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Oestman K, Rechis R, Williams PA, Brown JA, Treiman K, Zulkiewicz B, Walsh MT, Basen-Engquist K, Rodriguez T, Chennisi C, Macneish A, Neff A, Pomeroy M, Bhojani FA, Hawk E. Reducing risk for chronic disease: evaluation of a collective community approach to sustainable evidence-based health programming. BMC Public Health 2024; 24:240. [PMID: 38245669 PMCID: PMC10799505 DOI: 10.1186/s12889-024-17670-3] [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: 02/01/2023] [Accepted: 01/04/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Community initiatives can shape health behaviors, such as physical activity and dietary habits, across a population and help reduce the risk of developing chronic disease. To achieve this goal and impact health outcomes, Pasadena Vibrant Community aimed to engage communities in an ongoing dialogue about the importance of healthy behaviors, implement and advance community-based strategies to promote health, and improve diet and physical activity behaviors. The initiative was centered around a collaboration between a backbone organization, steering committee, and 7 collaborating organizations funded to implement multicomponent, evidence-based programs.. The common agenda was detailed in a community action plan, which included 19 interventions targeting healthy eating and active living among adults and youth in Pasadena, Texas. METHODS A mixed methods evaluation of the initiative was conducted over 4 years. Data sources included document reviews of quarterly progress reports (n = 86) and supplemental data reports (n = 16) provided by collaborating organizations, annual Steering Committee surveys (n = 4), and interviews conducted with staff from a subset of Collaborating Organizations (n = 4). RESULTS The initiative reached over 50,000 community members per year through 19 evidence-based interventions and impacted health outcomes, including knowledge and adoption of healthy eating practices and increased physical activity. Thirty-one systems-level changes were implemented during the initiative, including 16 environmental changes. Steering Committee meetings and shared goals enabled connections, communication, and cooperation, which allowed Collaborating Organizations to address challenges and combine resources to deliver their programs. CONCLUSIONS Community initiatives can effectively permeate the community by reaching individuals, improving physical activity and dietary habits, and ensuring sustainability. Based on the experience reported here, the success of a community initiative can be facilitated if collaborating organizations come together to implement evidence-based interventions and tailor them to the community, and if they are empowered by significant leadership and supportive collaboration and aligned by a common agenda.
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Affiliation(s)
- Katherine Oestman
- The University of Texas MD Anderson Cancer Center, 7007 Bertner Ave Unit 1628, Houston, TX, 77030, USA
| | - Ruth Rechis
- The University of Texas MD Anderson Cancer Center, 7007 Bertner Ave Unit 1628, Houston, TX, 77030, USA.
| | - Pamela A Williams
- RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Jill A Brown
- RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Katherine Treiman
- RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Brittany Zulkiewicz
- RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Michael T Walsh
- The University of Texas MD Anderson Cancer Center, 7007 Bertner Ave Unit 1628, Houston, TX, 77030, USA
| | - Karen Basen-Engquist
- The University of Texas MD Anderson Cancer Center, 7007 Bertner Ave Unit 1628, Houston, TX, 77030, USA
| | - Trina Rodriguez
- City of Pasadena Texas Parks and Recreation Department, 3111 San Augustine Avenue, Pasadena, TX, 77503, USA
| | - Catherine Chennisi
- Harris County Public Health, 2223 West Loop South, Houston, TX, 77027, USA
| | - Amber Macneish
- Pasadena Independent School District, 1515 Cherrybrook Lane, Pasadena, TX, 77502, USA
| | - Alise Neff
- Pasadena Independent School District, 1515 Cherrybrook Lane, Pasadena, TX, 77502, USA
| | - Mike Pomeroy
- Brighter Bites, 535 Portwall Street, Houston, TX, 77029, USA
| | - Faiyaz A Bhojani
- Shell USA, Inc, 150 N. Dairy Ashford Road, Houston, TX, 77002, USA
| | - Ernest Hawk
- The University of Texas MD Anderson Cancer Center, 7007 Bertner Ave Unit 1628, Houston, TX, 77030, USA
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Dixon J, Stage VC, Truesdale KP, Wu Q, Kolasa K, Haynes-Maslow L, McGuirt JT, Jilcott Pitts S. Associations between food and beverage purchases and skin carotenoids among diverse small food retail store customers. Public Health Nutr 2023; 26:2211-2217. [PMID: 37548230 DOI: 10.1017/s1368980023001581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
OBJECTIVE To determine if customer purchases at small food stores are associated with healthfulness of the diet as approximated by skin carotenoids. DESIGN This is a cross-sectional survey of customers in small food stores regarding demographics and food purchases. Food and beverage purchases were classified as 'healthy' or 'non-healthy' and 'carotenoid' v. 'non-carotenoid' using a systematic classification scheme. Fruit and vegetable intake was objectively assessed using a non-invasive device to measure skin carotenoids. Associations between variables of interest were examined using Pearson's correlation coefficients, t tests and multiple linear regression analyses. SETTING Twenty-two small food retail stores in rural (n 7 stores) and urban (n 15) areas of North Carolina. PARTICIPANTS Customers of small food stores. RESULTS Of study participants (n 1086), 55·1 % were male, 60·0 % were African American/Black and 4·2 % were Hispanic, with a mean age of 43·5 years. Overall, 36 % purchased at least one healthy item, and 7·6 % of participants purchased a carotenoid-containing food/beverage. Healthy foods and beverages purchased included produce, lean meats, 100 % juices, plain popcorn, plain nuts, milk and yogurt. Unhealthy items included non-100 % juices, crackers, chips, candy, cakes and donuts. Purchase of a healthy or carotenoid-containing item was positively associated with skin carotenoid scores (P = 0·002 and 0·006, respectively). CONCLUSIONS A relatively small proportion of customers purchased any healthy or carotenoid-containing foods and beverages, and those who did purchase healthy options had higher skin carotenoid scores. Future research should confirm these findings in different populations.
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Affiliation(s)
- Jocelyn Dixon
- Departments of Nutrition Science and Public Health, East Carolina University, Greenville, USA
- North Carolina State University, Raleigh, NC, USA
| | | | | | - Qiang Wu
- Department of Public Health, ECU, Greenville27834, USA
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Jilcott Pitts S, Moran NE, Laska MN, Wu Q, Harnack L, Moe S, Carr-Manthe P, Gates E, Chang J, Zaidi Y, Gelineau A, Berg L, Craft NE. Reflection Spectroscopy-Assessed Skin Carotenoids Are Sensitive to Change in Carotenoid Intake in a 6-Week Randomized Controlled Feeding Trial in a Racially/Ethnically Diverse Sample. J Nutr 2023; 153:1133-1142. [PMID: 36804322 PMCID: PMC10356992 DOI: 10.1016/j.tjnut.2023.02.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Reflection spectroscopy, utilized by the Veggie Meter, is a less-expensive, noninvasive method to quantify skin carotenoids and is a valid approximation of fruit and vegetable (FV) intake. However, it is unknown to what degree Veggie Meter-assessed skin carotenoid score change is responsive to changes in carotenoid intake. OBJECTIVES This study aimed to evaluate Veggie Meter-assessed skin carotenoid score response in a 6-wk randomized controlled trial of a carotenoid-containing juice to determine whether the Veggie Meter can be used to detect nutritionally relevant changes in carotenoid intake; and to compare skin and plasma carotenoid responses with the 6-wk trial. METHODS In this 6-wk trial, participants (n = 162) who self-identified as one of 4 US racial/ethnic groups (25% Black, 25% Asian, 27% non-Hispanic White, 23% Hispanic) were randomized to a control group, receiving negligible carotenoids (177 mL apple juice/d), moderate-dose group, receiving 4 mg total carotenoids/d (177 mL orange-carrot juice/d), or high-dose group, receiving 8 mg total carotenoids/d (355 mL orange-carrot juice/d). Skin carotenoid score and plasma total carotenoid concentrations (α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein, zeaxanthin) were assessed at baseline, 3 wk, and 6 wk (n = 158 completed the trial). Repeated measures linear models were used to examine skin and plasma carotenoids over time and between groups. RESULTS At 6 wk, participants in the high-dose and moderate-dose groups had significantly higher mean skin carotenoid scores [414.0 (SD = 100.6) and 369.7 (SD = 100.3), respectively] compared with those in the control group [305.2 (100.5)]. In the high-dose group, there was a 42% change in skin carotenoids from baseline (mean = 290.4) to a 6-wk follow-up (increase of 123, 123/290 = 42.4%). There was a 61% change in the plasma carotenoids in the high-dose group. CONCLUSIONS The Veggie Meter is sensitive to increases in daily carotenoid intake in diverse racial/ethnic groups over 6 wk. CLINICAL TRIALS REGISTRY NUMBER This trial was registered at clinicaltrials.gov as ID: NCT04056624. Study URL: https://clinicaltrials.gov/ct2/show/NCT04056624.
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Affiliation(s)
| | | | | | - Qiang Wu
- East Carolina University Department of Public Health, Greenville, NC, USA
| | | | - Stacey Moe
- University of Minnesota, Minneapolis, MN, USA
| | | | - Elizabeth Gates
- East Carolina University Department of Public Health, Greenville, NC, USA
| | | | - Yusuf Zaidi
- Baylor College of Medicine, Houston, TX, USA
| | | | - Lauren Berg
- University of Minnesota, Minneapolis, MN, USA
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Kaufman J, Khan M, Shepard Payne J, Mancini J, Summers White Y. Transgenerational Inheritance and Systemic Racism in America. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2023. [DOI: 10.1176/appi.prcp.20220043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Affiliation(s)
- Joan Kaufman
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute and Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD (J. Kaufman, M. Khan, J. Shepard Payne, J. Mancini, Y. Summers White)
| | - Maria Khan
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute and Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD (J. Kaufman, M. Khan, J. Shepard Payne, J. Mancini, Y. Summers White)
| | - Jennifer Shepard Payne
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute and Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD (J. Kaufman, M. Khan, J. Shepard Payne, J. Mancini, Y. Summers White)
| | - Julia Mancini
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute and Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD (J. Kaufman, M. Khan, J. Shepard Payne, J. Mancini, Y. Summers White)
| | - Yvonne Summers White
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute and Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD (J. Kaufman, M. Khan, J. Shepard Payne, J. Mancini, Y. Summers White)
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Wolgast H, Halverson MM, Kennedy N, Gallard I, Karpyn A. Encouraging Healthier Food and Beverage Purchasing and Consumption: A Review of Interventions within Grocery Retail Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16107. [PMID: 36498181 PMCID: PMC9737366 DOI: 10.3390/ijerph192316107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
This review identifies the most promising intervention strategies for promoting the purchase and consumption of healthier items within U.S. grocery retail settings, with a particular focus on those strategies that may be most effective when implemented within SNAP-authorized retail settings. Searches of nine electronic databases, as well as forward and backward searches, yielded 1942 studies. After being screened, 73 peer-reviewed academic articles were identified for inclusion. Of these, 33 analyzed single-component interventions, while 40 assessed multi-component interventions. The following unique intervention types were considered as evaluated in these studies for their ability to increase healthy item purchasing and consumption: (1) nutrition scoring, (2) nutritional messaging, (3) non-nutritional messaging, (4) endcaps and secondary placement, (5) point-of-sale interventions, (6) increased stocking, (7) food tasting and demonstrations, (8) nutrition education, and (9) placement on shelf interventions. Nutritional scoring and nutritional messaging emerged as the most rigorously tested and effective intervention strategies. Other strategies warrant more research attention. Simple intervention strategies, as opposed to complex ones, yield the most successful results and minimize shopper burden. Therefore, these strategies should be reviewed for policy implementation within SNAP-authorized grocery retailers.
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Affiliation(s)
- Henry Wolgast
- Center for Research in Education and Social Policy, University of Delaware, Newark, DE 19716, USA
| | - McKenna M. Halverson
- Center for Research in Education and Social Policy, University of Delaware, Newark, DE 19716, USA
| | - Nicole Kennedy
- Center for Research in Education and Social Policy, University of Delaware, Newark, DE 19716, USA
| | | | - Allison Karpyn
- Center for Research in Education and Social Policy, University of Delaware, Newark, DE 19716, USA
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Isaacs A, Halligan J, Neve K, Hawkes C. From healthy food environments to healthy wellbeing environments: Policy insights from a focused ethnography with low-income parents' in England. Health Place 2022; 77:102862. [PMID: 35926370 DOI: 10.1016/j.healthplace.2022.102862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 05/31/2022] [Accepted: 07/01/2022] [Indexed: 12/30/2022]
Abstract
Overweight and obesity continue to increase globally. In England, as in many other countries, this disproportionately affects people who experience socioeconomic deprivation. One factor blamed for inequalities in obesity is unhealthy food provisioning environments (FPEs), leading to a focus on policies and interventions to change FPEs. This paper aims to provide insights into how FPE policies could more effectively tackle inequalities in obesity by addressing a key research gap: how the structural contexts in which people live their lives influence their interaction with their FPEs. It aims to understand how low-income families engage with FPEs through in-depth focused ethnographic research with 60 parents across three locations in England: Great Yarmouth, Stoke-on-Trent, and the London Borough of Lewisham. Analysis was guided by sociological perspectives. FPEs simultaneously push low-income families towards unhealthy products while supporting multiple other family needs, such as social wellbeing. FPE policies and interventions to address obesity must acknowledge this challenge and consider not just the makeup of FPEs themselves but how various structural contexts shape how people come to use them.
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Affiliation(s)
- Anna Isaacs
- Centre for Food Policy, City University of London, UK.
| | - Joel Halligan
- Centre for Food Policy, City University of London, UK
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A Produce Prescription Program in Eastern North Carolina Results in Increased Voucher Redemption Rates and Increased Fruit and Vegetable Intake among Participants. Nutrients 2022; 14:nu14122431. [PMID: 35745161 PMCID: PMC9229115 DOI: 10.3390/nu14122431] [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: 04/29/2022] [Revised: 05/31/2022] [Accepted: 06/09/2022] [Indexed: 02/04/2023] Open
Abstract
Few produce prescription programs have taken place in rural areas, in the context of existing public health programs. Thus, the purpose of this mixed-methods study was to examine voucher redemption rates, change in fruit and vegetable intake, and suggestions for improvement among participants enrolled in a produce prescription program occurring in existing public health programs throughout rural eastern North Carolina. We examined voucher redemption rates and conducted pre- (n = 125) and post-intervention surveys assessing fruit and vegetable intake. t-tests were used to examine changes in intake pre- versus post-intervention among 50 participants. Participants (n = 32) also completed a semi-structured, telephone interview. Qualitative data were thematically analyzed to determine potential improvements. The overall voucher redemption rate was 52%. There was a 0.29 (standard deviation = 0.91, p = 0.031) cup increase in self-reported fruit intake comparing post- to pre-intervention data. Qualitative analyses indicated that participants enjoyed the financial benefits of the program and wanted it to continue. The produce prescription program was successful in increasing self-reported fruit intake among participants. More research is needed to determine if changes in intake persist when measured objectively, and on best methods for the program’s financial sustainability.
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Radtke MD, Poe M, Stookey J, Jilcott Pitts S, Moran NE, Landry MJ, Rubin LP, Stage VC, Scherr RE. Recommendations for the Use of the Veggie Meter® for Spectroscopy-Based Skin Carotenoid Measurements in the Research Setting. Curr Dev Nutr 2021; 5:nzab104. [PMID: 34476333 PMCID: PMC8405124 DOI: 10.1093/cdn/nzab104] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/18/2021] [Accepted: 07/22/2021] [Indexed: 12/20/2022] Open
Abstract
Carotenoids are a class of phytochemical compounds found in a variety of fruits and vegetables (F/V) and, therefore, are commonly used as a biomarker for F/V intake. The Veggie Meter® is a noninvasive research-grade instrument that detects and quantifies carotenoids in the skin. To determine current practices and examine variability among users, a survey was administered to researchers using the device (n = 19, response rate = 35.8%) and variation in anatomical site preparation, calibration, number of measurements, measurement site, and documentation was observed. A protocol was developed in partnership with Veggie Meter® users to outline the preparation, calibration, and data collection procedures for using this device for research purposes. Although many protocol conditions will benefit from additional validation, this standardized protocol supports the development of a universal data repository to establish usual observed ranges, with the ultimate goal of examining associations between skin carotenoid scores and diet-related health outcomes.
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Affiliation(s)
- Marcela D Radtke
- Department of Nutrition, University of California, Davis, Davis, CA, USA
- Center for Nutrition in Schools, University of California, Davis, Davis, CA, USA
| | - Mykaela Poe
- Department of Public Health Sciences, University of California, Davis, Davis, CA, USA
| | - Jodi Stookey
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Stephanie Jilcott Pitts
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Nancy E Moran
- USDA/Agricultural Research Service Children's Nutrition Research Center and Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Matthew J Landry
- Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, CA, USA
| | - Lewis P Rubin
- Department of Pediatrics, Georgetown University Medical Center, Washington, DC, USA
| | - Virginia C Stage
- Department of Nutrition Science, East Carolina University, Greenville, NC, USA
| | - Rachel E Scherr
- Department of Nutrition, University of California, Davis, Davis, CA, USA
- Center for Nutrition in Schools, University of California, Davis, Davis, CA, USA
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Haynes-Maslow L, Jilcott Pitts SB, Boys KA, McGuirt JT, Fleischhacker S, Ammerman AS, Johnson N, Kelley C, Donadio VE, Bell RA, Laska MN. Qualitative perspectives of the North Carolina healthy food small retailer program among customers in participating stores located in food deserts. BMC Public Health 2021; 21:1459. [PMID: 34315470 PMCID: PMC8317385 DOI: 10.1186/s12889-021-11509-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/10/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The North Carolina Healthy Food Small Retailer Program (NC HFSRP) was established through a policy passed by the state legislature to provide funding for small food retailers located in food deserts with the goal of increasing access to and sales of healthy foods and beverages among local residents. The purpose of this study was to qualitatively examine perceptions of the NC HFSRP among store customers. METHODS Qualitative interviews were conducted with 29 customers from five NC HFSRP stores in food deserts across eastern NC. Interview questions were related to shoppers' food and beverage purchases at NC HFSRP stores, whether they had noticed any in-store efforts to promote healthier foods and beverages, their suggestions for promoting healthier foods and beverages, their familiarity with and support of the NC HFSRP, and how their shopping and consumption habits had changed since implementation of the NC HFSRP. A codebook was developed based on deductive (from the interview guide questions) and inductive (emerged from the data) codes and operational definitions. Verbatim transcripts were double-coded and a thematic analysis was conducted based on code frequency, and depth of participant responses for each code. RESULTS Although very few participants were aware of the NC HFSRP legislation, they recognized changes within the store. Customers noted that the provision of healthier foods and beverages in the store had encouraged them to make healthier purchase and consumption choices. When a description of the NC HFSRP was provided to them, all participants were supportive of the state-funded program. Participants discussed program benefits including improving food access in low-income and/or rural areas and making healthy choices easier for youth and for those most at risk of diet-related chronic diseases. CONCLUSIONS Findings can inform future healthy corner store initiatives in terms of framing a rationale for funding or policies by focusing on increased food access among vulnerable populations.
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Affiliation(s)
- Lindsey Haynes-Maslow
- Department of Agricultural & Human Sciences, NC State University, 512 Brickhaven Drive, Room 240c, Raleigh, NC, 27695, USA.
| | - Stephanie B Jilcott Pitts
- Department of Public Health, East Carolina University, 115 Heart Drive, Room #2239, Greenville, NC, 27834, USA
| | - Kathryn A Boys
- Department of Agricultural and Resource Economics, North Carolina State University, 4306 Nelson Hall, Raleigh, NC, 27695-8109, USA
| | - Jared T McGuirt
- Department of Nutrition, University of North Carolina Greensboro, 319 Colllege Avenue, 318 Stone Building, Greensboro, NC, 27412, USA
| | | | - Alice S Ammerman
- Department of Nutrition, University of North Carolina at Chapel Hill, CB# 7426, 1700 MLK Jr. Blvd, Room 239, Chapel Hill, NC, 27599-7426, USA
| | - Nevin Johnson
- Department of Public Health, East Carolina University, 115 Heart Drive, Room #2239, Greenville, NC, 27834, USA
| | - Casey Kelley
- University of North Carolina at Chapel Hill, School of Medicine, Division of Geriatric Medicine, Center for Aging and Health, 5003 Old Clinic CB#7550, Chapel Hill, NC, 27599, USA
| | - Victoria E Donadio
- Department of Public Health, East Carolina University, 115 Heart Drive, Room #2239, Greenville, NC, 27834, USA
| | - Ronny A Bell
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Melissa N Laska
- Epidemiology & Community Health, University of Minnesota, 1300 South 2nd Street, WBOB Suite 300, Minneapolis, MN, 55454-1015, USA
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