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Cooper SL, Butcher LM, Scagnelli SD, Lo J, Ryan MM, Devine A, O’Sullivan TA. Australian Consumers Are Willing to Pay for the Health Star Rating Front-of-Pack Nutrition Label. Nutrients 2020; 12:E3876. [PMID: 33352995 PMCID: PMC7765932 DOI: 10.3390/nu12123876] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/13/2020] [Accepted: 12/15/2020] [Indexed: 11/22/2022] Open
Abstract
The Australia and New Zealand Ministerial Forum on Food Regulation has supported the recommendations set out in the 2019 Health Star Rating System Five Year Review Report. Specifically, the forum supported, in principle, Recommendation 9, to mandate the Health Star Rating if clear uptake targets were not achieved while the system is voluntary. Given that mandatory labelling is being considered, it is important to investigate how much consumers value the Health Star Rating in order to understand potential consumer uptake and inform industry. The aim of this study was to assess consumers' valuation of the Health Star Rating system by analysing their willingness to pay for a packaged food product with the Health Star Rating label, utilising a double-bounded dichotomous choice contingent valuation approach. The results indicate that almost two-thirds of Australian household grocery shoppers were willing to pay more for a product with the Health Star Rating, on average up to an additional 3.7% of the price of the product. However, public health nutrition benefits associated with consumers' willingness to pay more for products with the Health Star Rating is currently limited by the lack of guarantee of the systems' accuracy. Given consumer support, a well validated and comprehensive Health Star Rating labelling system can potentially improve health outcomes, cost effectiveness and reduce environmental impacts.
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Affiliation(s)
- Sheri L. Cooper
- School of Health and Human Sciences, Gold Coast Campus, Southern Cross University, Southern Cross Drive, Bilinga, QLD 4225, Australia
| | - Lucy M. Butcher
- School of Health and Medical Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; (L.M.B.); (A.D.); (T.A.O.)
- Foodbank WA, 23 Abbott Road, Perth Airport, WA 6105, Australia
| | - Simone D. Scagnelli
- School of Business and Law, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; (S.D.S.); (M.M.R.)
| | - Johnny Lo
- School of Science, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia;
| | - Maria M. Ryan
- School of Business and Law, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; (S.D.S.); (M.M.R.)
| | - Amanda Devine
- School of Health and Medical Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; (L.M.B.); (A.D.); (T.A.O.)
| | - Therese A. O’Sullivan
- School of Health and Medical Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; (L.M.B.); (A.D.); (T.A.O.)
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Butcher LM, O'Sullivan TA, Ryan MM, Lo J, Nyanjom J, Wilkins HC, Devine A. To dine in or not to dine in: A comparison of food selection and preparation behaviours in those with and without food security. Health Promot J Austr 2020; 32 Suppl 2:267-282. [PMID: 32991748 PMCID: PMC8597035 DOI: 10.1002/hpja.427] [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: 03/25/2020] [Revised: 09/17/2020] [Accepted: 09/20/2020] [Indexed: 11/18/2022] Open
Abstract
Issue addressed Vulnerable populations are disproportionately affected by food insecurity, resulting in heightened risk of suboptimal dietary intake. Food insecure people appear to implement several coping strategies and dietary compromises to avoid hunger. Less explored in the literature is how these strategies impact consumption of food inside and outside of the home. Methods An online survey was completed by adults (n = 1292) residing in one of five Australian states. The questionnaire comprised of the six‐item US Household Food Security Survey Module, 12 socio‐demographic variables and 32 questions related to elements of food literacy. Results Food insecure respondents were more likely to frequent fast food vs (P = .002), takeaway (P < .001) and food courts (P < .001) than their food secure counterparts. Food secure respondents reported greater use of raw (P = .043) and fresh, pre‐prepared produce (P = .002) when cooking, whereas food insecure respondents were more likely to prepare food using only frozen, pre‐packaged products (P < .001). No significant differences were found between food security status and the enjoyment and social bonding derived from cooking. Conclusions Food insecure respondents appeared to be accessing a poorer quality of food through greater consumption of takeaway and fast food. These dietary compromises are most likely related to perceived financial, time or cooking facility constraints and to a lesser extent food literacy skills. So what? This study highlights some of the health and social inequities apparent within food insecure populations. Food insecure households should be supported to access healthy fresh food and in‐home cooking practices. While a multi strategy approach is required, healthy food environment policy, particularly in disadvantaged areas, should be considered to guarantee that all Australians have dignified access to nutritious food.
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Affiliation(s)
- Lucy M Butcher
- Edith Cowan University, Joondalup, WA, Australia.,Foodbank WA, Perth Airport, WA, Australia
| | | | - Maria M Ryan
- Edith Cowan University, Joondalup, WA, Australia
| | - Johnny Lo
- Edith Cowan University, Joondalup, WA, Australia
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Khorramrouz F, Doustmohammadian A, Eslami O, Khadem-Rezaiyan M, Pourmohammadi P, Amini M, Khosravi M. Relationship between household food insecurity and food and nutrition literacy among children of 9-12 years of age: a cross-sectional study in a city of Iran. BMC Res Notes 2020; 13:433. [PMID: 32933579 PMCID: PMC7493354 DOI: 10.1186/s13104-020-05280-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/09/2020] [Indexed: 11/25/2022] Open
Abstract
Objective The aim of this study was to assess the relationship between household food insecurity (HFI) with food and nutrition literacy (FNLIT) in a sample of Iranian children. This cross sectional study was performed on 315 children aged 9 to 12 years recruited from the primary schools throughout Mashhad, Iran. The Household Food Insecurity Access Scale (HFIAS) was used to assess the HFI. Also, overall FNLIT score and its sub-categories were evaluated using a validated 40-item questionnaire. Results The prevalence of HFI in the total sample was about 56%. Also, almost 14% of students had a low FNLIT score. Food insecure children had significantly lower levels of FNLT and some subscales including nutrition knowledge, food choice literacy, and food label literacy than the food-secure subjects, moreover, they had a higher likelihood of having low FNLIT score (OR = 2.89, CI 1.03–8.09; p = 0.04). In conclusion, there is a negative association between HFI and FNLIT in children. Further studies to confirm this finding are needed.
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Affiliation(s)
- Fatemeh Khorramrouz
- Student Research Committee, Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Omid Eslami
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Khadem-Rezaiyan
- Clinical Research Development Unit of Akbar Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parisa Pourmohammadi
- Department of Nutrition, Varastegan Institute for Medical Sciences, Mashhad, Iran
| | - Maryam Amini
- Department of Nutrition Research, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Khosravi
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Vakilabad Blvd, Azadi Square, Mashhad, Iran.
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Martínez-García A, Trescastro-López EM, Galiana-Sánchez ME, Pereyra-Zamora P. Data Collection Instruments for Obesogenic Environments in Adults: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1414. [PMID: 31010209 PMCID: PMC6518267 DOI: 10.3390/ijerph16081414] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/10/2019] [Accepted: 04/17/2019] [Indexed: 12/25/2022]
Abstract
The rise in obesity prevalence has increased research interest in the obesogenic environment and its influence on excess weight. The aim of the present study was to review and map data collection instruments for obesogenic environments in adults in order to provide an overview of the existing evidence and enable comparisons. Through the scoping review method, different databases and webpages were searched between January 1997 and May 2018. Instruments were included if they targeted adults. The documents were categorised as food environment or built environment. In terms of results, 92 instruments were found: 46 instruments measuring the food environment, 42 measuring the built environment, and 4 that characterised both environments. Numerous diverse instruments have been developed to characterise the obesogenic environment, and some of them have been developed based on existing ones; however, most of them have not been validated and there is very little similarity between them, hindering comparison of the results obtained. In addition, most of them were developed and used in the United States and were written in English. In conclusion, there is a need for a robust instrument, improving or combining existing ones, for use within and across countries, and more sophisticated study designs where the environment is contemplated in an interdisciplinary approach.
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Affiliation(s)
- Alba Martínez-García
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science-University of Alicante. Campus de Sant Vicent del Raspeig. Ap. 99, E-03080 Alicante, Spain.
| | - Eva María Trescastro-López
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science-University of Alicante. Campus de Sant Vicent del Raspeig. Ap. 99, E-03080 Alicante, Spain.
| | - María Eugenia Galiana-Sánchez
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science-University of Alicante. Campus de Sant Vicent del Raspeig. Ap. 99, E-03080 Alicante, Spain.
| | - Pamela Pereyra-Zamora
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science-University of Alicante. Campus de Sant Vicent del Raspeig. Ap. 99, E-03080 Alicante, Spain.
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Butcher LM, Ryan MM, O'Sullivan TA, Lo J, Devine A. Food-Insecure Household's Self-Reported Perceptions of Food Labels, Product Attributes and Consumption Behaviours. Nutrients 2019; 11:nu11040828. [PMID: 31013699 PMCID: PMC6521285 DOI: 10.3390/nu11040828] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 11/20/2022] Open
Abstract
Dietary compromises related to food insecurity profoundly undermine health and constitute a serious public health issue, even in developed nations. The aim of this study was to explore the impact of food labelling and product attributes on the purchasing choices of food-insecure households in Australia. An online survey containing 19 food choice and 28 purchasing behaviours questions was completed by 1056 adults responsible for household grocery shopping. The short form of the US Household Food Security Survey Module was used as the food security indicator. Multinomial logistic regression modelling was employed to analyse the survey data. Respondents were classified as having either high-marginal (63.4%, n = 670), low (19.8%, n = 209) or very low (16.8%, n = 177) food security. Respondents with low or very low food security status were less likely to self-report understanding the information on the back of packaging (p < 0.001), find information on food labels useful (p = 0.002) or be influenced by product nutrition information (p = 0.002). Convenience (p < 0.001), organic (p = 0.027) and supermarket-branded products (p < 0.001) were more likely to be rated as important by food-insecure respondents when compared to their food-secure counterparts. When asked to rate “how healthy” their diet was, high–marginal FS respondents were twice as likely describe their diet as healthy than very low FS respondents (p = 0.001).
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Affiliation(s)
- Lucy M Butcher
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
- Foodbank Western Australia, Perth Airport, WA 6105, Australia.
| | - Maria M Ryan
- School of Business and Law, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - Therese A O'Sullivan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - Johnny Lo
- School of Science, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
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Coping with Food Insecurity Among African American in Public-Sector Mental Health Services: A Qualitative Study. Community Ment Health J 2019; 55:440-447. [PMID: 30825072 DOI: 10.1007/s10597-019-00376-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 02/01/2019] [Indexed: 10/27/2022]
Abstract
While there are high rates of food insecurity among individuals with serious mental illnesses, and among African Americans, there is very little research on the ways African Americans in public-sector mental health services cope with food insecurity. This research paper presents qualitative data from a mixed methods study on the prevalence and management of food insecurity among African Americans using public sector mental health services. We interviewed 21 people about their everyday experiences of food insecurity and strategies they used to cope. While participants reported experiencing high levels of food insecurity, they also described the use of communal strategies to help them cope, including sharing food and cooking meals jointly, which seemed to reduce the negative effects of living with high levels of food insecurity as well as a serious mental illness. Policy innovations like communal gardens and kitchens provided through public mental health services may be particularly helpful.
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The impact of a multilevel childhood obesity prevention intervention on healthful food acquisition, preparation, and fruit and vegetable consumption on African-American adult caregivers. Public Health Nutr 2018; 22:1300-1315. [PMID: 30463637 DOI: 10.1017/s1368980018003038] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To evaluate the secondary impact of a multilevel, child-focused, obesity intervention on food-related behaviours (acquisition, preparation, fruit and vegetable (FV) consumption) on youths' primary caregivers. DESIGN B'More Healthy Communities for Kids (BHCK) group-randomized controlled trial promoted access to healthy foods and food-related behaviours through wholesaler and small store strategies, peer mentor-led nutrition education aimed at youths, and social media and text messaging targeting their adult caregivers. Measures included caregivers' (n 516) self-reported household food acquisition frequency for FV, snacks and grocery items over 30 d, and usual FV consumption in a sub-sample of 226 caregivers via the NCI FV Screener. Hierarchical models assessed average treatment effects (ATE). Treatment-on-the-treated-effect (TTE) analyses evaluated correlation between behavioural change and exposure to BHCK. Exposure scores at post-assessment were based on self-reported viewing of BHCK materials and participating in activities. SETTING Thirty Baltimore City low-income neighbourhoods, USA.ParticipantsAdult caregivers of youths aged 9-15 years. RESULTS Of caregivers, 90·89 % were female; mean age 39·31 (sd 9·31) years. Baseline mean (sd) intake (servings/d) was 1·30 (1·69) fruits and 1·35 (1·05) vegetables. In ATE, no significant intervention effect was found on caregivers' food-related behaviours. In TTE, each point increase in BHCK exposure score (range: 0-6·9) increased caregivers' daily fruit consumption by 0·2 servings (0·24 (se 0·11); 95 % CI 0·04, 0·47). Caregivers reporting greater social media exposure tripled their daily fruit intake (3·16 (se 0·92); 95 % CI 1·33, 4·99) and increased their frequency of unhealthy food purchasing v. baseline. CONCLUSIONS Child-focused community-based nutrition interventions may also benefit family members' fruit intake. Child-focused interventions should involve adult caregivers and intervention effects on family members should be assessed. Future multilevel studies should consider using social media to improve reach and engage caregiver participants.
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Trude ACB, Surkan PJ, Cheskin LJ, Gittelsohn J. A multilevel, multicomponent childhood obesity prevention group-randomized controlled trial improves healthier food purchasing and reduces sweet-snack consumption among low-income African-American youth. Nutr J 2018; 17:96. [PMID: 30373597 PMCID: PMC6206663 DOI: 10.1186/s12937-018-0406-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 10/17/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Consumption of foods and beverages rich in sugar remains high across all races and ages in the United States. Interventions to address childhood obesity and decrease sugar intake are needed, particularly in low-income settings. METHODS B'more Healthy Communities for Kids (BHCK) was a group-randomized, controlled trial implemented among 9-15-year olds in 30 low-income areas of Baltimore. We increased access to low-sugar foods and beverages at wholesalers and small food stores. Concurrently, we encouraged their purchase and consumption by children through youth-led nutrition education in recreation centers, in-store promotions, text messaging and a social media program directed at caregivers. Sugar consumption (sugar sweetened beverage (SSB), sweets) in youth was assessed pre- (n = 534) and post-intervention (n = 401) using the Block Kids Food Frequency Questionnaire. Purchasing of 38 healthier and 28 less healthier food/beverage varieties in the previous 7 days was assessed via self-report. Multilevel models at the community and individual levels were used. Analyses were stratified by age (younger: 9-12-year olds (n = 339) vs older: 13-15 (n = 170)). Models were controlled for child's sex, race, total daily caloric intake, and caregiver's age and sex. RESULTS Overall baseline mean healthier food purchasing was 2.5 (+ 3.6; min. 0, max. 34 items per week), and unhealthier food purchasing 4.6 (+ 3.7; 0-19 items per week). Mean intake at baseline for kcal from SSB was 176 (+ 189.1) and 153 (+ 142.5), and % of calories from sweets (i.e. cookies, cakes, pies, donuts, candy, ice cream, sweetened cereals, and chocolate beverages) was 15.9 (+ 9.7) and 15.9 (+ 7.7) in comparison and intervention youth, respectively. Intervention youth increased healthier foods and beverages purchases by 1.4 more items per week than comparison youth (β = 1.4; 95% CI: 0.1; 2.8). After the intervention, there was a 3.5% decrease in kcal from sweets for older intervention youth, compared to the control group (β = - 3.5; 95% CI: -7.76; - 0.05). No impact was seen on SSB consumption. CONCLUSION BHCK successfully increased healthier food purchasing variety in youth, and decreased % calories from sweet snacks in older youth. Multilevel, multicomponent environmental childhood obesity programs are a promising strategy to improve eating behaviors among low-income urban youth. TRIAL REGISTRATION NCT02181010 (July 2, 2014, retrospectively registered).
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Affiliation(s)
- Angela C. B. Trude
- Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Pamela J. Surkan
- Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Lawrence J. Cheskin
- Department of Health Behavior and Society, and the Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, 550 N. Broadway, Baltimore, MD 21205 USA
| | - Joel Gittelsohn
- Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
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Trude ACB, Kharmats AY, Jones-Smith JC, Gittelsohn J. Exposure to a multi-level multi-component childhood obesity prevention community-randomized controlled trial: patterns, determinants, and implications. Trials 2018; 19:287. [PMID: 29788977 PMCID: PMC5964684 DOI: 10.1186/s13063-018-2663-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 05/03/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND For community interventions to be effective in real-world conditions, participants need to have sufficient exposure to the intervention. It is unclear how the dose and intensity of the intervention differ among study participants in low-income areas. We aimed to understand patterns of exposure to different components of a multi-level multi-component obesity prevention program to inform our future impact analyses. METHODS B'more Healthy Communities for Kids (BHCK) was a community-randomized controlled trial implemented in 28 low-income zones in Baltimore in two rounds (waves). Exposure to three different intervention components (corner store/carryout restaurants, social media/text messaging, and youth-led nutrition education) was assessed via post-intervention interviews with 385 low-income urban youths and their caregivers. Exposure scores were generated based on self-reported viewing of BHCK materials (posters, handouts, educational displays, and social media posts) and participating in activities, including taste tests during the intervention. For each intervention component, points were assigned for exposure to study materials and activities, then scaled (0-1 range), yielding an overall BHCK exposure score [youths: mean 1.1 (range 0-7.6 points); caregivers: 1.1 (0-6.7), possible highest score: 13]. Ordered logit regression analyses were used to investigate correlates of youths' and caregivers' exposure level (quartile of exposure). RESULTS Mean intervention exposure scores were significantly higher for intervention than comparison youths (mean 1.6 vs 0.5, p < 0.001) and caregivers (mean 1.6 vs 0.6, p < 0.001). However, exposure scores were low in both groups and 10% of the comparison group was moderately exposed to the intervention. For each 1-year increase in age, there was a 33% lower odds of being highly exposed to the intervention (odds ratio 0.77, 95% confidence interval 0.69; 0.88) in the unadjusted and adjusted model controlling for youths' sex and household income. CONCLUSION Treatment effects may be attenuated in community-based trials, as participants may be differentially exposed to intervention components and the comparison group may also be exposed. Exposure should be measured to provide context to impact evaluations in multi-level trials. Future analyses linking exposure scores to the outcome should control for potential confounders in the treatment-on-the-treated approach, while recognizing that confounding and selection bias may exist affecting causal inference. TRIAL REGISTRATION ClinicalTrials.gov, NCT02181010 . Retrospectively registered on 2 July 2014.
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Affiliation(s)
- Angela Cristina Bizzotto Trude
- Global Obesity Prevention Center and Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Anna Yevgenyevna Kharmats
- Global Obesity Prevention Center and Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Jessica C Jones-Smith
- Nutritional Sciences Program, University of Washington School of Public Health University of Washington, 353410, 306B Raitt Hall, Seattle, WA, USA
| | - Joel Gittelsohn
- Global Obesity Prevention Center and Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
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Henry JL, Trude ACB, Surkan PJ, Anderson Steeves E, Hopkins LC, Gittelsohn J. Psychosocial Determinants of Food Acquisition and Preparation in Low-Income, Urban African American Households. HEALTH EDUCATION & BEHAVIOR 2018; 45:898-907. [PMID: 29589482 DOI: 10.1177/1090198118760686] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Psychosocial factors are important determinants of health behaviors and diet-related outcomes, yet relatively little work has explored their relation to food-purchasing and preparation behaviors in low-income populations. AIM To evaluate the psychosocial factors associated with food-related behaviors. METHODS Cross-sectional data collected from 465 low-income African American adult caregivers in the baseline evaluation of the B'more Healthy Communities for Kids obesity prevention trial. Questionnaires were used to assess household sociodemographic characteristics, food sources frequently used, and food preparation and food acquisition behaviors. Multiple linear regression models explored the associations between caregiver psychosocial variables and food-related behaviors, controlling for caregivers' age, sex, household income, household size, and food assistance participation. RESULTS Caregivers purchased prepared food at carry-outs on average 3.8 times (standard deviation [ SD] = 4.6) within 30 days. Less healthy foods were acquired 2 times more frequently than healthier foods ( p < .001). Higher food-related behavioral intention and self-efficacy scores were positively associated with healthier food acquisition (β = 0.7; 95% confidence interval [CI] [0.09, 1.4]; β = 0.04; 95% CI [0.02, 0.06]) and negatively associated with frequency of purchasing at prepared food sources (β = -0.4; 95% CI [-0.6, -0.2]; β = -0.5; 95% CI [-0.7, -0.3]), respectively. Higher nutrition knowledge was associated with lower frequency of purchasing food at prepared food venues (β = -0.7; 95% CI: [-1.2, -0.2]). DISCUSSION Our findings indicate a positive association between psychosocial determinants and healthier food acquisition and food preparation behaviors. CONCLUSION Interventions that affect psychosocial factors (i.e., food-related behavioral intentions and self-efficacy) may have the potential to increase healthier food preparation and food-purchasing practices among low-income African American families.
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Affiliation(s)
| | - Angela C B Trude
- 2 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Pamela J Surkan
- 2 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Joel Gittelsohn
- 2 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Food skills confidence and household gatekeepers' dietary practices. Appetite 2017; 108:183-190. [DOI: 10.1016/j.appet.2016.09.033] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 08/29/2016] [Accepted: 09/27/2016] [Indexed: 12/21/2022]
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Trude ACB, Kharmats AY, Hurley KM, Anderson Steeves E, Talegawkar SA, Gittelsohn J. Household, psychosocial, and individual-level factors associated with fruit, vegetable, and fiber intake among low-income urban African American youth. BMC Public Health 2016; 16:872. [PMID: 27558162 PMCID: PMC4997673 DOI: 10.1186/s12889-016-3499-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 08/12/2016] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Childhood obesity, one of the greatest challenges to public health, disproportionately affects low-income urban minority populations. Fruits and vegetables (FV) are nutrient dense foods that may be inversely associated with excessive weight gain. We aimed to identify the individual characteristic, psychosocial, and household factors influencing FV and fiber consumption in low-income African-American (AA) youth in Baltimore, MD. METHODS Cross-sectional analysis of data collected from 285 low-income AA caregiver-youth (age range: 10-14 y) dyads participating in the baseline evaluation of the B'More Healthy Communities for Kids obesity prevention trial. The Kid's Block FFQ was used to estimate daily intakes of FV (including 100 % fruit juice) and dietary fiber. Questionnaires were used to assess household socio-demographics, caregiver and youth food purchasing and preparation behavior, and youth psychosocial information. Ordered logit regression analyses were conducted to examine psychosocial and food-related behavior associated with FV and dietary fiber intake (quartile of intake) controlling for youth age, sex, BMI percentile, total calorie intake and household income. RESULTS On average, youth consumed 1.5 ± 1.1 (M ± SD) servings of fruit, 1.8 ± 1.7 serving of vegetables, and 15.3 ± 10.9 g of fiber/day. There were no differences by gender, age or household income. Greater youth's healthy eating intentions and self-efficacy scores were associated with greater odds ratio for higher intake of FV and fiber (Intention: ORfruit 1.22; 95 % CI: 1.06-1.41, ORvegetable 1.31; 1.15-1.51 and ORfiber 1.46; 1.23-1.74, Self-efficacy: ORfruit 1.07; 1.03-1.12, ORvegetable 1.04; 1.01-1.09, ORfiber 1.10; 1.04-1.16). Youth receiving free/low-cost breakfast were more than twice as likely to have higher fiber intake than those who did not receive free breakfast (OR 2.7; 1.10; 6.9). In addition, youth shopping more frequently at supermarkets were more likely to have greater vegetable and fiber intake (OR 1.26; 1.06-1.50; OR 1.28; 1.03-1.58, respectively). Also, youth with parents who shopped more frequently at fast-food stores had 7 % lower odds for higher vegetable intake (95 % CI: 0.88-0.99). CONCLUSION In this study, both, youth and household factors were associated with youth FV and fiber intake, underscoring the need for a multi-level approach to increasing youths' diet quality. These results will inform and shape an effective intervention program for improving youth dietary intakes.
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Affiliation(s)
- Angela Cristina Bizzotto Trude
- The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center and Center for Human Nutrition, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Anna Yevgenyevna Kharmats
- The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center and Center for Human Nutrition, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Kristen Marie Hurley
- The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center and Center for Human Nutrition, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | | | - Sameera A. Talegawkar
- Milken Institute School of Public Health, Department of Exercise and Nutrition Sciences, The George Washington University, 950 New Hampshire Ave, NW, Washington, DC 20052 USA
| | - Joel Gittelsohn
- The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center and Center for Human Nutrition, 615 N. Wolfe Street, Baltimore, MD 21205 USA
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Food insecurity, overweight and obesity among low-income African-American families in Baltimore City: associations with food-related perceptions. Public Health Nutr 2015; 19:1405-16. [PMID: 26441159 DOI: 10.1017/s1368980015002888] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine associations between food insecurity, excess body weight, psychosocial factors and food behaviours among low-income African-American families. DESIGN Cross-sectional survey of participants in the baseline evaluation of the B'More Healthy Communities for Kids (BHCK) obesity prevention trial. We collected data on socio-economic factors, food source destinations, acquiring food, preparation methods, psychosocial factors, beliefs and attitudes, participation in food assistance programmes, anthropometry and food security. We used principal component analysis to identify patterns of food source destinations and logistic regression to examine associations. SETTING Fourteen low-income, predominantly African-American neighbourhoods in Baltimore City, MD, USA. SUBJECTS Two hundred and ninety-eight adult caregiver-child (10-14 years old) dyads. RESULTS Of households, 41·6 % had some level of food insecurity and 12·4 % experienced some level of hunger. Food-insecure participants with hunger were significantly more likely to be unemployed and to have lower incomes. We found high rates of excess body weight (overweight and obesity) among adults and children (82·8 % and 37·9 % among food insecure without hunger, 89·2 % and 45·9 % among food insecure with hunger, respectively), although there were no significant differences by food security status. Food source usage patterns, food acquisition, preparation, knowledge, self-efficacy and intentions did not differ by food security. Food security was associated with perceptions that healthy foods are affordable and convenient. Greater caregiver body satisfaction was associated with food insecurity and excess body weight. CONCLUSIONS In this setting, obesity and food insecurity are major problems. For many food-insecure families, perceptions of healthy foods may serve as additional barriers to their purchase and consumption.
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Lee RM, Rothstein JD, Gergen J, Zachary DA, Smith JC, Palmer AM, Gittelsohn J, Surkan PJ. Process Evaluation of a Comprehensive Supermarket Intervention in a Low-Income Baltimore Community. Health Promot Pract 2015; 16:849-58. [PMID: 26296352 DOI: 10.1177/1524839915599359] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Supermarket-based interventions are one approach to improving the local food environment and reducing obesity and chronic disease in low-income populations. We implemented a multicomponent intervention that aimed to reduce environmental barriers to healthy food purchasing in a supermarket in Southwest Baltimore. The intervention, Eat Right-Live Well! used: shelf labels and in-store displays promoting healthy foods, sales and promotions on healthy foods, in-store taste tests, increasing healthy food products, community outreach events to promote the intervention, and employee training. We evaluated program implementation through store environment, taste test session, and community event evaluation forms as well as an Employee Impact Questionnaire. The stocking, labeling, and advertising of promoted foods were implemented with high and moderate fidelity. Taste test sessions were implemented with moderate reach and low dose. Community outreach events were implemented with high reach and dose. Supermarket employee training had no significant impact on employees' knowledge, self-efficacy, or behavioral intention for helping customers with healthy purchasing or related topics of nutrition and food safety. In summary, components of this intervention to promote healthy eating were implemented with varying success within a large supermarket. Greater participation from management and employees could improve implementation.
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Affiliation(s)
- Ryan M Lee
- Johns Hopkins University, Baltimore, MD, USA Johns Hopkins Center for a Livable Future, Baltimore, MD, USA
| | | | | | | | - Joyce C Smith
- Johns Hopkins Center for a Livable Future, Baltimore, MD, USA Operation Reachout Southwest, Baltimore, MD, USA
| | - Anne M Palmer
- Johns Hopkins University, Baltimore, MD, USA Johns Hopkins Center for a Livable Future, Baltimore, MD, USA
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15
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Budd N, Cuccia A, Jeffries JK, Prasad D, Frick KD, Powell L, Katz FA, Gittelsohn J. B'More Healthy: Retail Rewards--design of a multi-level communications and pricing intervention to improve the food environment in Baltimore City. BMC Public Health 2015; 15:283. [PMID: 25885923 PMCID: PMC4379588 DOI: 10.1186/s12889-015-1616-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 03/05/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Low-income black residents of Baltimore City have disproportionately higher rates of obesity and chronic disease than other Maryland residents. Increasing the availability and affordability of healthy food are key strategies to improve the food environment and can lead to healthier diets. This paper describes B'More Healthy: Retail Rewards (BHRR), an intervention that tests the effectiveness of performance-based pricing discounts and health communications, separately and combined, on healthy food purchasing and consumption among low-income small store customers. METHODS/DESIGN BHRR is 2x2 factorial design randomized controlled trial. Fifteen regular customers recruited from each of 24 participating corner stores in Baltimore City were enrolled. Food stores were randomized to 1) pricing intervention, 2) communications intervention, 3) combined intervention, or 4) control. Pricing stores were given a 10-30% price discount on selected healthier food items, such as fresh fruits, frozen vegetables, and baked chips, at the point of purchase from two food wholesale stores during the 6-month trial. Storeowners agreed to pass on the discount to the consumer to increase demand for healthy food. Communications stores received visual and interactive materials to promote healthy items, including signage, taste tests, and refrigerators. Primary outcome measures include consumer food purchasing and associated psychosocial variables. Secondary outcome measures include consumer food consumption, store sales, and associated storeowner psychosocial factors. Process evaluation was monitored throughout the trial at wholesaler, small store, and consumer levels. DISCUSSION This is the first study to test the impact of performance-based pricing and communications incentives in small food stores, an innovative strategy to encourage local wholesalers and storeowners to share responsibility in creating a healthier food supply by stocking, promoting, and reducing costs of healthier foods in their stores. Local food wholesalers were involved in a top-down, participatory approach to develop and implement an effective and sustainable program. This study will provide evidence on the effectiveness of price incentives and health communications, separately and combined, among a low-income urban U.S. TRIAL REGISTRATION ClinicalTrials.gov: NCT02279849 (2/18/2014).
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Affiliation(s)
- Nadine Budd
- Center for Human Nutrition, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Alison Cuccia
- Army Institute of Public Health, Health Promotion & Wellness Portfolio, USAPHC, ATTN: MCHB-IP-H, 5158 Blackhawk Road, Aberdeen Proving Ground, Aberdeen, MD, 21010, USA.
| | - Jayne K Jeffries
- The Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA.
| | - Divya Prasad
- Joseph Stokes, Jr. Research Institute, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Kevin D Frick
- Carey Business School, Johns Hopkins University, 100 International Drive, Baltimore, MD, 21202, USA.
| | - Lisa Powell
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
| | - Fred A Katz
- Carey Business School, Johns Hopkins University, 100 International Drive, Baltimore, MD, 21202, USA.
| | - Joel Gittelsohn
- Center for Human Nutrition, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
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16
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Kharmats AY, Jones-Smith JC, Cheah YS, Budd N, Flamm L, Cuccia A, Mui Y, Trude A, Gittelsohn J. Relation between the Supplemental Nutritional Assistance Program cycle and dietary quality in low-income African Americans in Baltimore, Maryland. Am J Clin Nutr 2014; 99:1006-14. [PMID: 24622807 PMCID: PMC3985207 DOI: 10.3945/ajcn.113.075994] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There has been limited research regarding the Supplemental Nutritional Assistance Program (SNAP) and recipients' dietary quality during the days and weeks after benefit disbursement. OBJECTIVE We examined the relation between participants' stages in the SNAP cycle and their macronutrient consumption, Healthy Eating Index (HEI) scores, and fruit and vegetable intake. DESIGN In this cross-sectional study, we analyzed single 24-h dietary recalls collected from 244 African American SNAP participants recruited near 24 corner stores in Baltimore City. A multiple linear regression analysis and bootstrapping were used. RESULTS Among participants who received a SNAP benefit ≤15 d before being surveyed, energy intake adjusted for minimum energy requirements (-4.49%; 95% CI: -8.77%, -0.15%) and HEI dairy scores (-0.12; 95% CI: -0.22, -0.01) were lower for each 1-d increase in the time since SNAP distribution (TSSD). Among participants who received SNAP benefits >15 d before being surveyed, energy intake (1.35%; 95% CI: 0.01%, 2.73%), energy intake adjusted for minimum energy requirements (3.86%; 95% CI: 0.06%, 7.96%), total fat intake (1.96%; 95% CI: 0.29%, 3.8%), saturated fat intake (2.02%; 95% CI: 0.23%, 4.01%), and protein intake (2.09%; 95% CI: 0.70%, 3.62%) were higher per each 1-d increase in the TSSD. CONCLUSIONS These findings suggest that the relation between the TSSD and macronutrient intake might be U-shaped, with higher intake of calories, fat, and protein in individuals in the very early and late stages of their SNAP cycles. Foods high in these nutrients might be cheaper, more accessible, and have a longer shelf-life than healthier options, such as fruit, vegetables, and whole grains, for SNAP participants when their benefits run out. Additional efforts are needed to investigate the effect of the TSSD on dietary intake by using a longitudinal design and to improve the quality of dietary intake in African American SNAP participants.
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Affiliation(s)
- Anna Y Kharmats
- Departments of International Health (AYK, JCJ-S, YSC, NB, AC, YM, and JG) and Health, Behavior, and Society (LF), Johns Hopkins School of Public Health, Baltimore, MD, and the Health Science Department, Federal University of Sao Paulo, São Paulo, Brazil (AT)
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17
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Hoffman VA, Lee SH, Bleich SN, Goedkoop S, Gittelsohn J. Relationship Between BMI and Food Purchases in Low-Income, Urban African American Adult Carry-Out Customers. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2013. [DOI: 10.1080/19320248.2013.816985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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18
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Anderson Steeves E, Silbergeld E, Summers A, Chen L, Gittelsohn J. Risky food safety behaviors are associated with higher BMI and lower healthy eating self-efficacy and intentions among African American churchgoers in Baltimore [corrected]. PLoS One 2012; 7:e52122. [PMID: 23284894 PMCID: PMC3527398 DOI: 10.1371/journal.pone.0052122] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Accepted: 11/14/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There are an estimated 9.4 million cases of foodborne illness each year. Consumers have a key role in preventing foodborne illness, but differences in the practice of food safety behaviors exist, increasing risk for certain groups in the population. Identifying groups who are more likely to practice risky food safety behaviors can assist in development of interventions to reduce the disease burden of foodborne illnesses. The purpose of this investigation was to examine the relationships of health indicators and psychosocial factors with self-reported food safety behaviors. METHODS AND FINDINGS Data were collected via questionnaire from 153 African Americans who attend churches in Baltimore City. Individuals reported high overall concern with food safety (mean score: 0.80±0.49 on a scale of -1 to +1) and practiced food safety behaviors with moderate overall frequency (mean score: 5.26±4.01 on a scale of -12 to +12), with considerable variation in reported frequencies depending on the food safety behavior. After adjusting for demographic variables, food safety behaviors were significantly associated with BMI and psychosocial variables. Riskier food safety behaviors were associated with higher body mass index (BMI) (β = -0.141 95%CI (-0.237, -0.044), p = 0.004). Self-efficacy for healthy eating (standard β [std. β] = 0.250, p = 0.005) and healthy eating intentions (std. β = 0.178, p = 0.041) were associated with better food safety behaviors scores. CONCLUSIONS These results show important relationships between weight-related health indicators, psychosocial factors and food safety behaviors that have not previously been studied. Interventions tailored to higher-risk populations have the potential to reduce the burden of food-related illnesses. Additional studies are needed to further investigate these relationships with larger and more diverse samples.
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Kramer RF, Coutinho AJ, Vaeth E, Christiansen K, Suratkar S, Gittelsohn J. Healthier home food preparation methods and youth and caregiver psychosocial factors are associated with lower BMI in African American youth. J Nutr 2012; 142:948-54. [PMID: 22457390 DOI: 10.3945/jn.111.156380] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Obesity disproportionately affects African American (AA) children and adolescents and leads to an increased risk of adult chronic diseases. Eating few meals at home has been implicated as a cause of obesity among youth, but to our knowledge, previous studies have not specifically investigated this relationship in AA adolescents or looked at both the healthfulness and frequency of home meals in AA households. The objective of the present study was to investigate the relationship between home food preparation and adolescent BMI in a sample of 240 AA adolescents aged 10-15 y and their caregivers. Multiple linear regressions were used to model psychosocial characteristics, household factors, and adolescent and caregiver food preparation behaviors as predictors of adolescent BMI, and psychosocial and household factors as predictors of food preparation behavior. Adolescents in the sample had a mean BMI-for-age percentile of 70.4, and >90% of the sample families received at least one form of food assistance. Adolescent children of caregivers who used healthier cooking methods were more likely to use healthy cooking methods themselves (P = 0.02). Having more meals prepared by a caregiver was predictive of higher BMI-for-age percentile in adolescents (P = 0.02), but healthier cooking methods used by the caregiver was associated with reduced risk of adolescent overweight or obesity (P < 0.01). Meals prepared at home in AA households do not necessarily promote healthy BMI in youth. Family meals are a promising adolescent obesity prevention strategy, but it is important to target both frequency and healthfulness of meals prepared at home for effective health promotion in AA families.
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Affiliation(s)
- Rebecca F Kramer
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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20
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Dennisuk LA, Coutinho AJ, Suratkar S, Surkan PJ, Christiansen K, Riley M, Anliker JA, Sharma S, Gittelsohn J. Food expenditures and food purchasing among low-income, urban, African-American youth. Am J Prev Med 2011; 40:625-8. [PMID: 21565654 DOI: 10.1016/j.amepre.2011.02.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Revised: 01/07/2011] [Accepted: 02/03/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Low-income, urban African-American youth are at higher risk for obesity and less likely to meet dietary recommendations than white, higher-income youth. Patterns of food purchasing among youth likely contribute to these disparities, but little published information is available. PURPOSE To investigate food purchasing behaviors of low-income, urban African-American youth. METHODS A total of 242 African-American youth, aged 10-14 years, were recruited from 14 recreation centers in low-income, predominantly African-American neighborhoods in Baltimore MD. Youth reported the amount of money typically spent on food, the source of this money, the place of purchase, and frequency of purchase for 29 foods and beverages. Data were collected in 2008-2009 and analyzed in 2009-2010. RESULTS Youth reported spending an average of $3.96 on foods and beverages in a typical day. Corner stores were the most frequently visited food source (youth made purchases at these stores an average of 2.0 times per week). Chips, candy, and soda were the most commonly purchased items, with youth purchasing these an average of 2.5, 1.8, and 1.4 times per week, respectively. Older age was associated with more money spent on food in a typical day (p<0.01). CONCLUSIONS Food purchasing among low-income, urban African-American youth is frequent and substantial. Interventions aimed at preventing and treating obesity in this population should focus on increasing access to healthy foods in their neighborhoods, especially in corner stores.
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Affiliation(s)
- Lauren A Dennisuk
- Center for Human Nutrition, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 6156 N. Wolfe Street, Baltimore, MD 21205, USA
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Access to food source and food source use are associated with healthy and unhealthy food-purchasing behaviours among low-income African-American adults in Baltimore City. Public Health Nutr 2011; 14:1632-9. [PMID: 21450140 DOI: 10.1017/s1368980011000498] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Although previous research has shown limited availability of healthy food in low-income urban neighbourhoods, the association between food source use and food-purchasing patterns has not yet been examined. We explored food-purchasing patterns in the context of food source use and food source access factors in low-income areas of Baltimore City. DESIGN Cross-sectional survey. SETTING Predominantly low-income neighbourhoods in East and West Baltimore City. SUBJECTS A total of 175 low-income African-American adult residents. RESULTS Supermarkets and corner stores were the most frequently used food sources. Walking was the main form of transportation used by 57 % of all respondents, 97 % of corner-store shoppers and 49 % of supermarket shoppers. Multiple linear regression models adjusting for demographic factors, type of food source used and transportation type found that corner-store use was associated with obtaining more unhealthy food (P = 0·005), whereas driving to the food source was associated with obtaining more healthy food (P = 0·012). CONCLUSIONS The large number of corner stores compared with supermarkets in low-income neighbourhoods makes them an easily accessible and frequently used food source for many people. Interventions to increase the availability and promotion of healthy food in highly accessed corner stores in low-income neighbourhoods are needed. Increased access to transportation may also lead to the use of food sources beyond the corner store, and to increased healthy food purchasing.
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Healthy food purchasing among African American youth: associations with child gender, adult caregiver characteristics and the home food environment. Public Health Nutr 2010; 14:670-7. [DOI: 10.1017/s136898001000251x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AbstractObjectiveTo examine how factors related to the home food environment and individual characteristics are associated with healthy food purchasing among low-income African American (AA) youth.SubjectsA total of 206 AA youth (ninety-one boys and 115 girls), aged 10–14 years, and their primary adult caregivers.SettingFourteen Baltimore recreation centres in low-income neighbourhoods.DesignCross-sectional study. We collected information about food purchasing, the home food environment, sociodemographic and psychosocial factors drawn from social cognitive theory. Multivariable logistic regression was used to examine the factors associated with the frequency and proportion of healthy food purchases in all youth and stratified by gender. Low-fat or low-sugar foods were defined as healthy.ResultsYouth purchased an average of 1·5 healthy foods (range = 0–15) in the week before the interview, comprising an average of 11·6 % (range = 0–80 %) of total food purchases. The most commonly purchased healthy foods included water and sunflower seeds/nuts. Healthier food-related behavioural intentions were associated with a higher frequency of healthy foods purchased (OR = 1·4, P < 0·05), which was stronger in girls (OR = 1·9, P < 0·01). Greater caregiver self-efficacy for healthy food purchasing/preparation was associated with increased frequency of healthy purchasing among girls (OR = 1·3, P < 0·05). Among girls, more frequent food preparation by a family member (OR = 6·6, P < 0·01) was associated with purchasing a higher proportion of healthy foods. No significant associations were observed for boys.ConclusionsInterventions focused on AA girls should emphasize increasing food-related behavioural intentions. For girls, associations between caregiver self-efficacy and home food preparation suggest the importance of the caregiver in healthy food purchasing.
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