboration (PEC) framework that influenced patient–provider interaction during the provision of SDOH services. A qualitative study design was applied, and eight quality improvement interviews with healthcare providers were conducted to understand the existing community and health service system context. Six in-depth interviews were conducted with Mandarin-speaking Chinese American caregivers. Interviews were transcribed and coded in Mandarin and then translated into English. Results: Consistent with the PEC framework, we identified cognitive, affective, and communication gaps from both the patient and provider. Caregivers reported unaddressed needs in food, financial security, and mental health. Providers identified gaps in patient workflow, staffing, and the intake form process. Conclusions: Addressing social determinants of health among Chinese American immigrant populations is crucial for mitigating poor health outcomes in children and families. Multi-level community-engaged strategies are needed to alleviate the challenges facing this community. Recommendations for future research should consider the importance of language and cultural affinity, digital intake forms translated into the patient’s language, and regular on-site staffing during SDOH screenings.

6 March 2026 in Dietetics
Verified
Journal Article
Open access
PDF file
Monica Stanton KokoMonica Stanton Koko
Monica Stanton Koko
Silvia del CerroSilvia del Cerro
Silvia del Cerro
ACAlicia Chung
Alicia Chung
COVID-19 disrupted daily routines, altering eating patterns. However, it could encourage individuals to adopt healthier behaviors. While extensive research documented changes in dietary behaviors during the COVID-19 lockdown, few studies explored whether they persisted over time. This study aimed to identify the long-term effects of the pandemic on lifestyle and eating behaviors of families from a private primary school in Funes County, Rosario, Argentina. A total of 51 families (192 individuals) completed an anonymous survey on food intake and perceived dietary and lifestyle changes since the pandemic began. Multiple correspondence analysis revealed increased consumption of fast/processed foods, larger portion sizes, and snacking linked to eating from boredom, stress, or tiredness. Increased home-cooked meals, physical activity, interest in healthy habits, and leisure time enjoyment were also found. Dietary analysis revealed that higher intake of fruits, vegetables, legumes, and water was inversely associated with consumption of refined grains, cold cuts, pastries, and sugary drinks. Boredom, stress, or tiredness led to unfavorable changes. Interest in health, changes in home routines, spending more time together, and preparing meals with family resulted in healthier behaviors that remained present at the time of this study.

13 October 2018 in JMIR Preprints
Verified
Preprint
Open access
ACAlicia Chung
Alicia Chung
BWBarbara Wallace
Barbara Wallace
Monica Stanton KokoMonica Stanton Koko
Monica Stanton Koko
Azizi SeixasAzizi Seixas
Azizi Seixas
GJGirardin Jean-Louis
Girardin Jean-Louis
BACKGROUND African American youth (aged 8-14 years) do not adhere to national dietary and physical activity guidelines. Nonadherence to these recommendations contributes to disproportionate rates of obesity compared with their white counterparts. Culturally tailored electronic health (eHealth) solutions are needed to communicate nutrition and physical activity messages that resonate with this target population. OBJECTIVE This study aimed to identify the impact of exposure to a website hosting culturally tailored cartoons to inspire fruit and vegetable uptake and physical activity levels in African American mother-child dyads. METHODS Statistical analysis included paired sample t tests to evaluate knowledge gains, self-efficacy, and readiness to change. Adapted items from Prochaska’s Stages of Change toward the following 4 behaviors were assessed with pre- and posttest surveys: (1) fruit and vegetable selection on my plate, (2) meal preparation, (3) fruit and vegetable selection outside of home, and (4) physical activity. Open-ended comments on videos from mother-child dyads were used to determine user acceptance. Observations of repeated responses during content analysis informed coding and development of key themes. RESULTS A final sample size of 93 mother-child dyads completed the study. Mothers reported significant improvement from precontemplation or contemplation stages to preparation or action stages for (1) fruit and vegetable selection on her plate (P=.03), (2) meal preparation for her family (P=.01), (3) fruit and vegetable selection outside the home (P<.001), and (4) physical activity (P<.001). Significant improvements were found in knowledge, stage of change, and self-efficacy for the 4 target behaviors of interest (P<.001). Children’s open-ended commentary reported vicarious learning and positive character identification with brown-skinned cartoons exhibiting healthful food and exercise behaviors. Mothers commented on the lack of accessible produce in their neighborhoods not depicted in the cartoon videos. CONCLUSIONS Culturally adapted cartoons that incorporate tailored preferences by African American families, such as race or demography, may help increase adherence to target health behaviors when developing eHealth behavior solutions.