A multidisciplinary approach to promoting healthy subsistence fish consumption in culturally distinct communities

Educator beliefs and organizational constraints: Factors that influence informal education about fish consumption advisories in a southeastern US state

All US states, and many countries around the world, have waterways with environmental health advisories intended to protect individuals from harmful chemicals in fish, yet little is known about how informal science educators, even those who engage anglers along waterways, incorporate advisory information into their educational activities. This study, grounded in environmental health literacy, investigated the practices, knowledge, and beliefs of 24 informal educators housed in varied agencies and organizations in a southeastern US state. Participants described a range of educational activities and identified organizational constraints on their education about fish consumption advisories, which varied by organization type. Their knowledge of relevant environmental health concepts was incomplete, and they described health and teaching beliefs consistent with limited focus on advisory education. Local government and nonprofit educators were well positioned to educate anglers about advisories, due to their freedom to design and deliver instruction and their regular contact with anglers. Educators in wildlife agencies had more contact with anglers and were identified as potential conduits given their interactions, but organizational constraints (such as educators' ability to choose content/pedagogy and conflicting missions of agencies) would need to be addressed.

Impairment in Working Memory and Executive Function Associated with Mercury Exposure in Indigenous Populations in Upper Amazonian Peru

The Matsigenka people living traditional lifestyles in remote areas of the Amazon rely on a fish-based diet that exposes them to methylmercury (MeHg) at levels that have been associated with decreased IQ scores. In this study, the association between Hg levels and working memory was explored using the framework of the Multicomponent Model. Working memory tasks were modified to fit the culture and language of the Matsigenka when needed and included measures for verbal storage (Word Span) visuospatial storage (Corsi Block Task) and a measure of executive functions, the Self-Ordered Pointing Task (SOPT). An innovation of the Trail Making Tests A & B (TMT A & B) was pilot tested as another potential measure of executive functions. The mean hair Hg levels of 30 participants, ages 12 to 55 years, from three different communities (Maizal, Cacaotal and Yomibato) was 7.0 ppm (sd = 2.40), well above the World Health Organization (WHO) limit for hair of 2.0 ppm and ranged from 1.8 to 14.2 ppm, with 98% of a broader sample of 152 individuals exceeding the WHO limit. Hair Hg levels showed significant associations with cognitive performance, but the degree varied in magnitude according to the type of task. Hg levels were negatively associated with executive functioning performance (SOPT errors), while Hg levels and years of education predicted visuospatial performance (Corsi Block accuracy). Education was the only predictor of Word Span accuracy. The results show that Hg exposure is negatively associated with working memory performance when there is an increased reliance on executive functioning. Based on our findings and the review of the experimental research, we suggest that the SOPT and the Corsi Block have the potential to be alternatives to general intelligence tests when studying remote groups with extensive cultural differences.

Comparison of Recreational Fish Consumption Advisories Across the USA

PURPOSE OF REVIEW

Our comparative analysis sought to understand the factors which drive differences in fish consumption advisories across the USA - including exposure scenarios (acute and chronic health risk, non-cancer and cancer health endpoints), toxicity values (reference dose, cancer slope factor, acute tolerance level), and meal size and bodyweight assumptions.

RECENT FINDINGS

Fish consumption provides essential nutrients but also results in exposure to contaminants such as PCBs and methylmercury. To protect consumers from the risks of fish contaminants, fish consumption advisories are established, most often by state jurisdictions, to estimate the amount of a certain fish species a person could consume throughout their lifetime without harm. However, inconsistencies in advisories across the USA confuse consumers and undermine the public health goals of fish advisory programs. To date, no rigorous comparison of state and national fish consumption advisories has been reported. Our work identifies discrepancies in key assumptions used to derive risk-based advisories between US states, reflecting differences in the interpretation of toxicity science. We also address the implications for these differences by reviewing advisories issued by contiguous states bordering two waterbodies: Lake Michigan and the Lower Mississippi River. Our findings highlight the importance of regional collaboration when issuing advisories, so that consumers of self-caught fish are equipped with clear knowledge to make decisions to protect their health.

Altered health knowledge and attitudes among health sciences students following media exposure

Communications media that fails to present information supported by evidence-based practice has the potential to adversely influence knowledge and, ultimately, behaviors. We assessed the immediate effect of a health science documentary on knowledge, attitude, and beliefs among collegiate health sciences students enrolled in an entry-level nutrition course using surveys administered online. Participants (n = 160) completed the pre-survey, watched the documentary What the Health, and immediately completed the post-survey in one setting. Compared with pre-survey scores, participants reported a significant decrease in knowledge, change in attitude to health toward regulation of animal products, and increased agreement with all seven, pre-selected contradictory health claims presented in the documentary. Post-documentary, most participants reported they were planning to make a change in their dietary habits to reflect a plant-based diet. Documentaries providing health information contradictory to the current body of scientific literature are persuasive and can potentially increase negative health behaviors. Inclusion of practices within the health curriculum that encourage, and ultimately, improve health literacy among students before entering the health care workforce is essential.

Community involvement in design, implementation and evaluation of nutrition interventions to reduce chronic diseases in indigenous populations in the U.S.: a systematic review

Background

Indigenous peoples of the United States disproportionately experience chronic diseases associated with poor nutrition, including obesity and diabetes. While chronic disease related health disparities among Indigenous people are well documented, it is unknown whether interventions adequately address these health disparities. In addition, it is unknown whether and to what extent interventions are culturally adapted or tailored to the unique culture, worldview and nutrition environments of Indigenous people. The aim of this review was to identify and characterize nutrition interventions conducted with Indigenous populations in the US, and to determine whether and to what degree communities are involved in intervention design, implementation and evaluation.

Methods

Peer-reviewed articles were identified using MEDLINE. Articles included were published in English in a refereed journal between 2000 and 2015, reported on a diet-related intervention in Indigenous populations in the US, and reported outcome data. Data extracted were program objectives and activities, target population, geographic region, formative research to inform design and evaluation, partnership, capacity building, involvement of the local food system, and outcomes. Narrative synthesis of intervention characteristics and the degree and type of community involvement was performed.

Results

Of 1060 records identified, 49 studies were included. Overall, interventions were successful in producing changes in knowledge, behavior or health (79%). Interventions mostly targeted adults in the Western region and used a pre-test, post-test design. Involvement of communities in intervention design, implementation, and evaluation varied from not at all to involvement at all stages. Of programs reporting significant changes in outcomes, more than half used at least three strategies to engage communities. However, formative research to inform the evaluation was not performed to a great degree, and fewer than half of the programs identified described involvement of the local food system.

Conclusions

The extent of use of strategies to promote community engagement in programs reporting significant outcomes is notable. In planning interventions in Indigenous groups, researchers should consider ways to involve the community in intervention design, execution and evaluation. There is a particular need for studies focused on Indigenous youth in diverse regions of the US to further address diet-related chronic conditions.

Sociocultural factors associated with fish consumption in Lake Albert fishing community: Guidelines for lead and mercury

Fish consumption in subsistence fishing community is a life style associated with lead and mercury uptake for humans. Fish consumption is influenced by sociocultural factors, exposure and health risks. Unfortunately, no sociocultural study in the Lake Albert fishing community in light of lead and mercury exists. A cross-sectional sociocultural study was carried out between March and June 2015. A total of 270 household heads in four landing sites in Hoima district completed structured questionnaires and data analyzed using SPSS version 20. The majority of the households (74.8%) had primary education or below, 51.1% drank unboiled water, and 30% perceived lake water safe for drinking. Children under five ate soup (15%) and middle piece of the fish (29%). The Poisson general linear model predicting weekly fish consumption amounts against sociocultural factors showed that household size (p = 0.047), male child presence (p = 0.007), methods of preparation i.e. salting (p < 0.0001), fish parts consumed by adults (p < 0.0001), fish preference (p < 0.0001), awareness about the beach management unit (p < 0.0001), and income from charcoal selling (p < 0.0001) were positive predictors. The negative predictors of weekly fish consumption amounts were awareness about fish consumption benefits (p < 0.0001), eating young fish (p = 0.002), donor agency presence (p < 0.0001), and frying as the method of fish preparation (p = 0.002). In conclusion, knowledge of the sociocultural factors associated with fish consumption determines the amounts and frequency of the predominant fish eaten. Therefore, to establish and adopt fish consumption guidelines for lead and mercury in the Lake Albert, the sociocultural factors should be integrated in the message disseminated.

Perceptions about mercury and lead in fish consumed in Lake Albert fishing communities Uganda

Fish consumption is a lifestyle in fishing communities influenced by individual and communal perceptions. However, information about individual perceptions about fish consumption in the vulnerable fishing community in a developing country is lacking. Without this study, the benefits of fish consumption in a vulnerable community may not be realized. Data collection was executed using key informant interviews and survey structured questionnaires. The key informants include fisheries, community development, veterinary, community and environmental officers. The household heads were the respondents. The Qualitative data was organized and queried using QSR Nvivo 10 and quantitative data analyzed with SPSS version 22. The perceived benefits of eating fish are health, income, nutrition and manhood. The perceived risks are Stigma and ill health. The factors increasing fish consumption are heedless of fish consumption benefits (p = 0.041) and household size i.e. number of adults more than seven (p = 0.020). Those decreasing are methods of preparation of fish i.e. boiling and frying (p = 0.019 and p = 0.010) and oblivious about organizations dealing with fishing activities (p = 0.029). An awareness campaign is needed to demystify the health benefits and fallacies of fish consumption. The knowledge on individual perceptions associated with fish consumption will increase fish consumption but with fewer risks.