About

Jacey A Greece, DSc, MPH, is a Clinical Professor in the Department of Community Health Sciences at the Boston University School of Public Health. She teaches courses in health behavior theory, intervention planning, health communications, and epidemiology. Her professional and research interests are rooted in healthy eating, food access and security, childhood obesity, community-based interventions, behavioral epidemiology, monitoring and surveillance, and mixed methods program evaluation. Dr. Greece applies many field-based concepts to her teaching and is currently the evaluator for multiple grants focused on changing environmental conditions or systems to ultimately influence individual behavior. Her recent work includes evaluating provider training and education programs for organizations such as the National Institutes of Health, CDC, and HRSA, as well as community-based programs addressing hunger, opioid overdose, mental health, and COVID-19. She has previously evaluated public health programs aimed at improving quality of life for underserved populations and has conducted research on alcohol use and its effects on academic and occupational performance. Dr. Greece emphasizes field-based consultancy and case method teaching, co-developing the PBT STEPS Framework for practice-based teaching and creating the Collaborate.Health website. She has received awards for her innovative teaching approaches and serves as a reviewer for multiple health-related journals. She holds degrees from Tufts University and Boston University School of Public Health.

Research topics

• Medicine
• Psychology
• Medical education
• Political Science
• Sociology
• Pedagogy
• Nursing
• Environmental health
• Geography
• Business
• Economics
• Economic growth
• Engineering
• Socioeconomics

Selected publications

• Lessons learned from a sustained mobile prenatal care delivery program: results from a mixed-methods evaluation to understand appointment attendance and patient satisfaction

  BMC Pregnancy and Childbirth · 2026-04-22

  articleOpen accessSenior author

  Persistent racial and socioeconomic disparities in prenatal care attendance in the United States are driven by structural barriers, including transportation challenges, inflexible scheduling, and limited access to culturally responsive services. Mobile health clinics (MHCs) may mitigate these barriers by delivering care directly within underserved communities; however, evidence evaluating their effectiveness relative to fixed-site clinics (FSCs) remains limited. We conducted a mixed-methods evaluation of OhioHealth’s Wellness on Wheels Women’s Health (WOW-WH) mobile prenatal care program in Central Ohio, comparing appointment adherence and patient and provider experiences with two FSCs. Quantitative electronic medical record data were used to assess no-show rates for prenatal visits from July 2022 through June 2023. Differences in attendance across sites were analyzed using chi-square tests. Qualitative data were collected through seven focus groups with patients and providers and analyzed using the Practical, Robust Implementation and Sustainability Model (PRISM) to identify implementation-related facilitators and barriers influencing appointment adherence. The WOW-WH MHC demonstrated significantly lower prenatal care no-show rates (5.71%) compared with both FSCs (8.05% and 12.23%; χ² test, p < 0.001). Qualitative findings highlighted strong provider–patient relationships, proximity of services, and access to wraparound supports as key facilitators of appointment adherence. Identified barriers included fragmented scheduling processes and limited availability of interpreter services. This evaluation demonstrates that mobile prenatal care delivery is associated with improved appointment adherence compared with traditional fixed-site models. Integration of social services and continuity of provider teams fostered trust and engagement among patients. MHCs represent a scalable and sustainable strategy for advancing prenatal care access and promoting health equity. Targeted investments in mobile infrastructure, centralized scheduling, and language access services may further enhance the effectiveness of MHC-based prenatal care models.

  PublisherDOI

• A National Fetal Alcohol Spectrum Disorders Learning Collaborative for Pediatric Care Teams

  The Journal of Pediatrics Clinical Practice · 2026-03-05

  articleOpen access

  Objectives: To assess the impact of the SBIRT And FASD Education, Support and Treatment (SAFEST) Choice Learning Collaborative on US pediatric health care teams' knowledge, confidence, and clinical practices related to the identification and management of children with possible or diagnosed fetal alcohol spectrum disorders (FASD). Study design: The SAFEST Choice program included 2 year-long 10-session virtual learning collaboratives based on the Project ECHO (Extension for Community Healthcare Outcomes) model, which included participant case presentations highlighting clinical challenges. Using a pre-/posttest evaluation design, program outcomes included changes in participant FASD-related knowledge, confidence, and practice. Participant case clinical challenges were documented and analyzed for common themes. Results: The program enrolled 105 participants from 23 clinics in 8 states. Clinics attended a median of 9 of 10 ECHO sessions, whereas individual participants attended a median of 5 of 10. Participants were mostly physicians, nurse practitioners, and nurses. Upon program completion, participants reported increased FASD-related knowledge and significant increases in confidence and self-reported practices in screening for prenatal alcohol exposure and counseling families about, and managing patients with, prenatal alcohol exposure and FASD. Participant case clinical challenge themes included when to consider an FASD diagnosis, managing the care of patients with FASD, and addressing FASD-related stigma and bias. Conclusions: The SAFEST Choice program successfully trained pediatric health care teams in 2 year-long FASD learning collaboratives with high levels of participation. Participants had increased self-reported knowledge, confidence, and practice change related to FASD identification and care. This program offers a promising educational model to improve the care of individuals with possible or diagnosed FASD.

  PublisherDOI

• Investigating weight loss resistance across the menopausal transition: a preliminary quantitative survey of resistance-trained women

  Journal of the International Society of Sports Nutrition · 2025-08-26

  articleOpen access

  Background Many women enter midlife unaware of the physiological and hormonal changes associated with the menopause transition. This period is commonly characterized by increased fat mass and decreased lean body mass. Women who maintain a consistent fitness lifestyle may report that previously effective fat loss strategies become less effective or potentially ineffective during this transition. This phenomenon, referred to as weight loss resistance (WLR), is defined as the inability to lose body weight or body fat despite being in a caloric deficit or engaging in activities that would normally cause weight loss, or more specifically fat loss. This survey documents the prevalence of WLR in resistance-trained women across the premenopausal, perimenopausal, and postmenopausal stages.Methods An anonymous online survey was conducted in resistance-trained females aged 30–75 years old using Qualtrics Software (Qualtrics, Provo, UT, USA). Participants self-reported their menopause status. This preliminary analysis focused on the question: “Are you currently experiencing weight loss resistance?” with four close-ended responses: “Yes”; “No”; “I do not know”; “This does not apply to me because I am not trying to lose weight.” Only responses of “Yes” and No’ were included in the analysis. A 3 × 2 chi-square test compared WLR prevalence across the three menopausal groups. Post hoc 2 × 2 chi-square tests assessed paired-group differences.Results About 13.7% participants identified as premenopausal, 44.5% as perimenopausal, and 41.9% as postmenopausal. The analytic sample included 1,686 participants (excluded participants included 9.3% who selected “I do not know” and 15.6% who selected “This does not apply to me because I am not trying to lose weight”). The prevalence of women who report experiencing weight loss resistance is 67.3%, 74.6%, and 80.1% for pre, peri, and post-menopausal women, respectively. Postmenopausal women self-report the highest rates of WLR compared to premenopausal (p < 0.001) and perimenopausal women (p = 0.013). Further, perimenopausal women report higher rates of WLR compared to premenopausal women (p = 0.034).Conclusion These preliminary findings suggest that WLR is commonly reported among resistance-trained women across the menopause transition, increasing from premenopausal to perimenopausal and peaking in postmenopausal stages. This trend may reflect the impact of hormonal and physiological changes that hinder fat loss despite adherence to caloric deficits and increased energy expenditure. Further research is necessary to investigate the validity of these weight loss resistance claims as well as the potential disconnect between traditional weight loss strategies and midlife physiological and hormonal shifts to improve weight loss outcomes.

  PublisherOA PDFDOI

• Developing and testing sickle cell trait awareness messages to strive towards consistent and accurate education

  International Journal of Community Medicine and Public Health · 2025-05-31

  articleOpen accessSenior author

  Background: Sickle cell trait is often misrepresented as benign, leading to misinformation and a lack of awareness about potential health complications. In the United States, 1 in 13 Black individuals are affected, though people of any race or ethnicity can have the condition. Misconceptions, systemic racism, and underfunded research contribute to inconsistent communication and education. To that end, this initiative aimed to identify gaps in awareness and education and develop consistent, comprehensive, scientifically informed messages to improve public understanding. The goal was for these messages to be adopted by sickle cell trait organizations nationwide to promote consistency in education and communication. Methods: Using a mixed-methods approach, 19 key stakeholders including sickle cell organizations, medical experts, and individuals with sickle cell trait were engaged to identify communication gaps. The consolidated framework for implementation research (CFIR) guided survey and interview analysis, ensuring a structured approach to understanding stakeholder perspectives. The nominal group technique (NGT) validated findings during expert meetings, helping achieve consensus on messaging before testing with the sickle cell trait community. Results: Findings highlighted inconsistent messaging, limited public understanding, insufficient research funding, and inadequate provider knowledge. Stakeholders and community members stressed the need for accurate, culturally sensitive, consistent, and accessible messaging to improve awareness and patient-provider communication. Conclusions: Through collaboration and community validation, evidence-based messages were developed to promote informed decision-making, encourage self-advocacy, and enhance provider-patient communication. Standardized messaging is essential to combat misinformation, raise awareness, and improve health outcomes for individuals with sickle cell trait.

  PublisherOA PDFDOI

• Survey study of changes in total caloric and protein intake across the menopause transition: a preliminary analysis

  Journal of the International Society of Sports Nutrition · 2025-09-01

  articleOpen access

  Background The menopausal transition is characterized by hormonal shifts, particularly a decline in estrogen, which is associated with increased fat mass and reduced lean body mass. Adequate caloric and protein intake is essential for preserving muscle mass and mitigating these body composition changes. This preliminary analysis examined total energy and protein intake (g/kg body weight) across pre-menopausal, peri-menopausal, and post-menopausal women.Methods An anonymous online survey was conducted in resistance-trained females, aged 30–75 years old, using Qualtrics software (Qualtrics, Provo, UT, USA) to document fitness, nutrition, and hormone replacement therapy (HRT) practices during the menopause transition. This preliminary analysis focused on two nutrition-related close-ended questions: “How many calories do you consume (on average) each day?” and “How many grams of protein do you consume (on average) each day?.” Relative protein intake was reported in grams per kilogram of body weight (g/kg). Data is reported with descriptive statistics to estimate mean calorie and relative protein intake per menopausal group and analyzed via one-way ANOVA to compare intake across groups.Results There were 1,719 and 1,854 responses for total calorie and protein intakes, respectively. Participants self-reported their menopausal status, with 13.7% identifying as pre-menopausal, 44.5% as peri-menopausal, and 41.9% as post-menopausal. Average estimated caloric intake was the highest in pre-menopausal women (1861 ± 305.9 kcal), followed by peri-menopausal (1823.8 ± 321.6 kcal), and lowest in post-menopausal women (1741.3 ± 333.2 kcal), who consumed significantly fewer calories than both other groups (p < 0.001). No significant difference was found between pre-menopausal and peri-menopausal women (p = 0.228). Average relative protein intake followed a similar trend: highest in pre-menopausal (1.65 ± 0.53 g/kg), then peri-menopausal (1.63 ± 0.48 g/kg), and lowest in post-menopausal women (1.53 ± 0.55 g/kg), who consumed significantly less than both groups (p = 0.004 and p < 0.001, respectively). Differences between pre-menopausal and peri-menopausal women were not significant (p = 0.696).Conclusion Post-menopausal women reported to consume significantly fewer calories and less protein relative to their body weight compared to pre-menopausal and peri-menopausal women, who did not differ significantly from each other. While menopausal status appears to be associated with reduced dietary intake, it is important to note that overall, participants reported protein intakes within the recommended range (1.4–2.0 g/kg) for resistance-trained individuals to build or maintain lean mass. In addition to focusing on menopausal status, future research should investigate whether higher protein intakes are necessary to counteract anabolic resistance associated with aging.

  PublisherOA PDFDOI

• Using Community Perspectives to Address Sexual and Domestic Violence: Results of a Mixed Methods Formative Evaluation

  Journal of Health Science and Education · 2025-01-01

  articleOpen accessSenior author

  Purpose: Sexual and Domestic Violence (SDV) has escalated since the pandemic, highlighting the need to address the multi-faceted issue through community-based approaches.Understanding the community context is foundational to addressing gaps in unmet needs, improving collaboration, and increasing awareness surrounding SDV issues.This study addresses SDV in child and adult survivors in a small, under-resourced town in Massachusetts through a mixed-methods formative evaluation, conducted in collaboration between an academic institution and a local health department.Methods:The formative evaluation employed a mixed-methods approach guided by the Consolidated Framework for Implementation Research (CFIR).The CFIR explored internal context, individual traits, intervention design, external factors, and processes related to SDV including: 1) identifying engaged and unengaged entities regarding domestic violence (DV); 2) conducting stakeholder surveys (n=7) and interviews (n=8) with community organizations, schools, health agencies, public safety, and mental health clinicians; 3) analyzing qualitative and quantitative data on stakeholders' readiness, motivations, and influence to impact SDV; and, 3) recommending areas for intervention and further collaboration aligned with the CFIR domains.Results: Most respondents acknowledged SDV as a community issue (n=5, 71.4%) with unmet needs (n=5, 71.4%).Some perceived barriers to accessing SDV support included a lack of awareness among community members about existing resources (n=4, 57.1%) and a stigma that prevents access to these resources (n=6, 85.7%).Qualitative insights highlighted challenges such as mental health and substance use complicating SDV intervention barriers such as insufficient emergency housing and staffing, a lack of resources for addressing crises, a call for more preventative efforts for youth, and considerations for improving data communication.Conclusion: The findings led to actionable recommendations to enhance existing programs and create new initiatives, fostering a coordinated system to address SDV.By employing a mixed-methods approach, the study offers a nuanced understanding of local challenges and opportunities for implementation, informed by the diverse perspectives of community stakeholders.The involvement of community voice ensures that local efforts are targeted and appropriate, resulting in more effective and inclusive systems-level approaches to SDV.Findings highlighted the need for post-COVID strategies that target SDV awareness and prevention, address stigma and access, improve resource allocation, and support robust multi-sector collaboration.

  PublisherDOI

• Establishing and Sustaining Academic and Local Health Collaborations: A Case Study of Practice-Based Teaching and Workforce Development

  Health · 2025-01-01

  articleOpen accessSenior author

  The pandemic highlighted significant gaps in the public health infrastructure impacted by shortages of public health workers, an undertrained workforce, and years of disinvestment. These gaps required innovative problem-solving by public health agencies (PHAs), including local health departments (LHDs), to respond to rapidly changing community conditions during and after the pandemic. Many schools and programs of public health (SPPH) worked with PHAs to mobilize public health (PH) students through practice-based teaching (PBT). Current research indicates PBT benefits all stakeholders—PHAs, students, faculty, SPPH, and ultimately the community served. However, more research is needed on the utility of PBT in addressing a community’s systemic public health issues, the extent to which the academic-community collaboration enhances a PHA’s capacity, and the impact of the pedagogy on preparing the workforce for an evolving PH landscape. This paper examines the process of a semester-long PBT course, guided by the PBT STEPS framework, which includes five steps from collaboration to implementation to evaluation of a PBT course. The collaborating PHA and its student group addressed community trauma and resilience issues during the semester. Additionally, it examines the longer-term impacts after the semester for the PHA, community, and the workforce by 1) conducting a formative evaluation to understand needs and gaps in the community; 2) redesigning an intervention that merged the results of the formative evaluation with the intervention developed during the semester; and 3) securing funding and resources for intervention sustainability. Through the documentation of a post-course partnership between an LHD and faculty at a large school of public health, this case study illustrates the potential for PBT to lay the foundation for ongoing research that supports more impactful interventions for PHAs while bolstering the workforce abilities of students as future practitioners.

  PublisherOA PDFDOI

• A survey of hormone replacement therapy use among resistance-trained women across states of menopause transition – a preliminary analysis

  Journal of the International Society of Sports Nutrition · 2025-08-26

  articleOpen access

  Background Hormone Replacement Therapy (HRT) is considered the gold standard for management of vasomotor symptoms. It can also help improve bone health, potentially reducing the risk of osteoporosis and fractures. There is current debate regarding the use of HRT and its risk-to-benefit ratio for cardiovascular and cognitive health. While there is a plethora of research reporting HRT use among the general population, research on HRT use among resistance-trained women is lacking. In the United States, HRT use among the general population of post-menopausal women has rapidly declined. It was estimated to be 4.7% in 2020, down from 26.9% in 1999. The purpose of this study was to survey HRT usage among post-menopausal resistance-trained women.Methods The present study is part of a larger overall female fitness menopause survey consisting of 132 questions that were developed collaboratively by the authors and conducted through Qualtrics Software (Qualtrics, Provo, UT, USA). The survey was distributed via online platforms and relied on voluntary participation, which may have limited the respondent pool to individuals with internet access and higher digital literacy. This preliminary descriptive analysis focused on the question: “Are you currently using HRT?” with three close-ended responses: “Yes”; “No”; “I prefer not to answer.” In the survey, HRT use was defined as taking estrogen or progesterone. Data is presented descriptively.Results A total of 943 subjects identified themselves as post-menopausal. Of these, 514 reported to be currently using HRT (55% of total respondents).Conclusion This study suggests, within the population of self-identified post-menopausal resistance-trained women, there may be a much larger rate of HRT usage than previously reported. One notable limitation of this study is the use of a survey disseminated through social media platforms. This approach introduces potential selection bias, as users of social media platforms may not reflect the broader population in terms of socioeconomic status, education, and other demographic or behavioral characteristics. Additionally, the voluntary nature of survey participation on social media may lead to self-selection bias, whereby individuals with strong opinions or vested interest in the topic are more likely to respond. As such, the sample may over-represent particular demographic groups or viewpoints, limiting the generalizability of the findings. Future research should consider using stratified sampling or supplementing online recruitment with offline methods to ensure broader representation.

  PublisherOA PDFDOI

• Delivering Education Through a Podcast to Change Provider Practice: A Mixed Methods Evaluation of a Fetal Alcohol Spectrum Disorders Podcast

  Pedagogy in Health Promotion · 2024-11-12

  articleSenior authorCorresponding

  Education delivery through multi-media such as podcasts has become more common yet impacts on behavior change are understudied. To address this, we evaluated an educational podcast available for continuing education (CE) credit to all providers but specifically tailored for children and/or women-focused specialties (i.e., family medicine, OBGYN, pediatric, prenatal, primary care). The podcast consisted of three 20-minute episodes focused on: (1) prevalence of Fetal Alcohol Spectrum Disorders (FASDs); (2) perspectives from those with lived experience; and (3) treatment and prevention of FASDs at the provider level. Podcast effectiveness to educate providers was assessed using a mixed-methods evaluation. Participants completed registration information and an immediate post-test, which examined provider knowledge, self-efficacy, and practice behaviors related to FASD prevention. Qualitative data was collected from a sample of those who completed the post-test via focus groups conducted 6 months later. From March 2021 to March 2022 there were 579 listeners with 103 claiming CE credit (the evaluation sample) who participated in the evaluation. Participants reported high FASD-related knowledge; more than 85% were better able to educate patients about prenatal alcohol use risk and FASDs post-podcast. The majority (59.3%) intended to change practice based on what they learned. Qualitative results contextualized the benefits and challenges to changing practice, including structural barriers, and suggestions for enhancing the podcast in future seasons. Education delivered through podcasts can be effective in improving provider knowledge and self-efficacy and in promoting practice change. Podcasts offer broad reach and accessibility providing an opportunity to educate on topics including FASD.

  PublisherDOI

• Promoting Sickle Cell Trait Awareness and Education: A Typology of Interventions in the United States to Inform Ongoing Efforts to Patients and Providers

  Health · 2024-01-01 · 1 citations

  articleOpen accessSenior author

  Research Background: Sickle cell trait has no treatment or cure and predominantly affects people who are Black, but can affect anyone of any race or ethnicity. While commonly incorrectly considered benign by providers and the public, people with a sickle cell trait experience life-threatening outcomes that are exacerbated by extreme conditions. There is a severe lack of awareness and understanding of sickle cell trait and the associated health complications among sickle cell trait carriers and healthcare providers. Purpose/Aim: Interventions that aim to improve awareness of sickle cell trait differ in approaches and are not well documented in the literature. This typology aims to highlight current efforts to inform targeted interventions that raise awareness through consistent messaging, educate people and providers on sickle cell trait and the related health complications, and support the design and implementation of comprehensive sickle cell trait awareness initiatives. Methods: We conducted a scoping review of United States-based sickle cell trait interventions and performed a content analysis to identify the categories and characteristics of these efforts. We then organized the results into a typology according to established protocols. Results: Among 164 interventions, twenty-five (15%) met the typology inclusion criteria described above and were grouped into categories: Seven of twenty-five interventions were Educational Interventions (28%), three of twenty-five interventions (12%) were Combined Screening and Educational-Based Interventions, eight of twenty-five interventions (32%) were Policy and Guideline-Based Intervention, and six of twenty-five interventions (24%) were Sickle Cell Trait Organization-Led Interventions. Conclusions: There is a lack of consistency in messaging across interventions whether delivered by credible healthcare institutions or national organizations, which can result in lack of education and awareness and confusion around sickle cell trait. Categorizing interventions through a typology allows clarity and informs consistency in messaging, which should be at the forefront of future sickle cell trait efforts.

  PublisherOA PDFDOI

Frequent coauthors

• Jonathan Howland

  Boston University

  24 shared

• Damaris J. Rohsenow

  Brown University

  24 shared

• Alissa Almeida

  Boston University

  22 shared

• Sara Minsky

  21 shared

• J. Todd Arnedt

  17 shared

• Suzanne D. Sales

  University of Michigan–Ann Arbor

  16 shared

• Carrie S. Kempler

  Brown University

  16 shared

• Candice Bangham

  Boston University

  11 shared

Awards & honors

• BUSPH’s Educational Innovation Award
• Excellence in Teaching Award