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Adebayo CT, Olukotun OV, Olukotun M, Kirungi J, Gondwe KW, Crooks NK, Singer RB, Adams S, Alfaifi FY, Dressel A, Fahmy L, Kako P, Snethen J, Valhmu LM. Experiences of gender-based violence among Somali refugee women: a socio-ecological model approach. CULTURE, HEALTH & SEXUALITY 2024; 26:654-670. [PMID: 37516928 PMCID: PMC10825063 DOI: 10.1080/13691058.2023.2236163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 07/10/2023] [Indexed: 07/31/2023]
Abstract
Gender-based violence (GBV) is an all-encompassing term that speaks to acts or threats that may lead to physical, sexual or emotional harm to an individual based on their gender. This paper provides a scoping review of research on gender-based violence among Somali refugee women in different parts of the world. Using the socio-ecological model as a framework, we reviewed 30 empirical studies focusing on some form of GBV among Somali refugee women. We identified societal, community and individual factors contributing to the experience of GBV. We also discuss how these factors influence women's willingness to access care, especially healthcare and social services. The review reveals that oftentimes, institutions that work closely with this population have a limited understanding of how closely culture affects the willingness and ability to seek help about GBV. Based on our analysis, we suggest ways in which social institutions and healthcare providers can provide culturally-safe support to Somali refugee women who have experienced some form of GBV.
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Affiliation(s)
| | | | - Mary Olukotun
- Faculty of Nursing, University of Alberta-Edmonton, Edmonton, AB, Canada
| | - Jackline Kirungi
- Department of African & African Diaspora Studies, University of Wisconsin, Milwaukee, WI, USA
| | | | - Natasha K. Crooks
- Human Development Nursing Science, University of Illinois, Chicago, IL, USA
| | - Randi B. Singer
- Human Development Nursing Science, University of Illinois, Chicago, IL, USA
| | - Shukri Adams
- Ras Al Khaimah School of Nursing, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | | | - Anne Dressel
- College of Nursing, University of Wisconsin, Milwaukee, WI, USA
| | - Laila Fahmy
- Department of Psychology, Towson University, Towson, MD, USA
| | - Peninah Kako
- College of Nursing, University of Jazan, Gizan, Saudi Arabia
| | - Julia Snethen
- College of Nursing, University of Jazan, Gizan, Saudi Arabia
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Bogaert L, Willems I, Calders P, Dirinck E, Kinaupenne M, Decraene M, Lapauw B, Strumane B, Van Daele M, Verbestel V, De Craemer M. Explanatory variables of objectively measured 24-h movement behaviors in people with prediabetes and type 2 diabetes: A systematic review. Diabetes Metab Syndr 2024; 18:102995. [PMID: 38583307 DOI: 10.1016/j.dsx.2024.102995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 02/13/2024] [Accepted: 03/25/2024] [Indexed: 04/09/2024]
Abstract
AIM Physical activity (PA), sedentary behavior (SB) and sleep (i.e. 24-h movement behaviors) are associated with health indicators in people with prediabetes and type 2 diabetes (T2D). To optimize 24-h movement behaviors, it is crucial to identify explanatory variables related to these behaviors. This review aimed to summarize the explanatory variables of 24-h movement behaviors in people with prediabetes or T2D. METHODS A systematic search of four databases (PubMed, Web of Science, Scopus & Embase) was performed. Only objective measurements of 24-h movement behaviors were included in the search strategy. The explanatory variables were classified according to the levels of the socio-ecological model (i.e. intrapersonal, interpersonal and environmental). The risk of bias was assessed using the Joanna Briggs Institute appraisal checklist. RESULTS None of the 78 included studies investigated 24-h movement behaviors. The majority of the studies investigated PA in isolation. Most studied explanatory variables were situated at the intrapersonal level. Being male was associated with more moderate to vigorous PA but less light PA in people with T2D, and more total PA in people with prediabetes. An older age was associated with a decrease in all levels of PA in people with T2D. HbA1c was positively associated with sleep and SB in both groups. No associations were found at the interpersonal or environmental level. CONCLUSION The results of this review underscore the lack of a socio-ecological approach toward explanatory variables of 24-h movement behaviors and the lack of focus on an integrated 24-h movement behavior approach in both populations.
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Affiliation(s)
- Lotte Bogaert
- Ghent University, Department of Rehabilitation Sciences, Ghent, Belgium.
| | - Iris Willems
- Ghent University, Department of Rehabilitation Sciences, Ghent, Belgium; Research Foundation Flanders, Brussels, Belgium.
| | - Patrick Calders
- Ghent University, Department of Rehabilitation Sciences, Ghent, Belgium.
| | - Eveline Dirinck
- Department of Endocrinology, Antwerp University Hospital & University of Antwerp, Antwerp, Belgium.
| | - Manon Kinaupenne
- Ghent University, Department of Rehabilitation Sciences, Ghent, Belgium.
| | - Marga Decraene
- Ghent University, Department of Rehabilitation Sciences, Ghent, Belgium; Ghent University, Department of Movement and Sports Sciences, Ghent, Belgium.
| | - Bruno Lapauw
- Department of Endocrinology & Department of Internal Medicine and Pediatrics, Ghent University Hospital & Ghent University, Ghent, Belgium.
| | - Boyd Strumane
- Faculty of Medicine and Health Sciences, Ghent, Belgium.
| | | | - Vera Verbestel
- Faculty of Health, Medicine and Life Sciences, Department of Health Promotion, Research Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, the Netherlands; Faculty of Health, Medicine and Life Sciences, Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, the Netherlands.
| | - Marieke De Craemer
- Ghent University, Department of Rehabilitation Sciences, Ghent, Belgium.
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Raghoebar S, Mesch A, Gulikers J, Winkens LHH, Wesselink R, Haveman-Nies A. Experts' perceptions on motivators and barriers of healthy and sustainable dietary behaviors among adolescents: The SWITCH project. Appetite 2024; 194:107196. [PMID: 38154577 DOI: 10.1016/j.appet.2023.107196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 12/15/2023] [Accepted: 12/24/2023] [Indexed: 12/30/2023]
Abstract
The interplay of influences shaping dietary behaviors of adolescents needs to be well-understood to develop effective strategies stimulating healthy and sustainable behaviors. This study aimed to identify the most relevant, urgent, changeable and effective motivators and barriers of healthy and sustainable dietary behaviors among adolescents (10-19 years), as perceived by an inter- and transdisciplinary expert panel. Experts working in practice (N = 19) and academia (N = 13) - in the field of sustainability, health, nutrition and/or education - participated in this exploratory mixed-methods study. Five online semi-structured focus groups were conducted (6-7 participants). Data was thematically analyzed by two coders independently, using the socioecological framework. Subsequently, the same experts individually selected the five most relevant determinants and rated those on their urgency, changeability and effectiveness through an online questionnaire (N = 21). Participants revealed a wide system of 31 main determinants including 173 sub-determinants that motivate or hinder healthy and sustainable eating among adolescents. This system of determinants was mapped on the different layers of the socioecological model: individual factors (25 motivators; 30 barriers), social environments (15 motivators; 13 barriers), physical environments (18 motivators; 15 barriers), macro-level environments (19 motivators; 38 barriers). 'Role of peers' (social environment) was selected most as a determinant to be targeted in interventions (N = 13; urgency (M = 6.38) changeability (M = 3.85), effectiveness (M = 5.62)), followed by 'food environment around school' (N = 9; urgency (M = 5.78) changeability (M = 3.44), effectiveness (M = 5.44)), 'social influences' (N = 7; urgency (M = 5.43) changeability (M = 4.00), effectiveness (M = 5.71)), 'autonomy in development' (N = 7; urgency (M = 6.00) changeability (M = 4.29), effectiveness (M = 5.86)) and 'food availability' (N = 7; urgency (M = 6.29) changeability (M = 3.29), effectiveness (M = 6.29)). The prioritized determinants indicate that adolescents should be provided more supportive social and physical environments that promote healthy and sustainable dietary behaviors, taking into account their growing autonomy.
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Affiliation(s)
- Sanne Raghoebar
- Wageningen University & Research, Education & Learning Sciences Group, Wageningen, the Netherlands; Wageningen University & Research, Consumption & Healthy Lifestyles Group, Wageningen, the Netherlands.
| | - Anouk Mesch
- Wageningen University & Research, Education & Learning Sciences Group, Wageningen, the Netherlands; Wageningen University & Research, Consumption & Healthy Lifestyles Group, Wageningen, the Netherlands.
| | - Judith Gulikers
- Wageningen University & Research, Education & Learning Sciences Group, Wageningen, the Netherlands
| | - Laura H H Winkens
- Wageningen University & Research, Consumption & Healthy Lifestyles Group, Wageningen, the Netherlands
| | - Renate Wesselink
- Wageningen University & Research, Education & Learning Sciences Group, Wageningen, the Netherlands
| | - Annemien Haveman-Nies
- Wageningen University & Research, Consumption & Healthy Lifestyles Group, Wageningen, the Netherlands; GGD Noord- en Oost-Gelderland, Academic Collaborative Center AGORA, Zutphen, the Netherlands
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Prichett L, Berry AA, Calderon G, Wang J, Hager ER, Klein LM, Edwards LV, Liu Y, Johnson SB. Parents' and Caregivers' Support for in-School COVID-19 Mitigation Strategies: A Socioecological Perspective. Health Promot Pract 2024:15248399231221160. [PMID: 38174691 DOI: 10.1177/15248399231221160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Informed by the social ecological model, which asserts that health behaviors and beliefs are the result of multiple levels of influence, we examined factors related to parents' support for in-school COVID-19 mitigation strategies. Using data from a survey of 567 parents/caregivers of public elementary and middle school students in eight Maryland counties, we employed regression models to examine relationships between parent-, child-, family-, school-, and community-level factors and acceptability of mitigation strategies. Acceptance of COVID-19 mitigation strategies was positively correlated with child- and family-level factors, including child racial identity (parents of Black children were more accepting than those of White children, odds ratio [OR]: 2.5, 95% confidence interval [CI] = [1.5, 4.1]), parent receipt of the COVID-19 vaccine (OR: 2.4, 95% CI = [1.5, 3.7]), and parent Democrat or Independent political affiliation (compared with Republican affiliation, OR: 4.2, 95% CI = [2.6, 6.7]; OR: 2.2, 95%CI = [1.3, 3.8], respectively). Acceptance was also positively associated with parents' perceptions of their school's mitigation approach, including higher school mitigation score, indicating more intensive mitigation policies (OR: 1.1, 95% CI = [1.0, 1.1]), better school communication about COVID-19 (OR: 1.7, 95% CI = [1.4, 1.9]) and better school capacity to address COVID-19 (OR: 1.9, 95% CI = [1.5, 2.4]). Community-level factors were not associated with acceptance. Child- and parent-level factors identified suggest potential groups for messaging regarding mitigation strategies. School-level factors may play an important role in parents' acceptance of in-school mitigation strategies. Schools' capacity to address public health threats may offer an underappreciated and modifiable setting for disseminating and reinforcing public health guidance.
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Affiliation(s)
- Laura Prichett
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrea A Berry
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - June Wang
- Johns Hopkins University, Baltimore, MD, USA
| | - Erin R Hager
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lauren M Klein
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Yisi Liu
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sara B Johnson
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Aresi G, Giampaolo M, Chiavegatti B, Marta E. Process Evaluation of Food Game: A Gamified School-Based Intervention to Promote Healthier and More Sustainable Dietary Choices. JOURNAL OF PREVENTION (2022) 2023; 44:705-727. [PMID: 37544937 PMCID: PMC10638118 DOI: 10.1007/s10935-023-00741-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 08/08/2023]
Abstract
Food Game is a gamified school-based intervention that aims to promote healthier dietary choices (i.e., adherence to the Mediterranean diet) and more sustainable behaviors among high school students in an urban area in Northern Italy. The program consists of an offline and online competition in which groups of students participate in peer-led activities to design and communicate products promoting health and sustainability. This study aimed to examine how the program works in practice, understand its mechanisms of change and assess any variation in student outcomes. A mixed methods process evaluation was conducted. Students completed a three-wave longitudinal survey and participated in focus groups. Program staff and teachers were also interviewed. Qualitative and quantitative data analyses indicate that Food Game?s gamification strategy was successful in engaging students, who felt stimulated by the game, its embedded competition and the self-organized group work. Although no significant change in adherence to the Mediterranean diet was found, pro-environmental behaviors, attitudes and perceived peer approval on healthy eating increased over time. Findings provide preliminary support for Food Game as an acceptable and engaging intervention though there is yet not sufficient evidence that it is also promotes healthier and more sustainable behaviors. The results contribute to the limited evidence base for offline gamified school-based interventions and offer insight into the applicability of the gamification approach as a key motivational strategy in other prevention settings and contexts. Suggestions on how to strengthen the program include dosage increase and addition of activities to promote change on relevant school and community factors.
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Affiliation(s)
- Giovanni Aresi
- Psychology Department, Università Cattolica del Sacro Cuore, Largo Gemelli 1, Milano, 20123, Italy.
- CERISVICO Research Centre on Community Development and Organizational Quality of Life, via Trieste 17, Brescia, 25121, Italy.
| | - Martina Giampaolo
- Psychology Department, Università Cattolica del Sacro Cuore, Largo Gemelli 1, Milano, 20123, Italy
| | - Benedetta Chiavegatti
- Unità Complessa Igiene Alimenti e Nutrizione, Azienda Tutela della Salute, Città Metropolitana di Milano, Italy
| | - Elena Marta
- Psychology Department, Università Cattolica del Sacro Cuore, Largo Gemelli 1, Milano, 20123, Italy
- CERISVICO Research Centre on Community Development and Organizational Quality of Life, via Trieste 17, Brescia, 25121, Italy
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Varela P, De Rosso S, Ferreira Moura A, Galler M, Philippe K, Pickard A, Rageliene T, Sick J, van Nee R, Almli VL, Ares G, Grønhøj A, Spinelli S, van Kleef E. Bringing down barriers to children's healthy eating: a critical review of opportunities, within a complex food system. Nutr Res Rev 2023:1-21. [PMID: 37746804 DOI: 10.1017/s0954422423000203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
This narrative review revises the scientific evidence of recent years on healthy eating in children and adolescents, making sense of promising avenues of action, from a food system perspective. A conceptual framework is provided to better understand how eating habits of children and adolescents are shaped to identify key multisectoral approaches that should be implemented to promote healthier diets. The following influencing factors are discussed: individual factors (physiological and psychological factors, food preferences and food literacy competencies), factors within the personal and socio-cultural food environments, external food environments, and the supply chain. In each section, the main barriers to healthy eating are briefly discussed focussing on how to overcome them. Finally, a discussion with recommendations of actions is provided, anchored in scientific knowledge, and transferable to the general public, industry, and policymakers. We highlight that multidisciplinary approaches are not enough, a systems approach, with a truly holistic view, is needed. Apart from introducing systemic changes, a variety of interventions can be implemented at different levels to foster healthier diets in children through fostering healthier and more sustainable food environments, facilitating pleasurable sensory experiences, increasing their food literacy, and enhancing their agency by empowering them to make better food related decisions. Acknowledging children as unique individuals is required, through interpersonal interactions, as well as their role in their environments. Actions should aim to enable children and adolescents as active participants within sustainable food systems, to support healthier dietary behaviours that can be sustained throughout life, impacting health at a societal level.
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Affiliation(s)
| | - Sofia De Rosso
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne Franche-Comté, F-21000 Dijon, France
| | | | | | - Kaat Philippe
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne Franche-Comté, F-21000 Dijon, France
| | | | | | - Julia Sick
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Florence, Italy
| | - Roselinde van Nee
- Wageningen University, Marketing & Consumer Behaviour Group, Wageningen, The Netherlands
| | | | - Gastón Ares
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Montevideo, Uruguay
| | | | - Sara Spinelli
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Florence, Italy
| | - Ellen van Kleef
- Wageningen University, Marketing & Consumer Behaviour Group, Wageningen, The Netherlands
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Kim Y, Kim J, Lee B, Jung S, Chung SJ, Kim H, Shin N, Kim Y. Early childhood eating behaviors associated with risk of overweight and its socio-ecological determinants in Korean preschool children. Nutr Res Pract 2023; 17:717-734. [PMID: 37529267 PMCID: PMC10375334 DOI: 10.4162/nrp.2023.17.4.717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/31/2022] [Accepted: 01/09/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND/OBJECTIVES This study aimed to identify preschool children's eating behaviors associated with early childhood obesity and its multi-level, socio-ecological determinants. SUBJECTS/METHODS In a cross-sectional study of 364 mothers of preschool children aged 3-5 years, these children's healthy eating behaviors were assessed using a validated preschool nutrition quotient (NQ-P) questionnaire. The children's overweight or obesity statuses were determined based on body mass index percentiles from the 2017 Korean National Growth Chart. The associations between the NQ-P score and risk of overweight or obesity were examined using multivariable logistic regression. The associations of individual, maternal, physical, and media environmental factors with the NQ-P score were also examined using multivariable linear regression. RESULTS Preschool children with greater NQ-P scores were at a significantly lower risk of overweight or obesity (P < 0.01). The NQ-P score had a significantly positive association with maternal body mass index and an inverse association with household income (all P < 0.05). Maternal parenting and feeding practices exhibited associations with the NQ-P score. Positive associations were observed with "warm," "structured," and "autonomy-supportive" parenting as well as monitoring feeding practices (all P < 0.05). In addition, the NQ-P score had a significantly positive association with the childcare center's anti-obesogenic environment, such as the provision of nutritional and physical-activity support and vicinity of the built food environment to the home, including access to good-quality food, fruits and vegetables, and low-fat foods (all P < 0.05). Regarding media environments, the NQ-P score demonstrated more significant associations with viewing and eating and/or cooking content displayed on online video platforms (all P < 0.05) than with that on television. CONCLUSIONS Our findings confirm the significance of healthy eating behaviors in early-childhood-obesity prevention and underscore the importance of multilevel maternal, physical, and media environmental interventions that effectively guide eating behaviors in preschool children.
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Affiliation(s)
- Yeri Kim
- Department of Nutritional Science & Food Management, Ewha Womans University, Seoul 03760, Korea
| | - Jiye Kim
- Department of Health Convergence, Ewha Womans University, Seoul 03760, Korea
| | - Bomi Lee
- Department of Child Development & Intervention, Ewha Womans University, Seoul 03760, Korea
| | - Seungyoun Jung
- Department of Nutritional Science & Food Management, Ewha Womans University, Seoul 03760, Korea
- Department of Nutritional Science & Food Management, Graduate Program in System Health Science & Engineering, Ewha Womans University, Seoul 03760, Korea
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Seo-Jin Chung
- Department of Nutritional Science & Food Management, Ewha Womans University, Seoul 03760, Korea
| | - Hyekyeong Kim
- Department of Health Convergence, Ewha Womans University, Seoul 03760, Korea
| | - Nana Shin
- Department of Child Development & Intervention, Ewha Womans University, Seoul 03760, Korea
| | - Yuri Kim
- Department of Nutritional Science & Food Management, Ewha Womans University, Seoul 03760, Korea
- Department of Nutritional Science & Food Management, Graduate Program in System Health Science & Engineering, Ewha Womans University, Seoul 03760, Korea
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Kontrick AV, Thakkar PM, Mycyk MB. Do emergency medicine residents have access to healthy food options during work hours? AEM EDUCATION AND TRAINING 2023; 7:e10890. [PMID: 37469684 PMCID: PMC10352550 DOI: 10.1002/aet2.10890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/01/2023] [Accepted: 06/06/2023] [Indexed: 07/21/2023]
Abstract
Background Relatively little data describe how diet and food choices impact trainee well-being despite evidence that diet impacts both physical and mental health. The objective was to describe food options available to emergency medicine (EM) residents when on duty. Methods A survey utilizing closed-ended, binary, rank-order responses was developed by experts in graduate medical education and wellness; it was piloted, revised, and then electronically distributed to 211 EM residency programs over 2 weeks in 2021. The program director (PD) or associate PD was invited to participate. Results A total of 114 EM programs participated (54%). The primary teaching site included 43 community hospitals, 23 county hospitals, and 48 university hospitals. Resident access to an onsite hospital cafeteria was most common (97%); other onsite options were vending machines (87%), fresh food fridges (34%), national chains (32%), local restaurants (25%), food trucks (30%), and farmer's markets (11%). More than one-third (38%) reported that onsite options did not include healthy food, 26% reported being dissatisfied with onsite food, and 35% rarely or never purchased food onsite. Most programs (89%) do not have a dedicated "meal break" for residents while on duty. Few residency programs include diet or nutrition classes or counseling. When programs sponsor meals during residency events, nutritional value and dietary considerations were ranked less important than cost of food and convenience. Conclusions Access to healthy food options is not always available during scheduled resident work hours, and dedicated meal breaks are infrequent. These data should inform institutional initiatives to improve the health and well-being of resident physicians.
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Affiliation(s)
- Amy V. Kontrick
- Department of Emergency MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Pankti M. Thakkar
- Department of Emergency MedicineCook County HealthChicagoIllinoisUSA
| | - Mark B. Mycyk
- Department of Emergency MedicineCook County HealthChicagoIllinoisUSA
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Ningning W, Wenguang C. Influence of family parenting style on the formation of eating behaviors and habits in preschool children: The mediating role of quality of life and nutritional knowledge. PLoS One 2023; 18:e0288878. [PMID: 37471435 PMCID: PMC10358991 DOI: 10.1371/journal.pone.0288878] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023] Open
Abstract
To provide empirical support for understanding the effects of different family parenting styles on the development of preschool children's eating habits and to promote healthy child development. Using a randomized whole-group sampling method, full-time public kindergartens in three regions of China were selected as the study population of preschool children, and 1141 children's guardians in these regions were surveyed and evaluated. It was used to examine the differential effects of different family parenting styles (EMBU) on preschool children's eating behavior (CEBQ), while quality of survival (QLSCA) and nutritional literacy (NLS) played a mediating role in the process. The results showed that at the direct effect level, authoritative, authoritarian, coddling, and neglectful family parenting styles had significant effects on preschool children's eating behavior (-0.161 ≤ β ≤ 0.232, p < 0.05); at the indirect effect level, family survival quality (QLSCA), and nutritional literacy (NLS) under the influence of different family parenting styles (EMBU) on children's eating the total indirect effect was [OR] 0.273, 95%: CI 0.181-0.368. It is evident that it is imperative to develop good eating behaviors in children at preschool age.
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Affiliation(s)
- Wang Ningning
- School of Physical Education, Liaoning Normal University, Dalian, China
- Graduate Students' Affairs Department, Shenyang Sport University, Shenyang, China
| | - Cheng Wenguang
- School of Management and Journalism, Shenyang Sport University, Shenyang, China
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Erfani K, Grabowski A, Parker G, Garrity A, Peterson KE, Lee JM, Nanda U. Point of Decision Design to Address Adolescent Overweight and Obesity. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:182-194. [PMID: 36946329 PMCID: PMC11042780 DOI: 10.1177/19375867231153365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVES This study aims to utilize the point of decision design framework to understand how, where, and why adolescents and families make decisions about diet and physical activity and to explore how modifications to the environment can help to promote healthier choices and reduce obesity. BACKGROUND Child and adolescent obesity is a critical public health problem. As environmental factors are a primary contributor, understanding the role of design in our surrounding environment highlights an important area of interdisciplinary study. Design strategies have been used successfully to increase stair use and reduce sedentary behavior and can be used to further promote healthier diet and activity choices among adolescents and families. METHODS We leveraged the human-centered design-thinking process through (1) qualitative interviews and survey instruments, (2) persona and prompt development, and (3) a design workshop with multidisciplinary stakeholders. RESULTS Five personas were developed from the qualitative data and used in a design-thinking workshop. During the workshop, participants generated 12 influential factors and nine points of decision which were used to generate 33 solutions spanning the design continuum (from information and policy design to the design of urban, architectural, and interior environments) aimed at improving nutrition and physical activity among adolescents. Additionally, a tool kit was prototyped, which includes interview guides, a persona framework, and a workshop facilitation guide. CONCLUSIONS Our novel process led to the generation of design solutions that can be implemented to expand and improve upon existing interventions for childhood obesity and create environments that encourage positive health outcomes.
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Affiliation(s)
- Kimia Erfani
- A. Alfred Taubman College of Architecture and Urban Planning, University of Michigan, Ann Arbor, MI, USA
| | - Aria Grabowski
- Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, MI, USA
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Grant Parker
- A. Alfred Taubman College of Architecture and Urban Planning, University of Michigan, Ann Arbor, MI, USA
| | - Ashley Garrity
- Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, MI, USA
- Division of Pediatric Endocrinology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Karen E. Peterson
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Joyce M. Lee
- Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, MI, USA
- Division of Pediatric Endocrinology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Upali Nanda
- A. Alfred Taubman College of Architecture and Urban Planning, University of Michigan, Ann Arbor, MI, USA
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Liu Y, Cui T, Barnhart WR, Wang Q, Yu Y, He J. Associations among retrospective parenting styles, retrospective food parenting, and current eating behaviors in Chinese adults. Appetite 2023; 184:106512. [PMID: 36858260 DOI: 10.1016/j.appet.2023.106512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 02/02/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023]
Abstract
The current study explored the relationships between retrospective parenting styles and food parenting in childhood (≤ 12 years old) and Chinese adults' current maladaptive and adaptive eating behaviors. We recruited 501 Chinese adults (50.30% men, aged 19-46 years). A set of questionnaires were used to measure retrospective parenting styles (i.e., emotional warmth, rejection, and overprotection), food parenting (i.e., parental concern, monitoring, pressure to eat, and restriction), and current maladaptive (i.e., disordered eating) and adaptive (i.e., intuitive eating) eating behaviors. Correlation and mediation analyses were employed to analyze these data. Results revealed that retrospective parenting styles and food parenting were significantly related to current maladaptive and adaptive eating behaviors in both Chinese men and women. Mediation analyses showed that higher retrospective parental warmth was related to higher retrospective parental concern which, in turn, was related to higher current disordered eating in men (indirect effect = 0.14, 95% CI 0.08, 0.24). Furthermore, higher retrospective parental overprotection was related to higher retrospective parental pressure to eat which, in turn, was related to higher current disordered eating in men (indirect effect = 0.06, 95% CI 0.01, 0.14). For women, higher retrospective parental warmth was associated with higher retrospective parental concern which, in turn, was associated with lower current intuitive eating in women (indirect effect = -0.04, 95% CI = -0.10, -0.01). Furthermore, higher retrospective parental overprotection was associated with higher retrospective parental concern which, in turn, was associated with lower current intuitive eating in women (indirect effect = -0.03, 95% CI = -0.08, -0.004). The findings indicate the importance of including childhood parenting styles and food parenting in future research and intervention of adults' current maladaptive and adaptive eating behaviors.
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Affiliation(s)
- Yutian Liu
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Tianxiang Cui
- Department of Psychology, University of Macau, Macau, China
| | - Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Qingyang Wang
- School of Management and Economies, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Yiman Yu
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China.
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12
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Chang KB, Wooden A, Rosman L, Altema-Johnson D, Ramsing R. Strategies for reducing meat consumption within college and university settings: A systematic review and meta-analysis. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2023. [DOI: 10.3389/fsufs.2023.1103060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
IntroductionDespite the considerable public and planetary health benefits associated with reducing the amount of meat consumed in high-income countries, there is a limited empirical understanding of how these voluntary changes in food choice can be effectively facilitated across different settings. While prior reviews have given us broad insights into the varying capacities of behavior change strategies to promote meaningful reductions in meat consumption, none have compared how they perform relative to each other within a uniform dining context.MethodsTo address this gap in the literature, we synthesized the available research on university-implemented meat reduction interventions and examined the variations in the success rates and effect estimates associated with each of the three approaches identified in our systematic review.ResultsFrom our analyses of the 31 studies that met our criteria for inclusion (n = 31), we found that most were successful in reducing the amount of meat consumed within university settings. Moreover, independent of the number of individual strategies being used, multimodal interventions were found to be more reliable and effective in facilitating these changes in food choice than interventions targeting the choice architecture of the retail environment or conscious decision-making processes alone.DiscussionIn addition to demonstrating the overall value of behavior change initiatives in advancing more sustainable dining practices on college and university campuses, this study lends further insights into the merits and mechanics underlying strategically integrated approaches to dietary change. Further investigations exploring the persistence and generalizability of these effects and intervention design principles are needed.Systematic review registrationhttps://doi.org/10.17605/OSF.IO/DXQ5V, identifier: 10.17605/OSF.IO/DXQ5V.
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Socioecological Challenges of Polio Supplementary Immunization Activities (SIAs) in the Asia-Pacific Region: A Systematic Review. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2023; 2023:4801424. [PMID: 36747498 PMCID: PMC9899143 DOI: 10.1155/2023/4801424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/16/2022] [Accepted: 09/22/2022] [Indexed: 01/29/2023]
Abstract
Background Polio supplementary immunization activities (SIAs) are one of the polio eradication pillars in the Global Polio Eradication Initiative (GPEI) that increased the immunization coverage and made progress towards polio eradication. However, socioecological challenges faced during SIAs contribute to suboptimal campaign quality. The aim of this review is to identify the reported challenges during polio supplementary immunization activities (SIAs) and associated improvement strategies based on the socioecological model (SEM). Methods Articles were searched from three databases which were WOS, Scopus, and PubMed. The systemic review identified the primary articles related to SIA that focused on the impact of immunization coverage, challenges, and improvement strategies. The inclusion criteria were open access English articles that were published between 2012 and 2021 and conducted in the Asia region. Results There are nine articles described and explained regarding some form of supplementary immunization activities (SIAs) in their findings across Asia region. The majority of studies selected reported on post vaccination coverage and revealed a multifaceted challenge faced during SIAs which are widely diverse range from the microlevel of interpersonal aspects up to the macrolevel of government policy. Upon further analysis, the intervention at community level was the most dominant strategies reported during the SIA program. Conclusions An effective SIAs program provides the opportunity to increase the national capacity of the polio immunization program, reducing inequities in service delivery and offering additional public health benefits in controlling polio outbreaks in both endemic and nonendemic countries. Strengthening routine immunization (RI) programmes is also important for the sustainability of SIA's programs. Despite the challenges and hurdles, many Asian countries exhibited great political willingness to boost polio immunization coverage through SIA efforts.
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Almutairi N, Burns S, Portsmouth L. Barriers and enablers to the implementation of school-based obesity prevention strategies in Jeddah, KSA. Int J Qual Stud Health Well-being 2022; 17:2135197. [PMID: 36263729 PMCID: PMC9590444 DOI: 10.1080/17482631.2022.2135197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Despite schools' recognised role in mitigating childhood overweight, many schools fail to implement physical activity or nutrition strategies. The current study explored
the enablers and barriers to implementing obesity prevention strategies in
Jeddah, KSA. Methods This research is based on 14 semi-structured interviews with intermediate school principals and sports teachers to gain insight into their perception of barriers and enablers to implementing obesity prevention strategies. Themes were deductively generated from the data. Results Participants estimated the prevalence of overweight and obesity among their students to be between 3 and 15% with an increasing trend, particularly among female students. Participants identified five categories of barriers to implementation of obesity prevention intervention: curriculum; schools strategies promoting healthy weight; lack of resources; student’s lifstyle; and a lack of teachers in nutrition and sports. School regulations, staff and sufficient resources were the most frequently reported enablers. Participants also identified food services, awareness, and partnerships as barriers and enablers. Conclusion There is a need for better infrastructure and financial support for schools and professional development opportunities for teachers from the Saudi Ministry of Education. The Ministry also needs to support the development of multilevel health promotion strategies at school and home and reach out to the broader community.
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Affiliation(s)
- Naif Almutairi
- School of Population Health, Curtin University Bentley Campus, Perth, Australia,Department of Public Health, College of Health Sciences at Al-Leith, Umm Al-Qura University, Al-Leith, Kingdom of Saudi Arabia,CONTACT Naif Almutairi ; School of Population Health, Curtin University, GPO Box U1987, Perth6845, Australia
| | - Sharyn Burns
- School of Population Health, Curtin University Bentley Campus, Perth, Australia,Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia
| | - Linda Portsmouth
- School of Population Health, Curtin University Bentley Campus, Perth, Australia,Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia
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15
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Kissock KR, Neale EP, Beck EJ. Knowledge, Messaging, and Selection of Whole-Grain Foods: Consumer and Food Industry Perspectives. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:1086-1098. [PMID: 36244876 DOI: 10.1016/j.jneb.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To explore whole-grain food definitions in labeling and relevance to consumers and the food industry. DESIGN Semistructured focus groups and interviews. SETTING Online. PARTICIPANTS Consumers (n = 43) aged ≥ 18 years currently purchasing/consuming grain foods. Food industry participants (n = 17) currently/recently employed within grain food companies. PHENOMENON OF INTEREST Impact of using whole-grain food definitions in labeling. ANALYSIS Inductive thematic analysis. RESULTS Six major themes included: consumer knowledge and understanding of whole-grain foods; factors affecting consumer grain food choices; consumer skepticism of labeling; consumer preferences toward whole-grain labeling; acceptability and feasibility of whole-grain food definitions in the food industry; and food innovation/reformulation. For the food industry, definitions impact feasibility, food innovation, and reformulation. Skepticism affected consumer knowledge and understanding, impacting grain food choice and their preference regarding whole-grain labeling. Consumers preferred whole grain in the name of a food and placing the percent of whole grain on the front-of-pack. CONCLUSIONS AND IMPLICATIONS Our findings suggest that definitions and regulations, consumer education, and strategies addressing factors influencing consumer choice are needed to improve population whole-grain intakes. Future research may consider formal regulation and implementation of standardized whole-grain food definitions in labeling and explore the subsequent impact on consumer choice and whole-grain intake.
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Affiliation(s)
- Katrina R Kissock
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia.
| | - Elizabeth P Neale
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Eleanor J Beck
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
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Isbanner S, Carins J, Rundle-Thiele S. Healthy Eats-Evaluation of a Social Marketing Program Delivered in Primary School Settings in Queensland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14415. [PMID: 36361286 PMCID: PMC9655208 DOI: 10.3390/ijerph192114415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
One in four school children in Australia are overweight or obese. In response, the Healthy Eats program was developed, piloted, and delivered using a whole-of-school approach underpinned by the socio-ecological model to increase fruit and vegetable consumption among children aged 8-10 years in regional Queensland, Australia. This research presents an outcome evaluation of the Healthy Eats program using pre-post data collected throughout 2021 (cross-sectional for knowledge and longitudinal for behaviour) from 19 schools to assess whether changes occurred in students' nutritional knowledge (n = 1868 (pre = 933, post = 935)) and fruit and vegetable consumption (n = 1042 (pre = 521, post = 521)). Knowledge data was collected via self-reports two weeks prior and immediately after the Nutrition Module. Behavioural data on daily fruit and vegetable consumption was gathered via student passports (i.e., surveys) one week before and for four consecutive weeks after the Nutrition Module. Chi-Square Difference tests and t-Tests were conducted with a significance level set at p < 0.05. Across all 19 schools, knowledge of the daily recommended serves of fruit and vegetables improved significantly following participation in the program, aligning knowledge closer to the Australian dietary guidelines. Behavioural results for fruit consumption were favourable, with clear improvements reported. Increases in vegetable consumption were demonstrated in two of the eight schools. A discussion on the knowledge-action gap is provided, including recommendations for future iterations of the Healthy Eats program.
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Halladay J, MacKillop J, Munn C, Amlung M, Georgiades K. Individual- and school-level patterns of substance use and mental health symptoms in a population-based sample of secondary students: A multilevel latent profile analysis. Drug Alcohol Depend 2022; 240:109647. [PMID: 36244138 DOI: 10.1016/j.drugalcdep.2022.109647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND While substance use and mental health symptoms commonly co-occur among adolescents, few population-level studies have examined profiles of co-occurrence to inform tailored prevention and early interventions. METHODS A multilevel latent profile analysis was conducted on a representative sample of 11,994 students in 68 secondary schools to: 1) identify distinct profiles of co-occurring substance use and mental health symptoms; 2) identify types of schools based on student profiles; and 3) explore school correlates of student profiles and school types, including school climate, belonging, and safety. RESULTS Five student profiles and three school types were identified. Among students, 57.6 % were in a low substance use and mental health profile, 22.5 % were in a high mental health but low substance use profile, 9.7 % were in a heavy drinking and cannabis use profile, 3.7 % were in a heavy drinking and smoking profile, and 6.5 % were in a high substance use and mental health profile. Positive school climate, belonging, and safety increased the odds of students being in the low profile, with belonging yielding larger effects among females. Among schools, 28 % had low, 57 % had moderate, and 15 % had high levels of student substance use and comorbid mental health symptoms. Rural schools were disproportionately represented in higher risk school types. CONCLUSIONS The identified student substance use and mental health symptom profiles can serve as targets for tailored prevention and early interventions. Results support examining school-based interventions targeting school climate, belonging, and safety with potential benefits to both substance use and mental health.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada.
| | - James MacKillop
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - Catharine Munn
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7.
| | - Michael Amlung
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, 1000 Sunnyside Avenue, Lawrence, KS 66045, the United States of America.
| | - Katholiki Georgiades
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Offord Centre for Child Studies, McMaster University, Canada.
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Roberts NJ, Harvey LA, Poulos RG, Ní Shé É, Dillon Savage I, Rafferty G, Ivers R. Lesbian, gay, bisexual, transgender and gender diverse and queer (LGBTQ) community members' perspectives on palliative care in New South Wales (NSW), Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5926-e5945. [PMID: 36121264 PMCID: PMC10087150 DOI: 10.1111/hsc.14024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 08/12/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
Lesbian, gay, bisexual, transgender and gender diverse people, and queer people (LGBTQ people) are at increased risk of some chronic diseases and cancers. NSW Health palliative care health policy prioritises equitable access to quality care, however, little is known about community members' perspectives on palliative care. This study aimed to understand LGBTQ community views and preferences in palliative care in NSW. A community survey and follow-up interviews with LGBTQ people in NSW were conducted in mid-2020. A total of 419 people responded to the survey, with 222 completing it. Six semi-structured phone interviews were conducted with participants who volunteered for follow-up. The sample included LGBTQ people with varied levels of experience in palliative care. Thematic analysis was conducted on survey and interview data, to identify perceived barriers and enablers, and situate these factors in the socio-ecological model of health. Some perceived barriers from community members related to considering whether to be 'out' (i.e., making one's sexual orientation and gender known to services), knowledge and attitudes of staff, concern about potential substandard care or mistreatment (particularly for transgender health), decision making, biological family as a source of tension, and loneliness and isolation. Perceived enablers related to developing and distributing inclusive palliative care information, engaging with community(ies), fostering inclusive and non-discriminatory service delivery, ensuring respectful approaches to person-centred care, and staff training on and awareness building of LGBTQ needs and issues. Most of the participants who had experienced palliative care recounted positive interactions, however, we identified that LGBTQ people require better access to knowledgeable and supportive services. Palliative care information should be inclusive and services respectful and welcoming. Particular consideration should be given to how services respond to and engage with people from diverse population groups. These insights can support ongoing policy and service development activities to further enhance palliative care.
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Affiliation(s)
- Nick J. Roberts
- NSW Ministry of HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Lara A. Harvey
- Neuroscience Research AustraliaUniversity of New South WalesSydneyNew South WalesAustralia
- University of New South WalesSydneyNew South WalesAustralia
| | | | - Éidín Ní Shé
- Royal College of Surgeons in IrelandDublinIreland
| | | | - Gemma Rafferty
- NSW Ministry of HealthSt LeonardsNew South WalesAustralia
| | - Rebecca Ivers
- University of New South WalesSydneyNew South WalesAustralia
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Alkhunain N, Moore JB, Ensaff H. Online Pre-Order Systems for School Lunches: Insights from a Cross-Sectional Study in Primary Schools. Nutrients 2022; 14:nu14050951. [PMID: 35267926 PMCID: PMC8912561 DOI: 10.3390/nu14050951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/10/2022] [Accepted: 02/10/2022] [Indexed: 01/27/2023] Open
Abstract
Schools are increasingly using online pre-order systems for children to select school meals in advance. This study aimed to explore how children use and interact with these systems. Using a combination of direct observation and an online questionnaire, the operation of these systems in four UK primary schools was examined. This included how the menu options were displayed, how these were selected by children (4–11 years), and the interactions between children and others when making food selections. Where possible, most children pre-ordered their school lunch in the classroom, and differences in the food choice process among children were observed. These apparently related to children’s ages; older children (8–11 years) showed more independence when making food selections, whereas younger children were often supported by others. Most parents reported that their child was the decision maker when pre-ordering the school lunch, and the role of children in the selection of school lunches was evident. This may be accentuated by the online pre-order systems, and given the likely expansion of these systems in schools, there is an opportunity to implement interventions to influence children towards specific or different meal options from the school menu.
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Affiliation(s)
- Nahlah Alkhunain
- Nutritional Sciences and Epidemiology, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK; (N.A.); (J.B.M.)
- Clinical Nutrition, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
| | - Jennifer Bernadette Moore
- Nutritional Sciences and Epidemiology, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK; (N.A.); (J.B.M.)
| | - Hannah Ensaff
- Nutritional Sciences and Epidemiology, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK; (N.A.); (J.B.M.)
- Correspondence:
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20
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OUP accepted manuscript. Health Promot Int 2022:6570173. [DOI: 10.1093/heapro/daac042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Embracing challenging complexity: exploring handwashing behavior from a combined socioecological and intersectional perspective in Sierra Leone. BMC Public Health 2021; 21:1857. [PMID: 34649535 PMCID: PMC8515313 DOI: 10.1186/s12889-021-11923-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 10/05/2021] [Indexed: 11/30/2022] Open
Abstract
Background Handwashing with soap is a cost-effective, efficient health behavior to prevent various diseases. Despite its immense health benefits, the lowest prevalence of handwashing is found in low-income countries. Here, its practice is not only determined by individual behavior, but also heavily shaped by deprivations in the social and structural ecology. Moreover, handwashing barriers are not equally experienced as overlapping social identities (e.g., age and gender) intersect and create inequities between members of different social groups. To embrace the complexities of handwashing beyond individual-level behavior and singular social identities, a combined socioecological and intersectional perspective is employed. This multi-level approach with regards to intersecting privileges and disadvantages serves as a basis to promote this highly important health behavior. Methods This study used a qualitative, theory-based approach and combined data from two samples: experts in health promotion (n = 22) and local citizens stratified by gender and rural/urban location (n = 56). Data was collected in face-to-face interviews in Sierra Leone between November 2018 and January 2019 and analyzed using thematic analysis and typology of the qualitative data. Results The conceptualization of multi-level determinants of handwashing within a socioecological model showed the high relevance of inhibiting social and structural factors for handwashing practice. By establishing seven distinguishing social identity dimensions, data demonstrates that individuals within the same social setting yet with distinct social identities experience strikingly differing degrees of power and privileges to enact handwashing. While a local leader is influential and may also change structural-level determinants, a young, rural wife experiences multiple social and structural constraints to perform handwashing with soap, even if she has high handwashing intentions. Conclusion This study provides a holistic analytical framework for the identification of determinants on multiple levels and accumulating intersections of socially produced inequalities for handwashing and is applicable to other health topics. As the exploration of handwashing was approached from a solution-focused instead of a problem-focused perspective, the analysis can guide multi-level intervention approaches (e.g., using low-cost, participatory activities at the community level to make use of the available social capital). Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11923-1.
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Lai IJ, Chang LC, Lee CK, Liao LL. Nutrition Literacy Mediates the Relationships between Multi-Level Factors and College Students' Healthy Eating Behavior: Evidence from a Cross-Sectional Study. Nutrients 2021; 13:nu13103451. [PMID: 34684452 PMCID: PMC8539523 DOI: 10.3390/nu13103451] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/24/2021] [Accepted: 09/28/2021] [Indexed: 11/16/2022] Open
Abstract
College students experience new pressures and choices as they transition to independent living and can easily develop unhealthy eating habits, resulting in obesity and obesity-related chronic diseases in later life. This study aimed to test the hypothesis that nutrition literacy (NL) mediated the relationship between multi-level factors influencing healthy eating behavior identified from the social-ecological model and healthy eating behavior of college students. A four-part questionnaire was completed by 412 participants recruited from six different four-year universities in Taiwan (effective response rate = 85.8%). Data were analyzed using descriptive statistics, an independent samples t-test, hierarchical multiple regression, and mediation analysis. The results indicated that the students’ mean nutrition literacy score was 4.32 (SD = 0.78, range = 1–6). In the social-ecological framework, nutrition literacy significantly predicted healthy eating behavior (β = 0.28, p < 0.001; ΔF = 32.54, p < 0.001; ΔR2 = 0.05) with control variables of background, intrapersonal, interpersonal, environmental, and macrosystem factors. Nutrition literacy mediated the effects of seven factors on healthy eating behavior across four levels. These findings suggested that strengthening influential multi-level factors associated with healthy eating behavior not only enhanced NL, but also improved individuals’ healthy eating behavior.
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Affiliation(s)
- I-Ju Lai
- Department of Nutrition, I-Shou University, Kaohsiung City 824, Taiwan;
| | - Li-Chun Chang
- School of Nursing, Chang Gung University of Science and Technology, Taoyuan City 333, Taiwan;
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung City 204, Taiwan
| | - Chia-Kuei Lee
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City 701, Taiwan;
| | - Li-Ling Liao
- Department of Health Management, I-Shou University, Kaohsiung City 824, Taiwan
- Correspondence:
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van der Bend DLM, Jakstas T, van Kleef E, Shrewsbury VA, Bucher T. Making sense of adolescent-targeted social media food marketing: A qualitative study of expert views on key definitions, priorities and challenges. Appetite 2021; 168:105691. [PMID: 34509544 DOI: 10.1016/j.appet.2021.105691] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/25/2022]
Abstract
Traditional food marketing stimulates adolescents' consumption of energy-dense, nutrient-poor foods. These dietary behaviours may track into adulthood and lead to weight gain, obesity and related non-communicable diseases. While social media use in adolescents has proliferated, little is known about the content of food marketing within these platforms, and how this impacts adolescents' dietary behaviours. This paper aimed to obtain expert insights on factors involved in the association between social media food marketing (SMFM) and adolescent dietary behaviours, and to explore their views on key priorities, challenges and strategies for future SMFM research and policies. One-on-one semi-structured interviews (n = 17) were conducted with experts from Western Europe, Australia and North America, in the fields of public health (policy), nutrition science, social media marketing, adolescent medicine, clinical psychology, behavioural sciences, communication, food industry, social influencing, and social marketing. The experts' collective responses identified that the line between food content posted by social media users and food companies is blurred. Adolescents' processing of SMFM may be mostly implicit, involving social comparison, emotional engagement, and attaching symbolic meanings to foods. Mediating factors and adolescent-specific and SMFM-specific moderating factors potentially influencing adolescents' response to SMFM were summarized in a Social Ecological model. Experts agreed that there is limited scientific evidence on adolescent-targeted SMFM and there are no strict regulations in place to protect adolescents from unhealthy SMFM, while adolescents are active social media users who are cognitively vulnerable to implicit marketing tactics. Adolescent-targeted SMFM should be controlled by encouraging healthy food marketing or limiting junk food marketing. Also, prioritizing both quantitative research on SMFM exposure and its impact, and qualitative research to obtain adolescents' perspectives, is crucial to advocate for regulatory changes regarding adolescent-targeted SMFM content.
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Affiliation(s)
- Daphne L M van der Bend
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan NSW, 2308, Newcastle, Australia; Department of Social Sciences, Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, the Netherlands.
| | - Tammie Jakstas
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan NSW, 2308, Newcastle, Australia
| | - Ellen van Kleef
- Department of Social Sciences, Marketing and Consumer Behaviour Group, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, the Netherlands
| | - Vanessa A Shrewsbury
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan NSW, 2308, Newcastle, Australia
| | - Tamara Bucher
- School of Environmental and Life Sciences, College of Engineering, Science and Environment, The University of Newcastle, University Drive, Callaghan NSW, 2308, Newcastle, Australia
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Are Perceptions of Health Dependant on Social Class? Studying Soft Power and Symbolic Violence in a Health Promotion Program among Young Men at Vocational Schools. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147517. [PMID: 34299968 PMCID: PMC8307088 DOI: 10.3390/ijerph18147517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 11/30/2022]
Abstract
Health behaviour among young people has a social gradient, and tends to be skewed in terms of gender as well. Young men in vocational educational settings are an example where the inequality in health is apparent. Addressing this problem requires an understanding of health behaviour and its determinants in the target group in order to be able to develop interventions that can address the problem. The aim of the paper is to investigate to what extent a multicomponent intervention based on the Whole School Approach, targeting the risk behaviours, smoking, eating and physical activity that have an impact on health behaviour among male students in a disadvantaged educational setting. The paper uses self-reported longitudinal data on risk behaviours from the “Gearing up the Body” 1-year intervention program that was implemented among students at a Danish vocational school. For the analysis, we created a score model to categorise students and behaviour. Analyses suggest that interventions had only a modest impact and what evidence there is shows that the interventions reduced the health behaviour scores by 0.03 points. More specifically, we find that symbolic violence reduces the health behaviour score of the healthy types by 0.20 points, whereas soft power increases the health behaviour of the unhealthy type by 0.05 points. An explanation for the disappointing results of the “Gearing up the Body” program is tension between different understanding of what is “right” and “wrong” health behaviour. We find that the ideas of soft power and symbolic violence can contribute to a better understanding of why health and health behaviour is understood differently among vocational students. Thus, the finding demonstrates that one needs to apply a participatory approach rather than a normative approach addressing the health behaviour of disadvantaged individuals.
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Kaveh MH, Moradi L, Morowatisharifabad MA, Najarzadeh A, Fallahzadeh H. Motivation System of Healthy and Safe Nutrition in Iranian Adolescent Girls: A Qualitative Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5556759. [PMID: 34337025 PMCID: PMC8292067 DOI: 10.1155/2021/5556759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/05/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Motivation determines the possibility of an individual's intention to accept health-related behaviors. Despite the important role of the motivational system in conducting healthy and safe nutrition behavior, this issue has not been adequately addressed. The purpose of this qualitative study was to explain the healthy and safe nutrition motivation system among Iranian adolescent girls. METHOD In this qualitative study, conventional content analysis was used and participants were selected using the purposive sampling method. Semistructured in-depth interviews were conducted with 42 adolescent girls in Shiraz, Iran. The interviews continued until data saturation was obtained. Qualitative data were analyzed using the Graneheim and Lundman qualitative content analysis by MAX-Q-DA (version 10) software. RESULTS The data analysis resulted in three main categories for the participants' motivational factors for healthy and safe nutrition: (1) maintaining health and social functions, (2) maintaining the family's mental and economic health, and (3) achieving goals and success in life. The first category included two subcategories: "desire to have an appropriate look and appearance" and "fear of diseases and their complications." The second category included two subcategories of "maintaining the family's mental health" and "maintaining the family's economic health." The third category consisted of two subcategories: "desire to form a family and be successful in life" and "achieving the future career goals." CONCLUSION The motivation to maintain health and social functions, to maintain the family's mental and economic health, and to achieve goals and be successful in life has a powerful impact on the decisions and behaviors of adolescent girls to have safe and healthy nutrition. Therefore, recognizing the motivational system, as a key and determinative factor in developing the adolescents' intention to adopt health-related behaviors, is an effective step to design and develop successful interventions in promoting nutritional behaviors.
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Affiliation(s)
- Mohammad Hossein Kaveh
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz 71557, Iran
| | - Leila Moradi
- Social Determinants of Health Research Center, Department of Health Promotion, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd 89151, Iran
| | - Mohammad Ali Morowatisharifabad
- Elderly Health Research Center, Department of Health Promotion, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd 89151, Iran
| | - Azadeh Najarzadeh
- Nutrition and Food Security Research Center, Department of Nutrition, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd 89151, Iran
| | - Hossein Fallahzadeh
- Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of Biostatistics and Epidemiology, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd 89151, Iran
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Mburu CM, Bukachi SA, Shilabukha K, Tokpa KH, Ezekiel M, Fokou G, Bonfoh B, Kazwala R. Determinants of treatment-seeking behavior during self-reported febrile illness episodes using the socio-ecological model in Kilombero District, Tanzania. BMC Public Health 2021; 21:1075. [PMID: 34090402 PMCID: PMC8180143 DOI: 10.1186/s12889-021-11027-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 05/11/2021] [Indexed: 11/30/2022] Open
Abstract
Background Febrile diseases in Sub-Saharan Africa cause acute and chronic illness. Co-infections are common and these diseases have a complex etiology that includes zoonoses. For the implementation of appropriate treatment and control strategies, determinants of lay treatment-seeking behavior by the affected communities need to be understood. The objective of this study was to explore, using the socio-ecological model, the determinants of treatment-seeking actions among self-identified febrile illness cases in the Kilombero District of Tanzania. Methods Thirty-nine in-depth interviews were conducted with 28 men and 11 women in three villages in Kilombero district. These villages were purposively selected due to malaria endemicity in the area, animal husbandry practices, and proximity to livestock-wildlife interaction, all risk factors for contracting febrile zoonotic infections. Thematic analysis was conducted on the interviews to identify the key determinants of treatment-seeking actions. Results Study participants attributed febrile illnesses to malaria, typhoid and urinary tract infections. Treatment-seeking behavior was an iterative process, influenced by individual, socio-cultural, ecological and policy factors. Age, expendable income, previous history with a febrile illness, perceptions on disease severity, seasonal livelihood activities and access to timely healthcare were some of the determinants. Self-treatment with pharmaceutical drugs and herbs was usually the initial course of action. Formal healthcare was sought only when self-treatment failed and traditional healers were consulted after the perceived failure of conventional treatment. Delays in seeking appropriate health care and the consultation of medically unqualified individuals was very common. Conclusion The results imply that treatment-seeking behavior is shaped by multiple factors across all levels of the socio-ecological model. Public policy efforts need to focus on facilitating prompt health care seeking through community education on the complicated etiology of febrile illnesses. Improved access to timely treatment and better differential diagnostics by health professionals are essential to ensure correct and appropriate treatment and to reduce reliance of patients on unqualified persons. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11027-w.
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Affiliation(s)
- Caroline M Mburu
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya.
| | - Salome A Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Khamati Shilabukha
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Kathrin H Tokpa
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Mangi Ezekiel
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Gilbert Fokou
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
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Rose K, O'Malley C, Brown L, Ells LJ, Lake AA. 'Pizza every day - why?': A survey to evaluate the impact of COVID-19 guidelines on secondary school food provision in the UK. NUTR BULL 2021; 46:160-171. [PMID: 34149313 PMCID: PMC8206956 DOI: 10.1111/nbu.12496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 12/02/2022]
Abstract
The nutritional requirements of adolescence and the reported poor UK eating behaviours of young people are a significant public health concern. Schools are recognised as an effective ‘place’ setting to enable improvement to nutrition outcomes. The COVID‐19 pandemic resulted in UK school closures from March 2020. In re‐opening in September 2020, schools were required to meet guidelines to ensure the minimised impact of COVID‐19 on the population (DfE 2020). We aimed to evaluate the impact of COVID‐19 school guidelines on secondary and post‐16 (16–18 years) food provision. An online survey was posted on 8th October to 1st December 2020, targeted at young people, parents and staff of secondary/post‐16 education establishments in the UK. Two hundred and fifty‐two responses were received, of which 91% reported a change in their school food provision, 77% reported time for lunch was shortened and 44% indicated the provision was perceived as less healthy during September 2020 (post‐lockdown school return) compared with March 2020 (pre‐lockdown). Analyses demonstrated that time, limited choice and healthiness impacted negatively upon young people's school food experience. The COVID‐19 pandemic has presented a huge challenge to the delivery of healthy school food to young people. Therefore, schools require more support in following national food standards and incorporating nutrition education and behaviour change strategies within current guidelines.
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Affiliation(s)
- Kelly Rose
- Centre for Public Health Research School of Health and Life sciences Teesside University Middlesbrough UK.,Fuse - Centre for Translational Research in Public Health Newcastle upon Tyne UK
| | - Claire O'Malley
- Centre for Public Health Research School of Health and Life sciences Teesside University Middlesbrough UK.,Fuse - Centre for Translational Research in Public Health Newcastle upon Tyne UK
| | - Laura Brown
- Centre for Public Health Research School of Health and Life sciences Teesside University Middlesbrough UK
| | - Louisa Jane Ells
- School of Clinical and Applied Sciences Leeds Beckett University Leeds UK
| | - Amelia A Lake
- Centre for Public Health Research School of Health and Life sciences Teesside University Middlesbrough UK.,Fuse - Centre for Translational Research in Public Health Newcastle upon Tyne UK
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Almutairi NS, Burns S, Portsmouth L. Identifying factors associated with overweight and obesity among intermediate school students aged 12-15 years in school settings: mixed-methodology protocol. BMJ Open 2021; 11:e045877. [PMID: 34049915 PMCID: PMC8166636 DOI: 10.1136/bmjopen-2020-045877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Childhood obesity is a public health concern globally. In Arab countries, the prevalence of overweight and obesity has increased significantly over the last three decades. The level of childhood overweight and obesity in the Kingdom of Saudi Arabia (KSA) is high and continues to increase. This study will explore factors associated with overweight and obesity among adolescents and identify barriers and enablers to the implementation of comprehensive school-based obesity prevention interventions. METHODS AND ANALYSIS Socioecological model will inform this mixed-methods study. The study will include three phases: (1) a scoping review of the literature; (2) the development of a student survey instrument and (3) a mixed-method study comprising a cross-sectional survey targeting students aged 12-15 years with the collection of the students' height and weight measurements; one-on-one interviews with physical education teachers and school principals; and the administration of school climate audits using the Health Promoting School framework. Reliability and validity of the survey instrument will be examined during survey development. Descriptive, inferential and thematic analysis will be employed using appropriate statistical software. ETHICS AND DISSEMINATION Ethical approval has been granted from the Curtin University of Human Research Ethics Committee (HR2020-0337) and from the KSA Ministry of Education (4181827686). School principals will provide permission to conduct the study in individual schools. Individual consent/assent will be obtained from students and their parents, and teachers. Study findings will be disseminated via peer-review publications, reports and conferences.
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Affiliation(s)
- Naif Saleh Almutairi
- School of Population Health, Curtin University Bentley Campus, Perth, Western Australia, Australia
- Department of Public Health, College of Health Sciences at Al-Leith, Umm Al-Qura University, Al-Leith, Kingdom of Saudi Arabia
| | - Sharyn Burns
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Linda Portsmouth
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Western Australia, Australia
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Williams N, Mann G, Cafer A, Evers C, Kaiser K. “Bring back the salad bar”: perceptions of health in rural delta middle school students. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2021. [DOI: 10.1080/19320248.2021.1894298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Natalie Williams
- Department Nutrition and Hospitality Management, University of Mississippi, University, MS 38677, USA
| | - Georgianna Mann
- Department Nutrition and Hospitality Management, University of Mississippi, University, MS 38677, USA
| | - Anne Cafer
- University of Mississippi, University, MS 38677543, Lamar Hall, USA
| | - Charles Evers
- School of Medicine, 1670 University Blvd, University of Alabama, Birmingham, USA
| | - Kimberly Kaiser
- Department of Legal Studies, M302 Mayes, University of Mississippi, University, MS 38677, USA
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Benes S, Boyd KM, Cucina I, Alperin HL. School-Based Health Education Research: Charting the Course for the Future. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2021; 92:111-126. [PMID: 32097108 DOI: 10.1080/02701367.2020.1712315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 01/01/2020] [Indexed: 06/10/2023]
Abstract
SHAPE America has identified four goals as part of the 50 Million Strong by 2029 initiative; one of these goals is healthy behavior. School-based health education is uniquely positioned to be a primary route through which this goal can be achieved. Health education is an academic subject included in a well-rounded education, based on health behavior and learning theory, research-based and taught by licensed and trained health educators with adequate instructional time. Health education helps students acquire functional knowledge about a variety of topics and develop health-related skills resulting in personal competence and self-efficacy. The purpose of this paper is to provide an overview of the existing evidence examining school-based health education and to articulate future directions for research that will solidify school-based health education as a necessary and efficacious strategy for improving the health and wellness of youth.
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Tsiampalis T, Faka A, Kouvari M, Psaltopoulou T, Pitsavos C, Chalkias C, Panagiotakos DB. The impact of socioeconomic and environmental determinants on Mediterranean diet adherence: a municipal-level spatial analysis in Athens metropolitan area, Greece. Int J Food Sci Nutr 2021; 72:259-270. [PMID: 32657627 DOI: 10.1080/09637486.2020.1791057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of this study was to identify the geographical variability, the socio-economic and the environmental determinants of adherence to the Mediterranean diet in a general population sample. Level of adherence to the Mediterranean diet was estimated by the ATTICA epidemiological study for 2,749 participants, while socio-economic, demographic, and environmental characteristics were provided by official national and international databases. Higher adherence to the Mediterranean diet was detected in areas with a greater proportion of females and older people, with lower unemployment rate and immigrant population, as well as, in areas covered at a greater extent by green and with higher frequency of supermarkets and street markets. The present findings provide evidence for policy makers to better understand how layers of influence intersect to shape individuals' eating habits, while they may also contribute in identifying areas of emerging interventions needed.
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Affiliation(s)
- Thomas Tsiampalis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Antigoni Faka
- Department of Geography, School of Environment, Geography and Applied Economics, Harokopio University, Athens, Greece
| | - Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Theodora Psaltopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
| | | | - Christos Chalkias
- Department of Geography, School of Environment, Geography and Applied Economics, Harokopio University, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Faculty of Health, University of Canberra, Canberra, Australia
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Applying the socio-ecological model to understand factors associated with sugar-sweetened beverage behaviours among rural Appalachian adolescents. Public Health Nutr 2021; 24:3242-3252. [PMID: 33427154 PMCID: PMC8272722 DOI: 10.1017/s1368980021000069] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: The objective of the current study was to identify factors across the socio-ecological model (SEM) associated with adolescents’ sugar-sweetened beverage (SSB) intake. Design: This cross-sectional study surveyed adolescents using previously validated instruments. Analyses included descriptive statistics, ANOVA tests and stepwise nonlinear regression models (i.e., two-part models) adjusted to be cluster robust. Guided by SEM, a four-step model was used to identify factors associated with adolescent SSB intake – step 1: demographics (i.e., age, gender), step 2: intrapersonal (i.e., theory of planned behaviour (attitudes, subjective norms, perceived behavioural control, behavioural intentions), health literacy, media literacy, public health literacy), step 3: interpersonal (i.e., caregiver’s SSB behaviours, caregiver’s SSB rules) and step 4: environmental (i.e., home SSB availability) level variables. Setting: Eight middle schools across four rural southwest Virginia counties in Appalachia. Participants: Seven hundred ninety seventh grade students (55·4 % female, 44·6 % males, mean age 12 (sd 0·5) years). Results: Mean SSB intake was 36·3 (sd 42·5) fluid ounces or 433·4 (sd 493·6) calories per day. In the final step of the regression model, seven variables significantly explained adolescent’s SSB consumption: behavioural intention (P < 0·05), affective attitude (P < 0·05), perceived behavioural control (P < 0·05), health literacy (P < 0·001), caregiver behaviours (P < 0·05), caregiver rules (P < 0·05) and home availability (P < 0·001). Conclusions: SSB intake among adolescents in rural Appalachia was nearly three times above national mean. Home environment was the strongest predictor of adolescent SSB intake, followed by caregiver rules, caregiver behaviours and health literacy. Future interventions targeting these factors may provide the greatest opportunity to improve adolescent SSB intake.
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Zarychta K, Banik A, Kulis E, Lobczowska K. Parental and Child Self-Efficacy Explaining Food Intake through Self-Regulation: A Dyadic Prospective Study. Appl Psychol Health Well Being 2020; 13:174-194. [PMID: 32924262 PMCID: PMC7891348 DOI: 10.1111/aphw.12225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND According to social cognitive theory and socio-ecological models, self-efficacy and temptation-related self-regulation (the use of distraction or suppression) are modifiable predictors of health behaviors, such as food intake. Yet, there is limited evidence explaining how these factors are interlinked among parent-child dyads. This study investigated indirect effects of parental and child self-efficacy on food intake, via parental and child self-regulation. METHODS The prospective study (the baseline [T1] and the 10-month follow-up [T2]) enrolled 924 parent-child dyads (1,848 individuals; 54.3% girls, aged 5-11 years, 88.9% mothers). Dyads were interviewed or completed self-report measures. Path analyses with maximum likelihood estimation were conducted. RESULTS Child self-efficacy and distraction (T1) mediated between parental self-efficacy (T1) and higher levels of child fruit and vegetable intake (T2). No significant mediating effects of suppression were found, nor indirect effects of parental self-efficacy (T1) on energy-dense food intake (T2). CONCLUSION Health promotion interventions aiming at changing fruit and vegetable intake among 5-11-year-old children should target enhancing parental and child self-efficacy that may facilitate the use of self-regulation and, in turn, healthy diet.
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Affiliation(s)
- Karolina Zarychta
- SWPS University of Social Sciences and Humanities in Wroclaw, Wroclaw, Poland
| | - Anna Banik
- SWPS University of Social Sciences and Humanities in Wroclaw, Wroclaw, Poland
| | - Ewa Kulis
- SWPS University of Social Sciences and Humanities in Wroclaw, Wroclaw, Poland
| | - Karolina Lobczowska
- SWPS University of Social Sciences and Humanities in Wroclaw, Wroclaw, Poland
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Greaney ML, Wallington SF, Rampa S, Vigliotti VS, Cummings CA. Assessing health professionals' perception of health literacy in Rhode Island community health centers: a qualitative study. BMC Public Health 2020; 20:1289. [PMID: 32843002 PMCID: PMC7448344 DOI: 10.1186/s12889-020-09382-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 08/12/2020] [Indexed: 11/11/2022] Open
Abstract
Background Limited health literacy is linked with poor health behaviors, limited health care access, and poor health outcomes. Improving individual and population health outcomes requires understanding and addressing barriers to promoting health literacy. Methods Using the socio-ecological model as a guiding framework, this qualitative study (Phase 1 of a larger ongoing project) explored the interpersonal and organizational levels that may impact the health literacy levels of patients seeking care at federally qualified community health centers (FQCHCs) in Rhode Island. Focus groups were conducted with FQCHC employees (n = 37) to explore their perceptions of the health literacy skills of their patients, health literacy barriers patients encounter, and possible strategies to increase health literacy. The focus groups were audio-recorded and transcribed, and transcripts were coded using a process of open, axial, and selective coding. Codes were grouped into categories, and the constant comparative approach was used to identify themes. Results Eight unique themes centered on health literacy, sources of health information, organizational culture’s impact, challenges from limited health literacy, and suggestions to ameliorate the impact of limited health literacy. All focus group participants were versed in health literacy and viewed health literacy as impacting patients’ health status. Participants perceived that some patients at their FQCHC have limited health literacy. Participants spoke of themselves and of their FQCHC addressing health literacy through organizational- and provider-level strategies. They also identified additional strategies (e.g., training staff and providers on health literacy, providing patients with information that includes graphics) that could be adopted or expanded upon to address and promote health literacy. Conclusions Study findings suggest that strategies may need to be implemented at the organizational-, provider-, and patient- level to advance health literacy. The intervention phase of this project will explore intervention strategies informed by study results, and could include offering health literacy training to providers and staff to increase their understanding of health literacy to include motivation to make and act on healthy decisions and strategies to address health literacy, including the use of visual aids.
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Affiliation(s)
- Mary L Greaney
- Department of Health Studies, University of Rhode Island, Kingston, RI, 02881, USA.
| | - Sherrie F Wallington
- The George Washington School of Nursing & Milken Institute School of Public Health, Washington, DC, 20006, USA
| | - Sankeerth Rampa
- School of Business, Rhode Island College, Providence, RI, 02908-1991, USA
| | - Vivian S Vigliotti
- Robbins Institute for Health Policy & Leadership, Baylor University, Waco, TX, 76798, USA
| | - Carol A Cummings
- Department of Health & Physical Education, Feinstein School of Education and Human Development, Rhode Island College, Providence, RI, 02908-1991, USA
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Evenhuis IJ, Jacobs SM, Vyth EL, Veldhuis L, de Boer MR, Seidell JC, Renders CM. The Effect of Supportive Implementation of Healthier Canteen Guidelines on Changes in Dutch School Canteens and Student Purchase Behaviour. Nutrients 2020; 12:E2419. [PMID: 32806649 PMCID: PMC7468849 DOI: 10.3390/nu12082419] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 12/12/2022] Open
Abstract
We developed an implementation plan including several components to support implementation of the "Guidelines for Healthier Canteens" in Dutch secondary schools. This study evaluated the effect of this plan on changes in the school canteen and on food and drink purchases of students. In a 6 month quasi-experimental study, ten intervention schools (IS) received support implementing the guidelines, and ten control schools (CS) received only the guidelines. Changes in the health level of the cafeteria and vending machines were assessed and described. Effects on self-reported purchase behaviour of students were analysed using mixed logistic regression analyses. IS scored higher on healthier availability in the cafeteria (77.2%) and accessibility (59.0%) compared to CS (60.1%, resp. 50.0%) after the intervention. IS also showed more changes in healthier offers in the cafeteria (range -3 to 57%, mean change 31.4%) and accessibility (range 0 to 50%, mean change 15%) compared to CS (range -9 to 46%, mean change 9.7%; range -30 to 20% mean change 7% resp.). Multi-level logistic regression analyses on the intervention/control and health level of the canteen in relation to purchase behaviour showed no relevant relations. In conclusion, the offered support resulted in healthier canteens. However, there was no direct effect on students' purchase behaviour during the intervention.
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Affiliation(s)
- Irma J. Evenhuis
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (E.L.V.); (M.R.d.B.); (J.C.S.); (C.M.R.)
| | - Suzanne M. Jacobs
- Netherlands Nutrition Centre, PO Box 85700, 2508 CK The Hague, The Netherlands; (S.M.J.); (L.V.)
| | - Ellis L. Vyth
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (E.L.V.); (M.R.d.B.); (J.C.S.); (C.M.R.)
| | - Lydian Veldhuis
- Netherlands Nutrition Centre, PO Box 85700, 2508 CK The Hague, The Netherlands; (S.M.J.); (L.V.)
| | - Michiel R. de Boer
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (E.L.V.); (M.R.d.B.); (J.C.S.); (C.M.R.)
| | - Jacob C. Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (E.L.V.); (M.R.d.B.); (J.C.S.); (C.M.R.)
| | - Carry M. Renders
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (E.L.V.); (M.R.d.B.); (J.C.S.); (C.M.R.)
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Oliver TL, McKeever A, Shenkman R, Diewald LK. Successes and challenges of using a peer Mentor model for nutrition education within a food pantry: a qualitative study. BMC Nutr 2020; 6:27. [PMID: 32685182 PMCID: PMC7359598 DOI: 10.1186/s40795-020-00352-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 05/18/2020] [Indexed: 11/10/2022] Open
Abstract
Background Delivering nutrition education within an emergency food pantry (EFP) provides an opportunity to reach many food insecure households and underserved populations. However, little is known about using a peer mentor model, “Community Cooks,” as a modality to deliver nutrition education within this setting. This research aimed to identify the successes and challenges of using a peer mentor model within an EFP to better understand the best approaches to deliver nutrition education among community residents. Methods In spring 2018, semi-structured interviews were conducted with 11 peer mentors after they delivered a series of nutrition workshops to community members of the EFP. Interviews were audio-recorded and transcribed verbatim. Qualitative content analysis was used to analyze the data. Results All peer mentors were women over 40 years-of-age, were recruited from the EFP community; most were high school graduates and currently received some form of federal nutrition assistance. All peer mentors reported that the “Community Cooks” nutrition education program offered many benefits. Key successes of the program included serving in the role as a peer mentor was an empowering experience which gave them a sense of community, purpose, and camaraderie; 2) the nutrition education was appropriately tailored towards those living with food insecurity; 3) the recipes required minimal cooking skills and included low-cost easily accessible foods available at the EFP. Key challenges of the program were the lack of community member engagement in the nutrition education workshops. Conclusion Challenges continue to exist when delivering nutrition education within a community EFP setting. While the use of peer mentors to deliver nutrition education messages is promising, more research is needed to quantify the impact of using a peer mentor model in underserved and food insecure communities.
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Affiliation(s)
- Tracy L Oliver
- MacDonald Center for Obesity Prevention and Education, Villanova University M. Louise Fitzpatrick College of Nursing, 800 Lancaster Avenue, Villanova, PA 19085 USA
| | - Amy McKeever
- MacDonald Center for Obesity Prevention and Education, Villanova University M. Louise Fitzpatrick College of Nursing, 800 Lancaster Avenue, Villanova, PA 19085 USA
| | - Rebecca Shenkman
- MacDonald Center for Obesity Prevention and Education, Villanova University M. Louise Fitzpatrick College of Nursing, 800 Lancaster Avenue, Villanova, PA 19085 USA
| | - Lisa K Diewald
- MacDonald Center for Obesity Prevention and Education, Villanova University M. Louise Fitzpatrick College of Nursing, 800 Lancaster Avenue, Villanova, PA 19085 USA
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Phelan A, Kirwan M. Contextualising missed care in two healthcare inquiries using a socio-ecological systems approach. J Clin Nurs 2020; 29:3527-3540. [PMID: 32564410 DOI: 10.1111/jocn.15391] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 05/25/2020] [Accepted: 06/05/2020] [Indexed: 12/13/2022]
Abstract
AIMS AND OBJECTIVES To examine missed care within two patient safety public inquiries using a socio-ecological model. BACKGROUND Missed care is a care which has been omitted or rendered incomplete. Possible outcomes of missed care have been identified including poor patient outcomes such as higher mortality rates, reduced care quality and lower patient satisfaction, job dissatisfaction, staff burnout and higher attrition rates. DESIGN A qualitative design, specifically document analysis, was used to review two serious case reviews. METHODS Between August-December 2018, two public patient safety inquiries were examined using a document analysis method. Both inquiries are based in acute hospital care settings of nursing (UK) and midwifery (Ireland). The Standards for Reporting Qualitative Research checklist provided a framework to report the study methods, context, findings, analysis and interpretation. RESULTS Findings highlighted instances of missed care related to practice which contributed to poor patient outcomes. Missed care was located within contingency factors, such as unintended negative patient health and safety outcomes in multiple system levels which resulted in care deficits. CONCLUSIONS A socio-ecological model enabled consideration of how multi-system deficits combine to impact nursing and midwifery care delivery. To tackle current and future practice challenges, broader contextual issues that influence front-line cases should be identified and addressed before they create conditions which result in substandard care. RELEVANCE TO CLINICAL PRACTICE This paper adds to the scholarship on missed care by incorporating a greater contextual lens. Findings suggest that some factors contributing to missed care events may be systemic in origin. Practice, policy, research and education should foster nurses' and midwives' review of the totality of influencing factors impacting missed care and care deficits. Consequently, early warning signs and proactive responses at a system level should be inherent in all settings that nurses' and midwives' practice.
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Affiliation(s)
- Amanda Phelan
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Marcia Kirwan
- School of Nursing, Psychotherapy & Community Health, Dublin City University, Dublin, Ireland
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deMolitor L, Dunbar M, Vallis M. Diabetes Distress in Adults Living With Type 1 and Type 2 Diabetes: A Public Health Issue. Can J Diabetes 2020; 44:549-554. [PMID: 32690277 DOI: 10.1016/j.jcjd.2020.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Lisa deMolitor
- Nova Scotia Health Authority, Kentville, Nova Scotia, Canada.
| | - Margaret Dunbar
- Diabetes Care Program of Nova Scotia, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Michael Vallis
- Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Aktary ML, Caron-Roy S, Sajobi T, O'Hara H, Leblanc P, Dunn S, McCormack GR, Timmins D, Ball K, Downs S, Minaker LM, Nykiforuk CI, Godley J, Milaney K, Lashewicz B, Fournier B, Elliott C, Raine KD, Prowse RJ, Olstad DL. Impact of a farmers' market nutrition coupon programme on diet quality and psychosocial well-being among low-income adults: protocol for a randomised controlled trial and a longitudinal qualitative investigation. BMJ Open 2020; 10:e035143. [PMID: 32371514 PMCID: PMC7228519 DOI: 10.1136/bmjopen-2019-035143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 02/19/2020] [Accepted: 04/02/2020] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Low-income populations have poorer diet quality and lower psychosocial well-being than their higher-income counterparts. These inequities increase the burden of chronic disease in low-income populations. Farmers' market subsidies may improve diet quality and psychosocial well-being among low-income populations. In Canada, the British Columbia (BC) Farmers' Market Nutrition Coupon Programme (FMNCP) aims to improve dietary patterns and health among low-income participants by providing coupons to purchase healthy foods from farmers' markets. This study will assess the impact of the BC FMNCP on the diet quality and psychosocial well-being of low-income adults and explore mechanisms of programme impacts. METHODS AND ANALYSIS In a parallel group randomised controlled trial, low-income adults will be randomised to an FMNCP intervention (n=132) or a no-intervention control group (n=132). The FMNCP group will receive 16 coupon sheets valued at CAD$21/sheet over 10-15 weeks to purchase fruits, vegetables, dairy, meat/poultry/fish, eggs, nuts and herbs at farmers' markets and will be invited to participate in nutrition skill-building activities. Overall diet quality (primary outcome), diet quality subscores, mental well-being, sense of community, food insecurity and malnutrition risk (secondary outcomes) will be assessed at baseline, immediately post-intervention and 16 weeks post-intervention. Dietary intake will be assessed using the Automated Self-Administered 24-hour Dietary Recall. Diet quality will be calculated using the Healthy Eating Index-2015. Repeated measures mixed-effect regression will assess differences in outcomes between groups from baseline to 16 weeks post-intervention. Furthermore, 25-30 participants will partake in semi-structured interviews during and 5 weeks after programme completion to explore participants' experiences with and perceived outcomes from the programme. ETHICS AND DISSEMINATION Ethical approval was obtained from the University of Calgary Conjoint Health Research Ethics Board, Rutgers University Ethics and Compliance, and University of Waterloo Office of Research Ethics. Findings will be disseminated through policy briefs, conference presentations and peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT03952338.
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Affiliation(s)
- Michelle L Aktary
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | | | - Tolulope Sajobi
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Heather O'Hara
- British Columbia Association of Farmers' Markets, Vancouver, British Columbia, Canada
| | - Peter Leblanc
- British Columbia Association of Farmers' Markets, Vancouver, British Columbia, Canada
| | - Sharlette Dunn
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Gavin R McCormack
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
- School of Architecture, Planning and Landscape, University of Calgary, Calgary, Alberta, Canada
| | - Dianne Timmins
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Kylie Ball
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Victoria, Australia
| | - Shauna Downs
- School of Public Health, Rutgers University, Newark, New Jersey, USA
| | - Leia M Minaker
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Jenny Godley
- Department of Sociology, University of Calgary, Calgary, Alberta, Canada
| | - Katrina Milaney
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Bonnie Lashewicz
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Bonnie Fournier
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Charlene Elliott
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Communication Media and Film, University of Calgary, Calgary, Alberta, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Rachel Jl Prowse
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Dana Lee Olstad
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
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Eddie RS, Montoya C, Averill J. School Nutrition Policies and Practices on an American Indian Reservation: Research and Policy Considerations. Policy Polit Nurs Pract 2020; 21:71-81. [PMID: 32393113 DOI: 10.1177/1527154420923744] [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: 06/11/2023]
Abstract
Navajo (Diné) and other American Indian children are more affected by overweight and obesity than their U.S. counterparts. In this descriptive study, the authors combined a socioecological and Navajo cultural framework to analyze the various factors that influence food choices available to children in schools. The Healthy Hunger-Free Kids Act of 2010 updated nutrition standards for school meals and all other foods and beverages sold in schools. Some studies have shown that improved nutrition standards were not favorably received by students and school food programs. To better understand these broader trends in a Navajo context, the researcher administered in-person surveys to 6 principals and 14 food service workers from a sample of 6 schools and performed on-site observations of two schools. Data were analyzed using a combination of descriptive statistics, matrix analysis, and thematic analysis techniques. Results showed that schools were offering more healthy food options in school lunches and that some schools were still serving unhealthy foods, such as pizza, tater tots, and French fries. Classroom and fundraising events provided other sources for low-nutrient foods and beverages. Participants had mixed responses about the updated nutrition standards, and food waste of healthy foods was a major concern. This study proposes opportunities for nurses to engage in research and advance stronger policies that increase healthy food options and limit access to less healthy foods.
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Downs SM, Ahmed S, Fanzo J, Herforth A. Food Environment Typology: Advancing an Expanded Definition, Framework, and Methodological Approach for Improved Characterization of Wild, Cultivated, and Built Food Environments toward Sustainable Diets. Foods 2020; 9:E532. [PMID: 32331424 PMCID: PMC7230632 DOI: 10.3390/foods9040532] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/01/2020] [Accepted: 04/10/2020] [Indexed: 02/07/2023] Open
Abstract
The food environment is a critical place in the food system to implement interventions to support sustainable diets and address the global syndemic of obesity, undernutrition, and climate change, because it contains the total scope of options within which consumers make decisions about which foods to acquire and consume. In this paper, we build on existing definitions of the food environment, and provide an expanded definition that includes the parameter of sustainability properties of foods and beverages, in order to integrate linkages between food environments and sustainable diets. We further provide a graphical representation of the food environment using a socio-ecological framework. Next, we provide a typology with descriptions of the different types of food environments that consumers have access to in low-, middle-, and high-income countries including wild, cultivated, and built food environments. We characterize the availability, affordability, convenience, promotion and quality (previously termed desirability), and sustainability properties of food and beverages for each food environment type. Lastly, we identify a methodological approach with potential objective and subjective tools and metrics for measuring the different properties of various types of food environments. The definition, framework, typology, and methodological toolbox presented here are intended to facilitate scholars and practitioners to identify entry points in the food environment for implementing and evaluating interventions that support sustainable diets for enhancing human and planetary health.
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Affiliation(s)
- Shauna M. Downs
- Department of Urban-Global Public Health, School of Public Health, Rutgers University, Newark, NJ 07102, USA;
| | - Selena Ahmed
- Sustainable Food Systems Program, Department of Health and Human Development, Montana State University, Bozeman, MT 59717, USA
| | - Jessica Fanzo
- Berman Institute of Bioethics, Nitze School of Advanced International Studies and Bloomberg School of Public Health, Johns Hopkins University, Washington, DC 21205, USA;
| | - Anna Herforth
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard, University Boston, MA 02125, USA;
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Kwok ST, Capra S, Leveritt M. Enhancing healthy eating patterns among Hong Kong young adults. Health Promot Int 2020; 35:386-396. [PMID: 30927410 DOI: 10.1093/heapro/daz018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Every year, the majority of Hong Kong young adults who graduate from secondary school progress onto tertiary education. Poor eating patterns among young adults could lead to long-term health implications associated with overweight and obesity. Using the socio-ecological model as a theoretical framework, this paper reviews the current food-related policies in Hong Kong and proposes a comprehensive policy approach relevant to a variety of organizational contexts that has the potential to support positive eating patterns among young adults by enhancing the local food environment. Hong Kong has an unusual food supply in that more than 95% of food is imported, making it vulnerable to food insecurity. Education interventions commonly conducted in Hong Kong are unlikely to be helpful because young adults acquire nutrition-related knowledge when they attend secondary school. There is a need to change the food environment in Hong Kong so that young adults can easily translate their nutrition knowledge into making healthy food choices. Policy approaches might be among the most effective strategies for bringing positive changes in eating patterns because they have the potential to directly influence the food environment and context where an individual lives. A comprehensive suite of approaches that fill the policy gaps, remove barriers of healthy food consumption and create more healthy food choices is required to improve diet and health.
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Affiliation(s)
- Sin Tung Kwok
- School of Human Movement and Nutrition Sciences Building (26B), University of Queensland, Brisbane, QLD 4067, Australia
| | - Sandra Capra
- School of Human Movement and Nutrition Sciences Building (26B), University of Queensland, Brisbane, QLD 4067, Australia
| | - Michael Leveritt
- School of Human Movement and Nutrition Sciences Building (26B), University of Queensland, Brisbane, QLD 4067, Australia
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Tamrakar D, Shrestha A, Rai A, Karmacharya BM, Malik V, Mattei J, Spiegelman D. Drivers of healthy eating in a workplace in Nepal: a qualitative study. BMJ Open 2020; 10:e031404. [PMID: 32102804 PMCID: PMC7045197 DOI: 10.1136/bmjopen-2019-031404] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To explore the perceptions, enablers and barriers to employees' healthy eating in a hospital site. DESIGN A qualitative study including focus group discussion and in-depth interview, data were analysed using thematic analysis method. SETTING The study was carried out among employees of Dhulikhel Hospital-Kathmandu University Hospital, located about 30 km east of Nepal's capital Kathmandu. PARTICIPANTS Focus group discussions were conducted among the 33 participants, who were divided into four groups: (a) support staff (drivers, cook, laundry, gardeners and ward boys), (b) hospital administrators and managers, (c) health personnel (doctors, nurses and assistants) who work 8-12 hours shifts and (d) health personnel who work during office hours. Nine in-depth interviews were conducted among six canteen operators and three managers. RESULTS The major factors for promoting healthy eating were identified as the availability of affordable healthy food options in the cafeterias, a commitment to such promotion by the cafeteria manager, operators, staff and hospital administration and the level of education of the employees. The most commonly reported barriers for healthy eating were the unavailability of healthy options, including the lack of food supply from local market, the higher cost of healthy foods, individual food preferences and limited human resources in the cafeteria. CONCLUSION The availability of affordable healthy foods, supply of healthy foods from the market, commitment from cafeteria managers, hospital administrators and health awareness among cafeteria operators may promote healthy eating among employees in a Nepali hospital setting.
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Affiliation(s)
- Dipesh Tamrakar
- Department of Community Medicine, Kathmandu University School of Medical Sciences, Kathmandu, Nepal
| | - Archana Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Kathmandu, Nepal
- Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Anjana Rai
- Family Health International 360, Kathmandu, Nepal
| | - Biraj Man Karmacharya
- Department of Public Health, Kathmandu University School of Medical Sciences, Kathmandu, Nepal
| | - Vasanti Malik
- Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Donna Spiegelman
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut, USA
- Department of Biostatistics, Center on Methods for Implementation and Prevention Science, New Haven, Connecticut, USA
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Park J, Ten Hoor GA, Cho J, Kim S. Service Providers' Perspectives on Barriers of Healthy Eating to Prevent Obesity among Low-income Children Attending Community Childcare Centers in South Korea: A Qualitative Study. Ecol Food Nutr 2020; 59:311-328. [PMID: 32024393 DOI: 10.1080/03670244.2020.1722948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study aimed to identify individual and socio-ecological barriers in managing healthy eating among low-income children from the perspective of community childcare (CCC) center workers (n = 18) through focus group interviews. They perceived the increase in obesity among low-income children. The interviews revealed that the child's eating habits are affected by not only individual determinants including self-regulation and risk awareness but also environmental factors such as family, CCC centers, policy and social structure. To enhance children's health and behavior, it is necessary to consider the interactions among systems at a variety of levels, for example, local community and health care policies.
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Affiliation(s)
- Jiyoung Park
- Department of Nursing, Institute of Health Science, College of Medicine, Inje University , Busan, South Korea
| | - G A Ten Hoor
- Deprtment of Work & Social Psychology, Maastricht University , Maastricht, The Netherlands
| | - Jeonghyun Cho
- Department of Nursing, Institute of Health Science, College of Medicine, Inje University , Busan, South Korea
| | - Soobin Kim
- School of Social Work, University of Pittsburgh , Pittsburgh, Pennsylvania, USA
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Prevention of Stress Urinary Incontinence in Women. CURRENT BLADDER DYSFUNCTION REPORTS 2020. [DOI: 10.1007/s11884-019-00570-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Irwin BR, Hoxha K, Grépin KA. Conceptualising the effect of access to electricity on health in low- and middle-income countries: A systematic review. Glob Public Health 2019; 15:452-473. [PMID: 31770072 DOI: 10.1080/17441692.2019.1695873] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Access to electricity is an important issue in low- and middle-income countries (LMICs) however its health implications are poorly understood. This paper systematically reviews the health effects of access to electricity and develops a conceptual model to summarise the pathways through which these effects may occur. The databases CINAHL, Embase, and MEDLINE were searched for studies examining the effects of access to electricity on health in LMICs. Thirty-three studies met the inclusion criteria: 23 focusing on electrification and 10 focusing on electricity reliability. Using a modified socio-ecological model, 4 main levels of influence were identified: (1) individual, (2) household, (3) community, and (4) institutional. Electrification was generally associated with positive health outcomes, such as reduced mortality, lower rates of disease, and improved quality of and access to care, while poor electricity reliability was associated with negative health outcomes, including increased morbidity and mortality, lower quality of care, and reduced utilisation of health services. Although the overall quality of the evidence was weak, given the many potential pathways through which electricity may affect health, efforts should be made not only to increase the number of connected households globally, but to improve the reliability of the electricity supply as well.
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Affiliation(s)
- Bridget R Irwin
- Health Sciences Department, Wilfrid Laurier University, Waterloo, Canada
| | - Klesta Hoxha
- Health Sciences Department, Wilfrid Laurier University, Waterloo, Canada.,The School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Karen A Grépin
- Health Sciences Department, Wilfrid Laurier University, Waterloo, Canada.,School of Public Health, University of Hong Kong, Pokfulam, Hong Kong SAR
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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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O’Rourke TW. Reflections on Directions in Health Education: Implications for Policy and Practice. AAHE Scholar Address Revisited - Fast Forward 30 Years. AMERICAN JOURNAL OF HEALTH EDUCATION 2019. [DOI: 10.1080/19325037.2019.1662349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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49
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Adom T, Kengne AP, De Villiers A, Puoane T. Association between school-level attributes and weight status of Ghanaian primary school children. BMC Public Health 2019; 19:577. [PMID: 31092232 PMCID: PMC6521351 DOI: 10.1186/s12889-019-6937-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 05/02/2019] [Indexed: 11/25/2022] Open
Abstract
Background Little is known about the impact of the school environmental context on the emerging trend of childhood obesity in Africa. We examined the association of the schools’ contextual factors with body mass index (BMI), abdominal obesity and overweight (including obesity) in urban Ghana. Method Using cross-sectional data from 543 school children aged 8–11 years attending 14 primary schools, we applied multilevel logistic regressions and linear regression models to investigate the association of child- and school level attributes with overweight, abdominal obesity, and BMI. Results We observed significant variance of the random effects of schools in BMI (2.65, p < 0.05), abdominal obesity (0.85, p < 0.05), and overweight (1.41, p < 0.05), with school contextual levels accounting for 19.7, 20.6, and 30.0% of the total variability observed in BMI, abdominal obesity and overweight respectively. Attending high socioeconomic (SES) level school, private school and school with increased after-school recreational facilities were associated with higher BMI. Children were more likely to be overweight if they attended a high SES level school, had access to healthful foods at school, and after-school recreational facilities. With regards to abdominal obesity, attending a school with increased physical activity facilities decreased the odds of abdominal obesity; however the odds increased if they attended a school with access to after-school recreational facilities. Conclusion A number of school-level factors were associated with BMI, overweight and abdominal obesity of children in the present study. Our results provide support for improved school environment to reduce overweight.
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Affiliation(s)
- Theodosia Adom
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa. .,Nutrition Research Centre, Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Accra, Ghana.
| | - André Pascal Kengne
- Non-communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Anniza De Villiers
- Division of Research Capacity Development, South African Medical Research Council, Cape Town, South Africa
| | - Thandi Puoane
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
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Correlates, Facilitators and Barriers of Healthy Eating Among Primary Care Patients with Prediabetes in Singapore-A Mixed Methods Approach. Nutrients 2019; 11:nu11051014. [PMID: 31064063 PMCID: PMC6566398 DOI: 10.3390/nu11051014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 04/22/2019] [Accepted: 04/25/2019] [Indexed: 01/05/2023] Open
Abstract
Healthy diet remains the primary means to prevent chronic diseases among those with prediabetes. We conducted a mixed methods study, consisting of a cross-sectional survey and in-depth interviews to assess factors associated with fulfilling the healthy plate recommendation, and to explore reasons for the behaviour among primary care patients with prediabetes in Singapore. The prevalence of meeting the recommendation was 57.3%. This was positively associated with being married and negatively associated with being Malay, frequency of eating out weekly and frequency of deep-fried food consumption weekly. The recurrent themes for not meeting the recommendation included family influence, perception of healthy food being not tasty, lack of skills to prepare or choose healthy food, difficulty in finding healthier options when eating out, and healthy food being costly. The recurrent themes for meeting the recommendation included family influence, self-discipline, fear of disease complications, education by healthcare professionals, mass media influence and health promotion campaigns. Much more remains to be done to promote healthy eating among these patients. There were different levels of facilitators and barriers to healthy eating. Apart from the individual and interpersonal levels, practitioners and policy makers need to work together to address the organisational, community and policy barriers to healthy eating.
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