Obesity and Related Chronic Health Conditions as Predictors of Motivation to Engage in Healthy Eating Behaviors Among Black Adults

Healthcare provider-delivered healthy eating recommendations among U.S. Hispanic/Latino adults

U.S. Hispanic/Latino adults are at heightened risk for developing diet-related chronic diseases. Healthcare provider recommendations have shown to be effective for promoting health behavior change, but little is known about healthcare provider healthy eating recommendations among Hispanics/Latinos. To investigate the prevalence of and adherence to healthcare provider-delivered healthy eating recommendations among a U.S. sample of Hispanic/Latino adults, participants (N = 798; M = 39.6±15.1 years; 52% Mexican/Mexican American) were recruited via Qualtrics Panels to complete an online survey in January 2018. Most (61%) participants reported having ever received a healthcare provider-delivered dietary recommendation. Higher body mass index (AME = 0.015 [0.009, 0.021]) and having a chronic health condition (AME = 0.484 [0.398, 0.571]) were positively associated with receiving a dietary recommendation while age (AME = -0.004 [-0.007, -0.001]) and English proficiency (AME = -0.086 [-0.154, -0.018]) were negatively associated. Participants reported adhering regularly (49.7%) and sometimes (44.4%) to recommendations. There were no significant associations with patient characteristics and adherence to a healthcare provider-delivered dietary recommendation. Findings inform next steps toward increasing implementation of brief dietary counseling from healthcare providers to support prevention and management of chronic diseases among this under-studied population.

Participation effects of workplace promoting activities on healthy eating behavior

Objective

The study intends to examine the effect of participating healthy eating related games or activities in workplace on changes of employee's self-reported behavioral stage for adopting healthy eating.

Study design

A quasi-experimental study.

Methods

A multi-strategic intervention for 8-month was designed and implemented in a main staff canteen area within a non-profit academic organization. The initial event included exhibition of custom-made dining plates filled with correct portions of food models for three caloric levels and provision of user-friendly online resources, which were followed by three promotion activities (long-term exhibition of my balanced plates, matching games for six food groups, and do-it-yourself healthy plate) in the 8 months.

Results

A total of 86 adult participants (males = 37, female = 49) who had completed pre- and post-surveys were included in the analysis. Participants who participated all three promotion activities presented greater advancement in stage of healthy eating behaviors (HEB) than those who did not participate any activity (β= 1.118, 95% CI = 0.428-1.808, P = 0.001 among male participants; β = 0.740, 95% CI = 0.145-1.336, P = 0.015 among all participants). Adjustment has been made for significantly-associated covariates including types of promotion activities, initial-HEB and gender.

Conclusions

A multi-strategic intervention providing balanced food plates and online resources followed by consecutive promotion activities are effective in advancing HEB for the workplace adults. Differential impacts of promotion activities and gender should also be considered for designing workplace interventions.

The use of food swaps to encourage healthier online food choices: a randomized controlled trial

BACKGROUND

Online grocery stores offer opportunities to encourage healthier food choices at the moment that consumers place a product of their choice in their basket. This study assessed the effect of a swap offer, Nutri-Score labeling, and a descriptive norm message on the nutrient profiling (NP) score of food choices in an online food basket. Additionally explored was whether these interventions made it more motivating and easier for consumers to select healthier foods and whether potential effects were moderated by consumer health interest.

METHODS

Hypotheses were tested with a randomized controlled trial (RCT) in a simulated online supermarket. Dutch participants (n = 550) chose their preferred product out of six product options for four different categories (breakfast cereals, crackers, pizza, and muesli bars). Participants were randomly allocated to one of eight groups based on the interventions in a 2 (Nutri-Score: present, not present) X 2 (swap offer: present, not present) X 2 (norm message: present, not present) between subject design. The primary outcome was the difference in combined NP score of product choices, for which a lower score represented a healthier product.

RESULTS

Swap offer (B = - 9.58, 95% CI: [- 12.026; - 7.132], Ƞ² = 0.098) and Nutri-Score labeling (B = - 3.28, 95% CI: [- 5.724; -.829], Ƞ² = 0.013) significantly improved the combined NP score compared to the control condition (NP score M = 18.03, SD = 14.02), whereas a norm message did not have a significant effect (B = - 1.378, 95% CI [- 3.825; 1.070], Ƞ² = 0.002). No evidence was found that interventions made it more motivating or easier for consumers to select healthier food, but situational motivation significantly influenced the healthiness score of food choices for both swap offer (b = - 3.40, p < .001) and Nutri-Score (b = - 3.25, p < .001). Consumer health interest only significantly moderated the influence of Nutri-Score on ease of identifying the healthy food option (b = .23, p = .04).

CONCLUSIONS

Swap offer and Nutri-Score labeling were effective in enhancing healthy purchase behavior in the online store environment.

TRIAL REGISTRATION

This study was retrospectively registered in the ISRCTN database on 02-09-2021 ( ISRCTN80519674 ).

Perceived Neighborhood Crime Safety Moderates the Association Between Racial Discrimination Stress and Chronic Health Conditions Among Hispanic/Latino Adults

Background: Little is known about the link between perceived neighborhood walkability and prevalence of chronic disease. Even less is known regarding this association among Hispanic/Latino adults, despite exhibiting high rates of chronic diseases. Stress due to racial discrimination is a harmful social determinant of health in Hispanics/Latinos. Having both low perceived neighborhood walkability and high racial discrimination stress may exacerbate the chronic disease status of Hispanics/Latinos. Among a U.S. national sample of Hispanic/Latino adults, this cross-sectional study aims to examine (1) the associations among overall perceived neighborhood walkability, racial discrimination stress, and having a chronic health condition; and (2) whether overall perceived neighborhood walkability moderates the hypothesized association between racial discrimination stress and having a chronic health condition. Methods: In January 2018, 798 Hispanic/Latino adults (M age = 39.7 years, SD = 15.1; 58.6% female; 70.0% U.S. born; 52.0% Mexican/Mexican American) responded to a survey via Qualtrics Panels. Surveys included the Neighborhood Environment Walkability Scale-Abbreviated, Hispanic Stress Inventory-2, and self-reported presence/absence of chronic health conditions (e.g., hypertension, heart disease). A logistic regression was conducted testing for the moderation of the main effect of racial discrimination stress on the presence of a chronic health condition by overall perceived neighborhood walkability. Results: After controlling for age, body mass index, and income, racial discrimination stress was inversely associated with overall perceived neighborhood walkability (b = -0.18, p < 0.001) and positively associated with having a chronic health condition (OR = 1.02; 95% CI [1.00, 1.03]). While overall perceived neighborhood walkability was not associated with having a chronic health condition, perceived crime safety was inversely associated with having a chronic health condition (OR = 0.94; 95% CI [0.89, 0.99]). Perceived crime safety moderated the positive association between discrimination stress and having a chronic health condition, such that the association was only significant among those who perceived their neighborhood to be less safe (β = -0.004, 95% CI [-0.01, -0.00]). Conclusions: Overall perceived neighborhood walkability was inversely associated with racial discrimination stress, but not associated with having a chronic health condition. Perceived neighborhood crime safety, but not infrastructure or aesthetics, matters when it comes to the link between racial discrimination stress and having a chronic health condition among Hispanics/Latinos.

General Self-Efficacy and Body Weight: The Role of Race and Gender

Overweight and obesity have become a prominent concern for policymakers, the Surgeon General, scholars, and for work organizations. The estimated annual cost of obesity in terms of lost productivity is in the tens of billions of dollars, and the estimated annual medical cost of obesity is in the hundreds of millions of dollars. Psychologists have become increasingly interested in issues related to body weight, such as ways to help people reduce body weight. The aims of our study are twofold. First, based on social cognitive theory, we offer the first study of the relationship between general self-efficacy (GSE) and body weight based on a large, representative sample. Second, we also offer an understanding of the role of race and gender as potential boundary conditions of this relationship. Findings indicate that race moderates the relationship between GSE and body weight (both BMI and perceived weight) such that this relationship is positive for Blacks but negative for Whites. Gender did not moderate the relationship between GSE and body weight. These results suggest that body weight is unrelated to general self-efficacy in the population writ large and that body weight is differentially related to self-efficacy based on race but not gender.