High consumption of energy-dense nutrient-poor foods among low-income groups in the Mississippi Delta and Alabama

Strategies elementary school children use to influence mothers' food purchasing decisions

This study aimed to understand the strategies elementary-school-aged children used to influence mothers' food purchasing decisions. Semi-structured qualitative interviews were conducted with 40 children aged 6-11 years and their mothers living in South Carolina. Strategies to influence mothers' food purchases were collected from children and their mothers separately. The interviews were audio-recorded, transcribed verbatim, and open-coded. The constant comparative method was used for data analysis. Coding matrices were used to compare children's and mothers' responses on the children's strategies. Children reported 157 instances of 25 distinct strategies to influence mothers' purchasing decisions. Mothers had concordance with 83 instances of these strategies. Mothers were more concordant with sons than daughters. The most common and successful strategies reported by children and mothers were repeated polite requests, reasoned requests and referencing friends. Other strategies included offers to contribute money or service, using other family members to pursue mothers for the item, writing a list and grabbing desired items. Mothers perceived that children had a large influence on food purchasing decisions. Children were aware of the strategies that would get positive reactions from mothers. They (children) could get their desired items a lot of times, often, or several times in a month from their mothers irrespective of the healthfulness of the items. Children's influence can be used as a change agent for improving mothers' food purchases if children prefer healthy foods. Efforts are needed for mothers and children to help address children's strategies to influence mothers to purchase unhealthy foods and make healthy foods more appealing to children.

Health Behavior Changes Among Adults in the Supplemental Nutrition Assistance Program Education, Los Angeles County, California

PURPOSE AND OBJECTIVES

The Supplemental Nutrition Assistance Program Education (SNAP-Ed), the educational branch of SNAP, can play an important role in improving dietary outcomes, eliminating food insecurity, and preventing chronic disease among low-income populations. This study examined the effects of local SNAP-Ed efforts on self-reported health behaviors and body mass index (BMI) over a 1-year period, using data collected from intercept surveys of program-eligible adults.

INTERVENTION APPROACH

From 2016 to 2020, the Los Angeles County Department of Public Health partnered with 24 community-based organizations to provide nutrition education and to implement policy, systems, and environmental changes in the community.

EVALUATION METHODS

A cross-sectional survey was conducted in 2018 and repeated in 2019 to measure 6 outcomes describing population-level changes in health behaviors and BMI. The study recruited 4 samples: 2 samples from outside selected supermarkets (2018, n = 2,098; 2019, n = 2,323) and 2 samples from participants at SNAP-Ed class sites (2018, n = 651; 2019, n = 569).

RESULTS

While study results showed an increase in consumption of fruits and vegetables and in vigorous physical activity, they also showed an increase in BMI and high consumption of unhealthy foods. Participating in SNAP-Ed classes was positively associated with several health behaviors but no change in BMI. Participants who experienced food insecurity had worse health behavior outcomes than those who did not experience this condition.

IMPLICATIONS FOR PUBLIC HEALTH

SNAP-Ed interventions appear to have a favorable effect on fruit and vegetable consumption, but increases in BMI suggest that unhealthy food consumption is abundant and may be counteracting the benefits gained from eating more fruits and vegetables. Future efforts should take these results into consideration and optimize enrollment in nutrition assistance programs. These efforts should include coordinating with local programs to increase healthy food access for at-risk low-income populations in Los Angeles County.