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Cosco NG, Wells NM, Zhang D, Goodell LS, Monsur M, Xu T, Moore RC. Hands-on childcare garden intervention: A randomized controlled trial to assess effects on fruit and vegetable identification, liking, and consumption among children aged 3–5 years in North Carolina. Front Psychol 2022; 13:993637. [DOI: 10.3389/fpsyg.2022.993637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/10/2022] [Indexed: 11/12/2022] Open
Abstract
Gardening at childcare centers may have a potent influence on young children’s learning about fruits and vegetables and their development of healthy dietary behaviors. This randomized controlled trial examined the effect of a garden intervention on fruit and vegetable (FV) identification, FV liking, and FV consumption among 3–5-year-old children enrolled in childcare centers in Wake County, North Carolina, USA. Eligible childcare centers (serving primarily low-income families) were randomly selected and then randomly assigned to one of three groups: (1) intervention; (2) waitlist-control that served as a control in year 1 and received the intervention in year 2; or (3) no-intervention control. From the 15 participating childcare centers, 285 children aged 3–5 years were consented by their parents or guardians to participate. The intervention comprised six standardized, raised, mulched garden beds, planted with warm-season annual vegetables and fruits, and perennial fruits. A Gardening Activity Guide describing 12 age-appropriate, sequential gardening activities was distributed for teachers to lead hands-on gardening activities during the growing season. Data were gathered between Spring 2018 and Fall 2019. FV identification and liking were measured using an age-appropriate tablet-enabled protocol. FV consumption was measured by weighing each child’s fruit and vegetable snack tray before and after tasting sessions. Compared to children receiving no-intervention, children who received the garden intervention showed a greater increase in accurate identification of both fruits and vegetables as well as consumption of both fruit and vegetables during the tasting sessions. Consistent with prior research, the effects on fruit consumption were greater than on vegetable consumption. There was no significant effect of the garden intervention on children’s FV liking. Garden interventions implemented early in life foster learning about FV and promote healthy eating. Early exposure to gardening may yield a return on investment throughout the lifecourse, impacting healthy diet and associated health outcomes, which are particularly important within disadvantaged communities where children’s health is challenged by a host of risk factors. Clinical Trials Registration #NCT04864574 (clinicaltrials.gov).
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Chan CL, Tan PY, Gong YY. Evaluating the impacts of school garden-based programmes on diet and nutrition-related knowledge, attitudes and practices among the school children: a systematic review. BMC Public Health 2022; 22:1251. [PMID: 35751069 PMCID: PMC9233338 DOI: 10.1186/s12889-022-13587-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous evidence suggests that school garden-based programmes (SGBP) may be a promising yet cost-effective intervention to improve children's knowledge, attitudes and practices (KAP) on healthy eating. This review aimed to summarise and evaluate the evidence available on the impacts of SGBP in addressing diet and nutrition-related KAP among school-aged children. METHODS Five databases including PubMed, Embase, Cochrane, Web of Science and Scopus were searched until February 2021. Randomised, non-randomised controlled and pre-post intervention studies investigating the impacts of SGBP on at least one of the outcomes of interest including diet and nutrition-related knowledge, attitudes towards fruits and vegetables (F&V), food diversity and dietary practice among school-aged children were included. Study selection and data extraction were performed by one reviewer and checked for accuracy by the other two reviewers in accordance with PRISMA guideline. Quality appraisal for studies included was assessed using American Dietetic Association Quality Criteria Checklist. RESULTS A total of 10,836 records were identified, and 35 studies that met the inclusion and exclusion criteria were included. This includes 25,726 students from 341 schools and 8 nurseries from 12 countries. Intervention duration ranged from 6 weeks to 4 years with 18 studies involving a varied degree of parental participation. SGBP, which majorly includes school gardening activities, cooking lessons and nutrition education, demonstrated beneficial effects on children's nutritional knowledge, their attitudes and acceptability towards fruits and vegetables and children's dietary practices including the actual F&V consumption and dietary diversity. However, the impacts of SGBP on such outcomes were highly influenced by various social and environmental factors including the activities/components and duration of the intervention, parental involvement, sample size, and the age of children when interventions were first introduced. CONCLUSION These findings suggest that SGBP may be effective in promoting children's nutritional knowledge, attitudes and acceptability towards vegetables, however, the impacts may vary by the type, the extent, and the length of the programmes, and other factors such as parent involvement. Future SGBP is suggested to implement using a combined multidisciplinary approach targeting the children, parents, and community to effectively promote healthy eating among the children and prevent childhood obesity.
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Affiliation(s)
- Chong Ling Chan
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK
| | - Pui Yee Tan
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK
| | - Yun Yun Gong
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK.
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Gago CM, Jurkowski J, Beckerman-Hsu JP, Aftosmes-Tobio A, Figueroa R, Oddleifson C, Mattei J, Kenney EL, Haneuse S, Davison KK. Exploring a theory of change: Are increases in parental empowerment associated with healthier weight-related parenting practices? Soc Sci Med 2022; 296:114761. [PMID: 35123371 PMCID: PMC8894077 DOI: 10.1016/j.socscimed.2022.114761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/25/2022] [Accepted: 01/27/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Parent health-related empowerment is defined as the process by which parents realize control over their life situation and take action to promote a healthier lifestyle. For decades, researchers have described the theoretical potential of empowerment in health promotion efforts, though few have empirically examined this hypothesized relationship. This study is one of the first to examine the relationship between parental empowerment and healthy weight parenting practices (i.e., food, physical activity, sleep, and media parenting), as a mechanism for early childhood health promotion in community settings. METHODS Low-income parents of preschool-aged children attending Head Start in Greater Boston between fall 2017 and spring 2019 were invited to complete a survey in the fall and spring of each academic school year (n = 578 with two surveys and n = 45 with four). Parental empowerment and healthy weight parenting practices were assessed using validated surveys. We used a multilevel difference-in-difference approach to estimate changes in healthy weight parenting practices score by changes in parental empowerment score. RESULTS Out of a possible score of four, the unadjusted mean (SD) score in fall was 3.20 (0.40) for empowerment and 3.01 (0.40) for parenting. An increase in parental empowerment was associated with an increase in healthier parenting practices (b = 0.14; 95% CI = 0.08, 0.20; p < 0.0001). CONCLUSIONS Parent empowerment may be an important target in interventions to prevent obesity in low-income children.
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Affiliation(s)
- Cristina M Gago
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Janine Jurkowski
- Department of Health Policy, Management, and Behavior, State University of New York, Albany, NY, 12222, USA
| | | | | | - Roger Figueroa
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY, 14853, USA
| | - Carly Oddleifson
- School of Social Work, Boston College, Chestnut Hill, MA, 02467, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Erica L Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Kirsten K Davison
- School of Social Work, Boston College, Chestnut Hill, MA, 02467, USA.
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Ravikumar D, Spyreli E, Woodside J, McKinley M, Kelly C. Parental perceptions of the food environment and their influence on food decisions among low-income families: a rapid review of qualitative evidence. BMC Public Health 2022; 22:9. [PMID: 34983469 PMCID: PMC8727174 DOI: 10.1186/s12889-021-12414-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background The food environment within and surrounding homes influences family dietary habits with socio-economic areas at a nutritional disadvantage. Families’ perception of the food environment and how it influences their food decisions is less clear. This rapid review aimed to synthesise qualitative evidence of parental perspectives of the food environment and their influence on food decisions among disadvantaged families. Method Qualitative and mixed-methods peer-reviewed journal articles published after 2000, that explored the perspectives of low-income parents in relation to their food environment and how this impacted food decisions for families with children aged 2-17 years, were included in this review. Embase, Scopus and PsycINFO were the databases chosen for this review. Search strategies included seven concepts related to family, food, perceptions, influences, environment, socio-economic status and study type. Two independent reviewers screened sixty-four studies. Thematic synthesis was employed. Results Two thousand one hundred and forty five results were identified through database searching and 1,650 were screened. Fourteen articles that originated from the US, Australia and the UK were included in this review. No articles were excluded following quality appraisal. Child preferences, financial and time constraints, and location and access to food outlets were barriers to accessing healthy food. Parental nutrition education and feeding approaches varied but positive outcomes from interventions to address these behaviours will be short-lived if inequities in health caused by poverty and access to affordable and healthy food are not addressed. The reliance on social support from families or government sources played an important role for families but are likely to be short-term solutions to health and nutritional inequities. Conclusions This qualitative evidence synthesis provides an insight into the perceptions of low-income parents on the factors influencing food decisions. Findings have implications for public health and the development of effective strategies to improve the dietary habits of children of disadvantaged families. Sustainable changes to dietary habits for families on low-income requires policy responses to low income, food access and to the high cost of healthy foods.
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Affiliation(s)
- Divya Ravikumar
- Health Promotion Research Centre, National University of Ireland Galway, University Rd, Galway, Republic of Ireland
| | - Eleni Spyreli
- Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BJ, UK.
| | - Jayne Woodside
- Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - Michelle McKinley
- Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - Colette Kelly
- Health Promotion Research Centre, National University of Ireland Galway, University Rd, Galway, Republic of Ireland
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Craveiro D, Marques S, Bell R, Khan M, Godinho C, Peixeiro F. Behavioural change box? Applying the COM-B model to understand behavioural triggers that support consumption of fruits and vegetable among subscribers of a fruit and vegetable box scheme. Public Health Nutr 2021; 24:6488-6498. [PMID: 34482856 PMCID: PMC11374553 DOI: 10.1017/s1368980021003839] [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] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To understand the key mechanisms that support healthy dietary habits promoted by fruit and vegetable (F&V) box schemes, testing relevant behaviour change triggers identified under the COM-B model in an evaluation research study of a Portuguese F&V box scheme (PROVE). DESIGN Correlation study with a post-test-only non-equivalent group design based on survey data. The mechanisms underpinning the differences between subscribers and non-subscribers are operationalised as mediation effects. Data availability, theoretical relevance and empirical validation supported the selection and testing of four potential mediators for the effects of subscribing to the box scheme on F&V consumption. These estimations derive from the coefficients of a structural equation model combined with the product coefficient approach and Sobel test. SETTING The study is part of a wider evaluation study on the impact of the PROVE box scheme on sustainability, health and equity. PARTICIPANTS A sample of PROVE box subscribers (n 294) was compared with a matched subsample of non-subscribers (n 571) in a nationally representative survey. RESULTS Subscribing to the PROVE box correlates with an increased probability of eating at least five portions of F&V, irrespective of differences in age, education and perceived economic difficulties. Diet quality perceptions, and more robustly, the strength of meal habits and household availability were identified as relevant mediators. CONCLUSIONS The subscription to an F&V box scheme is connected with proximal context that enables the consumption of F&V by ensuring more readily available F&V and better situational conditions associated with healthier meal habits.
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Affiliation(s)
- Daniela Craveiro
- SOCIUS, Research Centre in Economic and Organizational Sociology, ISEG - School of Economics & Management,Universidade de Lisboa, Rua Miguel Lupi 20, Edifício Bento Jesus Caraça, Office 203, Lisboa1249-078, Portugal
- ISCTE-Instituto Universitário de Lisboa, CIS-IUL, Lisboa, Portugal
| | - Sibila Marques
- ISCTE-Instituto Universitário de Lisboa, CIS-IUL, Lisboa, Portugal
| | - Ruth Bell
- Institute of Health Equity, UCL, London, UK
| | - Matluba Khan
- School of Geography and Planning, Cardiff University, UK
| | - Cristina Godinho
- ISCTE-Instituto Universitário de Lisboa, CIS-IUL, Lisboa, Portugal
- Universidade Católica Portuguesa, Católica Research Centre for Psychological - Family and Social Wellbeing, Portugal
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Baranowski T, Thompson D, Hughes SO, O’Connor TM. Precision Food Parenting: A Proposed Conceptual Model and Research Agenda. Nutrients 2021; 13:3650. [PMID: 34684651 PMCID: PMC8538596 DOI: 10.3390/nu13103650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 12/11/2022] Open
Abstract
Precision medicine, nutrition and behavioral interventions are attempting to move beyond the specification of therapies applied to groups, since some people benefit, some do not and some are harmed by the same therapy. Instead, precision therapies are attempting to employ diverse sets of data to individualize or tailor interventions to optimize the benefits for the receiving individuals. The benefits to be achieved are mostly in the distant future, but the research needs to start now. While precision pediatric nutrition will combine diverse demographic, behavioral and biological variables to specify the optimal foods a child should eat to optimize health, precision food parenting will combine diverse parent and child psychosocial and related variables to identify the optimal parenting practices to help a specific child accept and consume the precision nutrition specified foods. This paper presents a conceptual overview and hypothetical model of factors we believe are needed to operationalize precision food parenting and a proposed research agenda to better understand the many specified relationships, how they change over the age of the child, and how to operationalize them to encourage food parenting practices most likely to be effective at promoting healthy child food choices.
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Affiliation(s)
- Tom Baranowski
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; (D.T.); (S.O.H.); (T.M.O.)
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Impact of a School-Based Gardening, Cooking, Nutrition Intervention on Diet Intake and Quality: The TX Sprouts Randomized Controlled Trial. Nutrients 2021; 13:nu13093081. [PMID: 34578959 PMCID: PMC8471386 DOI: 10.3390/nu13093081] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/26/2021] [Accepted: 08/30/2021] [Indexed: 12/15/2022] Open
Abstract
School gardens have become common school-based health promotion strategies to enhance dietary behaviors in the United States. The goal of this study was to examine the effects of TX Sprouts, a one-year school-based gardening, cooking, and nutrition cluster randomized controlled trial, on students' dietary intake and quality. Eight schools were randomly assigned to the TX Sprouts intervention and eight schools to control (i.e., delayed intervention) over three years (2016-2019). The intervention arm received: formation and training of Garden Leadership Committees; a 0.25-acre outdoor teaching garden; 18 student lessons including gardening, nutrition, and cooking activities, taught weekly in the teaching garden during school hours; and nine parent lessons, taught monthly. Dietary intake data via two 24 h dietary recalls (24 hDR) were collected on a random subsample (n = 468). Dietary quality was calculated using the Healthy Eating Index 2015 (HEI-2015). The intervention group compared to control resulted in a modest increase in protein intake as a percentage of total energy (0.4% vs. -0.3%, p = 0.021) and in HEI-2015 total vegetables component scores (+4% vs. -2%, p = 0.003). When stratified by ethnicity/race, non-Hispanic children had a significant increase in HEI-2015 total vegetable scores in the intervention group compared to the control group (+4% vs. -8%, p = 0.026). Both the intervention and control groups increased added sugar intake; however, to a lesser extent within the intervention group (0.3 vs. 2.6 g/day, p = 0.050). School-based gardening, cooking, and nutrition interventions can result in significant improvements in dietary intake. Further research on ways to scale and sustain nutrition education programs in schools is warranted. The trial is registered at ClinicalTrials.gov (NCT02668744).
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Di Noia J, Gellermann W. Use of the Spectroscopy-Based Veggie Meter ® to Objectively Assess Fruit and Vegetable Intake in Low-Income Adults. Nutrients 2021; 13:2270. [PMID: 34209048 PMCID: PMC8308249 DOI: 10.3390/nu13072270] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/21/2021] [Accepted: 06/29/2021] [Indexed: 12/20/2022] Open
Abstract
Reflection spectroscopy is an emerging approach for noninvasively assessing dermal carotenoids as a biomarker of fruit and vegetable (FV) intake. This study sought to profile and identify determinants of scores from a reflection spectroscopy device (the Veggie Meter (VM)®) among 297 urban, primarily Hispanic low-income adults served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The repeatability of the scores and bi- and multivariate relationships between VM scores, self-reported FV intake measured by a brief screener, and participant characteristics were examined. The mean VM score was 270 (range 0-695); 3- and 6-month test-retest correlations were positive and strong (r = 0.79 and 0.55, respectively). VM scores were negatively associated with body mass index (BMI; r = -0.22) and were higher among participants of Ecuadorian, Dominican, and Mexican Hispanic origin relative to those of Puerto Rican origin; foreign- vs. US-born participants, breastfeeding vs. non-breastfeeding participants, nonsmokers vs. smokers, and participants who consumed three or more cups of FV/day relative to those who consumed less than three cups of FV/day. Foreign-born nativity, consumption of three or more cups of FV/day, and smaller body size were determinants of increased VM scores. Although replication studies are needed to confirm these findings, investigators working with similar populations are encouraged to use the VM to longitudinally track FV intake and to target determinants of the scores in observational and intervention studies of FV intake as measured by the VM.
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Affiliation(s)
- Jennifer Di Noia
- Department of Sociology, William Paterson University, Wayne, NJ 07470, USA
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Immink V, Kornelis M, Van Kleef E. Vegetable interventions at unconventional occasions: the effect of freely available snack vegetables at workplace meetings on consumption. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2021. [DOI: 10.1108/ijwhm-06-2020-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeSnacks at work are often of poor dietary quality. The main objective of the current study is to examine the effect of making vegetable snacks available at workplace meetings on consumption.Design/methodology/approachIn three between-subjects field experiments conducted at a hospital and three ministries in the Netherlands, with meeting as the unit of condition assignment, attendees were exposed to an assortment of vegetables, varying in vegetable variety and presence of promotional leaflet in study 1 (N = 136 meetings), serving container in study 2 (N = 88 meetings) and additional presence of cookies in study 3 (N = 88 meetings). Consumption of vegetables and cookies was measured at meeting level to assess grams consumed per person.FindingsAcross the three studies, average consumption per meeting attendee was 74 g (SD = 43) for study 1; 78 g (SD = 43) for study 2 and 87 g (SD = 35) for study 3. In the first study, manipulation of perceived variety and information leaflets did not affect intake. In the second study, significantly more vegetables were eaten when they were offered in single sized portions (M = 97 g, SD = 45) versus in a shared multiple portions bowl (63 g, SD = 38) (p < 0.001). In the third study, no effect was found of the additional availability of cookies on vegetable consumption during the meeting.Practical implicationsThe present studies show how availability of vegetables at unconventional occasions makes meeting attendants consume considerable portions of vegetables on average. As such, offering healthy snacks at the workplace may be a valuable part of workplace health promotion programs and positively change the “office cake culture”.Originality/valueVegetable intake is less than recommended in many countries worldwide. Many snacking occasions are at work, which makes office meetings a potential consumption occasion to encourage vegetable intake. Hence, the aim of this study is to examine whether free availability of vegetable snacks during meetings contributes to their consumption among meeting attendees and under what conditions consumption is optimal.
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Golding SE, Bondaronek P, Bunten AK, Porter L, Maynard V, Rennie D, Durlik C, Sallis A, Chadborn T. Interventions to change purchasing behaviour in supermarkets: a systematic review and intervention content analysis. Health Psychol Rev 2021; 16:305-345. [PMID: 33847250 DOI: 10.1080/17437199.2021.1911670] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This systematic review and intervention content analysis used behavioural science frameworks to characterise content and function of interventions targeting supermarket shoppers' purchasing behaviour, and explore if coherence between content and function was linked to intervention effectiveness. Study eligibility: in-store interventions (physical supermarkets) with control conditions, targeting objectively measured food and/or non-alcoholic drink purchases, published in English (no date restrictions). Eleven electronic databases were searched; reference lists of systematic reviews were hand-searched. Methodological quality was assessed using the GATE checklist. A content analysis was performed to characterise intervention content and function, and theoretical coherence between these, using the Behaviour Change Wheel, Behaviour Change Techniques Taxonomy, and Typology of Interventions in Proximal Physical Micro-Environments (TIPPME). Forty-six articles (49 interventions) met inclusion criteria; 26 articles (32 interventions) were included in the content analysis. Twenty behaviour change techniques (BCTs), and four TIPPME intervention types were identified; three BCTs ('Prompts/cues', 'Material incentive', and 'Material reward') were more common in effective interventions. Nineteen interventions solely employed theoretically appropriate BCTs. Theoretical coherence between BCTs and intervention functions was more common in effective interventions. Effective interventions included price promotions and/or in-store merchandising. Future research should explore the effect of specific BCTs using factorial study designs. PROSPERO Registration: CRD42017071065.
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Affiliation(s)
- Sarah E Golding
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.,Behavioural Insights Team, Research, Translation and Innovation Division, Public Health England, London, UK
| | - Paulina Bondaronek
- Behavioural Insights Team, Research, Translation and Innovation Division, Public Health England, London, UK.,eHealth Unit, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Amanda K Bunten
- Behavioural Insights Team, Research, Translation and Innovation Division, Public Health England, London, UK
| | - Lucy Porter
- Behavioural Insights Team, Research, Translation and Innovation Division, Public Health England, London, UK
| | - Vera Maynard
- Behavioural Insights Team, Research, Translation and Innovation Division, Public Health England, London, UK
| | - Debi Rennie
- Behavioural Insights Team, Research, Translation and Innovation Division, Public Health England, London, UK
| | - Caroline Durlik
- Behavioural Insights Team, Research, Translation and Innovation Division, Public Health England, London, UK
| | - Anna Sallis
- Behavioural Insights Team, Research, Translation and Innovation Division, Public Health England, London, UK
| | - Tim Chadborn
- Behavioural Insights Team, Research, Translation and Innovation Division, Public Health England, London, UK
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Barriers to Preparing and Cooking Vegetables Are Associated with Decreased Home Availability of Vegetables in Low-Income Households. Nutrients 2020; 12:nu12061823. [PMID: 32570923 PMCID: PMC7353206 DOI: 10.3390/nu12061823] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/06/2020] [Accepted: 06/16/2020] [Indexed: 11/16/2022] Open
Abstract
Knowing which barriers to buying and preparing/cooking vegetables at home are linked with the home availability of vegetables and how food-security status impacts this relationship will facilitate the tailoring of future public health interventions. Baseline data were used from an elementary-school-based intervention. Data on household food-security status, availability of vegetables at home, and barriers to buying and preparing/cooking vegetables were collected from 1942 parents. Differences between food-secure and food-insecure households were examined for barriers to buying and preparing/cooking vegetables. Mixed-effects linear regression was used to estimate the associations between barriers to buying and preparing/cooking vegetables and food-security status on the home availability of vegetables. Food insecurity was reported in 27% of households. Food-insecure households were significantly more likely to report barriers to buying and preparing/cooking vegetables. The barriers to purchasing/cooking vegetables score was associated with a decrease in the home availability of vegetables score (β = −0.77; 95% CI: −0.88, −0.65; p < 0.001). Compared to food-secure households, food-insecure households were 15% less likely to have home vegetable availability (β = −1.18; 95% CI: −1.45, −0.92; p < 0.001). Although home availability of vegetables does not guarantee consumption, this study identified specific barriers that were associated with availability that can be targeted in future interventions seeking to improve vegetable consumption in the homes of low-income families.
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12
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Kehoe SH, Dhurde V, Bhaise S, Kale R, Kumaran K, Gelli A, Rengalakshmi R, Lawrence W, Bloom I, Sahariah SA, Potdar RD, Fall CHD. Barriers and Facilitators to Fruit and Vegetable Consumption Among Rural Indian Women of Reproductive Age. Food Nutr Bull 2019; 40:87-98. [PMID: 30974984 DOI: 10.1177/0379572118816459] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Micronutrient deficiencies have been a serious public health problem among women of reproductive age in low- and middle-income countries including India, adversely affecting maternal and child health and human capital outcomes. Fruit and vegetables are important sources of micronutrients, and consumption of these foods is less than recommendations. OBJECTIVE The objective of this study was to identify perceived barriers and facilitators to fruit and vegetable consumption among women of reproductive age living in rural communities in the State of Maharashtra, India. METHODS Women aged 18 to 40 years were recruited from 8 villages surrounding the city of Wardha, Maharashtra, India. We used qualitative methods and held 9 focus group discussions and 12 one-to-one interviews. The data collection was stopped when no new information emerged. We used inductive thematic coding to analyze the data. RESULTS Women knew that fruit and vegetables were beneficial to health and expressed that they wanted to increase the intake of these foods for themselves and their children. Seven main themes were identified as being barriers or facilitators to fruit and vegetable consumption: (1) personal factors, (2) household dynamics, (3) social and cultural norms, (4) workload, (5) time pressures, (6) environmental factors, and (7) cost. CONCLUSIONS Rural Indian women consumed fruit and vegetables infrequently and said they would like to consume more. Several potentially modifiable factors affecting the intake of fruit and vegetables were identified. Value chain analyses of fruit and vegetables in these communities will be important to identify opportunities to intervene and increase consumption.
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Affiliation(s)
| | - Varsha Dhurde
- 2 Centre for Study of Social Change, Mumbai, Maharashtra, India
| | - Shilpa Bhaise
- 2 Centre for Study of Social Change, Mumbai, Maharashtra, India
| | - Rashmi Kale
- 2 Centre for Study of Social Change, Mumbai, Maharashtra, India
| | | | - Aulo Gelli
- 3 International Food Policy Research Institute, Washington DC, USA
| | - R Rengalakshmi
- 4 MS Swaminathan Research Foundation, Chennai, Tamil Nadu, India
| | | | - Ilse Bloom
- 1 University of Southampton, Southampton, UK.,5 NIHR Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, UK
| | | | - Ramesh D Potdar
- 2 Centre for Study of Social Change, Mumbai, Maharashtra, India
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McGuirt JT, Jilcott Pitts SB, Gustafson A. Association between Spatial Access to Food Outlets, Frequency of Grocery Shopping, and Objectively-Assessed and Self-Reported Fruit and Vegetable Consumption. Nutrients 2018; 10:E1974. [PMID: 30551652 PMCID: PMC6316649 DOI: 10.3390/nu10121974] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/04/2018] [Accepted: 12/11/2018] [Indexed: 12/30/2022] Open
Abstract
Because supermarkets are a critical part of the community food environment, the purpose of this paper is to examine the association between accessibility to the supermarket where participants were surveyed, frequency of shopping at the supermarket, and self-reported and objectively-assessed fruit and vegetable consumption. Accessibility was assessed using Geographic Information Systems (GIS) measured distance and multiple versions of the modified Retail Food Environment Index (mRFEI), including a localized road network buffer version. Frequency of shopping was assessed using self-report. The National Cancer Institute Fruit and Vegetable screener was used to calculate daily servings of fruits and vegetables. Skin carotenoids were assessed using the "Veggie Meter™" which utilizes reflection spectroscopy to non-invasively assess skin carotenoids as an objective measure of fruit and vegetable consumption. Bivariate and multivariable statistics were used to examine the associations in RStudio. There was a positive association between skin carotenoids and the Special Supplemental Nutrition Program for Women Infants and Children (WIC) and mRFEI scores, suggesting that WIC participation and a healthier food environment were associated with objectively-assessed fruit and vegetable consumption (skin carotenoids). Future research should examine these associations using longitudinal study designs and larger sample sizes.
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Affiliation(s)
- Jared T McGuirt
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC 27412, USA.
| | - Stephanie B Jilcott Pitts
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA.
| | - Alison Gustafson
- Department of Dietetics and Human Nutrition, School of Human Environmental Sciences, University of Kentucky, Lexington, KY 40506, USA.
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15
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Arredondo EM, Ayala GX, Soto S, Slymen DJ, Horton LA, Parada H, Campbell N, Ibarra L, Engelberg M, Elder JP. Latina mothers as agents of change in children's eating habits: findings from the randomized controlled trial Entre Familia: Reflejos de Salud. Int J Behav Nutr Phys Act 2018; 15:95. [PMID: 30285755 PMCID: PMC6167856 DOI: 10.1186/s12966-018-0714-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 08/15/2018] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Few children consume sufficient servings of fruits and vegetables. Interventions aiming to improve children's dietary intake often target parent level factors, but limited research has examined the mediating role of parental factors on children's dietary intake. This study examined 10-month follow up data from the Entre Familia: Reflejos de Salud (Within the Family: Reflections of Health) trial to investigate (1) intervention effects on children's dietary intake, both sustained and new changes, and (2) whether changes in mothers' dietary intake, her parenting strategies, and behavioral strategies to promoting healthy eating in the home mediated changes in children's dietary intake. METHODS Participants were 361 Mexican-origin families living in Imperial County, California. Families were randomly assigned to a 4-month dietary intervention or a delayed treatment control group. The intervention was delivered by promotoras (community health workers) via home visits and telephone calls. Assessments occurred at baseline, and 4- and 10-months post-baseline. RESULTS At 10-months post-baseline, sustained intervention effects were observed on children's reported intake of varieties of vegetables, with differences getting larger over time. However, differential intervention effects on fast food were not sustained due to significant reductions in the control group compared with smaller changes in the intervention group. New intervention effects were observed on servings of sugar-sweetened beverages. However, the intervention continued to have no effect on children's reported fruit and vegetable servings, and varieties of fruits consumed. Mother-reported behavioral strategies to increase fiber and lower fat mediated the relationship between the intervention and children's intake of varieties of vegetables. Mothers' percent energy from fat and behavioral strategies to lower fat were mediators of children's daily servings of sugar-sweetened beverages. CONCLUSIONS This study suggests that a promotora-led family based intervention can provide mothers with skills to promote modest changes in children's diet. Examining the parent related mechanisms of change will inform future interventions on important targets for improving children's diet. TRIAL REGISTRATION https://clinicaltrials.gov/ . NCT02441049 . Retrospectively registered 05.06.2015.
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Affiliation(s)
- Elva M Arredondo
- Institute for Behavioral and Community Health, School of Public Health, San Diego State University, 9245 Sky Park Ct., Suite 221, San Diego, CA, 92123, USA.
| | - Guadalupe X Ayala
- Institute for Behavioral and Community Health, School of Public Health, San Diego State University, 9245 Sky Park Ct., Suite 221, San Diego, CA, 92123, USA
| | - Sandra Soto
- School of Nursing, University of North Carolina, Carrington Hall, Campus Box #7460, Chapel Hill, NC, 97599, USA
| | - Donald J Slymen
- Institute for Behavioral and Community Health, School of Public Health, San Diego State University, 9245 Sky Park Ct., Suite 221, San Diego, CA, 92123, USA
| | - Lucy A Horton
- Institute for Behavioral and Community Health, 9245 Sky Park Ct, Suite 221, San Diego, CA, 92123, USA
| | - Humberto Parada
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Nadia Campbell
- Institute for Behavioral and Community Health, 9245 Sky Park Ct, Suite 221, San Diego, CA, 92123, USA
| | - Leticia Ibarra
- Clínicas de Salud del Pueblo, Inc., 1166 K Street, Brawley, CA, 92227, USA
| | - Moshe Engelberg
- Research Works, 12396 World Trade Dr #313, San Diego, CA, 92128, USA
| | - John P Elder
- Institute for Behavioral and Community Health, School of Public Health, San Diego State University, 9245 Sky Park Ct., Suite 221, San Diego, CA, 92123, USA
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Giombi K, Wiecha J, Vine J, Rogers VW. Policies and Practices of High-Performing Let’s Go! Schools. AMERICAN JOURNAL OF HEALTH EDUCATION 2018. [DOI: 10.1080/19325037.2018.1489742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | - Jackie Vine
- The Barbara Bush Children’s Hospital at Maine Medical Center
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17
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Wells NM, Meyers BM, Todd LE, Henderson CR, Barale K, Gaolach B, Ferenz G, Aitken M, Tse CC, Pattison KO, Hendrix L, Carson JB, Taylor C, Franz NK. The carry-over effects of school gardens on fruit and vegetable availability at home: A randomized controlled trial with low-income elementary schools. Prev Med 2018; 112:152-159. [PMID: 29627512 DOI: 10.1016/j.ypmed.2018.03.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 02/26/2018] [Accepted: 03/28/2018] [Indexed: 11/26/2022]
Abstract
This group-randomized controlled trial examines the effects of a school garden intervention on availability of fruits and vegetables (FV) in elementary school children's homes. Within each region, low income U.S. schools in Arkansas, Iowa, New York, and Washington State were randomly assigned to intervention group (n = 24) or waitlist control group (n = 22). Children were in grades 2, 4, and 5 at baseline (n = 2768). The garden intervention consisted of both raised-bed garden kits and a series of grade-appropriate lessons. FV availability at home was measured with a modified version of the GEMS FJV Availability Questionnaire. The instrument was administered at baseline (Fall 2011) and throughout the intervention (Spring 2012, Fall 2012, Spring 2013). Analyses were completed using general linear mixed models. The garden intervention led to an overall increase in availability of low-fat vegetables at home. Among younger children (2nd grade at baseline), the garden intervention led to greater home availability of vegetables, especially, low-fat vegetables. Moreover, for the younger group, garden intervention fidelity (GIF) or robustness predicted home availability of fruit, vegetables, and low-fat vegetables. School gardens have potential to affect FV availability in the home environment.
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Affiliation(s)
- Nancy M Wells
- Department of Design & Environmental Analysis, College of Human Ecology, Cornell University, Ithaca, NY, United States.
| | - Beth M Meyers
- Department of Design & Environmental Analysis, College of Human Ecology, Cornell University, Ithaca, NY, United States
| | - Lauren E Todd
- Department of Design & Environmental Analysis, College of Human Ecology, Cornell University, Ithaca, NY, United States
| | - Charles R Henderson
- Human Development Department, College of Human Ecology, Cornell University, Ithaca, NY, United States
| | - Karen Barale
- Washington State University Extension, Tacoma, WA, United States
| | - Brad Gaolach
- Washington State University Extension, Seattle, WA, United States
| | - Gretchen Ferenz
- Cornell University Cooperative Extension, New York, NY, United States
| | - Martha Aitken
- Washington State University Extension, Tacoma, WA, United States
| | - Caroline C Tse
- Cornell University Cooperative Extension, New York, NY, United States
| | - Karen Ostlie Pattison
- Iowa State University Extension & Outreach, 4-H Youth Development, Osceola, IA, United States
| | - Laura Hendrix
- University of Arkansas Cooperative Extension Service, Little Rock, AR, United States
| | - Janet B Carson
- University of Arkansas Cooperative Extension Service, Little Rock, AR, United States
| | - Cayla Taylor
- Iowa 4-H Youth Development Program, Iowa State University, Ames, IA, United States
| | - Nancy K Franz
- School of Education, Iowa State University, Ames, IA, United States
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18
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Ziauddeen N, Page P, Penney TL, Nicholson S, Kirk SFL, Almiron-Roig E. Eating at food outlets and leisure places and "on the go" is associated with less-healthy food choices than eating at home and in school in children: cross-sectional data from the UK National Diet and Nutrition Survey Rolling Program (2008-2014). Am J Clin Nutr 2018; 107:992-1003. [PMID: 29741556 PMCID: PMC5985724 DOI: 10.1093/ajcn/nqy057] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 03/06/2018] [Indexed: 12/25/2022] Open
Abstract
Background Where children eat has been linked to variations in diet quality, including the consumption of low-nutrient, energy-dense food, a recognized risk factor for obesity. Objective The aim of this study was to provide a comprehensive analysis of consumption patterns and nutritional intake by eating location in British children with the use of a nationally representative survey. Design Cross-sectional data from 4636 children (80,075 eating occasions) aged 1.5-18 y from the UK National Diet and Nutrition Survey Rolling Program (2008-2014) were analyzed. Eating locations were categorized as home, school, work, leisure places, food outlets, and "on the go." Foods were classified into core (considered important or acceptable within a healthy diet) and noncore (all other foods). Other variables included the percentage of meals eaten at home, sex, ethnicity, body mass index, income, frequency of eating out, takeaway meal consumption, alcohol consumption, and smoking. Results The main eating location across all age groups was at home (69-79% of eating occasions), with the highest energy intakes. One-third of children from the least-affluent families consumed ≤25% of meals at home. Eating more at home was associated with less sugar and takeaway food consumption. Eating occasions in leisure places, food outlets, and "on the go" combined increased with age, from 5% (1.5-3 y) to 7% (11-18 y), with higher energy intakes from noncore foods in these locations. The school environment was associated with higher intakes of core foods and reduced intakes of noncore foods in children aged 4-10 y who ate school-sourced foods. Conclusions Home and school eating are associated with better food choices, whereas other locations are associated with poor food choices. Effective, sustained initiatives targeted at behaviors and improving access to healthy foods in leisure centers and food outlets, including food sold to eat "on the go," may improve food choices. Home remains an important target for intervention through family and nutrition education, outreach, and social marketing campaigns. This trial was registered with the ISRTCN registry (https://www.isrctn.com) as ISRCTN17261407.
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Affiliation(s)
- Nida Ziauddeen
- Medical Research Council (MRC) Elsie Widdowson Laboratory, Cambridge, United Kingdom
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Polly Page
- Medical Research Council (MRC) Elsie Widdowson Laboratory, Cambridge, United Kingdom
| | - Tarra L Penney
- UKCRC Center for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom
| | - Sonja Nicholson
- Medical Research Council (MRC) Elsie Widdowson Laboratory, Cambridge, United Kingdom
| | - Sara FL Kirk
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Eva Almiron-Roig
- Medical Research Council (MRC) Elsie Widdowson Laboratory, Cambridge, United Kingdom
- Center for Nutrition Research, University of Navarra, Pamplona, Spain
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Does the distribution frequency matter? A subgroup specific analysis of the effectiveness of the EU School Fruit and Vegetable Scheme in Germany comparing twice and thrice weekly deliveries. Public Health Nutr 2018; 21:1375-1387. [PMID: 29370878 DOI: 10.1017/s1368980017003949] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present study aimed to examine the effectiveness of two different implementation forms of the EU School Fruit and Vegetable Scheme (SFVS). DESIGN A quasi-experimental design was applied including a thrice as well as a twice weekly intervention group. Repeated 24 h dietary recalls were used to measure children's fruit and vegetable (F&V) intake. Effects were analysed on days with and without F&V deliveries using hierarchical linear regression models. SETTING Twelve primary schools in North Rhine-Westphalia, Germany. SUBJECTS Third and fourth graders (n 664). RESULTS Average daily F&V intake at pre-intervention was 0·84 frequencies in the thrice weekly intervention group, 0·90 frequencies in the twice weekly intervention group and 1·25 frequencies in the control group. Providing children thrice weekly with F&V increased children's F&V intake on average by 0·96 (P<0·001) frequencies/d. The effects were higher on days with (1·07; P<0·001) than on days without (0·75; P<0·001) F&V deliveries. Distributing F&V twice weekly resulted in an increase of 0·75 (P<0·001) frequencies/d on average, again with higher effects on days with (1·30; P<0·001) than without (0·48; P<0·003) F&V deliveries. Subgroup analysis revealed some indications for differential effectiveness only in the twice weekly intervention group. CONCLUSIONS The SFVS with thrice or twice weekly deliveries of F&V led to a significant increase in children's F&V intake on days with and without deliveries. The latter might provide an indication of positive long-term effects of the scheme. The scheme shows equal efficiency for almost all subgroups.
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20
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Dietary patterns and their associations with home food availability among Finnish pre-school children: a cross-sectional study. Public Health Nutr 2018; 21:1232-1242. [DOI: 10.1017/s1368980017003871] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
AbstractObjectiveTo study the associations between home food availability and dietary patterns among pre-school children.DesignCross-sectional study in which parents of the participating children filled in an FFQ and reported how often they had certain foods in their homes. We derived dietary pattern scores using principal component analysis, and composite scores describing the availability of fruits and vegetables as well as sugar-enriched foods in the home were created for each participant. We used multilevel models to investigate the associations between availability and dietary pattern scores.SettingThe DAGIS study, Finland.SubjectsThe participants were 864 Finnish 3–6-year-old children recruited from sixty-six pre-schools. The analyses included 711 children with sufficient data.ResultsWe identified three dietary patterns explaining 16·7 % of the variance. The patterns were named ‘sweets-and-treats’ (high loadings of e.g. sweet biscuits, chocolate, ice cream), ‘health-conscious’ (high loadings of e.g. nuts, natural yoghurt, berries) and ‘vegetables-and-processed meats’ (high loadings of e.g. vegetables, cold cuts, fruit). In multivariate models, the availability of fruits and vegetables was inversely associated with the sweets-and-treats pattern (β=−0·05, P<0·01) and positively associated with the health-conscious (β=0·07, P<0·01) and vegetables-and-processed meats patterns (β=0·06, P<0·01). The availability of sugar-enriched foods was positively associated with the sweets-and-treats pattern (β=0·10, P<0·01) and inversely associated with the health-conscious pattern (β=−0·03, P<0·01).ConclusionsConsidering dietary patterns, the availability of sugar-enriched foods in the home seems to have a stronger role than that of fruits and vegetables. Parents should restrict the availability of unhealthy foods in the home.
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Matanane L, Fialkowski MK, Silva J, Li F, Nigg C, Leon Guerrero RT, Novotny R. Para I Famagu'on-Ta: Fruit and Vegetable Intake, Food Store Environment, and Childhood Overweight/Obesity in the Children's Healthy Living Program on Guam. HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2017; 76:225-233. [PMID: 28808612 PMCID: PMC5551277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This cross-sectional study examined the: (1) association between food store environment (FSE), fruit and vegetable (FV) availability and access, and prevalence of early childhood overweight/obesity (COWOB); and (2) influence of young child actual FV intake on the relationship between the FSE and early COWOB prevalence. Anthropometric and socio-demographic data of children (2 to 8 years; N=466) in baseline communities on Guam participating in the Children's Healthy Living (CHL) Program community trial were included. CDC year 2000 growth charts were used to calculate BMI z-scores and categories. FSE factors (fresh FV scores, store type) were assessed using the CX3 Food Availability and Marketing Survey amended for CHL. ArcGIS maps were constructed with geographic coordinates of participant residences and food stores to calculate food store scores within 1 mile of participant's residences. A sub-sample of participants (n = 355) had Food and Activity Log data to calculate FV and energy intakes. Bivariate correlations and logistic regression evaluated associations. Of 111 stores surveyed, 73% were small markets, 16% were convenience stores, and 11% were large grocery/supermarkets. Supermarkets/large grocery stores averaged the highest FV scores. Most participants did not meet FV intake recommendations while nearly half exceeded energy intake recommendations. Living near a small market was negatively correlated with BMI z-score (r = - 0.129, P < .05) while living near a convenience store was positively correlated with BMI z-score (r = 0.092, P < .05). Logistic regression analysis yielded non-significant associations. The high density of small markets may be an opportunity for FSE intervention but further investigation of Guam's FSE influence on health is needed.
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Affiliation(s)
| | | | | | - Fenfang Li
- University of Guam, Mangilao, Guam (LM, RTLG)
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22
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DeSmet A, Liu Y, De Bourdeaudhuij I, Baranowski T, Thompson D. The effectiveness of asking behaviors among 9-11 year-old children in increasing home availability and children's intake of fruit and vegetables: results from the Squire's Quest II self-regulation game intervention. Int J Behav Nutr Phys Act 2017; 14:51. [PMID: 28431547 PMCID: PMC5399846 DOI: 10.1186/s12966-017-0506-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 04/07/2017] [Indexed: 01/26/2023] Open
Abstract
Background Home environment has an important influence on children’s fruit and vegetable (FV) consumption, but children may in turn also impact their home FV environment, e.g. by asking for FV. The Squire’s Quest II serious game intervention aimed to increase asking behaviors to improve home FV availability and children’s FV intake. This study’s aims were to assess: 1) did asking behaviors at baseline predict home FV availability at baseline (T0) (RQ1); 2) were asking behaviors and home FV availability influenced by the intervention (RQ2); 3) did increases in asking behaviors predict increased home FV availability (RQ3); and 4) did increases in asking behaviors and increases in home FV availability mediate increases in FV intake among children (RQ4)? Methods This is a secondary analysis of a study using a randomized controlled trial, with 4 groups (each n = 100 child–parent dyads). All groups were analyzed together for this paper since groups did not vary on components relevant to our analysis. All children and parents (n = 400 dyads) received a self-regulation serious game intervention and parent material. The intervention ran for three months. Measurements were taken at baseline, immediately after intervention and at 3-month follow-up. Asking behavior and home FV availability were measured using questionnaires; child FV intake was measured using 24-h dietary recalls. ANCOVA methods (research question 1), linear mixed-effect models (research question 2), and Structural Equation Modeling (research questions 3 and 4) were used. Results Baseline child asking behaviors predicted baseline home FV availability. The intervention increased child asking behaviors and home FV availability. Increases in child asking behaviors, however, did not predict increased home FV availability. Increased child asking behaviors and home FV availability also did not mediate the increases in child FV intake. Conclusions Children influence their home FV environment through their asking behaviors, which can be enhanced via a serious game intervention. The obtained increases in asking behavior were, however, insufficient to affect home FV availability or intake. Other factors, such as child preferences, sample characteristics, intervention duration and parental direct involvement may play a role and warrant examination in future research. Trials Registration ClinicalTrials.gov NCT01004094. Date registered 10/28/2009 Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0506-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ann DeSmet
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, Ghent, Belgium.
| | - Yan Liu
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St. Houston, TX, 77030, Houston, USA
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, Ghent, Belgium
| | - Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St. Houston, TX, 77030, Houston, USA
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St. Houston, TX, 77030, Houston, USA
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Robles B, Kuo T. Predictors of public support for nutrition-focused policy, systems and environmental change strategies in Los Angeles County, 2013. BMJ Open 2017; 7:e012654. [PMID: 28087545 PMCID: PMC5253563 DOI: 10.1136/bmjopen-2016-012654] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Since 2010, federal and local agencies have invested broadly in a variety of nutrition-focused policy, systems and environmental change (PSE) initiatives in Los Angeles County (LAC). To date, little is known about whether the public supports such efforts. We address this gap in the literature by examining predictors of support for a variety of PSEs. METHODS Voters residing in LAC (n=1007) were randomly selected to participate in a cross-sectional telephone survey commissioned by the LAC Department of Public Health. The survey asked questions about attitudes towards the obesity epidemic, nutrition knowledge and behaviours, public opinions about changing business practices/government policies related to nutrition, and sociodemographics. A factor analysis informed outcome variable selection (ie, type of PSEs). Multivariable regression analyses were performed to examine predictors of public support. Predictors in the regression models included (primary regressor) community economic hardship; (control variables) political affiliation, sex, age, race and income; and (independent variables) perceptions about obesity, perceived health and weight status, frequency reading nutrition labels, ease of finding healthy and unhealthy foods, and food consumption behaviours (ie, fruit and vegetables, non-diet soda, fast-food and sit-down restaurant meals). RESULTS 3 types of PSE outcome variables were identified: promotional/incentivising, limiting/restrictive and business practices. Community economic hardship was not found to be a significant predictor of public support for any of the 3 PSE types. However, Republican party affiliation, being female and perceiving obesity as a serious health problem were. CONCLUSIONS These findings have implications for public health practice and community planning in local health jurisdictions.
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Affiliation(s)
- Brenda Robles
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, California, USA
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Tony Kuo
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, California, USA
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
- Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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Shier V, Nicosia N, Datar A. Neighborhood and home food environment and children's diet and obesity: Evidence from military personnel's installation assignment. Soc Sci Med 2016; 158:122-31. [PMID: 27135542 PMCID: PMC5042141 DOI: 10.1016/j.socscimed.2016.03.043] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 02/24/2016] [Accepted: 03/29/2016] [Indexed: 01/08/2023]
Abstract
Research and policy initiatives are increasingly focused on the role of neighborhood food environment in children's diet and obesity. However, existing evidence relies on observational data that is limited by neighborhood selection bias. The Military Teenagers' Environments, Exercise, and Nutrition Study (M-TEENS) leverages the quasi-random variation in neighborhood environment generated by military personnel's assignment to installations to examine whether neighborhood food environments are associated with children's dietary behaviors and BMI. Our results suggest that neither the actual nor the perceived availability of particular food outlets in the neighborhood is associated with children's diet or BMI. The availability of supermarkets and convenience stores in the neighborhood was not associated with where families shop for food or children's dietary behaviors. Further, the type of store that families shop at was not associated with the healthiness of food available at home. Similarly, availability of fast food and restaurants was unrelated to children's dietary behaviors or how often children eat fast food or restaurant meals. However, the healthiness of food available at home was associated with healthy dietary behaviors while eating at fast food outlets and restaurants were associated with unhealthy dietary behaviors in children. Further, parental supervision, including limits on snack foods and meals eaten as a family, was associated with dietary behaviors. These findings suggest that focusing only on the neighborhood food environment may ignore important factors that influence children's outcomes. Future research should also consider how families make decisions about what foods to purchase, where to shop for foods and eating out, how closely to monitor their children's food intake, and, ultimately how these decisions collectively impact children's outcomes.
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Affiliation(s)
- Victoria Shier
- Pardee RAND Graduate School, 1776 Main St, Santa Monica CA 90401, USA.
| | - Nancy Nicosia
- RAND Corporation, 20 Park Plaza #920, Boston, MA 02116, USA.
| | - Ashlesha Datar
- Center for Economic and Social Research, University of Southern California, 635 Downey Way, Los Angeles, CA 90089, USA.
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Morgan EH, Vatucawaqa P, Snowdon W, Worsley A, Dangour AD, Lock K. Factors influencing fruit and vegetable intake among urban Fijians: A qualitative study. Appetite 2016; 101:114-8. [PMID: 26952559 DOI: 10.1016/j.appet.2016.03.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 02/13/2016] [Accepted: 03/01/2016] [Indexed: 10/22/2022]
Abstract
Low fruit and vegetable intake is an important risk factor for micronutrient deficiencies and non-communicable diseases, but many people worldwide, including most Fijians, eat less than the World Health Organization recommended amount. The present qualitative study explores factors that influence fruit and vegetable intake among 57 urban Fijians (50 women, 7 men) of indigenous Fijian (iTaukei) and South Asian (Indian) descent. Eight focus group discussions were held in and around Suva, Fiji's capital and largest urban area, which explored motivation for eating fruit and vegetables, understandings of links to health and disease, availability and sources, determinants of product choice, and preferred ways of preparing and eating fruit and vegetables. Data were analysed using thematic content analysis. Regardless of ethnicity, participants indicated that they enjoyed and valued eating fruit and vegetables, were aware of the health benefits, and had confidence in their cooking skills. In both cultures, fruit and vegetables were essential components of traditional diets. However, increasing preferences for processed and imported foods, and inconsistent availability and affordability of high-quality, low-priced, fresh produce, were identified as important barriers. The findings indicate that efforts to improve fruit and vegetable intake in urban Fijians should target the stability of the domestic fruit and vegetable supply and access.
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Affiliation(s)
- E H Morgan
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; Leverhulme Centre for Integrative Research on Agriculture and Health (LCIRAH), 36 Gordon Square, London WC1H 0PD, UK.
| | - P Vatucawaqa
- National Food and Nutrition Centre, Ministry of Health and Medical Services, P.O. Box 2450, Government Buildings, Suva, Fiji.
| | - W Snowdon
- C-POND, College of Medicine Nursing and Health Sciences, Tamavua Campus, Fiji National University and Deakin University, Suva, Fiji.
| | - A Worsley
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
| | - A D Dangour
- Leverhulme Centre for Integrative Research on Agriculture and Health (LCIRAH), 36 Gordon Square, London WC1H 0PD, UK; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
| | - K Lock
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; Leverhulme Centre for Integrative Research on Agriculture and Health (LCIRAH), 36 Gordon Square, London WC1H 0PD, UK.
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Using a mixed-methods approach to measure impact of a school-based nutrition and media education intervention study on fruit and vegetable intake of Italian children. Public Health Nutr 2016; 19:1952-63. [PMID: 26857624 DOI: 10.1017/s1368980015003729] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The purpose of the present study was to investigate the impact of a school-based nutrition and media education intervention on the promotion of fruit and vegetable consumption to help prevent childhood obesity. DESIGN The 10-week-long intervention included sessions on nutrition education and media literacy. It also included a health communication media-based campaign workshop during which the children created posters, newsletters and video commercials related to fruits and vegetables targeted to their parents. For evaluation purposes, the study utilized a mixed-methods approach, including a quasi-experimental study (with one intervention group and one control group) and a focus group study. SETTING Four different elementary schools in Treviso (Veneto Region of Italy) agreed to participate in the research. SUBJECTS The target population for the study included 10-year-old Italian children and their parents. RESULTS Data indicate that this intervention was effective for children but not for parents. Evaluation results show that the intervention was effective in significantly increasing children's fruit and vegetable intake (P<0·05) and all psychosocial determinants (P<0·05). CONCLUSIONS The study results confirm the efficacy of a school-based health and media education intervention to address the children's obesity issue and, in particular, to increase children's fruit and vegetable intake. The study also opens a new perspective on the theoretical constructs investigated, because the development of 'ability of expression' could be considered one of the most important factors to determine the efficacy of the intervention.
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Canter KS, Roberts MC, Davis AM. The role of health behaviors and food insecurity in predicting fruit and vegetable intake in low-income children. CHILDRENS HEALTH CARE 2016. [DOI: 10.1080/02739615.2015.1124772] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Springvloet L, Lechner L, de Vries H, Oenema A. Long-term efficacy of a Web-based computer-tailored nutrition education intervention for adults including cognitive and environmental feedback: a randomized controlled trial. BMC Public Health 2015; 15:372. [PMID: 25887891 PMCID: PMC4424509 DOI: 10.1186/s12889-015-1707-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 03/30/2015] [Indexed: 11/19/2022] Open
Abstract
Background Unhealthy diets are prevalent in Western countries, especially among low-educated people. To have an effect on health, it is important that dietary changes are sustained over time. This study examines long-term effects of a cognitive and environmental-feedback version of a Web-based computer-tailored (CT) nutrition education intervention targeting fruit, vegetables, high-energy snacks and saturated fat. Methods A randomized controlled trial was conducted with a basic (tailored intervention targeting individual cognitions and self-regulation processes; n = 456), plus (additionally targeting environmental-level factors; n = 459) and control group (generic nutrition information; n = 434). Participants were recruited from the general population and randomly assigned to a study group. Online self-reported questionnaires assessed fruit, vegetable, high-energy snack and saturated fat intake, self-regulation, self-control, and Body Mass Index (BMI) at baseline and nine-months post-intervention. Linear mixed model analyses examined group differences in change over time. Educational differences were examined by ‘group X time X education’ interaction terms. Effects were examined in the total sample and among participants who did not comply with dietary- or BMI guidelines. Results The effects on vegetable intake in the total sample differed according to educational level (p = 02). Among low/moderate-educated participants, the basic version was significantly more effective in increasing vegetable intake than the control program (effect size (ES) = 0.32) and plus version (ES = 0.22). No effects were found for high-educated participants. Self-regulation change was significantly larger in the control group than in the basic (ES = 0.18) and plus (ES = 0.16) group. Conclusions In general, both intervention versions did not result in long-term intervention effects. The exception was an effect of the basic version on self-reported vegetable intake among low/moderate-educated adults in the total sample. More research is needed on how targeting self-regulation processes and environmental-level factors in Web-based CT nutrition education interventions can increase long-term efficacy. Trial registration Netherlands Trial Registry NTR3396. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1707-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Linda Springvloet
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, Maastricht, MD, 6200, the Netherlands.
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P.O. Box 2960, Heerlen, DL, 6401, the Netherlands.
| | - Hein de Vries
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, Maastricht, MD, 6200, the Netherlands.
| | - Anke Oenema
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, Maastricht, MD, 6200, the Netherlands.
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Smith TM, Pinard CA, Byker Shanks C, Wethington H, Blanck HM, Yaroch AL. Fruits and vegetables as a healthier snack throughout the day among families with older children: findings from a survey of parent-child dyads. Eat Behav 2015; 17:136-9. [PMID: 25706949 DOI: 10.1016/j.eatbeh.2015.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 12/17/2014] [Accepted: 01/28/2015] [Indexed: 10/24/2022]
Abstract
Most U.S. youth fail to eat the recommended amount of fruits and vegetables (FV) however many consume too many calories as added sugars and solid fats, often as snacks. The aim of this study was to assess factors associated with serving FV as snacks and with meals using parent-child dyads. A cross-sectional sample of U.S. children aged 9 to 18, and their caregiver/parent (n=1522) were part of a Consumer Panel of households for the 2008 YouthStyles mail survey. Chi-square test of independence and multivariable logistic regression were used to assess associations between serving patterns of FV as snacks with variations in serving patterns, and covariates including dietary habits. Most parents (72%) reported serving FV at meals and as snacks. Fruit was most frequently served as a snack during the day (52%) and vegetables were most frequently served as a snack during the day (22%) but rarely in the morning. Significant differences in child FV intake existed among FV as a snack serving patterns by parents. Compared to children whose parents served FV only at meals, children whose parents reported serving FV as snacks in addition to meals were significantly more likely to have consumed FV the day before (using a previous day screener), P<0.05. Contributing to the growing collection of literature describing parent-child dyad dietary behaviors, these findings suggest promoting FV access and intake throughout the day, not only at meals, by including serving as snacks, may increase FV intake among older children and adolescents.
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Affiliation(s)
- Teresa M Smith
- Gretchen Swanson Center for Nutrition, 8401 West Dodge Road, Suite 100, Omaha, NE 68114, USA; University of Nebraska Medical Center, Department of Health Promotion, Social & Behavioral Health, UNMC College of Public Health, 984365 Nebraska Medical Center, Omaha, NE 68198-4365, USA.
| | - Courtney A Pinard
- Gretchen Swanson Center for Nutrition, 8401 West Dodge Road, Suite 100, Omaha, NE 68114, USA; University of Nebraska Medical Center, Department of Health Promotion, Social & Behavioral Health, UNMC College of Public Health, 984365 Nebraska Medical Center, Omaha, NE 68198-4365, USA
| | - Carmen Byker Shanks
- Montana State University, Department of Health and Human Development, 222 Romney Gym, Bozeman, MT 59717, USA
| | - Holly Wethington
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention & Health Promotion, CDC, 1600 Clifton Rd. Atlanta, GA 30333, USA
| | - Heidi M Blanck
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention & Health Promotion, CDC, 1600 Clifton Rd. Atlanta, GA 30333, USA
| | - Amy L Yaroch
- Gretchen Swanson Center for Nutrition, 8401 West Dodge Road, Suite 100, Omaha, NE 68114, USA; University of Nebraska Medical Center, Department of Health Promotion, Social & Behavioral Health, UNMC College of Public Health, 984365 Nebraska Medical Center, Omaha, NE 68198-4365, USA
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Olstad DL, Goonewardene LA, McCargar LJ, Raine KD. If we offer it, will children buy it? Sales of healthy foods mirrored their availability in a community sport, commercial setting in Alberta, Canada. Child Obes 2015; 11:156-64. [PMID: 25719538 DOI: 10.1089/chi.2014.0131] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Community sports settings are often sources of unhealthy foods for children. Many managers in these settings are reluctant to increase availability of healthy food options because they perceive that healthy foods are not profitable. This study assessed the independent contribution of increased availability of healthy foods to their sales in a community sport, commercial context. Change in revenues per patron was also examined. METHODS The availability of healthy items was increased from 9.1% at baseline (35 days) to 25.0% during the intervention period (40 days), returning to 9.1% postintervention (6 days). Purchases of all patrons who bought foods/beverages (n=17,262 items sold) from two concessions at an outdoor community pool were assessed from baseline to postintervention. Chi-square analyses assessed differences in the proportion of healthy and unhealthy items sold, as well as in the proportion of total revenues per patron across periods. A trained observer also recorded qualitative observations pertaining to a subset of patrons' (n=221) dietary behaviors and activities. RESULTS Healthy items represented 7.7%, 22.7%, and 9.8% of sales during the preintervention, intervention, and postintervention periods, respectively (p<0.01). Sales of healthy beverages exceeded sales of all other product types. The proportion of total revenues per patron did not differ by period. CONCLUSIONS Food availability was an important environmental determinant of food purchasing behaviors in this community commercial context, given that sales of healthy foods closely mirrored their availability. Increased availability of healthy foods in community and commercial settings is important because concurrent changes within multiple environments will be required to improve children's dietary behaviors.
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Affiliation(s)
- Dana Lee Olstad
- 1 School of Public Health, University of Alberta , Edmonton, Alberta, Canada
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Fruit and vegetable consumption in the former Soviet Union: the role of individual- and community-level factors. Public Health Nutr 2015; 18:2825-35. [PMID: 25686483 PMCID: PMC4595861 DOI: 10.1017/s1368980015000105] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To explain patterns of fruit and vegetable consumption in nine former Soviet Union countries by exploring the influence of a range of individual- and community-level determinants. DESIGN Cross-sectional nationally representative surveys and area profiles were undertaken in 2010 in nine countries of the former Soviet Union as part of the Health in Times of Transition (HITT) study. Individual- and area-level determinants were analysed, taking into account potential confounding at the individual and area level. SETTING Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. SUBJECTS Adult survey respondents (n 17 998) aged 18-95 years. RESULTS Being male, increasing age, lack of education and lack of financial resources were associated with lower probability of consuming adequate amounts of fruit or vegetables. Daily fruit or vegetable consumption was positively correlated with the number of shops selling fruit and vegetables (for women) and with the number of convenience stores (for men). Billboard advertising of snacks and sweet drinks was negatively related to daily fruit or vegetable consumption, although the reverse was true for billboards advertising soft drinks. Men living near a fast-food outlet had a lower probability of fruit or vegetable consumption, while the opposite was true for the number of local food restaurants. CONCLUSIONS Overall fruit and vegetable consumption in the former Soviet Union is inadequate, particularly among lower socio-economic groups. Both individual- and community-level factors play a role in explaining inadequate nutrition and thus provide potential entry points for policy interventions, while the nuanced influence of community factors informs the agenda for future research.
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Springvloet L, Lechner L, de Vries H, Candel MJJM, Oenema A. Short- and medium-term efficacy of a Web-based computer-tailored nutrition education intervention for adults including cognitive and environmental feedback: randomized controlled trial. J Med Internet Res 2015; 17:e23. [PMID: 25599828 PMCID: PMC4319071 DOI: 10.2196/jmir.3837] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 11/12/2014] [Accepted: 12/10/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Web-based, computer-tailored nutrition education interventions can be effective in modifying self-reported dietary behaviors. Traditional computer-tailored programs primarily targeted individual cognitions (knowledge, awareness, attitude, self-efficacy). Tailoring on additional variables such as self-regulation processes and environmental-level factors (the home food environment arrangement and perception of availability and prices of healthy food products in supermarkets) may improve efficacy and effect sizes (ES) of Web-based computer-tailored nutrition education interventions. OBJECTIVE This study evaluated the short- and medium-term efficacy and educational differences in efficacy of a cognitive and environmental feedback version of a Web-based computer-tailored nutrition education intervention on self-reported fruit, vegetable, high-energy snack, and saturated fat intake compared to generic nutrition information in the total sample and among participants who did not comply with dietary guidelines (the risk groups). METHODS A randomized controlled trial was conducted with a basic (tailored intervention targeting individual cognition and self-regulation processes; n=456), plus (basic intervention additionally targeting environmental-level factors; n=459), and control (generic nutrition information; n=434) group. Participants were recruited from the general population and randomly assigned to a study group. Self-reported fruit, vegetable, high-energy snack, and saturated fat intake were assessed at baseline and at 1- (T1) and 4-months (T2) postintervention using online questionnaires. Linear mixed model analyses examined group differences in change over time. Educational differences were examined with group×time×education interaction terms. RESULTS In the total sample, the basic (T1: ES=-0.30; T2: ES=-0.18) and plus intervention groups (T1: ES=-0.29; T2: ES=-0.27) had larger decreases in high-energy snack intake than the control group. The basic version resulted in a larger decrease in saturated fat intake than the control intervention (T1: ES=-0.19; T2: ES=-0.17). In the risk groups, the basic version caused larger decreases in fat (T1: ES=-0.28; T2: ES=-0.28) and high-energy snack intake (T1: ES=-0.34; T2: ES=-0.20) than the control intervention. The plus version resulted in a larger increase in fruit (T1: ES=0.25; T2: ES=0.37) and a larger decrease in high-energy snack intake (T1: ES=-0.38; T2: ES=-0.32) than the control intervention. For high-energy snack intake, educational differences were found. Stratified analyses showed that the plus version was most effective for high-educated participants. CONCLUSIONS Both intervention versions were more effective in improving some of the self-reported dietary behaviors than generic nutrition information, especially in the risk groups, among both higher- and lower-educated participants. For fruit intake, only the plus version was more effective than providing generic nutrition information. Although feasible, incorporating environmental-level information is time-consuming. Therefore, the basic version may be more feasible for further implementation, although inclusion of feedback on the arrangement of the home food environment and on availability and prices may be considered for fruit and, for high-educated people, for high-energy snack intake. TRIAL REGISTRATION Netherlands Trial Registry NTR3396; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3396 (Archived by WebCite at http://www.webcitation.org/6VNZbdL6w).
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Affiliation(s)
- Linda Springvloet
- Maastricht University, Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht, Netherlands.
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Ranjit N, Evans AE, Springer AE, Hoelscher DM, Kelder SH. Racial and ethnic differences in the home food environment explain disparities in dietary practices of middle school children in Texas. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2015; 47:53-60. [PMID: 25439762 DOI: 10.1016/j.jneb.2014.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 09/03/2014] [Accepted: 09/07/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To examine racial and ethnic differences among middle school children in the home food environment (HFE) and the extent to which associations of healthy and unhealthy eating with the HFE differ by race and ethnicity. DESIGN Cross-sectional secondary analyses of baseline data from Coordinated Approach to Child Health Middle School, a school-based intervention targeting obesity and obesogenic behaviors among middle school children in Austin, TX. PARTICIPANTS A total of 2,502 children (mean age, 13.9 years; 58% Hispanic, 28% white, and 14% black). VARIABLES MEASURED Availability and accessibility of healthy foods, and parental support of healthy eating, and family meals. Consumption of both healthy and unhealthy foods was examined. ANALYSIS Differences across racial and ethnic groups in aspects of HFE were estimated using linear regression. Models also examined racial and ethnic differences in consumption of healthy and unhealthy foods. If adjusting for HFE, such differences were accounted for. RESULTS White children had significantly better HFEs than Hispanic and black children with greater availability and accessibility of healthy foods (P < .001). Adjusting for a healthy HFE reduced disparities in consumption of healthy foods but not in consumption of unhealthy foods. CONCLUSIONS AND IMPLICATIONS Improved HFE may increase healthy eating among ethnic minorities but is unlikely to reduce unhealthy eating.
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Affiliation(s)
- Nalini Ranjit
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin Regional Campus, Austin, TX.
| | - Alexandra E Evans
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin Regional Campus, Austin, TX
| | - Andrew E Springer
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin Regional Campus, Austin, TX
| | - Deanna M Hoelscher
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin Regional Campus, Austin, TX
| | - Steve H Kelder
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin Regional Campus, Austin, TX
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Christian MS, Evans CEL, Cade JE. Does the Royal Horticultural Society Campaign for School Gardening increase intake of fruit and vegetables in children? Results from two randomised controlled trials. PUBLIC HEALTH RESEARCH 2014. [DOI: 10.3310/phr02040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundChildren’s fruit and vegetable intake in the UK is low. Changing intake is challenging. Gardening in schools might be a vehicle for facilitating fruit and vegetable intake.ObjectivesTo undertake the first clustered randomised controlled trials (RCTs) of a gardening intervention. To evaluate the impact of a school gardening programme, the Royal Horticultural Society (RHS) Campaign for School Gardening, on children’s fruit and vegetable intake.MethodsPrimary school children aged 8–11 years from eight London boroughs were included in one of two related RCTs. Trial 1 consisted of 23 schools, randomised to receive either a RHS-led or teacher-led intervention. Trial 2 consisted of 31 schools, randomised to either the teacher-led intervention or a comparison group. A 24-hour food diary [the Child And Diet Evaluation Tool (CADET)] collected baseline and follow-up dietary intake. Questionnaires measured children’s knowledge and attitudes towards fruit and vegetables and assessed intervention implementation. Data were collected by fieldworkers who were blind to the original allocation of the school. The primary outcome was change in fruit and vegetable intake analysed using a random effects model, based on intention to treat.ResultsTotal sample size at baseline for both trials (2529 children) was lower than the original aim of 2900 children. The final sample size was 1557, with 641 children completing trial 1 (RHS-led,n = 312; teacher-led,n = 329) and 916 children completing trial 2 (teacher-led,n = 488; control,n = 428). The response rate at follow-up for the two combined was 62%.Baseline analysis of children’s fruit and vegetable intake showed that eating a family meal together, cutting up fruit and vegetables, and parental modelling of fruit and vegetable intakes were all associated with higher intakes of fruit and vegetables in children.The primary trial outcome, combined fruit and vegetable intake, showed that in trial 1 the teacher-led group had a mean change in intake of 8 g [95% confidence interval (CI) –19 to 36 g], compared with a mean of –32 g (95% CI –60 to –3 g) in the RHS-led group. However, this difference was not significant (intervention effect –43 g, 95% CI –88 to 1 g;p = 0.06). In trial 2, the teacher-led group consumed 15 g (95% CI –36 to 148 g) more fruit and vegetables than the comparison group; this difference was not significant. No change was found in children’s knowledge and attitudes. However, if schools improved their RHS gardening score by three levels, children had a higher intake of 81 g of fruit and vegetables (95% CI 0 to 163 g;p = 0.05) compared with schools with no change in gardening score.ConclusionResults from these trials provide little evidence that school gardening alone can improve children’s fruit and vegetable intake. In both trials, gardening levels increased across all groups from baseline to follow-up, with no statistically significant difference between groups in terms of improvement in gardening level. This lack of differentiation between groups is likely to have influenced the primary outcome. However, when the gardening intervention was implemented at the highest intensities there was a suggestion that it could improve children’s fruit and vegetable intake by a portion. Analysis of the baseline data showed that family support for fruit and vegetable intakes was associated with higher intakes of fruit and vegetables in children. This study highlights the need for more sophisticated and accurate tools to evaluate diet in children. Future intervention designs should include a greater level of parental involvement in school interventions, along with related components such as cooking, to substantially improve children’s fruit and vegetable intake. In addition, the home environment has been demonstrated to be an important focus for intervention.Trial registrationCurrent Controlled Trials ISRCTN11396528.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 2, No. 4. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Meaghan S Christian
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Charlotte EL Evans
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Janet E Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
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Chu YL, Storey KE, Veugelers PJ. Involvement in meal preparation at home is associated with better diet quality among Canadian children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2014; 46:304-308. [PMID: 24238908 DOI: 10.1016/j.jneb.2013.10.003] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 09/26/2013] [Accepted: 10/06/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To examine the associations between home meal preparation involvement with diet quality and food group intake among children. METHODS Grade 5 children aged 10-11 years (n = 3,398) were surveyed. Food intake was measured using the Harvard Youth/Adolescent Food Frequency Questionnaire, and diet quality was measured using the Diet Quality Index-International. Random effects regression models with children nested within schools were used to test for associations. RESULTS Higher frequency of involvement in home meal preparation was associated with higher Diet Quality Index-International scores. Children who were involved in meal preparation daily ate 1 more serving/d of vegetables and fruit compared with children who never helped (P < .001). Similar significant differences, although small, were observed for intake of the other food groups. CONCLUSIONS AND IMPLICATIONS Children who were more involved in home meal preparation also consumed healthier diets. Encouraging parents to involve their children in meal preparation could be a viable health promotion strategy.
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Affiliation(s)
- Yen Li Chu
- Department of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
| | - Kate E Storey
- Department of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Paul J Veugelers
- Department of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Association between home availability and vegetable consumption in youth: a review. Public Health Nutr 2014; 18:640-8. [DOI: 10.1017/s1368980014000664] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AbstractObjectiveTo systematically review literature examining the association between vegetable home availability and vegetable intake in youth.DesignArticles were identified through December 2012 using a search of PubMed, PsychINFO and OVID/Medline databases, using the following keywords in varying combinations: home, environment, availability, vegetable, intake, consumption, children. Quantitative studies examining home vegetable availability and vegetable intake in children and adolescents were included. Fifteen studies were included that met inclusion criteria.SettingStudies were conducted in the USA (n 8), Australia (n 1), Greece (n 1), Iceland (n 1), Denmark (n 1), the UK (n 1), the Netherlands (n 1) and a combination of nine European countries (n 1).SubjectsVarious populations of children and adolescents were examined.ResultsSeven of the studies (47 %) found a positive association between vegetable availability and intake, with the others reporting null findings. There were no clear patterns of association by study design, age of subjects included, comprehensiveness of measures, or inclusion of covariates in analyses. Child report of home availability was associated with child vegetable intake (n 6, all found a positive association), while parent report of home availability was only minimally associated (n 9, one found a positive association; P=0·001 from post hoc Fisher’s exact test comparing parent v. child report).ConclusionsParent perception of availability may be closer to truth, given the parental role in food shopping and preparation. Therefore, to impact child vegetable intake, absolute availability may not be as important as child perception of vegetables in the home. Child perception of availability may be altered by level of familiarity with vegetables.
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Privitera GJ, Zuraikat FM. Proximity of foods in a competitive food environment influences consumption of a low calorie and a high calorie food. Appetite 2014; 76:175-9. [DOI: 10.1016/j.appet.2014.02.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Revised: 01/30/2014] [Accepted: 02/01/2014] [Indexed: 11/15/2022]
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Diana R, Khomsan A, Sukandar D, Riyadi H. Nutrition Extension and Home Garden Intervention in Posyandu: Impact on Nutrition
Knowledge, Vegetable Consumption and Intake of Vitamin A. ACTA ACUST UNITED AC 2014. [DOI: 10.3923/pjn.2014.88.92] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Graham DJ, Pelletier J, Neumark-Sztainer D, Lust K, Laska MN. Perceived social-ecological factors associated with fruit and vegetable purchasing, preparation, and consumption among young adults. J Acad Nutr Diet 2013; 113:1366-74. [PMID: 23958116 PMCID: PMC3840531 DOI: 10.1016/j.jand.2013.06.348] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 06/11/2013] [Indexed: 11/23/2022]
Abstract
Most young adults do not consume recommended levels of fruits and vegetables (F/V), and interventions to increase F/V-related behaviors among this understudied population are needed. Therefore, it is important to identify correlates of F/V intake among young adults to guide intervention development. This cross-sectional study used data from an online survey to identify factors related to young adults' F/V purchasing, preparation, and consumption, and to explore between-factor relationships using mediation analysis. In 2010, 1,201 college students in Minnesota completed questionnaires assessing F/V behaviors as well as perceptions of F/V-related individual, social, and environmental factors. Factor analysis identified questionnaire items assessing similar constructs. Seven factors were identified (personal barriers, F/V knowledge, family, friends, neighborhood, access barriers, and campus) and evaluated for relationships with F/V purchasing, preparation, and consumption using linear regression. Results revealed that perceived personal barriers (eg, lacking cooking skills) were inversely related to all F/V outcomes. Perception that family and friends eat healthfully and neighborhood access to F/V were positively related to all outcomes. Individual-, social-, and environment-level perceptions were related to purchasing, preparation, and consumption, and the effects of these factors were similar when accounting for mediated effects. Factors at all three levels and the ways in which these various factors operate together may be important to consider in future efforts to improve F/V behaviors among young adults.
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Affiliation(s)
- Dan J. Graham
- Division of Epidemiology and Community Health, University of Minnesota, Twin Cities, 1300 S 2 Street, Suite 300, Minneapolis MN 55454,
| | | | | | - Katherine Lust
- Epidemiology and Community Health, University of Minnesota,
| | - Melissa N. Laska
- Division of Epidemiology and Community Health, University of Minnesota
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Schmied EA, Parada H, Horton LA, Madanat H, Ayala GX. Family Support Is Associated With Behavioral Strategies for Healthy Eating Among Latinas. HEALTH EDUCATION & BEHAVIOR 2013; 41:34-41. [DOI: 10.1177/1090198113485754] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Healthy eating is important for obesity control. Dietary interventions target the adoption of behavioral strategies to increase fiber and decrease fat consumption. However, little is known about the contributions of psychosocial factors to the use of these strategies. Purpose. This study examined psychosocial correlates of behavioral strategies for healthy eating among Latinas. Method. Participants included 361 Latino mothers living along the U.S.–Mexico border in California. Data included measures of sociodemographics, acculturation, and psychosocial determinants of healthy eating. A 30-item dietary behavioral strategies scale assessed strategies to increase fiber and decrease fat consumption. Results. Family interactions regarding dietary habits (β = .224, p < .001) and financial status (β = .148, p = .029) were associated with the use of strategies to decrease fat consumption. Positive family interactions regarding dietary habits (β = .226, p < .001), fewer barriers to obtaining fruits and vegetables (β = −.207, p < .001), and more family support for vegetable purchasing (β = .070, p = .047) were associated with use of strategies to increase fiber consumption. Conclusions. Future interventions would benefit from improving family systems associated with healthy eating.
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Affiliation(s)
| | - Humberto Parada
- San Diego State University Research Foundation, San Diego, CA, USA
| | - Lucy A. Horton
- San Diego State University Research Foundation, San Diego, CA, USA
| | - Hala Madanat
- San Diego State University, San Diego, CA, USA
- San Diego State University Research Foundation, San Diego, CA, USA
- Institute for Behavioral and Community Health Studies, San Diego, CA, USA
| | - Guadalupe X. Ayala
- San Diego State University, San Diego, CA, USA
- San Diego State University Research Foundation, San Diego, CA, USA
- Institute for Behavioral and Community Health Studies, San Diego, CA, USA
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Adolescent fruit and vegetable intake: influence of family support and moderation by home availability of relationships with afrocentric values and taste preferences. J Acad Nutr Diet 2013; 113:803-8. [PMID: 23545060 DOI: 10.1016/j.jand.2013.02.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 01/28/2013] [Indexed: 11/20/2022]
Abstract
Economically disadvantaged African-American adolescents have fruit and vegetable (F/V) intakes that are less than optimal. To facilitate intervention planning to address low F/V intake in this population, an understanding of determinants of youths' intake is needed. The influence of determinants consistently supported by evidence (ie, home F/V availability, F/V taste preferences, and parental modeling/intake) and variables hypothesized to influence intake in the targeted population (ie, family support for F/V consumption and Afrocentric values) were examined. Participants were African-American adolescents recruited in 2011 through summer camps serving low-income youths (N=93). Youths completed a cross-sectional survey. Hierarchical logistic regression analysis was used to examine whether availability directly influenced (ie, explained variations in) intake and whether it moderated (ie, affected the direction and/or strength of) the relationships between the other hypothesized determinants and intake. The dependent variable was intake of five or more daily servings of F/V estimated with the Block 7-item food frequency questionnaire. Family support was directly related to intake (odds ratio=1.062; 95% CI 1.007 to 1.120; P=0.026). The relationships between F/V intake and taste preferences and Afrocentric values were moderated by (ie, differed based on) home F/V availability. When availability was high, taste preferences (odds ratio=1.081; 95% CI 1.007 to 1.161; P=0.032) and Afrocentric values (OR=2.504; 95% CI 1.303 to 4.811; P=0.006) had positive influences on intake. To enhance intervention effectiveness, more research is warranted on approaches for increasing home F/V availability and family support for F/V consumption in the targeted population.
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Baranowski T, Diep C, Baranowski J. Influences on Children's Dietary Behavior, and Innovative Attempts to Change It. ANNALS OF NUTRITION AND METABOLISM 2013; 62 Suppl 3:38-46. [DOI: 10.1159/000351539] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Ganann R, Fitzpatrick-Lewis D, Ciliska D, Peirson L. Community-based interventions for enhancing access to or consumption of fruit and vegetables among five to 18-year olds: a scoping review. BMC Public Health 2012; 12:711. [PMID: 22931474 PMCID: PMC3505745 DOI: 10.1186/1471-2458-12-711] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 08/23/2012] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Low fruit and vegetable ( FV) consumption is a key risk factor for morbidity and mortality. Consumption of FV is limited by a lack of access to FV. Enhanced understanding of interventions and their impact on both access to and consumption of FV can provide guidance to public health decision-makers. The purpose of this scoping review is to identify and map literature that has evaluated effects of community-based interventions designed to increase FV access or consumption among five to 18-year olds. METHODS The search included 21 electronic bibliographic databases, grey literature, targeted organization websites, and 15 key journals for relevant studies published up to May 2011. Retrieved citations were screened in duplicate for relevance. Data extracted from included studies covered: year, country, study design, target audience, intervention setting, intervention strategies, interventionists, and reported outcomes. RESULTS The search located 19,607 unique citations. Full text relevance screening was conducted on 1,908 studies. The final 289 unique studies included 30 knowledge syntheses, 27 randomized controlled trials, 55 quasi-experimental studies, 113 cluster controlled studies, 60 before-after studies, one mixed method study, and three controlled time series studies. Of these studies, 46 included access outcomes and 278 included consumption outcomes. In terms of target population, 110 studies focused on five to seven year olds, 175 targeted eight to 10 year olds, 192 targeted 11 to 14 year olds, 73 targeted 15 to 18 year olds, 55 targeted parents, and 30 targeted teachers, other service providers, or the general public. The most common intervention locations included schools, communities or community centres, and homes. Most studies implemented multi-faceted intervention strategies to increase FV access or consumption. CONCLUSIONS While consumption measures were commonly reported, this review identified a small yet important subset of literature examining access to FV. This is a critically important issue since consumption is contingent upon access. Future research should examine the impact of interventions on direct outcome measures of FV access and a focused systematic review that examines these interventions is also needed. In addition, research on interventions in low- and middle-income countries is warranted based on a limited existing knowledge base.
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Affiliation(s)
- Rebecca Ganann
- Effective Public Health Practice Project, McMaster University, Hamilton, ON, Canada
| | | | - Donna Ciliska
- Effective Public Health Practice Project, McMaster University, Hamilton, ON, Canada
| | - Leslea Peirson
- Effective Public Health Practice Project, McMaster University, Hamilton, ON, Canada
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Neighbourhood deprivation and outlet density for tobacco, alcohol and fast food: first hints of obesogenic and addictive environments in Germany. Public Health Nutr 2012; 16:1168-77. [PMID: 22781559 DOI: 10.1017/s1368980012003321] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The current discussion regarding ‘place effects on health’ is increasingly focusing on the characteristics of a specific physical environment. Our study investigated whether socially deprived residential areas are more likely than affluent neighbourhoods to provide access to addictive substances and fast food. DESIGN In this ecological study the total number of tobacco, alcohol and fastfood outlets was recorded and visualized using a geographic information system. Area affluence was measured through the percentage of parents with children of kindergarten or school age with joint annual taxable income ,h12 272. SETTING Eighteen social areas in Cologne, Germany. SUBJECTS All social areas in four districts in Cologne, Germany, with a total of 92 000 inhabitants, were analysed. RESULTS In the investigation area, 339 tobacco, 353 alcohol and sixty-seven fastfood outlets were identified. As area affluence declined the availability of the following potentially health damaging sources increased: cigarettes (Kendall’s tau50?433; P50?012), alcohol (Kendall’s tau50?341, P50?049) and fast food (Kendall’s tau50?473; P50?009). CONCLUSIONS The availability of addictive substances and fast food can be seen to have a contextual influence on an individual’s lifestyle and can, in the form of physical exposure to obesogenic and addictive environments, contribute to a culmination of health risks.
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Zhou QP, Remsburg R, Caufield K, Itote EW. Lifestyle behaviors, chronic diseases, and ratings of health between black and white adults with pre-diabetes. DIABETES EDUCATOR 2012; 38:219-28. [PMID: 22454406 DOI: 10.1177/0145721712440334] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSES The purposes of this study were to assess differences in lifestyle behaviors and other health-related factors between black and white adults with pre-diabetes and to identify predictors for lifestyle behaviors. METHODS Using the 2007 and 2009 data from the Behavioral Risk Factor Surveillance System (BRFSS), an annual cross-sectional survey of randomly selected samples from each state, black (n = 1156) and white (n = 9539) adults with pre-diabetes were compared on lifestyle behaviors, general health practices, perceptions of health, chronic diseases, and access to care. Predictors for participating in regular physical activity and adequate intake of fruits and vegetables were identified for each racial and gender group using multiple regression procedures. RESULTS Less than 40% of the adults with pre-diabetes participated in regular physical activity, and less than a quarter had adequate intake of fruits and vegetables; only 20% met the body weight recommendations. Compared to whites, blacks were more likely to be overweight/obese (86% vs 79%) and less likely to engage in regular physical activity (29% vs 40%). Except for adequate intake of fruits and vegetables, each racial and gender group had different predictors for regular physical activity. For black males, the predictors included impaired physical health and coronary heart disease/stroke. For black females, the predictors were younger age and routine checkup. CONCLUSIONS Significant disparities exist between blacks and whites in lifestyle behaviors and other health-related factors. Targeted intervention strategies are needed to motivate blacks to modify behaviors to prevent or delay the development of diabetes.
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Baranowski T. Understanding the behavioral linkages needed for designing effective interventions to increase fruit and vegetable intake in diverse populations. ACTA ACUST UNITED AC 2011; 111:1472-5. [PMID: 21963012 DOI: 10.1016/j.jada.2011.07.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 06/29/2011] [Indexed: 01/07/2023]
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Krølner R, Rasmussen M, Brug J, Klepp KI, Wind M, Due P. Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part II: qualitative studies. Int J Behav Nutr Phys Act 2011; 8:112. [PMID: 21999291 PMCID: PMC3260149 DOI: 10.1186/1479-5868-8-112] [Citation(s) in RCA: 206] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 10/14/2011] [Indexed: 11/30/2022] Open
Abstract
Background Large proportions of children do not fulfil the World Health Organization recommendation of eating at least 400 grams of fruit and vegetables (FV) per day. To promote an increased FV intake among children it is important to identify factors which influence their consumption. Both qualitative and quantitative studies are needed. Earlier reviews have analysed evidence from quantitative studies. The aim of this paper is to present a systematic review of qualitative studies of determinants of children's FV intake. Methods Relevant studies were identified by searching Anthropology Plus, Cinahl, CSA illumine, Embase, International Bibliography of the Social Sciences, Medline, PsycINFO, and Web of Science using combinations of synonyms for FV intake, children/adolescents and qualitative methods as search terms. The literature search was completed by December 1st 2010. Papers were included if they applied qualitative methods to investigate 6-18-year-olds' perceptions of factors influencing their FV consumption. Quantitative studies, review studies, studies reported in other languages than English, and non-peer reviewed or unpublished manuscripts were excluded. The papers were reviewed systematically using standardised templates for summary of papers, quality assessment, and synthesis of findings across papers. Results The review included 31 studies, mostly based on US populations and focus group discussions. The synthesis identified the following potential determinants for FV intake which supplement the quantitative knowledge base: Time costs; lack of taste guarantee; satiety value; appropriate time/occasions/settings for eating FV; sensory and physical aspects; variety, visibility, methods of preparation; access to unhealthy food; the symbolic value of food for image, gender identity and social interaction with peers; short term outcome expectancies. Conclusions The review highlights numerous potential determinants which have not been investigated thoroughly in quantitative studies. Future large scale quantitative studies should attempt to quantify the importance of these factors. Further, mechanisms behind gender, age and socioeconomic differences in FV consumption are proposed which should be tested quantitatively in order to better tailor interventions to vulnerable groups. Finally, the review provides input to the conceptualisation and measurements of concepts (i.e. peer influence, availability in schools) which may refine survey instruments and theoretical frameworks concerning eating behaviours.
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Affiliation(s)
- Rikke Krølner
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
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Ghirardelli A, Quinn V, Sugerman S. Reliability of a retail food store survey and development of an accompanying retail scoring system to communicate survey findings and identify vendors for healthful food and marketing initiatives. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2011; 43:S104-S112. [PMID: 21683279 DOI: 10.1016/j.jneb.2011.03.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 03/01/2011] [Accepted: 03/07/2011] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To develop a retail grocery instrument with weighted scoring to be used as an indicator of the food environment. PARTICIPANTS/SETTING Twenty six retail food stores in low-income areas in California. INTERVENTION Observational. MAIN OUTCOME MEASURE(S) Inter-rater reliability for grocery store survey instrument. Description of store scoring methodology weighted to emphasize availability of healthful food. ANALYSIS Type A intra-class correlation coefficients (ICC) with absolute agreement definition or a κ test for measures using ranges as categories. RESULTS Measures of availability and price of fruits and vegetables performed well in reliability testing (κ = 0.681-0.800). Items for vegetable quality were better than for fruit (ICC 0.708 vs 0.528). Kappa scores indicated low to moderate agreement (0.372-0.674) on external store marketing measures and higher scores for internal store marketing. "Next to" the checkout counter was more reliable than "within 6 feet." Health departments using the store scoring system reported it as the most useful communication of neighborhood findings. CONCLUSIONS AND IMPLICATIONS There was good reliability of the measures among the research pairs. The local store scores can show the need to bring in resources and to provide access to fruits and vegetables and other healthful food.
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Affiliation(s)
- Alyssa Ghirardelli
- Network for a Healthy California, California Department of Public Health and Public Health Institute, Sacramento, CA, USA.
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Backman D, Gonzaga G, Sugerman S, Francis D, Cook S. Effect of fresh fruit availability at worksites on the fruit and vegetable consumption of low-wage employees. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2011; 43:S113-S121. [PMID: 21683280 DOI: 10.1016/j.jneb.2011.04.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Revised: 03/28/2011] [Accepted: 04/18/2011] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To examine the impact of fresh fruit availability at worksites on the fruit and vegetable consumption and related psychosocial determinants of low-wage employees. DESIGN A prospective, randomized block experimental design. SETTING Seven apparel manufacturing and 2 food processing worksites. PARTICIPANTS A convenience sample of 391 low-wage employees in 6 intervention worksites and 137 low-wage employees in 3 control worksites in Los Angeles, CA. INTERVENTION Fresh fruit deliveries with enough for 1 serving per employee, 3 days a week for 12 consecutive weeks. The control worksites did not receive the fruit deliveries. MAIN OUTCOME MEASURES Participants' fruit and vegetable consumption, fruit and vegetable purchasing habits, self-efficacy, job satisfaction, and overall health were measured at baseline, weeks 4 and 8, and following the 12-week intervention. ANALYSIS Descriptive statistics and growth curve analysis using hierarchical linear modeling were employed to analyze the data. RESULTS Participants in the intervention worksites showed a significant increase in fruit, vegetable, and total fruit and vegetable consumption, purchasing of fruit, family purchasing of vegetables, and self-efficacy toward eating 2 servings of fruit each day compared to the control worksites. CONCLUSIONS AND IMPLICATIONS Improving access to fruit during the workday can improve fruit and vegetable consumption, purchasing habits, and self-efficacy of low-income employees.
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Affiliation(s)
- Desiree Backman
- Network for a Healthy California, California Department of Public Health and Public Health Institute, Sacramento, CA, USA.
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