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Fernández-Gaxiola AC, Cruz-Casarrubias C, Pacheco-Miranda S, Marrón-Ponce JA, Quezada AD, García-Guerra A, Donovan J. Access to Healthy Wheat and Maize Processed Foods in Mexico City: Comparisons across Socioeconomic Areas and Store Types. Nutrients 2022; 14:1173. [PMID: 35334830 PMCID: PMC8955009 DOI: 10.3390/nu14061173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/19/2022] [Accepted: 02/24/2022] [Indexed: 11/17/2022] Open
Abstract
The contributions of processed foods to the overweight and obesity problem in Latin America are well known. Engagement with the private and public sectors on possible solutions requires deeper insights into where and how these products are sold and the related implications for diet quality. This article characterizes the diversity of wheat and maize processed foods (WMPFs) available to consumers in Mexico City. Data were gathered across nine product categories at different points of sale (supermarkets, small grocery stores, convenience stores) in high and low socioeconomic (SE) areas. We assessed WMPFs based on Nutri-Score profile, price, and health and nutrition claims. Roughly 17.4% of the WMPFs were considered healthy, of which 62.2% were pastas and breads. Availability of healthy WMPFs was scarce in most stores, particularly in convenience stores Compared to supermarkets in the low SE area, those in the high SE area exhibited greater variety in access to healthy WMPFs across all product categories. In the low SE area, healthy WMPFs were priced 16-69% lower than unhealthy WMPFs across product categories. The extensive variety of unhealthy WMPFs, the limited stock of healthy WMPFs in most retail outlets, and the confusing health and nutrition claims on packaging make it difficult for urban consumers to find and choose healthy WMPFs.
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Affiliation(s)
- Ana Cecilia Fernández-Gaxiola
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública (INSP), Universidad No. 655, Colonia Santa María Ahuacatitlán Cerrada Los Pinos y Caminera, Cuernavaca C.P. 62100, Mexico; (A.C.F.-G.); (C.C.-C.); (S.P.-M.); (J.A.M.-P.)
| | - Carlos Cruz-Casarrubias
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública (INSP), Universidad No. 655, Colonia Santa María Ahuacatitlán Cerrada Los Pinos y Caminera, Cuernavaca C.P. 62100, Mexico; (A.C.F.-G.); (C.C.-C.); (S.P.-M.); (J.A.M.-P.)
| | - Selene Pacheco-Miranda
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública (INSP), Universidad No. 655, Colonia Santa María Ahuacatitlán Cerrada Los Pinos y Caminera, Cuernavaca C.P. 62100, Mexico; (A.C.F.-G.); (C.C.-C.); (S.P.-M.); (J.A.M.-P.)
| | - Joaquín Alejandro Marrón-Ponce
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública (INSP), Universidad No. 655, Colonia Santa María Ahuacatitlán Cerrada Los Pinos y Caminera, Cuernavaca C.P. 62100, Mexico; (A.C.F.-G.); (C.C.-C.); (S.P.-M.); (J.A.M.-P.)
| | - Amado David Quezada
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública (INSP), Universidad No. 655, Colonia Santa María Ahuacatitlán Cerrada Los Pinos y Caminera, Cuernavaca C.P. 62100, Mexico;
| | - Armando García-Guerra
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública (INSP), Universidad No. 655, Colonia Santa María Ahuacatitlán Cerrada Los Pinos y Caminera, Cuernavaca C.P. 62100, Mexico; (A.C.F.-G.); (C.C.-C.); (S.P.-M.); (J.A.M.-P.)
| | - Jason Donovan
- International Maize and Wheat Improvement Center (CIMMYT), Carretera México-Veracruz Km 45, El Batán, Texcoco C.P. 56237, Mexico;
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Oktay LA, Abuelgasim E, Abdelwahed A, Houbby N, Lampridou S, Normahani P, Peters N, Jaffer U. Factors Affecting Engagement in Web-Based Health Care Patient Information: Narrative Review of the Literature. J Med Internet Res 2021; 23:e19896. [PMID: 34554104 PMCID: PMC8498891 DOI: 10.2196/19896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/06/2020] [Accepted: 11/02/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Web-based content is rapidly becoming the primary source of health care information. There is a pressing need for web-based health care content to not only be accurate but also be engaging. Improved engagement of people with web-based health care content has the potential to inform as well as influence behavioral change to enable people to make better health care choices. The factors associated with better engagement with web-based health care content have previously not been considered. OBJECTIVE The aims of this study are to identify the factors that affect engagement with web-based health care content and develop a framework to be considered when creating such content. METHODS A comprehensive search of the PubMed and MEDLINE database was performed from January 1, 1946, to January 5, 2020. The reference lists of all included studies were also searched. The Medical Subject Headings database was used to derive the following keywords: "patient information," "online," "internet," "web," and "content." All studies in English pertaining to the factors affecting engagement in web-based health care patient information were included. No restrictions were set on the study type. Analysis of the themes arising from the results was performed using inductive content analysis. RESULTS The search yielded 814 articles, of which 56 (6.9%) met our inclusion criteria. The studies ranged from observational and noncontrolled studies to quasi-experimental studies. Overall, there was significant heterogeneity in the types of interventions and outcome assessments, which made quantitative assessment difficult. Consensus among all authors of this study resulted in six categories that formed the basis of a framework to assess the factors affecting engagement in web-based health care content: easy to understand, support, adaptability, accessibility, visuals and content, and credibility and completeness. CONCLUSIONS There is a paucity of high-quality data relating to the factors that improve the quality of engagement with web-based health care content. Our framework summarizes the reported studies, which may be useful to health care content creators. An evaluation of the utility of web-based content to engage users is of significant importance and may be accessible through tools such as the Net Promoter score. Web 3.0 technology and development of the field of psychographics for health care offer further potential for development. Future work may also involve improvement of the framework through a co-design process.
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Affiliation(s)
| | | | | | - Nour Houbby
- Imperial College London, London, United Kingdom
| | | | | | | | - Usman Jaffer
- Imperial College NHS Trust, London, United Kingdom
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Mavhu W, Neuman M, Hatzold K, Buzuzi S, Maringwa G, Chabata ST, Mangenah C, Taruberekera N, Madidi N, Munjoma M, Ncube G, Xaba S, Mugurungi O, Johnson CC, Corbett EL, Weiss HA, Fielding K, Cowan FM. Innovative demand creation strategies to increase voluntary medical male circumcision uptake: a pragmatic randomised controlled trial in Zimbabwe. BMJ Glob Health 2021; 6:bmjgh-2021-006141. [PMID: 34275877 PMCID: PMC8287600 DOI: 10.1136/bmjgh-2021-006141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/16/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Reaching men aged 20-35 years, the group at greatest risk of HIV, with voluntary medical male circumcision (VMMC) remains a challenge. We assessed the impact of two VMMC demand creation approaches targeting this age group in a randomised controlled trial (RCT). METHODS We conducted a 2×2 factorial RCT comparing arms with and without two interventions: (1) standard demand creation augmented by human-centred design (HCD)-informed approach; (2) standard demand creation plus offer of HIV self-testing (HIVST). Interpersonal communication (IPC) agents were the unit of randomisation. We observed implementation of demand creation over 6 months (1 May to 31 October 2018), with number of men circumcised assessed over 7 months. The primary outcome was the number of men circumcised per IPC agent using the as-treated population of actual number of months each IPC agent worked. We conducted a mixed-methods process evaluation within the RCT. RESULTS We randomised 140 IPC agents, 35 in each arm. 132/140 (94.3%) attended study training and 105/132 (79.5%) reached at least one client during the trial period and were included in final analysis. There was no evidence that the HCD-informed intervention increased VMMC uptake versus no HCD-informed intervention (incident rate ratio (IRR) 0.87, 95% CI 0.38 to 2.02; p=0.75). Nor did offering men a HIVST kit at time of VMMC mobilisation (IRR 0.65, 95% CI 0.28 to 1.50; p=0.31). Among IPC agents that reported reaching at least one man with demand creation, both the HCD-informed intervention and HIVST were deemed useful. There were some challenges with trial implementation; <50% of IPC agents converted any men to VMMC, which undermined our ability to show an effect of demand creation and may reflect acceptability and feasibility of the interventions. CONCLUSION This RCT did not show evidence of an effect of HCD-informed demand intervention or HIVST on VMMC uptake. Findings will inform future design and implementation of demand creation evaluations. TRIAL REGISTRATION NUMBER PACTR201804003064160.
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Affiliation(s)
- Webster Mavhu
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe .,Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Melissa Neuman
- MRC International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Karin Hatzold
- Population Services International, Washington, District of Columbia, USA
| | - Stephen Buzuzi
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe
| | - Galven Maringwa
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe
| | - Sungai T Chabata
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe
| | - Collin Mangenah
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe
| | | | | | - Malvern Munjoma
- Population Services International Zimbabwe, Harare, Zimbabwe
| | | | | | | | | | - Elizabeth L Corbett
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Helen A Weiss
- MRC International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Katherine Fielding
- MRC International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Frances M Cowan
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe,Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
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Sewak A, Kim J, Rundle-Thiele S, Deshpande S. Influencing household-level waste-sorting and composting behaviour: What works? A systematic review (1995-2020) of waste management interventions. WASTE MANAGEMENT & RESEARCH : THE JOURNAL OF THE INTERNATIONAL SOLID WASTES AND PUBLIC CLEANSING ASSOCIATION, ISWA 2021; 39:892-909. [PMID: 33472560 DOI: 10.1177/0734242x20985608] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Decentralized waste sorting and composting can divert almost two-thirds of household waste from landfill. However, national rates of composting and recycling remain low in many parts of the globe. This review critically evaluates the design and efficacy of behaviour-change interventions to influence households to sort and compost organic waste. The systematic literature search yielded 3595 titles and abstracts which were reviewed and resulted in 14 unique interventions. The social marketing benchmark criteria are utilized to critically examine the design of these interventions. Synthesized results indicate a need for customized interventions that are co-designed with users and tailored to address their specific needs and challenges. Interventions with four or more social marketing elements produced positive behavioural outcomes, albeit with varying impact. This review highlights gaps in the design of waste management interventions and provides suggestions for future practices.
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Affiliation(s)
- Aarti Sewak
- Department of Marketing, Griffith University, Queensland, Australia
| | - Jeawon Kim
- Department of Marketing, Griffith University, Queensland, Australia
| | | | - Sameer Deshpande
- Department of Marketing, Griffith University, Queensland, Australia
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Bell J, Sharma S, Malone S, Levy M, Reast J, Ciecieląg J, Gogolina S, Ansons T, Fourie S, Braz R, Little K, Hasen N. Targeting interventions for HIV testing and treatment uptake: An attitudinal and behavioural segmentation of men aged 20-34 in KwaZulu-Natal and Mpumalanga, South Africa. PLoS One 2021; 16:e0247483. [PMID: 33690691 PMCID: PMC7946194 DOI: 10.1371/journal.pone.0247483] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 02/08/2021] [Indexed: 11/19/2022] Open
Abstract
Despite recent improvements, men still have worse HIV outcomes than women in South Africa. This study describes how young men form distinct behavioural and attitudinal subgroups, and is intended to inform the design of targeted interventions to encourage HIV testing and initiation on antiretroviral therapy. Data were collected using a cross-sectional survey with questions on men’s attitudes, beliefs and behaviours around HIV/AIDS. A total of 2,019 men were randomly sampled from eight district municipalities in KwaZulu-Natal and Mpumalanga provinces between October 2018 and January 2019. Men were eligible to participate if they were aged 20–34, Black African, had an education level below university graduation, were aware of HIV and were willing to disclose whether they had tested for HIV. Each participant responded to a questionnaire asking about their demographic characteristics, reported sexual behaviour, engagement with HIV testing and treatment services, alcohol consumption, HIV knowledge, attitudes to gender equity and reported level of depressive symptoms. Data were analysed using canonical correlation, hierarchical clustering and factor analysis techniques to produce five groups of men. The results were synthesised using Human Centred Design principles to suggests areas for potential intervention for each segment. The results showed that men vary based on their attitudes to gender and masculinity, use of alcohol, testing and treatment behaviour, HIV-related fears and preferences for testing modalities. Segment 1 (21%) avoids the topic of HIV, perhaps fearful of the impact on his life. Segment 2 (23%) is well connected to his community and has social concerns about HIV. Segment 3 (15%) struggles with more distal determinants of HIV acquisition such as unemployment and poor mental health. Segment 4 (25%) has concerns about the lifestyle changes that would be required if he were HIV positive. Segment 5 (16%) has a strong traditional mindset and is fearful of the ramifications of HIV in his community. The results will be used to design targeted interventions to increase HIV testing and treatment rates among young men in South Africa. Further research is required to understand the impact of interventions designed in this way.
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Affiliation(s)
- James Bell
- Ipsos Healthcare, London, United Kingdom
- * E-mail:
| | | | - Shawn Malone
- Population Services International, Johannesburg, South Africa
| | | | | | | | | | - Tamara Ansons
- Global Science Organisation, Ipsos, London, United Kingdom
| | | | | | - Kristen Little
- Population Services International, Washington, DC, United States of America
| | - Nina Hasen
- Population Services International, Washington, DC, United States of America
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Mathur S, Pilgrim N, Patel SK, Okal J, Mwapasa V, Chipeta E, Musheke M, Mahapatra B, Pulerwitz J. HIV vulnerability among adolescent girls and young women: a multi-country latent class analysis approach. Int J Public Health 2020; 65:399-411. [PMID: 32270233 PMCID: PMC7274997 DOI: 10.1007/s00038-020-01350-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 02/06/2020] [Accepted: 03/11/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To stem the HIV epidemic among adolescent girls and young women (AGYW, 15-24 years), prevention programs need to reach AGYW who are most at risk. We examine whether individual- and household-level factors could be used to define HIV vulnerability for AGYW. METHODS We surveyed out-of-school AGYW in urban and peri-urban Kenya (N = 1014), in urban Zambia (N = 846), and in rural Malawi (N = 1654) from October 2016 to 2017. LCA identified classes based on respondent characteristics, attitudes and knowledge, and household characteristics. Multilevel regressions examined associations between class membership and HIV-related health outcomes. RESULTS We identified two latent classes-high and low HIV vulnerability profiles-among AGYW in each country; 32% of the sample in Kenya, 53% in Malawi, and 51% in Zambia belonged to the high vulnerability group. As compared to AGYW with a low-vulnerability profile, AGYW with a high-vulnerability profile had significantly higher odds of HIV-related outcomes (e.g., very early sexual debut, transactional sex, sexual violence from partners). CONCLUSIONS Out-of-school AGYW had differential vulnerability to HIV. Interventions should focus on reaching AGYW in the high HIV vulnerability profiles.
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Affiliation(s)
- Sanyukta Mathur
- Population Council, 4301 Connecticut Ave, Suite 280, Washington, DC USA
| | | | | | | | - Victor Mwapasa
- Centre for Reproductive Health, College of Medicine, Blantyre, Malawi
| | - Effie Chipeta
- Centre for Reproductive Health, College of Medicine, Blantyre, Malawi
| | | | | | - Julie Pulerwitz
- Population Council, 4301 Connecticut Ave, Suite 280, Washington, DC USA
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