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Estradé M, Burgos-Gil R, Witting L, Rivera I, Gittelsohn J, Colón-Ramos U. Shared Perceptions on Upstream Factors that Influence Water and Sugar-Sweetened Beverage Consumption Among Hispanic Families in the Greater Washington, DC, Metro Area: Qualitative Results From Focus Group Discussions. J Acad Nutr Diet 2024; 124:833-840. [PMID: 38224835 DOI: 10.1016/j.jand.2024.01.003] [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: 08/23/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/17/2024]
Abstract
BACKGROUND Hispanics in the United States are among those with highest consumption of sugar-sweetened beverages (SSBs) and lowest consumption of water. These dietary disparities are rooted in systemic influences that must be identified and addressed. OBJECTIVE The study aimed to describe how Hispanic parents currently living in the greater Washington, DC, metro area and born outside of the United States, perceived upstream factors that influenced their current beverage choice. DESIGN Six qualitative focus groups were conducted in Spanish in 2021. PARTICIPANTS/SETTING Hispanic parents (n = 31) of children enrolled in Early Head Start in the greater Washington, DC, metro area were recruited (all women, born outside the United States, and spoke Spanish as a first language). STATISTICAL ANALYSIS Verbatim transcripts were analyzed deductively using the Community Energy Balance Framework. RESULTS The five key findings were: Growing up (in their countries of origin in Central America and Mexico) participants were used to drinking water, often gathered it from the source, and liked its flavor. Relatives passed down their knowledge about potabilization of water, the health benefits of drinking water, and health consequences of drinking SSBs. Growing up, prepackaged SSBs were not as accessible compared with where they now live in the United States. Participants perceived that sociocultural hospitality norms dictated that guests should be served SSBs and not water. Participants noted that messages regarding juice and water across US public health programs and policies were not aligned. CONCLUSIONS These findings suggest there are opportunities for public health messaging and procurement of safe, palatable drinking water in lieu of SSBs and juice.
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Affiliation(s)
- Michelle Estradé
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Lillian Witting
- Milken Institute, School of Public Health, George Washington University, Washington, District of Columbia
| | | | - Joel Gittelsohn
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Uriyoán Colón-Ramos
- Milken Institute, School of Public Health, George Washington University, Washington, District of Columbia.
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Johnson SL, Moding KJ, Flesher A, Boenig R, Campain J. I'll Never Give Up: A Qualitative Study of Caregivers' Perceptions and Decisional Processes When Feeding Infants and Toddlers Novel and Disliked Foods. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024:S1499-4046(24)00008-3. [PMID: 38493374 DOI: 10.1016/j.jneb.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE To better understand caregivers' decisional processes related to offering novel and disliked foods to their infants and toddlers. DESIGN As part of a parent study on young children's food acceptance that took place in Denver, CO, this secondary analysis used a basic qualitative approach to explore caregivers' decisional processes related to repeated exposure and children's food rejection. PARTICIPANTS English-speaking caregivers of infants and toddlers (aged 6-24 months; n = 106) were recruited via flyers and social media and interviewed (from July, 2017 to January, 2018) during a laboratory visit focused on introducing a novel food. PHENOMENON OF INTEREST Factors influencing caregiver decisions to (dis)continue offering novel or disliked foods. ANALYSIS Using a combined deductive and inductive coding approach, trained researchers coded transcripts and codes, which were reviewed and discussed by all investigators to identify themes. RESULTS Three major themes (and 2 subthemes) were generated regarding caregivers' decisions about re-offering rejected foods: 1) Caregivers understand that multiple experiences with new foods are needed because children's reactions can be unpredictable and depend upon time, developmental stage, and child traits; 2) Caregivers vary in their persistence and decisions to keep offering foods depending on responsiveness to child cues (sub-theme) and adult-centered beliefs, needs, and decisions (sub-theme); 3) Child food acceptance will change with time, circumstances, and development if you keep trying. CONCLUSIONS AND IMPLICATIONS Although caregivers are aware of repeated exposure, additional implementation research focused on translating theory into effective home practices could assist caregivers to persist in offering novel or disliked foods.
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Affiliation(s)
- Susan L Johnson
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Kameron J Moding
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN
| | - Abigail Flesher
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Rebecca Boenig
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Joseph Campain
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO
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Pemjean I, Mediano F, Ferrer P, Garmendia ML, Corvalán C. Food access, domestic environments, and dietary quality of low-middle income Chilean children during the COVID-19 pandemic. Front Public Health 2023; 11:1164357. [PMID: 37408742 PMCID: PMC10319070 DOI: 10.3389/fpubh.2023.1164357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 05/25/2023] [Indexed: 07/07/2023] Open
Abstract
Introduction Food access is associated with dietary quality; however, people living in similar physical environments can have different food access profiles. Domestic environments may also influence how food access relates to dietary quality. We studied food access profiles of 999 low-middle income Chilean families with children during the COVID-19 lockdown and how these profiles relate to dietary quality; secondarily, we also explore the role of the domestic environment in this relationship. Materials and methods Participants of two longitudinal studies conducted in the southeast of Santiago, Chile, answered online surveys at the beginning and end of the COVID-19 pandemic lockdown. Food access profiles were developed by a latent class analysis considering food outlets and government food transfers. Children's dietary quality was estimated by self-reported compliance with the Chilean Dietary Guidelines of Americans (DGA) and daily ultra-processed food (UPF) consumption. Logistic and linear regressions were used to assess the association between food access profiles and dietary quality. Domestic environment data (i.e., the sex of the person who buys food and cooks, meal frequency, cooking skills, etc.) were incorporated in the models to assess their influence on the relationship between food access and dietary quality. Results We have categorized three food access profiles: Classic (70.2%), Multiple (17.9%), and Supermarket-Restaurant (11.9%). Households led by women are concentrated in the Multiple profile, while families from higher income or education levels are focused on the Supermarket-Restaurant profile. On average, children presented poor dietary quality, with a high daily UPF consumption (median = 4.4; IQR: 3) and low compliance with national DGA recommendations (median = 1.2; IQR: 2). Except for the fish recommendation (OR = 1.77, 95% CI:1.00-3.12; p: 0.048 for the Supermarket-Restaurant profile), the food access profiles were poorly associated with children's dietary quality. However, further analyses showed that domestic environment variables related to routine and time use influenced the association between food access profiles and dietary quality. Conclusion In a sample of low-middle income Chilean families, we identified three different food access profiles that presented a socioeconomic gradient; however, these profiles did not significantly explain children's dietary quality. Studies diving deeper into household dynamics might give us some clues on intra-household behaviors and roles that could be influencing how food access relates to dietary quality.
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Affiliation(s)
- Isabel Pemjean
- Doctoral Program in Public Health, School of Public Health, University of Chile, Santiago, Chile
| | - Fernanda Mediano
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, United States
| | - Pedro Ferrer
- Center for Research in Food Environments and Prevention of Nutrition-Related Diseases (CIAPEC), Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - María Luisa Garmendia
- Center for Research in Food Environments and Prevention of Nutrition-Related Diseases (CIAPEC), Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Camila Corvalán
- Center for Research in Food Environments and Prevention of Nutrition-Related Diseases (CIAPEC), Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
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Colburn AT, Buman MP, Wutich A, Vega-López S, Ohri-Vachaspati P, Kavouras SA. Determinants of tap water mistrust among Phoenix, Arizona Latinx adults. JOURNAL OF WATER AND HEALTH 2023; 21:702-718. [PMID: 37387337 PMCID: wh_2023_267 DOI: 10.2166/wh.2023.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
The purpose of this investigation was to characterize factors that predict tap water mistrust among Phoenix, Arizona Latinx adults. Participants (n = 492, 28 ± 7 years, 37.4% female) completed water security experience-based scales and an Adapted Survey of Water Issues in Arizona. Binary logistic regression determined odds ratios (OR) with 95% confidence intervals (95% CI) for the odds of perceiving tap water to be unsafe. Of all participants, 51.2% perceived their tap water to be unsafe. The odds of mistrusting tap water were significantly greater for each additional favorable perception of bottled compared to tap water (e.g., tastes/smells better; OR = 1.94, 95% CI = 1.50, 2.50), negative home tap water experience (e.g., hard water mineral deposits and rusty color; OR = 1.32, 95% CI = 1.12, 1.56), use of alternatives to home tap water (OR = 1.25, 95% CI = 1.04, 1.51), and with decreased water quality and acceptability (OR = 1.21, 95% CI = 1.01, 1.45; P < 0.05). The odds of mistrusting tap water were significantly lower for those whose primary source of drinking water is the public supply (municipal) (OR = 0.07, 95% CI = 0.01, 0.63) and with decreased water access (OR = 0.56, 95% CI = 0.48, 0.66; P < 0.05). Latinx mistrust of tap water appears to be associated with organoleptic perceptions and reliance on alternatives to the home drinking water system.
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Affiliation(s)
- Abigail T Colburn
- John B. Pierce Laboratory, 290 Congress Avenue, New Haven, CT 06519, USA; Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA E-mail:
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, 550 North 3rd Street, Phoenix, AZ 85004, USA
| | - Amber Wutich
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ 85281, USA
| | - Sonia Vega-López
- College of Health Solutions, Arizona State University, 550 North 3rd Street, Phoenix, AZ 85004, USA; Southwest Interdisciplinary Research Center, Arizona State University, 400 E Van Buren St, Suite 800, Phoenix, AZ 85004, USA
| | - Punam Ohri-Vachaspati
- College of Health Solutions, Arizona State University, 550 North 3rd Street, Phoenix, AZ 85004, USA
| | - Stavros A Kavouras
- College of Health Solutions, Arizona State University, 550 North 3rd Street, Phoenix, AZ 85004, USA; Hydration Science Lab, Arizona State University, 850 North 5th Street, Phoenix, AZ 85004, USA
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Houghtaling B, Greene M, Parab KV, Singleton CR. Improving Fruit and Vegetable Accessibility, Purchasing, and Consumption to Advance Nutrition Security and Health Equity in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11220. [PMID: 36141494 PMCID: PMC9517087 DOI: 10.3390/ijerph191811220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
In recent years, national and local efforts to improve diet and health in the United States have stressed the importance of nutrition security, which emphasizes consistent access to foods and beverages that promote health and prevent disease among all individuals. At the core of this endeavor is fruit and vegetable (FV) consumption, a dietary practice that is integral to attaining and sustaining a healthy diet. Unfortunately, significant inequities in FV accessibility, purchasing, and consumption exist, particularly among populations that are socially and economically disadvantaged. To achieve nutrition and health equity in the United States, the field must center the goal of nutrition security and initiatives that aim to increase FV consumption, specifically, in future work. The International Journal of Environmental Research and Public Health (IJERPH) Special Issue titled "Nutrition and Health Equity: Revisiting the Importance of Fruit and Vegetable Availability, Purchasing, and Consumption" features several scholarly publications from experts conducting timely research on these topics. In this commentary, we (1) summarize the U.S.-based literature on inequities in FV accessibility, purchasing, and consumption, (2) describe how the contributions to this IJERPH special issue can advance nutrition security and health equity, and (3) outline future research questions from our perspective.
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Affiliation(s)
- Bailey Houghtaling
- Gretchen Swanson Center for Nutrition, Omaha, NE 68514, USA
- School of Nutrition and Food Sciences, Louisiana State University (LSU) & LSU Agricultural Center, Baton Rouge, LA 70803, USA
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA
| | - Matthew Greene
- School of Nutrition and Food Sciences, Louisiana State University (LSU) & LSU Agricultural Center, Baton Rouge, LA 70803, USA
| | - Kaustubh V. Parab
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| | - Chelsea R. Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
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How providing a low-cost water filter pitcher led Latino parents to reduce sugar-sweetened beverages and increase their water intake: explanatory qualitative results from the Water Up!@Home intervention trial. Public Health Nutr 2022; 25:3195-3203. [PMID: 35983682 DOI: 10.1017/s1368980022001744] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study sought to explain results of the Water Up!@Home randomized controlled trial where low-income parents were randomized to receive an educational intervention +a low-cost water filter pitcher or only the filter. Parents in both groups had reported statistically significant reductions in SSB and increases in water intake post-intervention. DESIGN Qualitative explanatory in-depth interviews analyzed thematically and deductively. SETTING Washington DC metropolitan area, US. PARTICIPANTS Low-income Latino parents of infants/toddlers who had participated in the Water UP! @Home randomized controlled trial. RESULTS The filter stimulated water consumption in both groups by: 1) increasing parents' perception of water safety, 2) acting as a cue to action to drink water, 3) improving the flavor of water (which was linked to perceptions of safety), and 4) increasing the perception that this option was more economical than purchasing bottled water. Safe and palatable drinking water was more accessible and freely available in their homes; participants felt they did not need to ration their water consumption as before. Only intervention participants were able to describe a reduction in SSB intake and described strategies, skills, and knowledge gained to reduce SSB intake. Among the comparison group, there was no thematic consensus about changes in SSB or any strategies or skills to reduce SSB intake. CONCLUSIONS A low-cost water filter facilitated water consumption, which actively (or passively for comparison group) displaced SSB consumption. The findings have implications for understanding and addressing the role of water security on SSB consumption.
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Othman SI, Fertig A, Trofholz A, Berge JM. How time in the US and race/ethnicity shape food parenting practices and child diet quality. Appetite 2021; 171:105870. [PMID: 34973995 DOI: 10.1016/j.appet.2021.105870] [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] [Received: 05/16/2021] [Revised: 12/07/2021] [Accepted: 12/12/2021] [Indexed: 11/17/2022]
Abstract
Childhood obesity prevalence is high among children from immigrant/refugee households who live in high-income countries. Poor child dietary intake is a critical risk factor for elevated obesity prevalence and food parenting practices have been found to be associated with child dietary intake and eating behaviors. The main aim of this study was to examine the associations between migrants'/refugees' food parenting practices, the length of residence time in the US, race/ethnicity, and child diet quality. The current study included 577 families from three racial/ethnic groups that include mostly foreign-born parents (Latino, Hmong, and Somali/Ethiopian), and a comparison group of 239 non-Hispanic White families. Results showed that for Latino and Hmong parents, some food parenting practices varied by how long they had lived in the US. For example, more recently moved parents engaged in more non-directive (e.g., avoid buying sweets) practices compared with US-born parents. In contrast, Somali/Ethiopian parents engaged in different food parenting practices than White parents, regardless of time in the US. Results also showed that diet quality among Hmong children was lower if their parents were US-born compared to foreign-born. Future researchers may want to consider studying why some food parenting practices change when parents move to the US and explore whether there is a combination of food parenting practices that are most useful in promoting a healthful child's diet and weight among immigrant and refugee families.
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Affiliation(s)
- Sally I Othman
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St SE, Suite 425, Minneapolis, MN, 55414, USA.
| | - Angela Fertig
- University of Minnesota, Humphrey School of Public Affairs, USA
| | - Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St SE, Suite 425, Minneapolis, MN, 55414, USA
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St SE, Suite 425, Minneapolis, MN, 55414, USA
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Residents' Insights on Their Local Food Environment and Dietary Behaviors: A Cross-City Comparison Using Photovoice in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910134. [PMID: 34639435 PMCID: PMC8507815 DOI: 10.3390/ijerph181910134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/15/2021] [Accepted: 09/23/2021] [Indexed: 12/26/2022]
Abstract
Perceptions of local food environments and the ability of citizens to engage in participatory research may vary, even if participants share similar cultural and socioeconomic contexts. In this study, we aimed to describe participants’ narratives about their local food environment in two cities in Spain. We used the participatory methodology of Photovoice to engage participants in Madrid (n = 24) and Bilbao (n = 17) who took and discussed photographs about their local food environment (Madrid; n = 163 and Bilbao; n = 70). Common themes emerged across both cities (food insecurity, poverty, use of public spaces for eating and social gathering, cultural diversity and overconsumption of unhealthy foods); however, in Bilbao citizens perceived that there was sufficient availability of healthy foods despite that living in impoverished communities. Photovoice was a useful tool to engage participating citizens to improve their local food environments in both cities. This new approach allowed for a photovoice cross-city comparison that could be useful to fully understand the complexity and diversity of residents’ perceptions regardless of their place of residence.
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Food environment interactions after migration: a scoping review on low- and middle-income country immigrants in high-income countries. Public Health Nutr 2021; 25:136-158. [PMID: 34509180 PMCID: PMC8825972 DOI: 10.1017/s1368980021003943] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Objective: To map and characterise the interactions between the food environment and immigrant populations from low- and middle-income countries living in high-income countries. Design: A scoping review was carried out following the framework outlined by Arksey and O’Malley, as well as Levac et al. Peer-reviewed studies in English published between 2007 and 2021 were included. Two reviewers screened and selected the papers according to predefined inclusion criteria and reporting of results follows the PRISMA-ScR guidelines. A ‘Best fit’ framework synthesis was carried out using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. Setting: High-income countries. Participants: Immigrants from low- and middle-income countries. Results: A total of sixty-eight articles were included, primarily based in the USA, as well as Canada, Australia and Europe, with immigrants originating from five regions of the globe. The analysis identified three overarching themes that interconnected different aspects of the food environment in addition to the four themes of the ANGELO framework. They demonstrate that in valuing fresh, healthy and traditional foods, immigrants were compelled to surpass barriers in order to acquire these, though children’s demands, low incomes, time scarcity and mobility influenced the healthiness of the foods acquired. Conclusion: This study brought together evidence on interactions between immigrant populations and the food environment. Immigrants attempted to access fresh, traditional, healthier food, though they faced structural and family-level barriers that impacted the healthiness of the food they acquired. Understanding the food environment and interactions therein is key to proposing interventions and policies that can potentially impact the most vulnerable.
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McCarley S, López-Ríos M, Burgos Gil R, Turner MM, Cleary SD, Edberg M, Colón-Ramos U. Using a Community-Based Participatory Mixed Methods Research Approach to Develop, Evaluate, and Refine a Nutrition Intervention to Replace Sugary Drinks with Filtered Tap Water among Predominantly Central-American Immigrant Families with Infants and Toddlers: The Water Up @Home Pilot Evaluation Study. Nutrients 2021; 13:2942. [PMID: 34578820 PMCID: PMC8468015 DOI: 10.3390/nu13092942] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/12/2021] [Accepted: 08/20/2021] [Indexed: 11/17/2022] Open
Abstract
Descriptions of the implementation of community-based participatory mixed-methods research (CBPMMR) in all phases of the engagement approach are limited. This manuscript describes the explicit integration of mixed-methods in four stages of CBPR: (1) connecting and diagnosing, (2) prescribing-implementing, (3) evaluating, and (4) disseminating and refining an intervention that aimed to motivate Latino parents (predominantly Central American in the US) of infants and toddlers to replace sugary drinks with filtered tap water. CBPMMR allowed for co-learning that led to the identification of preliminary behavioral outcomes, insights into potential mechanisms of behavior change, and revisions to the intervention design, implementation and evaluation.
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Affiliation(s)
- Shannon McCarley
- Global Health Department, Milken Institute School of Public Health, The George Washington University (GWU MISPH), Washington, DC 20052, USA;
| | | | - Rosalina Burgos Gil
- Senior Director of Early Childhood Education Programs, CentroNía, Washington, DC 20009, USA;
| | | | - Sean D. Cleary
- Department of Epidemiology, GWU MISPH, Washington, DC 20052, USA;
| | - Mark Edberg
- Department of Prevention and Community Health, GWU MISPH, Washington, DC 20052, USA;
| | - Uriyoán Colón-Ramos
- Global Health Department, Milken Institute School of Public Health, The George Washington University (GWU MISPH), Washington, DC 20052, USA;
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'You run out of hope': an exploration of low-income parents' experiences with food insecurity using Photovoice. Public Health Nutr 2021; 25:987-993. [PMID: 34167607 DOI: 10.1017/s1368980021002743] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Using an adaption of the Photovoice method, this study explored how food insecurity affected parents' ability to provide food for their family, their strategies for managing household food insecurity and the impact of food insecurity on their well-being. DESIGN Parents submitted photos around their families' experiences with food insecurity. Afterwards, they completed in-depth, semi-structured interviews about their photos. The interviews were transcribed and analysed for thematic content using the constant comparative method. SETTING San Francisco Bay Area, California, USA. PARTICIPANTS Seventeen parents (fourteen mothers and three fathers) were recruited from a broader qualitative study on understanding the experiences of food insecurity in low-income families. RESULTS Four themes were identified from the parents' photos and interviews. First, parents described multiple aspects of their food environment that promoted unhealthy eating behaviours. Second, parents shared strategies they employed to acquire food with limited resources. Third, parents expressed feelings of shame, guilt and distress resulting from their experience of food insecurity. And finally, parents described treating their children to special foods to cultivate a sense of normalcy. CONCLUSIONS Parents highlighted the external contributors and internal struggles of their experiences of food insecurity. Additional research to understand the experiences of the food-insecure families may help to improve nutrition interventions targeting this structurally vulnerable population.
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A relational approach to evaluate food environments finds that the proximate food environment matters for those who use it. Health Place 2021; 69:102564. [PMID: 33894655 DOI: 10.1016/j.healthplace.2021.102564] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/18/2021] [Accepted: 03/14/2021] [Indexed: 11/22/2022]
Abstract
Using a relational approach, this study investigates whether shopping close to home moderates the relationship between the proximate food environment and diet. To address this question, we develop the proximate food retail quality (PFRQ) score, an inverse-distance weighted measure of all food retailers within a resident's neighborhood that incorporates audit data of each food retailer. This study relies on data collected through 24-h dietary recalls and psychosocial surveys administered to 449 adults in two socioeconomically matched neighborhoods. Food retailer audits collected data on the availability, price, and quality of healthful foods. Seventy-one percent of study participants report conducting at least 50% of their food shopping within approximately one mile of their home. Household income and education are associated with likelihood to shop close to home, while access to a personal vehicle is not. Finally, results suggest that, for residents who shop primarily close to home, a one unit increase in proximate food retail environment score is associated with a 17.2-point increase in HEI-2010 score, a measure of overall diet quality that ranges from zero to 100. This study suggests that the food environment matters for those who use it and that a low-quality proximate food environment can amplify individual disadvantage.
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Floríndez LI, Floríndez DC, Price ME, Floríndez FM, Como DH, Polido JC, Baezconde-Garbanati L, Pyatak E, Cermak SA. Exploring Eating Challenges and Food Selectivity for Latinx Children with and without Autism Spectrum Disorder Using Qualitative Visual Methodology: Implications for Oral Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3751. [PMID: 33916808 PMCID: PMC8038332 DOI: 10.3390/ijerph18073751] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 01/16/2023]
Abstract
Diet and food choices significantly impact teeth, including enamel quality and development of dental caries. However, studies focusing on diet and its relation to oral care in Latinx children with and without Autism Spectrum Disorders (ASD) have been minimally addressed in research. This qualitative study used an inclusive visual methodology to explore what Latinx caregivers learned about their child's diet preferences and food routines in relation to their oral health. As a secondary aim, the study sought to explore whether notable differences in diet emerged between Latinx children with and without ASD. Participants were 32 Latinx caregivers from 18 families with children with and without Autism (n = 8 with a typically developing child and n = 10 with a child with ASD) who completed a food journal activity and photo elicitation interview. Interviews were thematically coded for themes pertaining to parents' perceptions of their child's diet and oral health. Findings of this study indicate that the process of taking photos helped Latinx caregivers to better situate the barriers and behaviors influencing everyday food routines in their children within the context of relating to their overall oral health. Via their active participation in the research process, parents were empowered to note strategies they could employ that would directly impact their child's oral health outcomes, such as reducing juice intake and monitoring sugar consumption. Therefore, visual research methodologies are an important strategy for researchers to consider in order to empower participants to be part of the research process and part of the outcomes, and to offer better understanding of the lived experience of populations underrepresented in the literature, such as Latinx children with and without ASD and their families.
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Affiliation(s)
- Lucía I. Floríndez
- Department of Nursing Research, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA
| | | | - Mia E. Price
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (M.E.P.); (D.H.C.); (E.P.); (S.A.C.)
| | | | - Dominique H. Como
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (M.E.P.); (D.H.C.); (E.P.); (S.A.C.)
| | - Jose C. Polido
- Division of Dentistry, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA;
| | | | - Elizabeth Pyatak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (M.E.P.); (D.H.C.); (E.P.); (S.A.C.)
| | - Sharon A. Cermak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (M.E.P.); (D.H.C.); (E.P.); (S.A.C.)
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Hawkes C, Fox E, Downs SM, Fanzo J, Neve K. Child-centered food systems: Reorienting food systems towards healthy diets for children. GLOBAL FOOD SECURITY 2020. [DOI: 10.1016/j.gfs.2020.100414] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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15
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Brazilian immigrant fathers' perspectives on child's eating and feeding practices: a qualitative study conducted in the United States. Public Health Nutr 2020; 23:3211-3225. [PMID: 32576301 DOI: 10.1017/s1368980020001123] [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: 11/06/2022]
Abstract
OBJECTIVES Brazilians comprise a rapidly growing immigrant Latino group in the USA, yet little research has focused on health issues affecting Brazilian children in immigrant families. As increasing evidence is documenting fathers' influential role in their children's eating behaviours and ultimately weight status, the current study sought to explore the Brazilian immigrant fathers' perspectives and practices related to child's feeding practices and their preschool-aged children's eating. DESIGN Qualitative study using in-depth, semi-structured interviews. Interviews were conducted in Portuguese by native Brazilian research staff using a semi-structured interview guide. Interviews were audio-recorded and transcribed verbatim. Transcripts were analysed thematically using a hybrid approach that incorporated deductive and inductive analytical approaches. SETTING Massachusetts. PARTICIPANTS Twenty-one Brazilian immigrant fathers who had at least one child aged 2-5 years. RESULTS Results revealed fathers' awareness of the importance of healthy eating for their children, their influence as role models and their involvement in feeding routines of their preschool-aged children. Moreover, fathers were receptive to participating in family interventions to promote their children's healthy eating. Nearly all fathers reported wanting to learn more and to do 'what's right' for their children. CONCLUSIONS The current study provides new information about Brazilian immigrant fathers' views about factors influencing their children's healthy eating behaviours and paternal feeding practices. Future research should quantify fathers' feeding styles and practices and solicit fathers' input in the design of culturally appropriate family interventions targeting the home environment of preschool-aged children of Brazilian immigrant families.
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16
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Phillips AZ, Rodriguez HP. U.S. county "food swamp" severity and hospitalization rates among adults with diabetes: A nonlinear relationship. Soc Sci Med 2020; 249:112858. [PMID: 32088514 PMCID: PMC7430494 DOI: 10.1016/j.socscimed.2020.112858] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 12/09/2019] [Accepted: 02/13/2020] [Indexed: 12/11/2022]
Abstract
The relationship between food environments and diabetes morbidity is vastly understudied, despite the well-recognized linkage between dietary quality and diabetes complications. Further, literature demonstrates that attributes of places can have nonlinear relationships with health outcomes. This study examines the extent to which "food swamps" are associated with greater rates of hospitalizations for complications among adults with diabetes over time as well as the linearity of this relationship. We conduct a longitudinal county-level analysis of 832 counties across 16 U.S. states in 2010, 2012, and 2014 using data from the USDA Food Environment Atlas and the AHRQ Health Care Cost and Utilization Project State Inpatient Databases. Food swamp severity is measured as the percentage of food outlets in a county that sell primarily unhealthy foods. Hierarchical linear mixed models with county random intercepts are estimated, controlling for area-level covariates and state and year fixed effects. Curvilinear relationships are explored by additively incorporating quadratic terms. We find that, over the study period, mean food swamp severity remained relatively stable. Mean hospitalization rates decreased from 296.72 to 262.82 hospitalizations per 1000 diabetic adults (p < 0.001). In adjusted models, greater food swamp severity was associated with higher hospitalization rates in a curvilinear manner (severity: β = 2.181, p = 0.02; severity2: β = -0.017, p = 0.04), plateauing at approximately 64% unhealthy outlets, a saturation point observed in 17% of observations. Policies that limit saturation of the environment with unhealthy outlets may help in the prevention of diabetic complications, but more saturated counties will likely require more extensive intervention.
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Affiliation(s)
- Aryn Z Phillips
- University of California, Berkeley, School of Public Health, Center for Healthcare Organizational and Innovation Research, 2121 Berkeley Way West, Berkeley, CA, 94720-1650, USA.
| | - Hector P Rodriguez
- University of California, Berkeley, School of Public Health, Center for Healthcare Organizational and Innovation Research, 2121 Berkeley Way West, Berkeley, CA, 94720-1650, USA.
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17
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Immigrant Women's Experiences as Mothers in the United States: A Scoping Review. MCN Am J Matern Child Nurs 2019; 45:6-16. [PMID: 31651421 DOI: 10.1097/nmc.0000000000000582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Immigrant mothers are raising an increasing proportion of the population of children in the United States. PURPOSE The purpose of this review was to explore existing research on immigrant women's experiences of being mothers in the United States and identify key concepts, gaps in the literature, and implications for future research that builds on the strengths of immigrant women while addressing their unique challenges. STUDY DESIGN AND METHODS In this scoping review, Ovid MEDLINE, CINAHL, SCOPUS, Web of Science, JUSTOR, and PsycINFO databases were searched using a combination of applicable key words. RESULTS Twenty-two articles were selected. Few studies were identified. Analyses revealed a broad array in purpose, populations, theoretical frameworks, settings, study instruments, and practices, making comparison difficult. Although mothering is a universal experience among women who have children, little is known about the broad experiences of immigrant women from different cultures. CLINICAL IMPLICATIONS Immigrant mothers are not a monolithic group. More research is needed to provide a deeper understanding of strengths, challenges, and solutions of various immigrant groups, which can facilitate development of nursing interventions that support immigrant women and their children in the United States, and strengthen their families.
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18
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Fuster M, Weindorf S, Mateo KF, Barata-Cavalcanti O, Leung MM. "It's Sort Of, Like, in My Family's Blood": Exploring Latino Pre-adolescent Children and Their Parents' Perceived Cultural Influences on Food Practices. Ecol Food Nutr 2019; 58:620-636. [PMID: 31397190 DOI: 10.1080/03670244.2019.1652819] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study examined the perceived connections between culture and food practices among Latino pre-adolescents (n = 17) and their parents (n = 15) through semi-structured interviews. Results show that pre-adolescents have formed perceptions concerning the association between their eating behaviors and cultural background that coincide with their parent's notions. Participants associated culture to both healthy and unhealthy food practices. Latin American food environments were described as healthier than in the US. The interviews revealed conflict between traditional foods preferences and perceptions of health, underscoring the need for better approaches to help Latino families navigate US food environments, while also preserving healthful traditional food practices.
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Affiliation(s)
- Melissa Fuster
- Department of Health and Nutrition Sciences, City University of New York Brooklyn College, Brooklyn, New York, USA
| | - Sarah Weindorf
- Hunter College School of Urban Public Health, New York, New York, USA
| | - Katrina F Mateo
- Hunter College School of Urban Public Health, New York, New York, USA.,City University of New York Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Olivia Barata-Cavalcanti
- Hunter College School of Urban Public Health, New York, New York, USA.,City University of New York Graduate School of Public Health and Health Policy, New York, New York, USA
| | - May May Leung
- Hunter College School of Urban Public Health, New York, New York, USA
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19
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Suprawoto DN, Hayati H, Rachmawati IN, Wanda D. "Fat Kids Are Adorable": The Experiences of Mothers Caring for Overweight Children in Indonesia. Compr Child Adolesc Nurs 2019; 42:226-233. [PMID: 31192711 DOI: 10.1080/24694193.2019.1594454] [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: 10/26/2022]
Abstract
This study aims to explore mothers' experiences in caring for overweight children under five years of age. This study used a descriptive phenomenology approach, with in-depth interviews with ten mothers who had overweight children under five years of age (2-5 years) selected by purposive sampling. The data was then analyzed using thematic analysis based on Collaizi's approach. This study produced eight themes illustrating that mothers were not only unaware of the children's overweight condition, but even felt more pleased to have overweight kids. This caused mothers not to give the optimum effort in limiting their children's food intake. The low awareness mothers had towards their children's overweight condition indicated the need for an intervention program that focuses on overweight children under five years of age to empower the family and increase family awareness in managing obesity early.
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Affiliation(s)
| | - Happy Hayati
- a Faculty of Nursing , Universitas Indonesia , Depok , West Java , Indonesia
| | | | - Dessie Wanda
- a Faculty of Nursing , Universitas Indonesia , Depok , West Java , Indonesia
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20
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Fuster M, Colón-Ramos U. Changing Places, Changing Plates? A Binational Comparison of Barriers and Facilitators to Healthful Eating Among Central American Communities. J Immigr Minor Health 2019; 20:705-710. [PMID: 28424997 DOI: 10.1007/s10903-017-0588-2] [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: 12/01/2022]
Abstract
To understand the process by which immigrants adopt dietary practices, this study offers a binational comparison of factors that predispose, enable, and reinforce healthful eating in the sending and receiving countries. Data are from two qualitative studies that examined barriers and facilitators to healthful eating in El Salvador (four focus groups, n = 28 adults) and in the US (30 in-depth interviews n = 15 mothers recently migrated from Central America). There was a strong emphasis on hygiene and vitamin-content of foods among participants in El Salvador. In both settings, participants perceived that their respective community food environments (schools, food stores) exposed their families to highly processed, unhealthful foods. In both settings, they described similar struggles to encourage their families to eat foods healthfully (traditional, home-made foods). These results underscore the importance of acknowledging the changing food environment in sending countries where people may already be exposed to processed foods.
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Affiliation(s)
- Melissa Fuster
- City University of New York - Brooklyn College, 2900 Bedford Ave., Brooklyn, NY, 11210, USA.
| | - Uriyoán Colón-Ramos
- George Washington University Milken Institute School of Public Health, Washington, DC, 20052, USA
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21
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Feeding decision-making among first generation Latinas living in non-metropolitan and small metro areas. PLoS One 2019; 14:e0213442. [PMID: 30883597 PMCID: PMC6422285 DOI: 10.1371/journal.pone.0213442] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 02/21/2019] [Indexed: 11/19/2022] Open
Abstract
Background Worldwide, overweight and obesity rates have more than tripled over the past three decades. Overweight and obesity rates are particularly high among Latinos. In order to determine some of the potential reasons, it is imperative to investigate how first-generation Latina mothers living in non-metropolitan and small metro areas decide how and what to feed their children. Using the Socio-Ecological Model, this study aimed to understand how Latina immigrant mothers make feeding decisions for their children. Methods A total of 29 semi-structured interviews were conducted with a purposive sample of immigrant mothers from Latin American countries whose preschoolers were enrolled in a Women, Infant, and Children supplemental nutrition program located in non-metropolitan and small metro areas. All interviews were recorded and transcribed verbatim in Spanish, and analyzed by a bilingual team. Results Multi-stage qualitative analysis was employed to analyze the data. Nineteen participants originated from Mexico, four from Central America, and six from South America. Five themes emerged that helped illuminate mother’s decision-making around feeding choices: 1) culture as all-encompassing, 2) location and access to fresh and traditional foods, 3) disjunction between health provider advice and cultural knowledge 4) responsiveness to family needs and wants as determinants of food choices, 5) intrapersonal conflict stemming from childhood poverty and food insufficiency. Conclusion Findings suggest that Latina immigrant mothers engage in a difficult and even conflicting process when deciding how to feed their children. Future interventions should focus on implementing hands-on activities that can help consolidate, promote, and encourage healthy feeding choices.
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22
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Cooksey-Stowers K, Schwartz MB, Brownell KD. Food Swamps Predict Obesity Rates Better Than Food Deserts in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1366. [PMID: 29135909 PMCID: PMC5708005 DOI: 10.3390/ijerph14111366] [Citation(s) in RCA: 251] [Impact Index Per Article: 35.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 10/10/2017] [Accepted: 10/21/2017] [Indexed: 01/14/2023]
Abstract
This paper investigates the effect of food environments, characterized as food swamps, on adult obesity rates. Food swamps have been described as areas with a high-density of establishments selling high-calorie fast food and junk food, relative to healthier food options. This study examines multiple ways of categorizing food environments as food swamps and food deserts, including alternate versions of the Retail Food Environment Index. We merged food outlet, sociodemographic and obesity data from the United States Department of Agriculture (USDA) Food Environment Atlas, the American Community Survey, and a commercial street reference dataset. We employed an instrumental variables (IV) strategy to correct for the endogeneity of food environments (i.e., that individuals self-select into neighborhoods and may consider food availability in their decision). Our results suggest that the presence of a food swamp is a stronger predictor of obesity rates than the absence of full-service grocery stores. We found, even after controlling for food desert effects, food swamps have a positive, statistically significant effect on adult obesity rates. All three food swamp measures indicated the same positive association, but reflected different magnitudes of the food swamp effect on rates of adult obesity (p values ranged from 0.00 to 0.16). Our adjustment for reverse causality, using an IV approach, revealed a stronger effect of food swamps than would have been obtained by naïve ordinary least squares (OLS) estimates. The food swamp effect was stronger in counties with greater income inequality (p < 0.05) and where residents are less mobile (p < 0.01). Based on these findings, local government policies such as zoning laws simultaneously restricting access to unhealthy food outlets and incentivizing healthy food retailers to locate in underserved neighborhoods warrant consideration as strategies to increase health equity.
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Affiliation(s)
- Kristen Cooksey-Stowers
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT 06103, USA.
| | - Marlene B Schwartz
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT 06103, USA.
| | - Kelly D Brownell
- Sanford School of Public Policy, Duke University, Durham, NC 27708, USA.
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