1
|
Prowse R, Lawlor N, Powell R, Neumann EM. Creating healthy food environments in recreation and sport settings using choice architecture: a scoping review. Health Promot Int 2023; 38:daad098. [PMID: 37705493 PMCID: PMC10500220 DOI: 10.1093/heapro/daad098] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
Recreation and sport settings (RSS) are ideal for health promotion, however, they often promote unhealthy eating. Choice architecture, a strategy to nudge consumers towards healthier options, has not been comprehensively reviewed in RSS and indicators for setting-based multi-level, multi-component healthy eating interventions in RSS are lacking. This scoping review aimed to generate healthy food environment indicators for RSS by reviewing peer-reviewed and grey literature evidence mapped onto an adapted choice architecture framework. One hundred thirty-two documents were included in a systematic search after screening. Data were extracted and coded, first, according to Canada's dietary guideline key messages, and were, second, mapped onto a choice architecture framework with eight nudging strategies (profile, portion, pricing, promotion, picks, priming, place and proximity) plus two multi-level factors (policy and people). We collated data to identify overarching guiding principles. We identified numerous indicators related to foods, water, sugary beverages, food marketing and sponsorship. There were four cross-cutting guiding principles: (i) healthy food and beverages are available, (ii) the pricing and placement of food and beverages favours healthy options, (iii) promotional messages related to food and beverages supports healthy eating and (iv) RSS are committed to supporting healthy eating and healthy food environments. The findings can be used to design nested, multipronged healthy food environment interventions. Future research is needed to test and systematically review the effectiveness of healthy eating interventions to identify the most promising indicators for setting-based health promotion in RSS.
Collapse
Affiliation(s)
- Rachel Prowse
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's NL A1B 3V6, Canada
| | - Natasha Lawlor
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's NL A1B 3V6, Canada
| | - Rachael Powell
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's NL A1B 3V6, Canada
| | - Eva-Marie Neumann
- Library Services Division, Health Canada, Jeanne Mance Building, 200 Eglantine Driveway, Tunney’s Pasture, Ottawa, ON K1A 0K9, Canada
| |
Collapse
|
2
|
Rosenthal MD, Schmidt LA, Vargas R, Blacker LS, McCulloch CE, Ezennia J, Patel AI. Drink Tap: A Multisector Program to Promote Water Access and Intake in San Francisco Parks. Prev Chronic Dis 2023; 20:E74. [PMID: 37616470 PMCID: PMC10457103 DOI: 10.5888/pcd20.230007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Abstract
Taxes on sugar-sweetened beverages (SSBs), or drinks with added sugars, show promise in decreasing purchases and consumption of SSBs. Some have called for coupling such taxes with improvements in access to safe drinking water as a strategy for reducing inequities in SSB intake, yet no studies have examined such an approach. Drink Tap is a San Francisco-based program in which public tap water stations were installed in parks and public spaces (winter 2017) and promotional efforts (fall and winter 2018) encouraged water intake. At the same time, San Francisco and surrounding communities were also implementing SSB taxes. We conducted a quasi-experimental study to examine whether water access and promotion combined with SSB taxes affected beverage intake habits more than SSB taxes alone. We conducted 1-hour observations (N = 960) at 10 intervention parks (Drink Tap plus SSB taxes) and 20 comparison parks (SSB taxes only) in San Francisco Bay Area cities before (July-September 2016) and after (June-August 2019) implementation of Drink Tap. We found significant adjusted percentage increases in drinking water among visitors to intervention parks, compared with comparison parks: water from park water sources (+80%, P < .001) and water from reusable bottles (+40%, P = .02). We found no significant reductions in visitors observed drinking bottled water, juices, or SSBs. The Drink Tap intervention led to increases in water intake from park sources and reusable bottles across parks that surpassed increases achieved through SSB taxes alone. Jurisdictions should consider coupling tap water access and promotion with policies for reducing intake of SSBs.
Collapse
Affiliation(s)
- Margaret D Rosenthal
- School of Medicine, University of Alabama at Birmingham
- University of Alabama at Birmingham Heersink School of Medicine, Department of Medical Education, 1670 University Blvd, Birmingham, AL 35233
| | - Laura A Schmidt
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
| | - Roberto Vargas
- Center for Community Engagement, Clinical and Translational Science Institute, University of California, San Francisco
| | - Lauren S Blacker
- Division of General Pediatrics, Stanford University School of Medicine, Palo Alto, California
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | | | - Anisha I Patel
- Division of General Pediatrics, Stanford University School of Medicine, Palo Alto, California
| |
Collapse
|
3
|
Larose D, Chih-Shing Chen M, Panahi S, Yessis J, Tremblay A, Drapeau V. Interventions to promote healthy lifestyle behaviors in children and adolescents in summer day camps: a scoping review. BMC Public Health 2023; 23:773. [PMID: 37101170 PMCID: PMC10134537 DOI: 10.1186/s12889-023-15521-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/24/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Children and adolescents have suboptimal physical activity and eating habits during summer breaks. Unlike the school setting, there is little evidence on interventions to promote healthy lifestyle behaviors in Summer Day Camps (SDCs). METHODS The aim of this scoping review was to examine physical activity, healthy eating, and sedentary behavior interventions in the SDCs. A systematic search on four platforms (EBSCOhost, MEDLINE, EMBASE, and Web of Science) was performed in May 2021 and was updated in June 2022. Studies related to promoting healthy behaviors, physical activity, sedentary behaviors and/or healthy eating among campers aged 6 to 16 in Summer Day Camps were retained. The protocol and writing of the scoping review were done according to the guidelines of the "Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR)". RESULTS Most interventions had a positive effect on the behavioral determinants or the behaviors themselves (i.e., physical activity, sedentary behaviors, or healthy eating). Involving counsellors and parents, setting camp goals, gardening, and education are all relevant strategies in promoting healthy lifestyle behaviors in SDCs. CONCLUSIONS Since only one intervention directly targeted sedentary behaviors, it should strongly be considered for inclusion in future studies. In addition, more long-term and experimental studies are needed to establish cause-and-effect relationships between healthy behavior interventions in SDCs and behaviors of children and young adolescents.
Collapse
Affiliation(s)
- David Larose
- Department of Kinesiology, Université Laval, Québec, G1V 0A6, Canada
- Quebec Heart and Lung Institute Research Center, Université Laval, Québec, G1V 0A6, Canada
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, G1V 0A6, Canada
- Centre de recherche interuniversitaire sur la formation et la profession enseignante (CRIFPE), Université Laval, Québec, G1V 0A6, Canada
| | | | - Shirin Panahi
- Department of Kinesiology, Université Laval, Québec, G1V 0A6, Canada
- Quebec Heart and Lung Institute Research Center, Université Laval, Québec, G1V 0A6, Canada
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, G1V 0A6, Canada
- Centre de recherche interuniversitaire sur la formation et la profession enseignante (CRIFPE), Université Laval, Québec, G1V 0A6, Canada
- Department of Physical Education, Université Laval, Québec, G1V 0A6, Canada
| | - Jennifer Yessis
- School of Public Health Sciences, University of Waterloo, Waterloo, N2L 3G1, Canada
| | - Angelo Tremblay
- Department of Kinesiology, Université Laval, Québec, G1V 0A6, Canada
- Quebec Heart and Lung Institute Research Center, Université Laval, Québec, G1V 0A6, Canada
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, G1V 0A6, Canada
- Centre de recherche interuniversitaire sur la formation et la profession enseignante (CRIFPE), Université Laval, Québec, G1V 0A6, Canada
| | - Vicky Drapeau
- Quebec Heart and Lung Institute Research Center, Université Laval, Québec, G1V 0A6, Canada.
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, G1V 0A6, Canada.
- Centre de recherche interuniversitaire sur la formation et la profession enseignante (CRIFPE), Université Laval, Québec, G1V 0A6, Canada.
- Department of Physical Education, Université Laval, Québec, G1V 0A6, Canada.
| |
Collapse
|
4
|
Vieux F, Maillot M, Rehm CD, Barrios P, Drewnowski A. Opposing Consumption Trends for Sugar-Sweetened Beverages and Plain Drinking Water: Analyses of NHANES 2011-16 Data. Front Nutr 2020; 7:587123. [PMID: 33304919 PMCID: PMC7701252 DOI: 10.3389/fnut.2020.587123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/08/2020] [Indexed: 12/21/2022] Open
Abstract
Background: Choosing water in place of sugar-sweetened beverages (SSB) can reduce added sugars while maintaining adequate hydration. The present goal was to examine 2011-16 time trends in SSB vs. water consumption across US population subgroups. Methods: Dietary intake data for 22,716 persons aged >4 years came from two 24-h dietary recalls in successive cycles of the National Health and Examination Survey (NHANES 2011-16). Water intakes (in mL/d) from plain water (tap and bottled) and from beverages (SSB and not-SSB) were the principal outcome variables. Intakes were analyzed by age group, income to poverty ratio (IPR), and race/ethnicity. Time trends by demographics were also examined. Results: SSB and water intakes followed distinct social gradients. Most SSB was consumed by Non-Hispanic Black and lower-income groups. Most tap water was consumed by Non-Hispanic White and higher-income groups. During 2011-16, water from SSB declined from 322 to 262 mL/d (p < 0.005), whereas plain water increased (1,011-1,144 mL/d) (p < 0.05). Groups aged <30 years reduced SSB consumption (p < 0.0001) but it was groups aged >30 years that increased drinking water (p < 0.001). Non-Hispanic White groups reduced SSB and increased tap water consumption. Non-Hispanic Black and lower income groups reduced SSB and increased bottled water, not tap. Conclusion: The opposing time trends in SSB and water consumption were not uniform across age groups or sociodemographic strata. Only the non-Hispanic White population reduced SSB and showed a corresponding increase in tap water. Lower-income and minority groups consumed relatively little plain drinking water from the tap.
Collapse
Affiliation(s)
- Florent Vieux
- MS-Nutrition, 27 bld Jean Moulin, Faculté de Médecine la Timone, Laboratoire C2VN, Marseille, France
| | - Matthieu Maillot
- MS-Nutrition, 27 bld Jean Moulin, Faculté de Médecine la Timone, Laboratoire C2VN, Marseille, France
| | | | | | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA, United States
| |
Collapse
|
5
|
Patel AI, Hecht CE, Cradock A, Edwards MA, Ritchie LD. Drinking Water in the United States: Implications of Water Safety, Access, and Consumption. Annu Rev Nutr 2020; 40:345-373. [PMID: 32966189 DOI: 10.1146/annurev-nutr-122319-035707] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Recent water quality crises in the United States, and recognition of the health importance of drinking water in lieu of sugar-sweetened beverages, have raised interest in water safety, access, and consumption. This review uses a socioecological lens to examine these topics across the life course. We review water intakes in the United States relative to requirements, including variation by age and race/ethnicity. We describe US regulations that seek to ensure that drinking water is safe to consume for most Americans and discuss strategies to reduce drinking water exposure to lead, a high-profile regulated drinking water contaminant. We discuss programs, policies, and environmental interventions that foster effective drinking water access, a concept that encompasses key elements needed to improve water intake. We conclude with recommendations for research, policies, regulations, and practices needed to ensure optimal water intake by all in the United States and elsewhere.
Collapse
Affiliation(s)
- Anisha I Patel
- Division of General Pediatrics, Stanford University, Palo Alto, California 94305, USA
| | - Christina E Hecht
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley, California 94704, USA;
| | - Angie Cradock
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, USA
| | - Marc A Edwards
- Department of Civil and Environmental Engineering, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - Lorrene D Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley, California 94704, USA;
| |
Collapse
|
6
|
Lawman HG, Grossman S, Lofton X, Tasian G, Patel AI. Hydrate Philly: An Intervention to Increase Water Access and Appeal in Recreation Centers. Prev Chronic Dis 2020; 17:E15. [PMID: 32078503 PMCID: PMC7085906 DOI: 10.5888/pcd17.190277] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Previous interventions to increase water access and consumption have focused on school settings, have shown mixed results on sugar-sweetened beverage (SSB) consumption, and have rarely addressed tap water safety. Our randomized controlled trial examined how improving access and appeal of water in recreation centers in low-income neighborhoods affected counts of SSBs carried by youth attending summer camp. METHODS Recreation centers (N = 28) matched on their characteristics were randomly assigned to control or intervention groups. Intervention centers received a new water fountain with a bottle filler (hydration station), water testing services, reusable water bottles, and water promotion and education training and materials. Primary outcomes were 1-year changes in center-level average daily gallons of water from fountains and hydration stations (flowmeter readings). Secondary outcomes were counts of SSBs observed, use of bottled water and reusable water bottles, staff SSB consumption, and hydration station maintenance. RESULTS Results showed increased water use (b = 8.6, 95% CI, 4.2-13.0) and reusable bottle counts (b = 10.2, 95% CI, 4.2-16.1) in intervention centers compared with control centers. No change occurred in youth carrying SSBs at camp, but center staff's past 30-day SSB consumption frequency decreased (b = -34.8, 95% CI, -67.7 to -1.9). Intervention sites had marginally lower odds of maintenance problems (OR = 0.09; 95% CI, 0.004-0.76, P = .06) than control sites. CONCLUSION Although providing hydration stations along with water testing, reusable water bottles, education, and promotion increased water consumption among youth at recreation centers, it had no effect on the number of SSBs observed during camp. Future strategies to increase water consumption should also address reducing SSB intake.
Collapse
Affiliation(s)
- Hannah G Lawman
- Division of Chronic Disease and Injury Prevention, Philadelphia Department of Public Health, Philadelphia, Pennsylvania
- Division of Chronic Disease Prevention, Philadelphia Department of Public Health, 1101 Market St, 9th Flr, Philadelphia, PA 19107.
| | - Sara Grossman
- Division of Chronic Disease and Injury Prevention, Philadelphia Department of Public Health, Philadelphia, Pennsylvania
| | - Xavier Lofton
- Division of Chronic Disease and Injury Prevention, Philadelphia Department of Public Health, Philadelphia, Pennsylvania
| | - Gregory Tasian
- Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Surgery, Division of Urology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Anisha I Patel
- School of Medicine, Stanford University, Stanford, California
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California
| |
Collapse
|
7
|
Patel AI, Hecht AA, Hampton KE, Hecht C, Buck S. Agua4All: Providing Safe Drinking Water in Rural California Communities. Prev Chronic Dis 2019; 16:E151. [PMID: 31726021 PMCID: PMC6880921 DOI: 10.5888/pcd16.190165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Drinking water instead of sugar-sweetened beverages may reduce obesity and dental caries. Tap water is more affordable and sustainable than bottled water and more likely to contain fluoride, which prevents caries. To address inequities in access to safe tap water, cross-sector partners established the Agua4All safe drinking-water program in 2 rural San Joaquin Valley, California, communities. The program's objective was to examine Agua4All's feasibility, acceptability, and effect on water intake. METHODS We provided bottle-filling stations dispensing safe water at 12 sites in 2 communities and provided limited promotional support. To compare the effect of different levels of promotion, sites in 1 community also received a promotions toolkit, a stipend, and assistance in developing and conducting their own promotional activities (site-led promotion). Beverage intake at sites was observed at baseline (pre-installation), at time 1 (post-installation), and at times 2 and 3 (post-promotion). Flowmeters tracked water dispensings. Staff interviews examined implementation barriers and facilitators. RESULTS From baseline to time 3, a nonsignificant increase (21.16%) occurred in the proportion of people drinking water at sites with water stations and site-led promotion compared with sites with water stations and limited promotion (5.13%) (P = .14). Mean daily gallons of water taken from stations per site was 3.61 (standard deviation, 3.84). Most staff members (77%) at the sites preferred water stations to traditional drinking fountains. CONCLUSION Bottle-filling stations with safe water and site-led promotion are a promising strategy for increasing water intake in communities without safe tap water. Larger studies should examine the effects of such stations on intake of sugar-sweetened beverages and on overall health.
Collapse
Affiliation(s)
- Anisha I Patel
- Division of General Pediatrics, Stanford University, Medical School Office Building, 1265 Welch Road, Stanford, CA 94305. .,Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California
| | - Amelie A Hecht
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California.,Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Christina Hecht
- Nutrition Policy Institute at the University of California, Division of Agriculture and Natural Resources, Oakland, California
| | - Sarah Buck
- RCAP Inc., Washington, District of Columbia.,Rural Community Assistance Corporation, Sacramento, California
| |
Collapse
|