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Gance-Cleveland B, Frenn M, Browne N, Greenberg CS, Snethen JA, Hodges EA, Fial AV, Small L, Irving SY. A scoping review of the role of policy in mitigating childhood obesity in underserved populations using the RE-AIM framework. Worldviews Evid Based Nurs 2024; 21:445-453. [PMID: 38584314 DOI: 10.1111/wvn.12725] [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: 10/10/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Childhood obesity is an escalating crisis in the United States. Health policy may impact this epidemic which disproportionally affects underserved populations. AIM The aim was to use the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework to assess health policy impact on preventing or treating school-aged children (5 > 18 years) with obesity in underserved populations. METHODS A scoping review of 842 articles was conducted. Twenty-four articles met the inclusion criteria and underwent data extraction. RESULTS Twelve studies included subgroup analysis, with four suggesting an impact of policy on at-risk groups. None of the 24 studies fully applied the RE-AIM framework. Policies positively impacted childhood obesity in 12 studies across the sample. LINKING EVIDENCE TO ACTION Our review revealed inconsistent evidence for the effectiveness of policy on childhood obesity, perhaps due to the lack of focus on the social determinants of health. In addition, many studies did not evaluate the outcomes for underserved populations. Therefore, we propose more attention to social determinants in future legislation and evaluation of policy effectiveness on underserved populations. Findings identify an urgent need for the design, implementation, and evaluation of policies specifically directed to address the inequities of racism, social injustices, and social determinants of health that impact childhood obesity in the United States. Future work needs to identify who was reached by the policy, who benefitted from the policy, and how policies were implemented to address obesity-related health disparities. Nurses should advocate for the evaluation of childhood obesity policies, particularly in underserved populations, to determine effectiveness. Nurses, particularly those trained in population and community health and research, should advocate for policy research that considers inequities rather than controls for these variables. Multi-layered interventions can then be tailored to sub-populations and evaluated more effectively.
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Affiliation(s)
- Bonnie Gance-Cleveland
- University of Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Marilyn Frenn
- Marquette University College of Nursing, Milwaukee, Wisconsin, USA
| | | | | | - Julia A Snethen
- University of Wisconsin-Milwaukee, School of Nursing, Milwaukee, Wisconsin, USA
| | - Eric A Hodges
- The University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA
| | - Alissa V Fial
- Marquette University, Raynor Memorial Libraries, Milwaukee, Wisconsin, USA
| | - Leigh Small
- Michigan State University College of Nursing, East Lansing, Michigan, USA
| | - Sharon Y Irving
- University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania, USA
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Miller S, Shier V, Wong E, Datar A. A natural experiment: The opening of a supermarket in a public housing community and impacts on children's dietary patterns. Prev Med Rep 2024; 39:102664. [PMID: 38426038 PMCID: PMC10901910 DOI: 10.1016/j.pmedr.2024.102664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/02/2024] Open
Abstract
Objective The aim of the present study is to utilize a natural experiment and examine changes in dietary patterns of predominantly low-income, racial and ethnic minority children who live in a public housing community following the opening of a new supermarket. Methods Data comes from the Watts Neighborhood Health Study (WNHS), an ongoing study in South Los Angeles, United States, that follows residents of Jordan Downs, a public housing community undergoing redevelopment. Surveys were administered to children aged 9-17 years (n = 297), as well as an adult in the household. The second baseline data collection was conducted June-December 2019, and follow-up was conducted June 2020-April 2021, shortly after the introduction of the new supermarket in January 2020. ANCOVA linear regression models were estimated to examine the association between children's proximity to the new supermarket with dietary outcomes at follow-up. Interactions with barriers to food access were also explored. Results Living close to the new supermarket was not significantly associated with dietary outcomes at follow-up. However, for children who lived in households with no vehicle access, living close to the new supermarket was associated with increased fruit and vegetable consumption, compared to children in the comparison group. Conclusion Proximity to the new supermarket was not associated with improved dietary outcomes among children unless they had transportation barriers. This adds to the growing body of literature that suggests that the effects of neighborhood food environments may be modified by individuals' mobility, and that comprehensive interventions are needed.
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Affiliation(s)
- Sydney Miller
- Dornsife School of Public Health, Drexel University, United States
- Keck School of Medicine, University of Southern California, United States
| | - Victoria Shier
- Price School of Public Policy, Schaeffer Center for Health Policy and Economics, University of Southern California, United States
| | - Elizabeth Wong
- Center for Economic and Social Research, University of Southern California, United States
| | - Ashlesha Datar
- Center for Economic and Social Research, University of Southern California, United States
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Datar A, Nicosia N, Samek A. Heterogeneity in place effects on health: The case of time preferences and adolescent obesity. ECONOMICS AND HUMAN BIOLOGY 2023; 49:101218. [PMID: 36623470 PMCID: PMC10164697 DOI: 10.1016/j.ehb.2022.101218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/06/2022] [Accepted: 12/20/2022] [Indexed: 05/08/2023]
Abstract
We leverage a natural experiment in combination with data on adolescents' time preferences to assess whether there is heterogeneity in place effects on adolescent obesity. We exploit the plausibly exogenous assignment of military servicemembers, and consequently their children, to different installations to identify place effects. Adolescents' time preferences are measured by a validated survey scale. Using the obesity rate in the assigned installation county as a summary measure of its obesity-related environments, we show that exposure to counties with higher obesity rates increases the likelihood of obesity among less patient adolescents but not among their more patient counterparts.
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Affiliation(s)
- Ashlesha Datar
- Center for Economic and Social Research, University of Southern California, 635 Downey Way, Los Angeles, CA 90089, USA.
| | - Nancy Nicosia
- RAND Corporation, 20 Park Plaza # 920, Boston, MA 02116, USA.
| | - Anya Samek
- Rady School of Management, University of California, San Diego, Wells Fargo Hall, 9500 Gilman Drive #0553, La Jolla, CA 92093, USA.
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Silva C, Pereira B, Figueiredo G, Rosário P, Núñez JC, Magalhães P. Self-Efficacy to Regulate Eating Behaviors Scale for Children: A Validation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2807. [PMID: 36833503 PMCID: PMC9956400 DOI: 10.3390/ijerph20042807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Self-efficacy has a strong influence on children's eating behavior. Feeling capable of regulating one's eating behavior is especially relevant in situations of activation while facing temptations or experiencing negative emotions. Despite the relevance, there is no validated measure to assess children's self-efficacy to regulate eating behaviors in these domains. The present study examines the psychometric properties of the Self-Efficacy to Regulate Eating Behaviors Scale for Children based on a sample of 724 elementary school children in Portugal. The sample was split randomly into two groups, and a principal component analysis with Group 1 and a confirmatory factor analysis with Group 2 were carried out. The scale comprises two distinct but related factors-self-efficacy to regulate eating behaviors in activation and temptation situations and self-efficacy to regulate eating behaviors in negative emotional situations. Moreover, self-efficacy to regulate eating behaviors was positively and statistically related to self-regulation processes toward healthy eating, declarative knowledge about healthy eating, and attitudes and perceptions toward healthy eating. The present study provides preliminary evidence that the Self-Efficacy to Regulate Eating Behaviors Scale for Children is valid and reliable for evaluating children's self-efficacy in regulating their eating behaviors.
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Affiliation(s)
- Cátia Silva
- Department of Applied Psychology, University of Minho, 4710-052 Braga, Portugal
| | - Beatriz Pereira
- Department of Applied Psychology, University of Minho, 4710-052 Braga, Portugal
| | - Gabriela Figueiredo
- Department of Applied Psychology, University of Minho, 4710-052 Braga, Portugal
| | - Pedro Rosário
- Department of Applied Psychology, University of Minho, 4710-052 Braga, Portugal
| | | | - Paula Magalhães
- Department of Applied Psychology, University of Minho, 4710-052 Braga, Portugal
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Outcome Evaluation on Impact of the Nutrition Intervention among Adolescents: A Feasibility, Randomised Control Study from Myheart Beat (Malaysian Health and Adolescents Longitudinal Research Team—Behavioural Epidemiology and Trial). Nutrients 2022; 14:nu14132733. [PMID: 35807911 PMCID: PMC9268738 DOI: 10.3390/nu14132733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 01/27/2023] Open
Abstract
A healthy eating environment in the school setting is crucial to nurture the healthy eating pattern for youth. Thus, it helps to combat the obesity issue. However, the impact of healthy school environment on healthy eating habits among Asian adolescents is scarce and less clear. This clustered randomised-control study has two objectives. The first objective was to evaluate the changes in adolescents’ dietary intake after the interventions for all arms (control; healthy cooking training only; subsidization with healthy cooking training). The second objective was to compare the effect of subsidization with healthy cooking training and healthy cooking training only with the control arm on adolescents’ dietary intakes. This study consisted of 340 secondary school students aged 14 years in rural and urban Malaysia. A total of two arms of intervention and one arm of control were included. Intervention one focused on healthy cooking preparation for the canteen and convenience shop operators. Intervention two included subsidization for fruits and vegetables with a healthy cooking preparation training for the canteen and suggestions on providing healthy options to the convenience shop operators. The outcome measured was changes to dietary intake. It was measured using a three-day dietary history pre- and post-intervention. A paired-t test was used to evaluate the outcome of intervention programmes on dietary changes for all arms (control, intervention one and two). An ANCOVA test was used to investigate the effect of providing subsidization and healthy cooking preparation training to the canteen and convenience shop operators on adolescents’ dietary intakes as compared to the control arm. Overall, the reduction in energy and carbohydrates for all arms were observed. Interestingly, fat intake was significantly increased after the four-week intervention programme under healthy cooking intervention but not in the food subsidization group. When comparing between control, healthy cooking training only and subsidization with the healthy cooking training arm, there was no significant changes between arms. A robust intervention to include subsidization of healthy foods for intervention programmes at schools in a larger scale study is needed to confirm this finding.
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Rocha LL, Pessoa MC, Gratão LHA, do Carmo AS, Cordeiro NG, Cunha CDF, de Oliveira TRPR, Mendes LL. Characteristics of the School Food Environment Affect the Consumption of Sugar-Sweetened Beverages Among Adolescents. Front Nutr 2021; 8:742744. [PMID: 34692751 PMCID: PMC8531082 DOI: 10.3389/fnut.2021.742744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/13/2021] [Indexed: 01/12/2023] Open
Abstract
Sugar-sweetened beverages are widely available and accessible in school environment, and their presence and characteristics of this environment can influence their consumption. This study examines the association of drinking fountains per 100 students, soft drink sales, soft drink advertising, and the presence of street vendors and sugar-sweetened beverages consumption among adolescents in Brazil. This cross-sectional study was carried out using data from the Study of Cardiovascular Risk in Adolescents that was conducted between March 2013 and December 2014. The sample comprised 71,475 adolescents aged 12–17 years from 1,247 public and private schools in Brazilian cities. Sugar-sweetened beverages consumption was the dependent variable. The main effect was the school food environment, which was evaluated based on drinking fountains per 100 students, soft drink sales, soft drink advertising, and the presence of street vendors. Public and private schools that sold soft drinks were associated with higher average sugar-sweetened beverages consumption among adolescents. Our study highlights the importance of creating healthy school food environments by banning sugar-sweetened beverages in schools accordingly.
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Affiliation(s)
- Luana Lara Rocha
- Preventive and Social Medicine Department, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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"More Than Buying Extra Fruits and Veggies, Please Hide the Fats and Sugars": Children's Diet Latent Profiles and Family-Related Factors. Nutrients 2021; 13:nu13072403. [PMID: 34371913 PMCID: PMC8308907 DOI: 10.3390/nu13072403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 12/12/2022] Open
Abstract
Promoting children’s healthy diets is a key public health priority. Family can play a relevant role in children’s eating patterns. The goals of the current research were to identify different latent diet profiles in children based on their food consumption and to assess the relationship between profiles and family-related factors. A total of 678 school-aged children from the fifth and sixth grades participated. The study design was cross-sectional and questionnaire based. Research assessed healthy (fruit and vegetables) and unhealthy (fast food, sugar-sweetened beverages, and candies) food consumption and family-related factors. A latent profile analysis and multivariate data analysis were developed. Four diet profiles were identified: Combined Diet, Mainly Healthy Diet, Mainly Unhealthy Diet, and Very Unhealthy Diet. Nearly half of the children (45.22%) showed a Combined Diet profile, meaning that they reported eating nearly the same amount of healthy and unhealthy types of foods. Associations between the diet profiles, family income, and food availability were found. For example, the Mainly Healthy Diet profile was statistically associated with a higher family income and less access to unhealthy foods. The present study reinforces the idea that profiling diets can allow for a tailored healthy eating intervention model according to the specific needs of each diet profile.
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Field AE. Do Not Throw the Baby Out With the Bath Water: It Is Too Early to Know Whether School Food Policy Can Shape Dietary Choices and Prevent Obesity. J Adolesc Health 2020; 67:739-740. [PMID: 33220794 DOI: 10.1016/j.jadohealth.2020.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Alison E Field
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
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