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Ruggiero CF, Trexberg KM, Moore AM, Savage JS. Applying the Family Stress Model to responsive feeding and early obesity prevention. Appetite 2024; 200:107515. [PMID: 38797237 PMCID: PMC11227407 DOI: 10.1016/j.appet.2024.107515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/13/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
Rapid weight gain during infancy and obesity during early childhood may lead to adverse health outcomes during later childhood and into adulthood, especially in families experiencing economic hardship. Families experiencing economic hardship may also experience food insecurity, which can impact child development and responsive feeding, an important target for obesity prevention in early life. The Family Stress Model suggests that stress, particularly economic hardship, can negatively impact parents' mental health, parenting, and quality of family relationships. This review proposes a conceptual model that expands upon the original Family Stress Model by including parent-child dyadic interactions during feeding (i.e., responsive feeding) as well as the coparenting relationship around feeding. Our conceptual model integrates responsive feeding into the Family Stress Model and includes the impact of food insecurity on feeding and child health outcomes. Such models that consider multiple influences on child development have implications for the design of effective interventions to promote healthy growth for entire families. Future directions in this research will empirically test the model and explore early intervention strategies that aim to promote responsive feeding, nutrition security, and health within families. Continuing interdisciplinary research between the fields of nutrition and family development will be key to addressing the complex interplay of family stressors, parent responsiveness, and childhood obesity.
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Affiliation(s)
- Cara F Ruggiero
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA; Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Kaitlin M Trexberg
- Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA.
| | - Amy M Moore
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA.
| | - Jennifer S Savage
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA; Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA.
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Liu Z, Zou W. Breaking Taboos in Women's Reproductive Health: The Communication Strategies Used by Top OB/GYN Influencers in Chinese Social Media. HEALTH COMMUNICATION 2024; 39:685-696. [PMID: 36803354 DOI: 10.1080/10410236.2023.2181677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Numerous women struggling with health issues dare not go to the hospital due to the stigmatization of obstetric and gynecological diseases in traditional Chinese culture. Social media provide a platform for women to access health information from experts easily. Guided by the doctor-patient communication model, attribution theory, and destigmatization framework, we sought to understand the topics/diseases covered by top OB/GYN influencers on Weibo and the prevalent functions, language style, responsibility attribution, and destigmatization cues used by them. We also examined how these communication strategies predicted followers' engagement behavior. The results showed that women's childbirth-related issues received the highest exposure in the leading OB/GYN influencers' Weibo posts. Influencers' emphasis on building psychological connectedness with their followers was exhibited in the following communication strategies: avoiding using complex medical terminology, drawing equivalences between the outgroup and ingroup, and providing health information. However, using everyday language, responding to emotions, and removing blame served as the three most influential predictors of followers' engagement. Theoretical and practical implications are also discussed.
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Affiliation(s)
- Zikun Liu
- School of Journalism and Communication, Tsinghua University
| | - Wenxue Zou
- Department of Communication and Journalism, Texas A&M University
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3
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Rivera JA, Colchero MA, Pérez-Ferrer C, Barquera S. Perspective: Mexico's Experience in Building a Toolkit for Obesity and Noncommunicable Diseases Prevention. Adv Nutr 2024; 15:100180. [PMID: 38246349 PMCID: PMC10877686 DOI: 10.1016/j.advnut.2024.100180] [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: 10/17/2023] [Revised: 12/15/2023] [Accepted: 01/16/2024] [Indexed: 01/23/2024] Open
Abstract
Noncommunicable diseases (NCDs) are a leading cause of death and disability worldwide, with a higher risk of death in low- and middle-income countries. Diet and excess weight are risk factors for NCDs. In Mexico, the prevalence of overweight and obesity increased dramatically in the last 30 y and is among the highest in the world. To address this public health problem, governments and public health professionals have several policy instruments available. In this study, we present the policy instruments currently approved in Mexico, which include fiscal, informational, and authoritative tools that aim to improve the food environment and promote healthy behaviors (taxes, school food guidelines, front-of-pack labeling, marketing regulations, and dietary guidelines). These types of interventions are important in regions like Latin America, where social inequities and poor access to information are common, and individual healthy choices are often limited. These interventions target the environments in which individuals live, study, work, and seek entertainment, while limiting access to unhealthy choices and offering information to promote healthy alternatives. The Mexican experience in design, implementation, and evaluation of policies to improve the food environment can be useful for other low- and middle-income countries facing similar challenges.
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Affiliation(s)
- Juan A Rivera
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Mónica Arantxa Colchero
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Carolina Pérez-Ferrer
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Kokabisaghi F, Emadi MSM, Tajik A, Sharifi F, Houshmand E, Varmaghani M. The prevalence and causes of self-medication among medical university students in Iran during COVID-19 outbreak and its implications for public health and health systems: A cross-sectional study. Health Sci Rep 2024; 7:e1983. [PMID: 38515543 PMCID: PMC10955222 DOI: 10.1002/hsr2.1983] [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: 07/15/2023] [Revised: 10/09/2023] [Accepted: 03/01/2024] [Indexed: 03/23/2024] Open
Abstract
Background and Aims Self-medication is a worldwide phenomenon that brings advantages and disadvantages to public health and health systems. This study investigated the extent and causes of self-medication among medical university students and its implications for public health in Iran in 2020. Methods The present study was designed as a descriptive-analytical cross-sectional study that examined the knowledge, attitude, and practice of self-medication. The population of the study was the students of health sciences programs who all entered the study. The data collection tool included a questionnaire designed online and available to students. The content validity ratio of the questionnaire was 0.84, and the alpha Cronbach coefficient was calculated at 0.8936. Results The prevalence of self-medication among medical university students was 19%. The most common reason for self-medication was the safety of medicines (66.67%). The most usual form of medication used was the tablet (35.67%), the most common drug taken was acetaminophen (69.01%), and the most common disease to self-medicate for was headache (67.36%). Estimating the odds ratio of self-medication with demographic variables showed no relationship. However, after adjusting the variables, age and type of degree showed an association with self-medication, as the older participants and postgraduate students had positive attitudes toward self-medication. Conclusion Self-medication may be helpful, but it often needs proper guidance and logic and can carry various risks. Considering that medical sciences students will be influential in society in the future, it is necessary to pay more attention to correcting their drug use culture and providing access to health services for everyone. Appropriate prescription of medicines, controlling drug sales in pharmacies, highlighting the role of pharmacists in safe self-medication, and controlling the prevalence of self-medication is necessary.
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Affiliation(s)
- Fatemeh Kokabisaghi
- Social Determinants of Health Research CenterMashhad University of Medical SciencesMashhadIran
- Department of Health Economics and Management Sciences, School of HealthMashhad University of Medical SciencesMashhadIran
| | - Mina Sadat Mousavi Emadi
- Social Determinants of Health Research CenterMashhad University of Medical SciencesMashhadIran
- Department of Health Economics and Management Sciences, School of HealthMashhad University of Medical SciencesMashhadIran
| | - Amirmohammad Tajik
- School of PharmacyMashhad University of Medical SciencesMashhadIran
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Elaheh Houshmand
- Social Determinants of Health Research CenterMashhad University of Medical SciencesMashhadIran
- Department of Health Economics and Management Sciences, School of HealthMashhad University of Medical SciencesMashhadIran
| | - Mehdi Varmaghani
- Social Determinants of Health Research CenterMashhad University of Medical SciencesMashhadIran
- Department of Health Economics and Management Sciences, School of HealthMashhad University of Medical SciencesMashhadIran
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5
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Duarte MKRN, Leite-Lais L, Agnez-Lima LF, Maciel BLL, Morais AHDA. Obesity and Nutrigenetics Testing: New Insights. Nutrients 2024; 16:607. [PMID: 38474735 DOI: 10.3390/nu16050607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Obesity results from interactions between environmental factors, lifestyle, and genetics. In this scenario, nutritional genomics and nutrigenetic tests stand out, with the promise of helping patients avoid or treat obesity. This narrative review investigates whether nutrigenetic tests may help to prevent or treat obesity. Scientific studies in PubMed Science Direct were reviewed, focusing on using nutrigenetic tests in obesity. The work showed that few studies address the use of tools in obesity. However, most of the studies listed reported their beneficial effects in weight loss. Ethical conflicts were also discussed, as in most countries, there are no regulations to standardize these tools, and there needs to be more scientific knowledge for health professionals who interpret them. International Societies, such as the Academy of Nutrition and Dietetics and the Brazilian Association for the Study of Obesity and Metabolic Syndrome, do not recommend nutrigenetic tests to prevent or treat obesity, especially in isolation. Advancing nutrigenetics depends on strengthening three pillars: regulation between countries, scientific evidence with clinical validity, and professional training.
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Affiliation(s)
| | - Lúcia Leite-Lais
- Department of Cell Biology and Genetics, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Lucymara Fassarella Agnez-Lima
- Biochemistry and Molecular Biology Postgraduate Program, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Department of Cell Biology and Genetics, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Bruna Leal Lima Maciel
- Department of Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Postgraduate Program in Nutrition, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Ana Heloneida de Araújo Morais
- Biochemistry and Molecular Biology Postgraduate Program, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Department of Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
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Hernandez I, Wright DR, Guo J, Shrank WH. Medicare Part D Coverage of Anti-obesity Medications: a Call for Forward-Looking Policy Reform. J Gen Intern Med 2024; 39:306-308. [PMID: 37715099 PMCID: PMC10853087 DOI: 10.1007/s11606-023-08416-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/05/2023] [Indexed: 09/17/2023]
Abstract
When the Medicare Part D benefit was constructed, drugs for weight loss were explicitly excluded from coverage, as the limited effectiveness and unfavorable safety profile of medications available at the time failed to justify coverage of drugs perceived to be used for cosmetic purposes. In recent years, drugs activating the glucagon-like peptide-1 receptor (GLP-1R) pathway have proved to achieve significant reductions in body weight with a favorable safety profile. The effectiveness of GLP-1R agonists in reducing weight and improving the metabolic profile warrants the reconsideration of the historical exclusion of weight loss drugs from Part D coverage. In this perspective, we outline policy options to enable Part D coverage of GLP-1R agonists. These include legislative change through the passage of the Treat and Reduce Obesity Act and evaluation of coverage policies under the waiver authority of the Center for Medicare and Medicaid Innovation.
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Affiliation(s)
- Inmaculada Hernandez
- Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, La Jolla, USA.
| | - Davene R Wright
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, USA
| | - Jingchuan Guo
- Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, USA
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Novilla MLB, Goates MC, Leffler T, Novilla NKB, Wu CY, Dall A, Hansen C. Integrating Social Care into Healthcare: A Review on Applying the Social Determinants of Health in Clinical Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6873. [PMID: 37835143 PMCID: PMC10573056 DOI: 10.3390/ijerph20196873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/23/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023]
Abstract
Despite the substantial health and economic burdens posed by the social determinants of health (SDH), these have yet to be efficiently, sufficiently, and sustainably addressed in clinical settings-medical offices, hospitals, and healthcare systems. Our study contextualized SDH application strategies in U.S. clinical settings by exploring the reasons for integration and identifying target patients/conditions, barriers, and recommendations for clinical translation. The foremost reason for integrating SDH in clinical settings was to identify unmet social needs and link patients to community resources, particularly for vulnerable and complex care populations. This was mainly carried out through SDH screening during patient intake to collect individual-level SDH data within the context of chronic medical, mental health, or behavioral conditions. Challenges and opportunities for integration occurred at the educational, practice, and administrative/institutional levels. Gaps remain in incorporating SDH in patient workflows and EHRs for making clinical decisions and predicting health outcomes. Current strategies are largely directed at moderating individual-level social needs versus addressing community-level root causes of health inequities. Obtaining policy, funding, administrative and staff support for integration, applying a systems approach through interprofessional/intersectoral partnerships, and delivering SDH-centered medical school curricula and training are vital in helping individuals and communities achieve their best possible health.
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Affiliation(s)
- M. Lelinneth B. Novilla
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (T.L.); (N.K.B.N.); (C.-Y.W.); (A.D.); (C.H.)
| | - Michael C. Goates
- Harold B. Lee Library, Brigham Young University, Provo, UT 84602, USA;
| | - Tyler Leffler
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (T.L.); (N.K.B.N.); (C.-Y.W.); (A.D.); (C.H.)
| | - Nathan Kenneth B. Novilla
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (T.L.); (N.K.B.N.); (C.-Y.W.); (A.D.); (C.H.)
| | - Chung-Yuan Wu
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (T.L.); (N.K.B.N.); (C.-Y.W.); (A.D.); (C.H.)
| | - Alexa Dall
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (T.L.); (N.K.B.N.); (C.-Y.W.); (A.D.); (C.H.)
| | - Cole Hansen
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (T.L.); (N.K.B.N.); (C.-Y.W.); (A.D.); (C.H.)
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Levy N, Savulescu J. The Myth of Zero-Sum Responsibility: Towards Scaffolded Responsibility for Health. JOURNAL OF MORAL PHILOSOPHY 2023; 21:85-105. [PMID: 38623184 PMCID: PMC7615831 DOI: 10.1163/17455243-20233725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Some people argue that the distribution of medical resources should be sensitive to agents' responsibility for their ill-health. In contrast, others point to the social determinants of health to argue that the collective agents that control the conditions in which agents act should bear responsibility. To a large degree, this is a debate in which those who hold individuals responsible currently have the upper hand: warranted appeals to individual responsibility effectively block allocation of any significant degree of responsibility to collective agents. We suggest that a different understanding of individual responsibility might lead to a fairer allocation of blame. Scaffolded agency is individual agency exercised in a context in which opportunities and affordances are structured by others. Appeals to scaffolded agency at once recognize the role of the individual and of the collective agents who have put the scaffolds in place.
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Affiliation(s)
- Neil Levy
- Uehiro Centre for Practical Ethics, University of Oxford, Oxford, United Kingdom
| | - Julian Savulescu
- Centre for Biomedical Ethics, National University of Singapore, Singapore
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Giles ML, Ball GDC, Bonder R, Buchholz A, Gorter JW, Morrison KM, Perez A, Walker M, McPherson AC. Exploring the complexities of weight management care for children with spina bifida: a qualitative study with children and parents. Disabil Rehabil 2023:1-9. [PMID: 37665663 DOI: 10.1080/09638288.2023.2251878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE 1) To explore how children with spina bifida (SB) and their parents understand bodyweight, health and weight management; and 2) To identify what services and supports children with SB and their families feel are most appropriate to help them manage their health and weight. METHODS The study used interpretive description within a qualitative design. Participants were children with SB (aged 10-18) attending two Canadian SB clinics and their parents. Data were collected through individual interviews and analyzed using inductive thematic analysis. RESULTS Five children and five parents participated in the study. Children and parents had a weight-centric approach to health, which was related to the child's mobility. Weight was considered to be under individual control and mostly through diet. Trusting relationships between healthcare providers, children and families were important to discuss weight in a non-judgemental manner. Children should be involved in setting meaningful and achievable weight management goals. CONCLUSION Greater knowledge of how children with SB and their families understand weight and health offers opportunities for non-judgemental discussions about their needs and wishes. Helping families to place more value on health over weight may reduce feelings of stigma, while allowing children to develop some autonomy over health-related decisions.
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Affiliation(s)
- Madison L Giles
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Revi Bonder
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Annick Buchholz
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Jan Willem Gorter
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands. Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- CanChild, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Katherine M Morrison
- Centre for Metabolism, Obesity and Diabetes Research, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Arnaldo Perez
- Educational Research & Scholarship Unit, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Meaghan Walker
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Amy C McPherson
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
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Özdemir AA, Türkben H. The relationship between weight self-stigma, depression and loneliness in people with obesity. Afr Health Sci 2023; 23:696-704. [PMID: 38357107 PMCID: PMC10862624 DOI: 10.4314/ahs.v23i3.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
The research was conducted to determine the level of weight self-stigma, depression loneliness and whether is there a relationship between them. This was a descriptive correlational study. The study was conducted in a diet outpatient clinic of a university hospital. Participants had moderate weight self-stigma, depression and loneliness. Weight self-stigma sub-dimensions self-devaluation (β=0.28; p<0.001) and fear of enacted stigma (β=0.28; p<0.001) equally predicted depression. Fear of enacted stigma predicted social loneliness negatively (β=-.44; p<0.001). Fear of enacted stigma (β =.16, p<.005) and depression (β =.44, p<.001) predicted emotional loneliness positively. Weight self-stigma was positively correlated with depression and loneliness (p<0.001).
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Affiliation(s)
- Aysel A Özdemir
- Department of Nursing, Faculty of Health Sciences, Turgut Özal University Malatya/ Turkey
| | - Hilal Türkben
- Department of Nursing, Seydişehir Kamil Akkanat Faculty of Health Sciences Necmettin Erbakan University Konya/Turkey
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Venkatesh KK, Walker DM, Yee LM, Wu J, Garner J, McNeil B, Haas DM, Mercer B, Reddy UM, Silver R, Wapner R, Saade G, Parry S, Simhan H, Lindsay K, Grobman WA. Association of Living in a Food Desert and Poor Periconceptional Diet Quality in a Cohort of Nulliparous Pregnant Individuals. J Nutr 2023; 153:2432-2441. [PMID: 37364682 PMCID: PMC10447609 DOI: 10.1016/j.tjnut.2023.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/15/2023] [Accepted: 06/22/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND A poor diet can result from adverse social determinants of health and increases the risk of adverse pregnancy outcomes. OBJECTIVE We aimed to assess, using data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be prospective cohort, whether nulliparous pregnant individuals who lived in a food desert were more likely to experience poorer periconceptional diet quality compared with those who did not live in a food desert. METHODS The exposure was living in a food desert based on a spatial overview of food access indicators by income and supermarket access per the Food Access Research Atlas. The outcome was periconceptional diet quality per the Healthy Eating Index (HEI)-2010, analyzed by quartile (Q) from the highest or best (Q4, reference) to the lowest or worst dietary quality (Q1); and secondarily, nonadherence (yes or no) to 12 key aspects of dietary quality. RESULTS Among 7,956 assessed individuals, 24.9% lived in a food desert. The mean HEI-2010 score was 61.1 of 100 (SD: 12.5). Poorer periconceptional dietary quality was more common among those who lived in a food desert compared with those who did not live in a food desert (Q4: 19.8%, Q3: 23.6%, Q2: 26.5%, and Q1: 30.0% vs. Q4: 26.8%, Q3: 25.8%, Q2: 24.5%, and Q1: 22.9%; overall P < 0.001). Individuals living in a food desert were more likely to report a diet in lower quartiles of the HEI-2010 (i.e., poorer dietary quality) (aOR: 1.34 per quartile; 95% CI: 1.21, 1.49). They were more likely to be nonadherent to recommended standards for 5 adequacy components of the HEI-2010, including fruit, total vegetables, greens and beans, seafood and plant proteins, and fatty acids, and less likely to report excess intake of empty calories. CONCLUSIONS Nulliparous pregnant individuals living in a food desert were more likely to experience poorer periconceptional diet quality compared with those who did not live in a food desert.
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Affiliation(s)
- Kartik K Venkatesh
- Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, United States.
| | - Daniel M Walker
- Department of Family and Community Medicine, The Ohio State University, Columbus, OH, United States
| | - Lynn M Yee
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, United States
| | - Jiqiang Wu
- Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, United States
| | - Jennifer Garner
- John Glenn College of Public Affairs, The Ohio State University, Columbus, OH, United States
| | | | - David M Haas
- Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN, United States
| | - Brian Mercer
- Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH, United States
| | - Uma M Reddy
- Department of Obstetrics and Gynecology, Columbia University, New York, NY, United States
| | - Robert Silver
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, United States
| | - Ronald Wapner
- Department of Obstetrics and Gynecology, Columbia University, New York, NY, United States
| | - George Saade
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, United States
| | - Samuel Parry
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, United States
| | - Hyagriv Simhan
- Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsbugh, PA, United States
| | - Karen Lindsay
- UCI Susan Samueli Integrative Health Institute, Susan & Henry Samueli College of Health Sciences, University of California, Irvine, CA, United States; Department of Pediatrics, Division of Endocrinology, University of California, Irvine; School of Medicine, Orange, CA, United States
| | - William A Grobman
- Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, United States
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12
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Martin LT, Carman K, Yeung D. What drives health mindset and expectations in the United States? J Public Health Policy 2023; 44:34-46. [PMID: 36526740 PMCID: PMC9756721 DOI: 10.1057/s41271-022-00382-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2022] [Indexed: 12/23/2022]
Abstract
Health mindset is a group of beliefs or assumptions that individuals hold about the causes of health and well-being. Strengthening our understanding of factors that shape mindset and how mindset shapes expectations for who can and should be responsible for health can inform the success and sustainability of solutions to current health crises including the COVID-19 pandemic, ongoing disparities in health outcomes, and gun violence. We first examined associations between personal characteristics and experiences with health mindset. Next, we examined the association between mindset and the belief that government involvement can help address pressing health questions, using obesity as an example of a health outcome that is shaped both by personal choices and factors outside one's control. Going forward, it will be important to consider health mindset in broader transformations of the health system and population approaches to improving health.
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Affiliation(s)
- Laurie T Martin
- RAND Corporation, 1200 South Hayes Street, Arlington, VA, 22202, USA.
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Horii RI, Mann T. Norms and attributions about weight gain during the COVID-19 pandemic. Psychol Health 2022:1-18. [PMID: 36384371 DOI: 10.1080/08870446.2022.2142224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/08/2022] [Accepted: 10/20/2022] [Indexed: 11/19/2022]
Abstract
Objective. Weight gain was common during the first year of the COVID-19 pandemic, potentially creating a new descriptive norm about weight gain. The unique context of a global pandemic may have influenced situational attributions for weight gain that were not typical prior to the pandemic. We examined the effects of the new norm on people's views about responsibility and blame for weight gain.Methods. In two preregistered surveys, we aimed to manipulate the salience of weight gain during COVID-19, and measured views about responsibility and blame for weight gain.Results. Among participants who gained weight, the more common they perceived weight gain to be, the more they felt their own weight gain was understandable (b = 0.09, se = 0.04, p = 0.02), but perceived commonness didn't relate to their feelings of responsibility and blame for weight gain. For participants who didn't gain weight, the perceived commonness of weight gain was associated with less blame towards people who gained weight (b = 0.11, se= 1.46, p = 0.044), but not with responsibility for weight gain.Conclusion. Participants believed weight gain was common during COVID, but this descriptive norm had mixed associations with attributions for one's own and others' weight gain.
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Affiliation(s)
- Rina I Horii
- Department of Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Traci Mann
- Department of Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
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Harwood A, Carter D, Eliott J. A public health framework for reducing stigma: the example of weight stigma. JOURNAL OF BIOETHICAL INQUIRY 2022; 19:511-520. [PMID: 35857213 PMCID: PMC9463314 DOI: 10.1007/s11673-022-10199-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 04/01/2022] [Indexed: 05/15/2023]
Abstract
We examine stigma and how it operates, then develop a novel framework to classify the range of positions that are conceptually possible regarding how stigma ought to be handled from a public health perspective. In the case of weight stigma, the possible positions range from encouraging the intentional use of weight stigma as an obesity prevention and reduction strategy to arguing not only that this is harmful but that weight stigma, independent of obesity, needs to be actively challenged and reduced. Using weight stigma as an illustrative example, we draw on prior theoretical work on stigma mechanisms and intervention strategies to develop a framework for improving the understanding, evaluation, and planning of anti-stigma interventions. This framework has the potential to help public health actors to map out how protest, contact, education, and regulation strategies can be used to reduce direct discrimination, structural discrimination, and internalized stigma (self-stigma).
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Affiliation(s)
- Alison Harwood
- The Office of Research Ethics, Compliance and Integrity, The University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Drew Carter
- Adelaide Health Technology Assessment, School of Public Health, The University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Jaklin Eliott
- Associate Professor, School of Public Health, The University of Adelaide, Adelaide, South Australia 5005 Australia
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Speirs DP, Kuijer RG, Yogeeswaran K. Examining how framing obesity as disease vs. food addiction influences stigma among fitness practitioners. Obes Res Clin Pract 2022; 16:429-433. [PMID: 36058838 DOI: 10.1016/j.orcp.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/27/2022] [Accepted: 08/18/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To determine if framing the etiology of obesity as a disease, food addiction, or caloric imbalance would increase or decrease anti-fat attitudes (AFA) and challenge the belief that obesity is caused by a lack of personal responsibility or willpower. METHODS Two hundred and forty-nine fitness practitioners (Mage = 37.49 years) were randomly assigned to one of four experimental conditions and asked to read a short article describing obesity as either: (a) food addiction, (b) disease, or (c) caloric imbalance, while a control group read an unrelated article. All practitioners then completed a measure of AFA. RESULTS Practitioners in the food addiction condition recorded significantly lower AFA than practitioners in the disease condition, specifically on the subscale relating to the belief that obesity is a matter of personal responsibility and willpower, or lack thereof. The differing etiologies of obesity had no impact on fitness practitioners' dislike for people with obesity or their personal fears about gaining weight CONCLUSION: Presenting the etiology of obesity as a food addiction may be more effective than the disease or caloric imbalance etiologies at reducing obesity stigma relating to the belief that obesity results from a lack of willpower. Such an understanding can help reduce obesity stigma and may encourage governments to implement obesity reduction policies as recommended by organisations such as the WHO.
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Affiliation(s)
- Daniel P Speirs
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand; New Zealand Institute of Health and Fitness, New Zealand.
| | - Roeline G Kuijer
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Kumar Yogeeswaran
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
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Kim HK, Kim Y. Multilevel causal attributions on transboundary risk: Effects on attributions of responsibility, psychological distance, and policy support. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2022; 43:1310-1328. [PMID: 35988922 DOI: 10.1111/risa.14000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study used two randomized experiments in a prospective design (Study 1 N = 297, Study 2 N = 296) to examine how multilevel causal attribution dimensions (internal vs. external to an individual or a country) shape domestic and foreign policy support to counter transboundary risk. Results from Study 1 and 2 showed that external-country (vs. internal-country) causal attribution reduced perceptions of internal-country attributions of responsibility, which had a cross-lagged effect on support for domestic-industry policies to mitigate the risk. In contrast, perceptions of external-country attributions of responsibility increased support for foreign policies in a 2-week follow up. This study offers theoretical insights into the demarcation of multilevel causal attribution dimensions in studying media framing effects. It also highlights some important causal mechanisms of how media frames shape public support for policies aimed at transboundary risk mitigation.
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Affiliation(s)
- Hye Kyung Kim
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore
| | - Yungwook Kim
- School of Communication & Media, Ewha Womans University, Seoul, South Korea
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Cleveland LP, Grummon AH, Konieczynski E, Mancini S, Rao A, Simon D, Block JP. Obesity prevention across the US: A review of state‐level policies from 2009 to 2019. Obes Sci Pract 2022; 9:95-102. [PMID: 37034562 PMCID: PMC10073818 DOI: 10.1002/osp4.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/13/2022] [Accepted: 05/23/2022] [Indexed: 11/11/2022] Open
Abstract
Objective Uniquely, state legislators may enact obesity prevention policies tailored to each state's needs and take diverse policy approaches to address obesity prevalence. The objective of this study was to identify and describe state-level obesity-related policies between 2009 and 2019. Methods Using a database of legislation covering 2009-2019, researchers categorized obesity-related legislation by status (proposed/enacted), topic, and environment impacted. Researchers determined the number of policies proposed; enacted, by political party control; obesity prevalence, by states over time. Results 3256 obesity-related policies were proposed among 50 states and Washington DC between 2009 and 2019. Collectively, 18% (593) of policies were enacted; California (96), New and Jersey (57) enacted the most. Across environment and topics, the most enacted policies categorized in school environment (226) and school nutrition (150) topic area. Most policies were proposed (496) and enacted (77) in 2011. On average, Democrat-controlled states had higher enactment rates than Republican-controlled states, as did states with lower (vs. higher) obesity prevalence. Conclusions States have actively pursued obesity-related legislation across multiple topics and environments from 2009 to 2019, with mixed enactment rates. Evaluating the impact of these policies, alone and in combination, will be important to determine whether these state-level efforts reduce obesity.
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Affiliation(s)
- Lauren P. Cleveland
- Department of Population Medicine Harvard Pilgrim Health Care Institute & Harvard Medical School Boston Massachusetts USA
| | - Anna H. Grummon
- Department of Population Medicine Harvard Pilgrim Health Care Institute & Harvard Medical School Boston Massachusetts USA
- Department of Nutrition Harvard TH Chan School of Public Health Boston Massachusetts USA
| | - Elsa Konieczynski
- Department of Population Medicine Harvard Pilgrim Health Care Institute & Harvard Medical School Boston Massachusetts USA
| | - Sally Mancini
- Rudd Center for Food Policy and Health University of Connecticut Hartford Connecticut USA
| | - Anjali Rao
- Department of Population Medicine Harvard Pilgrim Health Care Institute & Harvard Medical School Boston Massachusetts USA
| | - Denise Simon
- Department of Population Medicine Harvard Pilgrim Health Care Institute & Harvard Medical School Boston Massachusetts USA
| | - Jason P. Block
- Department of Population Medicine Harvard Pilgrim Health Care Institute & Harvard Medical School Boston Massachusetts USA
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Nyemcsok C, Pitt H, Kremer P, Thomas SL. Young men's perceptions about the risks associated with sports betting: a critical qualitative inquiry. BMC Public Health 2022; 22:867. [PMID: 35501801 PMCID: PMC9059698 DOI: 10.1186/s12889-022-13164-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Gambling is an inherently risky activity. New technologies have led to the development of new, online forms of gambling such as sports betting, with round the clock availability and accessibility. While young men have been identified as a group that may be particularly vulnerable to the harms associated with these new online products, few studies have qualitatively explored young men's perceptions of the risks associated with these products. Using concepts associated with the sociology of risk, this paper sought to explore the range of factors that may influence how 18-24 year old young Australian men conceptualise the risks associated with sports betting. METHODS Using a critical qualitative inquiry approach, in-depth interviews were conducted with sixteen participants in Victoria, Australia, who engaged in sports betting at least monthly. The data interpreted for this study included questions relating to awareness of gambling, the contexts associated with early gambling experiences; the factors that influenced current gambling behaviours, and why they engaged in gambling. A reflexive approach to thematic analysis was used to interpreted themes from the data. RESULTS Four key themes were constructed from the data relating to the factors that influenced risk perceptions. These included: 1) 'The role of early experiences', including exposure to gambling advertising in sport, and the gambling behaviours of social networks; 2) 'The influence of peer rivalry and competition', in which sports betting was used to form connections within and across peer groups; 3) 'The normalisation of gambling', including the embedding of gambling in everyday activities; and 4) 'The influence of perceptions of knowledge, skill, and control', including the belief that they could engage in responsible behaviours and stop gambling if they needed to. CONCLUSION This study indicated that a range of factors may influence how young men conceptualise the risks and benefits associated with sports betting. Current public health strategies for gambling that focus on individual determinants and responsibility paradigms must be broadened to target the social and commercial factors that influence young men's attitudes towards, and engagement in sports betting.
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Affiliation(s)
- Christian Nyemcsok
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Gheringhap St, Geelong, Australia
| | - Hannah Pitt
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Gheringhap St, Geelong, Australia
| | - Peter Kremer
- Centre for Sport Research, School of Exercise & Nutrition Sciences, Faculty of Health, Deakin University, Gheringhap St, Geelong, Australia
| | - Samantha L. Thomas
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Gheringhap St, Geelong, Australia
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Marko S, Thomas SL, Robinson K, Daube M. Gamblers' perceptions of responsibility for gambling harm: a critical qualitative inquiry. BMC Public Health 2022; 22:725. [PMID: 35413823 PMCID: PMC9004097 DOI: 10.1186/s12889-022-13109-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/29/2022] [Indexed: 12/31/2022] Open
Abstract
Background Gambling has traditionally been conceptualised as an issue of addiction and personal responsibility. While there are now clear public health models that recognise that gambling harm is caused by a range of socio-cultural, environmental, commercial and political determinants, government and industry messages about gambling are still largely personal responsibility focused. Given the well-recognised issues associated with personal responsibility paradigms, this study sought to understand how gamblers themselves conceptualised responsibility for gambling harm. Methods A qualitatively led online panel survey was conducted with 363 adult gamblers in New South Wales and Victoria, Australia. Participants were asked to respond to what they thought were the causes of gambling harm, and what could be done to prevent harm. A reflexive thematic analysis was conducted. Results Six common tropes were constructed from gamblers’ responses: (1) Gambling in moderation; (2) Personal responsibility for rational behaviour; (3) Character flaws; (4) Personal responsibility to seek help; (5) More education is needed; and (6) Governments are responsible for action – but motivation and efficacy are questioned. Gamblers primarily understood gambling harm as being a matter of personal responsibility, and government responsibility was generally seen as limited to providing information to facilitate informed gambling choices. Conclusions This study demonstrates that gamblers’ perceptions of gambling harm are similar to the personal responsibility framings and tropes present in industry and government messaging strategies. Refocusing public communication strategies away from ‘responsible gambling’ messaging, and towards evidence-based approaches, will be an important part of addressing the harms associated with gambling.
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Affiliation(s)
- Sarah Marko
- Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, Australia.
| | - Samantha L Thomas
- Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, Australia
| | - Kim Robinson
- School of Health and Social Development, Faculty of Health, Deakin University, Melbourne, Australia
| | - Mike Daube
- Faculty of Health Sciences, Curtin University, Perth, Australia
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Radesky J, Hiniker A. From Moral Panic to Systemic Change: Making Child-Centered Design the Default. INTERNATIONAL JOURNAL OF CHILD-COMPUTER INTERACTION 2022; 31:100351. [PMID: 35340408 PMCID: PMC8942378 DOI: 10.1016/j.ijcci.2021.100351] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Academic scholarship and public discourse about children's digital media use often invokes concepts such as 'screen time' that place the locus of responsibility on individual users and families rather than on designers creating digital environments. In this vision article, we argue that research, design, and policy frameworks that assume individual responsibility contribute to intensive parenting messaging about children's media use, are less likely than systemic approaches to achieve population-level change, and produce inequities in children's access to positive, child-centered media. Platforms (e.g., app marketplaces, video streaming services) act as entry points for children's use of digital spaces, and thus are strong determinants of children's experiences. As such, platforms are an ideal point of intervention for systemic change and have the potential to create equitable and child-centered digital environments at an ecosystem level. We contend that policies that encourage platforms to establish child-centered design as the default user interface will both create better experiences for children and relieve pressure on parents as gatekeepers. Finally, we review the types of research questions that could examine how to measure and optimize platforms for their impact on child wellbeing and outline steps researchers can take to provide evidence-based guidance to industry about designing ecosystems for children's best interests.
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Affiliation(s)
- Jenny Radesky
- Department of Pediatrics, University of Michigan Medical School
| | - Alexis Hiniker
- University of Washington Information School, Seattle, WA
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Porter L, Cox JS, Wright KA, Lawrence NS, Gillison FB. The impact of COVID-19 on the eating habits of families engaged in a healthy eating pilot trial: a thematic analysis. Health Psychol Behav Med 2022; 10:241-261. [PMID: 35251773 PMCID: PMC8890518 DOI: 10.1080/21642850.2022.2043750] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- Lucy Porter
- Washington Singer Laboratories, School of Psychology, University of Exeter, Perry Road, Exeter, United Kingdom
| | - Jennifer S. Cox
- National Institute for Health Research Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, United Kingdom
| | - Kim A. Wright
- Washington Singer Laboratories, School of Psychology, University of Exeter, Perry Road, Exeter, United Kingdom
| | - Natalia S. Lawrence
- Washington Singer Laboratories, School of Psychology, University of Exeter, Perry Road, Exeter, United Kingdom
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Factors Involved in the Food Choices of Diners in a Kibbutz Communal Dining Room Buffet: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031885. [PMID: 35162905 PMCID: PMC8835611 DOI: 10.3390/ijerph19031885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/28/2022] [Accepted: 02/05/2022] [Indexed: 11/19/2022]
Abstract
Improving nutrition improves health outcomes. Eating in a catering system may provide an environment for promoting healthy dietary choices. To map the factors that shape the food choices of diners who routinely eat in catering systems, we collected and analyzed qualitative data about diners’ perceptions of their food choices in communal dining rooms in three kibbutzim in Israel. From May to July 2014, we conducted in-depth, semi-structured, face-to-face interviews with 13 diners who ate at least three lunches per week in the kibbutz’s dining room. Data analysis followed thematic analysis principles. Two categories of themes emerged from the interviews. In the personal context category, the themes identified were eating as a task and attempts to control one’s eating. In the contextual aspects of eating in the catering system category, themes identified were eating in the dining room as a default, the characteristics of the food served, routine, and personal versus public aspects. The sub-theme of the diners’ freedom of choice emerged in the two categories of themes. Diners’ wishes of maintaining their freedom of choice may be an important contribution to the debate of whether catering systems should provide only healthy foods, which may jeopardize diners’ freedom of choice.
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Katz-Shufan O, Shahar DR, Sabag L, Simon-Tuval T. Incremental Costs and Diners' Satisfaction Associated with Improvement in Nutritional Value of Catering Dishes. Nutrients 2022; 14:nu14030617. [PMID: 35276974 PMCID: PMC8840232 DOI: 10.3390/nu14030617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/27/2022] [Accepted: 01/27/2022] [Indexed: 02/01/2023] Open
Abstract
Eating in catering systems has been identified as a driver of poor diet quality. Interventions within catering systems increase the nutrient density of dishes. Little is known about the incremental costs associated with this strategy. One part of the NEKST (Nutrition Environmental Kibbutzim Study) intervention was nutritional improvement of recipes (decreasing the amount of energy, sodium, and saturated fat). We evaluated the nutritional content of dishes per 100 g and the incremental costs associated with these changes from the catering system’s perspective, as well as diners’ satisfaction with the catering system before and after the intervention. Our results revealed that as energy and saturated fat decreased, the associated incremental cost increased (rs = −0.593, p = 0.010 and rs = −0.748, p < 0.001, respectively). However, the decrease in sodium was not associated with increased costs (rs = 0.099, p = 0.696). While diners’ satisfaction decreased in the control group, it did not change in the intervention group following the intervention (p = 0.018). We concluded that recipe modification improved the nutritional value of dishes without increasing cost. This intervention was not associated with decreased diner satisfaction. This evidence encourages the implementation of policies to improve the nutritional quality of food served by caterers without jeopardizing sales and with the potential to improve public health.
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Affiliation(s)
- Ofira Katz-Shufan
- Department of Public Health, The Health & Nutrition Innovative International Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva 8410501, Israel; (D.R.S.); (L.S.)
- Correspondence: ; Tel.: +972-52-4326540
| | - Danit R. Shahar
- Department of Public Health, The Health & Nutrition Innovative International Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva 8410501, Israel; (D.R.S.); (L.S.)
| | - Liron Sabag
- Department of Public Health, The Health & Nutrition Innovative International Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva 8410501, Israel; (D.R.S.); (L.S.)
| | - Tzahit Simon-Tuval
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva 8410501, Israel;
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Lemmon G, Jensen JM, Kuljanin G. A primer with purpose: Research implications of the objectification of weight in the workplace. JOURNAL OF OCCUPATIONAL AND ORGANIZATIONAL PSYCHOLOGY 2021. [DOI: 10.1111/joop.12378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Grace Lemmon
- Department of Management & Entrepreneurship DePaul University Chicago Illinois USA
| | - Jaclyn M. Jensen
- Department of Management & Entrepreneurship DePaul University Chicago Illinois USA
| | - Goran Kuljanin
- Department of Management & Entrepreneurship DePaul University Chicago Illinois USA
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de Boer B, Lemke M. Bringing disgust in through the backdoor in healthy food promotion: a phenomenological perspective. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2021; 24:731-743. [PMID: 34184195 PMCID: PMC8557171 DOI: 10.1007/s11019-021-10037-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
Obesity has been pointed out as one of the main current health risks leading to calls for a so-called "war on obesity". As we show in this paper, activities that attempt to counter obesity by persuading people to adjust a specific behavior often employ a pedagogy of regret and disgust. Nowadays, however, public healthcare campaigns that aim to tackle obesity have often replaced or augmented the explicit negative depictions of obesity and/or excessive food intake with the positive promotion of healthy food items. In this paper, we draw on a phenomenological perspective on disgust to highlight that food-related disgust is connected to the character and behavior of a perceived individual even in the context of promoting healthy food items. We argue that the focus on "making the healthy food choice the easy choice" might be an important step towards the de-stigmatization of people that are affected by obesity. However, so we suggest, this focus threatens to bring back an image of individuals affected by obesity as disgusting "through the backdoor". It does so not by portraying bodies with overweight as disgusting, but instead by implying that lifestyle choices, character and habits of people that are affected by obesity are markers of a lack of control. We argue that the close relationship between disgust and the perception of self-control in the context of obesity should be taken into consideration in the context of assessing the implications of new health promotion strategies to minimize the risk of stigmatizing people.
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Affiliation(s)
- Bas de Boer
- University of Twente, Enschede, The Netherlands.
| | - Mailin Lemke
- Delft University of Technology, Delft, The Netherlands
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Abstract
Abstract
This paper proposes that public health is the sort of institution that has a role in producing structures of virtue in society. This proposal builds upon work that describes how virtues are structured by the practices of institutions, at the collective or whole-of-society level. This work seeks to fill a gap in public health ethics when it comes to virtues. Mainstay moral theories tend to incorporate some role for virtues, but within public health ethics this role has not been fully articulated. Two recent papers have proposed ways in which the virtues might be incorporated: working from a structural account, Rozier suggests that public health could work to instil virtues, like temperance, in the public in order to achieve its health-related goals; Nihlén Fahlquist suggests that compassion is among three virtues that practitioners of public health should cultivate in order to do their work well. In the end, both accounts recommend incorporating virtues at the level of individuals, among the public and among practitioners. I propose a third kind of role for virtue in public health that focuses on structures. Public health activities take place at the population level, and a public health virtue ethics must also be suitably population-focussed.
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Grannell A, le Roux CW, McGillicuddy D. "You Are Always at War With Yourself" The Perceptions and Beliefs of People With Obesity Regarding Obesity as a Disease. QUALITATIVE HEALTH RESEARCH 2021; 31:2470-2485. [PMID: 34581642 DOI: 10.1177/10497323211040767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Obesity as a disease remains poorly understood by key stakeholders. Here, in people living with severe obesity, perceptions and beliefs relating to obesity as a disease and obesity causality were examined. Semi-structured interviews were conducted in a tertiary care obesity clinic. 23 people with obesity (10 males, 13 females) volunteered. An overall agreement that obesity is a disease was present. Perceptions related to why obesity is and is not a disease were diverse: Lack of control and addiction, biological determinism, and personal responsibility. For weight loss maintenance, the perceptions and beliefs were heterogeneous with biological factors not considered a determinant of success. Instead, exercise, support, and willpower were described as associated with success. Barriers related to remaining in a weight-reduced state included the following: Emotional eating, sustainability of diet, occupational impact, and defeatism due to misaligned expectation and outcome. In conclusion, people living with obesity tend to agree obesity is a disease yet an incomplete understanding of the disease is present.
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McCarthy S, Pitt H, Bellringer ME, Thomas SL. Strategies to prevent and reduce gambling harm in Australian women. DRUGS: EDUCATION, PREVENTION AND POLICY 2021. [DOI: 10.1080/09687637.2021.1973963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Simone McCarthy
- Institute of Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Hannah Pitt
- Institute of Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Maria E. Bellringer
- Gambling and Addictions Research Centre, School of Public Health and Interdisciplinary Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Samantha L. Thomas
- Institute of Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
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Grannell A, Fallon F, Al-Najim W, le Roux C. Obesity and responsibility: Is it time to rethink agency? Obes Rev 2021; 22:e13270. [PMID: 33977636 DOI: 10.1111/obr.13270] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/09/2021] [Accepted: 04/15/2021] [Indexed: 12/16/2022]
Abstract
Despite obesity declared a disease, there still exists considerable weight stigma in both popular culture and health care, which negatively impacts policy making regarding prevention and treatment. While viewed as a choice or a failure of willpower by many, evidence exists to challenge the argument that both weight gain and failure to achieve weight loss maintenance are the individuals' fault due to personal failure or lack of responsibility. In this article, we draw upon literature from obesity treatment, neuroscience, philosophy of mind, and weight stigma to challenge the commonly held beliefs that individuals are free to choose how much they can weigh, and achievement of long-term weight loss maintenance is completely subject to conscious choice. In reality, the regulation of hunger, satiety, energy balance, and body weight takes place in subcortical regions of the brain. Thus, hunger and satiety signals are generated in regions of the brain, which are not associated with conscious experience. This points towards biological determinism of weight and challenges ideas of willpower and resultant moralization regarding body weight regulation. In this article, we will thus argue that in the context of dysregulation of hunger and satiety contributing to the obesity epidemic, a wider discourse related to personal responsibility and the stigma of obesity is needed to enhance understanding, prevention, and treatment of this complex disease. Obesity is a chronic disease requiring personalized treatment. Lifestyle interventions alone may not be enough to achieve medically significant and sustained weight loss for many individuals with obesity. By understanding that obesity is not due to a lack of motivation or willpower, the availability and utilization of additional treatments or combination of treatments such as lifestyle, pharmacotherapy, and surgery are likely to improve the quality of life for many suffering with this disease.
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Affiliation(s)
- Andrew Grannell
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
| | - Finian Fallon
- Department of Psychology, City Colleges, Dublin, Ireland
| | - Werd Al-Najim
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
| | - Carel le Roux
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
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Hoe C, Taber N, Champagne S, Bachani AM. Drink, but don't drive? The alcohol industry's involvement in global road safety. Health Policy Plan 2021; 35:1328-1338. [PMID: 33221890 PMCID: PMC7886444 DOI: 10.1093/heapol/czaa097] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2020] [Indexed: 12/21/2022] Open
Abstract
Drink-driving is a major cause of global road traffic fatalities, yet few countries have laws that meet international best practices. One possible reason is the alcohol industry’s opposition to meaningful policies that are perceived to directly threaten sales. Our primary objectives are to document alcohol industry involvement in global road safety policies and programmes and to critically evaluate the responses of public health and road safety communities to this involvement. Under the guidance of the Policy Dystopia Model, we used a mixed methods approach in which data were gathered from expert interviews and a mapping review of 11 databases, 5 watchdog websites and 7 alcohol industry-sponsored initiatives. Triangulation was used to identify points of convergence among data sources. A total of 20 expert interviews and 94 documents were analysed. Our study showed that the alcohol industry acknowledges that drink-driving is an issue but argues for solutions that would limit impact on sales, akin to the message ‘drink—but do not drive’. Industry actors have been involved in road safety through: (1) coalition coupling and decoupling, (2) information production and management, (3) direct involvement in policymaking and (4) implementation of interventions. Our study also shed light on the lack of cohesion within and among the public health and road safety communities, particularly with regard to the topics of receiving funding from and partnering with the alcohol industry. These results were subsequently used to adapt the Policy Dystopia Model as a conceptual framework that illustrates the ways in which the alcohol industry has been involved in global road safety. Several implications can be drawn from this study, including the urgent need to increase awareness about the involvement of the alcohol industry in road safety and to build a cohesive transnational alcohol control advocacy alliance to curb injuries and deaths related to drink-driving.
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Affiliation(s)
- Connie Hoe
- Johns Hopkins International Injury Research Unit, Department of International Health, Health Systems Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Niloufer Taber
- Johns Hopkins International Injury Research Unit, Department of International Health, Health Systems Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Sarah Champagne
- Johns Hopkins International Injury Research Unit, Department of International Health, Health Systems Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Abdulgafoor M Bachani
- Johns Hopkins International Injury Research Unit, Department of International Health, Health Systems Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
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Structured Lifestyle Modification Prior to Bariatric Surgery: How Much is Enough? Obes Surg 2021; 31:4585-4591. [PMID: 34297255 PMCID: PMC8458190 DOI: 10.1007/s11695-021-05573-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/22/2021] [Accepted: 06/30/2021] [Indexed: 01/06/2023]
Abstract
Many healthcare systems require patients to participate in a structured lifestyle modification programme prior to bariatric surgery, even though bariatric consensus guidelines do not recommend this. While there is good evidence that such programmes improve health in other conditions such as metabolic and cardiovascular diseases, there is no evidence that they improve outcomes after bariatric surgery. The distinction needs to be drawn between the well-established need for individualised multidisciplinary dietetic and physical activity care for bariatric surgical patients and the potential harms from mandating participation in compulsory structured lifestyle programmes of fixed duration, frequency and intensity, which may delay surgery, reinforce obesity stigma, or both. Large clinical trials might help to address some of the uncertainty and provide an evidence base for clinicians and policymakers.
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Gutin I. Body mass index is just a number: Conflating riskiness and unhealthiness in discourse on body size. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:1437-1453. [PMID: 34086365 PMCID: PMC8363552 DOI: 10.1111/1467-9566.13309] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 05/07/2023]
Abstract
Despite the ubiquity of the body mass index (BMI) in discourse on health, there is ambiguity in its use as a biomarker of current abnormality versus future risk. This distinction is consequential for knowledge of the relationship between body size and health, as well as for individuals deemed to have abnormal and 'unhealthy' bodies. Consequently, the purposes of this review are threefold. The first is to differentiate this 'biomarker' perspective from extant critiques of BMI as a proxy for health behaviours or as the defining characteristic of obesity as a disease. The second is to highlight the shift towards treating BMI as a measure of attained unhealthiness, rather than a probabilistic indicator of risk. Finally, rather than call for the abolition of BMI, this paper argues that its continued use as 'just a number' is in keeping with the push for weight neutrality in research and practice. The review concludes by demonstrating how the riskiness and unhealthiness of body size is conflated in public health messaging on COVID-19. BMI is a marker of risk, but its use as a surrogate for COVID-19 severity equates body size with health, shaping beliefs about vulnerability and personal responsibility amid an ongoing pandemic.
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Affiliation(s)
- Iliya Gutin
- Department of Sociology, University of North Carolina at Chapel Hill
- Carolina Population Center
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Booth E, Halliday V, Cooper RJ. Headteachers' and chairs of governors' perspectives on adolescent obesity and its prevention in English secondary school settings. J Public Health (Oxf) 2021; 43:e213-e223. [PMID: 31832667 DOI: 10.1093/pubmed/fdz151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Secondary schools are an important setting for preventing obesity in adolescence. Headteachers and chairs of governors are identified in national guidance as crucial stakeholders for school-based preventative action. Despite this, their views remain unexplored and unrepresented. METHODS A sequential mixed method study was conducted. Semi-structured interviews were undertaken with a purposive sample of 22 secondary school headteachers and chairs of governors in England. Data were thematically analysed and informed the development of a descriptive cross-sectional survey, completed by 127 participants from the same population. RESULTS Unhealthy dietary and sedentary behaviours were viewed as a more significant problem than adolescent obesity. Obesity was perceived as complex and multi-causal, and a range of stakeholders were deemed to have responsibility for its prevention, most notably parents. Support was identified for the role of secondary schools, although this was not an explicit priority and extensive internal and external barriers exist, which hinder preventative action. CONCLUSIONS Whilst secondary school settings in England remain an important setting for the prevention of adolescent obesity, it is crucial for policy makers and public health professionals to recognize the factors affecting school leaders' ability and willingness to contribute to this agenda.
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Affiliation(s)
- E Booth
- Section of Public Health, School of Health and Related Research (ScHARR), The University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - V Halliday
- Section of Public Health, School of Health and Related Research (ScHARR), The University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - R J Cooper
- Section of Public Health, School of Health and Related Research (ScHARR), The University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
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Clarke B, Kwon J, Swinburn B, Sacks G. Policy processes leading to the adoption of 'Jamie's Ministry of Food' programme in Victoria, Australia. Health Promot Int 2021; 37:6292205. [PMID: 34086910 DOI: 10.1093/heapro/daab079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study investigated the policy processes related to the 2012 adoption of the Jamie's Ministry of Food programme by the Victorian Government in Australia. The aim was to provide insight into obesity prevention policy change processes to help strengthen future health promotion action. State-level government policy processes were examined through key informant interviews and a review of relevant documentation. Data were analysed using the Multiple Streams Theory and the Advocacy Coalition Framework in order to understand influences on relevant policy processes and strategies used by policy advocates to facilitate policy adoption. We found that policy adoption was facilitated by dedicated national funding for preventive health at that time, the relatively small number of stakeholders involved in the policy development process and the anticipated support for the programme by the general public due to the association with celebrity chef, Jamie Oliver. We identified that policy brokers aligned the policy with decision-maker ideologies and broader government objectives, and proactively managed potential criticisms. Evidence of intervention effectiveness was not a major driver of policy adoption. We conclude that, iven the complexity of policy processes for obesity prevention, multiple, reinforcing strategies are likely to be needed to facilitate policy change. Support for the adoption of obesity prevention policies is likely to increase when framing of policy options aligns with decision-maker values and has broad public appeal.
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Affiliation(s)
- Brydie Clarke
- Deakin University, Geelong, Global Obesity Centre, Institute for Health Transformation, 75 Pigdons Road, Waurn Ponds, Victoria 3216, Australia
| | - Janelle Kwon
- Deakin University, Geelong, Global Obesity Centre, Institute for Health Transformation, 75 Pigdons Road, Waurn Ponds, Victoria 3216, Australia
| | - Boyd Swinburn
- School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Gary Sacks
- Deakin University, Geelong, Global Obesity Centre, Institute for Health Transformation, 75 Pigdons Road, Waurn Ponds, Victoria 3216, Australia
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Curtin KD, Thomson M, Nykiforuk CIJ. Who or what is to blame? Examining sociodemographic relationships to beliefs about causes, control, and responsibility for cancer and chronic disease prevention in Alberta, Canada. BMC Public Health 2021; 21:1047. [PMID: 34078341 PMCID: PMC8173791 DOI: 10.1186/s12889-021-11065-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 05/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Beliefs about causes and responsibility for chronic diseases can affect personal behaviour and support for healthy policies. In this research we examined relationships between socio-demographics (sex, age, education, employment, political alignment, perceived health, household income, household size) and perceptions of causes and responsibility for health behaviour, chronic disease correlates, and attitudes about cancer prevention and causes. METHODS Using data from the 2016 Chronic Disease Prevention survey in which participants (N = 1200) from Alberta, Canada responded to items regarding how much they believed personal health behaviours, prevention beliefs, and environmental factors (i.e., healthy eating, physical activity, alcohol, smoking, and where a person lives or works) are linked to getting cancer. Participants also responded to questions about causes and responsibility for obesity, alcohol, and tobacco (i.e., individual or societal). Relationships were examined using multinomial logistic regression on socio-demographics and survey items of interest. RESULTS Men (compared to women) were less likely to link regular exercise, or drinking excessive alcohol, to reducing or increasing cancer risk. Similarly, men were less likely to link environmental factors to cancer risk, and more likely to agree that cancer was not preventable, and that treatment is more important than prevention. Finally, men were more likely to believe that alcohol problems are an individual's fault. Left and central voters were more likely to believe that society was responsible for addressing alcohol, tobacco, and obesity problems compared to right voters. Those with less than post-secondary education were less likely to believe that regular exercise, maintaining a healthy body weight, or eating sufficient fruits and vegetables were linked to cancer - or that society should address obesity - compared to those with more education. Households making above the median income (versus below) were more likely to link a balanced diet with cancer and were less likely to think that tobacco problems were caused by external circumstances. CONCLUSIONS These results provide insight into the importance of health literacy, message framing, and how socio-demographic factors may impact healthy policy. Men, those with less education, and those with less income are important target groups when promoting health literacy and chronic disease prevention initiatives.
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Affiliation(s)
- Kimberley D Curtin
- Policy, Location and Access in Community Environments (PLACE) Research Lab, School of Public Health, Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - Mathew Thomson
- Policy, Location and Access in Community Environments (PLACE) Research Lab, School of Public Health, Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - Candace I J Nykiforuk
- Policy, Location and Access in Community Environments (PLACE) Research Lab, School of Public Health, Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Ave, Edmonton, AB, T6G 1C9, Canada.
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Jung J, Lee J, Lee YM, Lee DW, Kim HR, Kang MY. Educational Inequalities in Ill-Health Retirement Among Middle- and Older-Aged Workers in Korea: The Korean Longitudinal Study of Aging (2006-2016). J Occup Environ Med 2021; 63:e323-e329. [PMID: 33950041 DOI: 10.1097/jom.0000000000002200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To identify differences in risk of ill-health retirement (IHR) between groups with different levels of education and examine this difference with respect to working conditions and health-related factors. METHODS This study analysed the longitudinal data of 1691 paid workers aged 45 to 79 years from the Korean Longitudinal Study of Aging. Multivariate Cox regression analyses were conducted to identify the predictors and build a prediction model for IHR according to different final education levels. RESULTS Over the 10-year follow-up, 208 workers exited work because of poor health. Clear educational inequalities in reason of retirement and increased risk of IHR in low, intermediate, and high educational groups were observed. CONCLUSIONS Our results suggest an educational gradient for IHR among Korean male workers and revealed gender differences in the risk of IHR.
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Affiliation(s)
- Jiyoun Jung
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea (Dr Jung, Dr J. Lee, Dr Y.M. Lee, Dr Kim, Dr Kang); Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea (Dr D.W. Lee)
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Abstract
PURPOSE OF REVIEW This review explores potential sources of weight bias and stigma during the COVID-19 pandemic, including "quarantine-15" messages and discussion of obesity in media and public health campaigns. We examine evidence of the effects of weight bias on well-being during the pandemic and highlight unanswered questions to be addressed in future research. RECENT FINDINGS Studies that have investigated weight change during stay-at-home orders have yielded mixed findings and relied predominantly on self-reported retrospective recall, thus providing weak evidence of a widespread "quarantine-15" effect. No studies to date have evaluated the effects on weight stigma and health of obesity-focused COVID-19 media and public health messages. Individuals with a history of experiencing weight bias may be more vulnerable to binge eating and psychological distress during the pandemic. Weight bias and stigma during the COVID-19 pandemic, and their effects on health and well-being, warrant greater investigation and consideration in public health efforts.
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Affiliation(s)
- Rebecca L Pearl
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
| | - Erica M Schulte
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Olstad DL, Kirkpatrick SI. Planting seeds of change: reconceptualizing what people eat as eating practices and patterns. Int J Behav Nutr Phys Act 2021; 18:32. [PMID: 33663528 PMCID: PMC7934561 DOI: 10.1186/s12966-021-01102-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 02/18/2021] [Indexed: 12/15/2022] Open
Abstract
Language focused on individual dietary behaviors, or alternatively, lifestyle choices or decisions, suggests that what people eat and drink is primarily a choice that comes down to free will. Referring to and intervening upon food consumption as though it were a freely chosen behavior has an inherently logical appeal due to its simplicity and easily defined targets of intervention. However, despite decades of behavioral interventions, population-level patterns of food consumption remain suboptimal. This debate paper interrogates the manner in which language frames how problems related to poor diet quality are understood and addressed within society. We argue that referring to food consumption as a behavior conveys the idea that it is primarily a freely chosen act that can be ameliorated through imploring and educating individuals to make better selections. Leveraging practice theory, we subsequently propose that using the alternative language of eating practices and patterns better conveys the socially situated nature of food consumption. This language may therefore point to novel avenues for intervention beyond educating and motivating individuals to eat more healthfully, to instead focus on creating supportive contexts that enable sustained positive dietary change. Clearly, shifting discourse will not on its own transform the science and practice of nutrition. Nevertheless, the seeds of change may lie in aligning our terminology, and thus, our framing, with desired solutions.
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Affiliation(s)
- Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
| | - Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
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Arlinghaus KR, Laska MN. Parent Feeding Practices in the Context of Food Insecurity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020366. [PMID: 33418887 PMCID: PMC7825020 DOI: 10.3390/ijerph18020366] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/28/2020] [Accepted: 01/02/2021] [Indexed: 02/06/2023]
Abstract
The process of feeding is complex and highly dependent on parent, child, social, and environmental factors. Given the rising rates of food insecurity and concomitant poor nutrition and health, the purpose of this article was to outline the important and complex ways in which the context of food insecurity can impact parent feeding practices. Key factors discussed here include the impact of food insecurity on: expectations for motherhood, structural constraints, stress and depression, parents’ perceptions of health and child weight, and intergenerational transmission of parent feeding practices. Future research needs are also identified and discussed.
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40
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Gorlick JC, Gorman CV, Weeks HM, Pearlman AT, Schvey NA, Bauer KW. "I Feel Like Less of a Mom": Experiences of Weight Stigma by Association among Mothers of Children with Overweight and Obesity. Child Obes 2021; 17:68-75. [PMID: 33373542 PMCID: PMC7815062 DOI: 10.1089/chi.2020.0199] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: Parents of children with higher weight are blamed and shamed for their children's weight. However, parents' experiences of this form of stigma, termed weight stigma by association, are poorly understood. The objective of this study was to investigate the sources, forms, and impacts of weight stigma by association among mothers of children with overweight or obesity. Methods: In this qualitative study, mothers who reported concern about their children's weight participated in semistructured interviews administered by the research team. A coding scheme was developed and reliably applied to interview transcripts. Mothers' self-reported sociodemographic information, and height and weight were measured. Results: Thirty-four mothers (Mage: 43.4 years; 26.5% non-Hispanic Black or African American, 70.6% with obesity) participated in the study. Mothers reported that family members were a common source of negative comments about their children's weight; these comments were often critical of mothers' parenting and in some cases contributed to negative affect among mothers. Many mothers also reported negative experiences during children's physicians' visits as a result of their children's weight. Almost all mothers expressed guilt and sadness for their perceived role in their children's weight status, expressing regret that they did not parent differently. Conclusions: Mothers of children with overweight and obesity are frequently the target of weight stigma by association and experience negative cognitions and emotions regarding their perceived role in their children's weight. Continued research is needed to elucidate the impacts of stigma by association due to child weight on parents' health, the parent/child relationship, and children's health.
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Affiliation(s)
- Jenna C. Gorlick
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Claire V. Gorman
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Heidi M. Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Arielle T. Pearlman
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Natasha A. Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Katherine W. Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Grannell A, le Roux CW, McGillicuddy D. "I am terrified of something happening to me" The lived experience of people with obesity during the COVID-19 pandemic. Clin Obes 2020; 10:e12406. [PMID: 32885595 DOI: 10.1111/cob.12406] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/22/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022]
Abstract
Obesity is emerging as a risk factor for COVID-19 disease severity. The impact of the pandemic and knowledge of obesity as a risk factor on the lived experience of people with obesity is not fully understood. The aim of this study was to investigate the impact of the COVID-19 pandemic on people living with severe obesity (BMI ≥35 kg/m2 ), currently engaged in multi-modal treatment. The primary objectives were to examine the impact of the pandemic on their lived experience from a treatment and psychosocial standpoint and additionally explore their awareness of obesity as a risk factor for COVID-19 disease severity. An in-depth qualitative study was adopted employing semi-structured interviews with open-ended questions. Interpretive thematic analysis was adopted to analyse the data and identify key themes taking a grounded approach. Themes that emerged from the perspective of impact on lived experience were (a) challenge sustaining treatment and (b) psychosocial impact. There was an even split regarding awareness and lack of awareness of obesity as risk factor which itself contributes towards a negative psychosocial impact in most patients. The COVID-19 pandemic is posing a diverse challenge to people with obesity. This has implications for their on-going treatment. From an ethical standpoint, there is a need to fully elucidate the link between obesity and COVID-19, disseminate this information using people friendly language and imagery in a manner that does not exacerbate a harmful psychosocial response or lead to stigmatization.
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Affiliation(s)
- Andrew Grannell
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
| | - Carel W le Roux
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
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Falbe J. The ethics of excise taxes on sugar-sweetened beverages. Physiol Behav 2020; 225:113105. [PMID: 32712210 PMCID: PMC7377978 DOI: 10.1016/j.physbeh.2020.113105] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 02/07/2023]
Abstract
Sugar-sweetened beverage (SSB) taxation has emerged as a priority policy for promoting health and funding investments in communities most affected by diet-related disease. There are now 8 U.S. jurisdictions and over 40 countries that have implemented SSB taxes. Evaluations show that these policies reduce SSB consumption and purchasing while raising revenues to fund public health, education, and equity. However, there have been few analyses of the ethical considerations of SSB taxation. Using a framework for evaluating the ethics of public health interventions, this paper considers the ethical aspects of SSB excise taxes with respect to: physical health, psychosocial well-being, equality, informed choice, liberty, social and cultural values, and responsibility. Available evidence suggests there is a strong ethical case for levying SSB excise taxes on manufacturers and distributors. SSB excise taxes reduce consumption and purchasing of SSBs and are expected to meaningfully reduce obesity and diet-related morbidity and mortality. Because SSB taxes are specific to a product and its manufacturers, they are unlikely to harm psychosocial health by stigmatizing people who are overweight. SSB excise taxes should lead to greater equality because the health and social benefits are progressive (i.e., low-income individuals are likely to accrue the largest benefits from the tax, even more so when revenues are spent on health and social equity). Meanwhile, the average consumer cost burden that would result if distributors raise SSB prices in reponse to the tax is minimally regressive. Regarding liberty, SSB taxes do not eliminate the option of buying SSBs, but if SSB distributors raise SSB prices, it becomes somewhat more expensive to continue purchasing the same amount of SSBs. Meanwhile, the taxes expand beverage options by funding drinking water availability and prompting industry to expand offerings of unsweetened drinks and SSBs containing less sugar. Furthermore, by averting poor health, SSB taxes should expand overall freedom to pursue one's goals. Informed choice could be facilitated by seeing a higher SSB shelf price (which indicates a drink contains added sugar) and exposure to nutrition education funded with tax revenues. SSB taxation is unlikely to negatively interfere with social or cultural values because taxation would not eliminate having SSBs for special occasions, and SSBs are not a staple of traditional diets. Lastly, SSB taxation attributes responsibility for health in a manner that reflects industry's contribution to obesity and the multisectoral solutions that are needed to prevent diet-related disease.
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Affiliation(s)
- Jennifer Falbe
- Human Development and Family Studies Program, Department of Human Ecology, UC Davis. 1 Shields Ave, Davis, CA, 95616, United States.
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43
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Zatz LY, Hersh E, Gudzune KA, Thorndike AN, N Goldenberg M, Bleich SN. Physicians' political party affiliation and clinical management of obesity. Clin Obes 2020; 10:e12396. [PMID: 32803863 DOI: 10.1111/cob.12396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/02/2020] [Accepted: 07/07/2020] [Indexed: 11/30/2022]
Abstract
Studies have documented that few patients with obesity receive evidence-based care. One provider characteristic that may impact clinical obesity care, but that has been under studied to date, is political party affiliation. This study sought to evaluate how primary care physicians (PCPs) report managing patients with obesity and assess whether there are differences between Democratic and Republican PCPs. This was a secondary analysis of a cross-sectional survey of 225 PCPs registered to vote as Democrats or Republicans in 29 US States. After reading a patient vignette, the PCPs reported the following outcomes: likelihood of documenting obesity in the medical record; likelihood of discussing obesity with the patient; and likelihood of engaging in eight different obesity management options. Almost all PCPs reported they would document obesity in the medical record (Republican = 97.6%, Democrat = 94.3%) and discuss it further (Republican = 95.2%, Democrat = 92.2%). Among eight obesity management options, PCPs were least likely to say they would prescribe medication (3.9%) or refer the patient to counselling (24.0%), regardless of political affiliation. Republicans were more likely to report that they would inquire about the time course of obesity (73.4% v. 56.2%, P = 0.012) and discuss health risks of obesity (91.0% vs 78.3%, P = .018). Republican and Democratic PCPs report some differences in managing patients with obesity, suggesting that political beliefs may play a role in some clinical care.
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Affiliation(s)
- Laura Y Zatz
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Eitan Hersh
- Department of Political Science, Tufts University, Medford, Massachusetts, USA
| | - Kimberly A Gudzune
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anne N Thorndike
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Sara N Bleich
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Woteki CE, Kramer BL, Cohen S, Lancaster VA. Impacts and Echoes: The Lasting Influence of the White House Conference on Food, Nutrition, and Health. Annu Rev Nutr 2020; 40:437-461. [PMID: 32631144 DOI: 10.1146/annurev-nutr-121619-045319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The 1969 White House Conference on Food, Nutrition, and Health had a significant influence on the direction of food and nutrition policy in the United States. The conference produced recommendations leading to federal legislation and programs to alleviate hunger and malnutrition, improve consumers' nutrition knowledge through education and labeling, and monitor the nutritional status of the population. Fifty years later, its legacy was revisited at a conference convened by Harvard University and Tufts University. This article reviews the literature contributing to the first author's keynote speech at the conference, its influencers, and its influences. We focus on the highlights of five domains that set the stage for the conference: the social environment, the food environment, nutrition science, public health data, and policy events. We briefly describe the conference, its proposed directions, and its lasting legacy in these five domains.
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Affiliation(s)
- Catherine E Woteki
- Social and Decision Analytics, Biocomplexity Institute, University of Virginia, Arlington, Virginia 22209, USA;
| | - Brandon L Kramer
- Social and Decision Analytics, Biocomplexity Institute, University of Virginia, Arlington, Virginia 22209, USA;
| | - Samantha Cohen
- Social and Decision Analytics, Biocomplexity Institute, University of Virginia, Arlington, Virginia 22209, USA;
| | - Vicki A Lancaster
- Social and Decision Analytics, Biocomplexity Institute, University of Virginia, Arlington, Virginia 22209, USA;
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Prunty A, Clark MK, Hahn A, Edmonds S, O’Shea A. Enacted weight stigma and weight self stigma prevalence among 3821 adults. Obes Res Clin Pract 2020; 14:421-427. [DOI: 10.1016/j.orcp.2020.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/11/2020] [Indexed: 11/15/2022]
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Morar N, Skorburg JA. Why We Never Eat Alone: The Overlooked Role of Microbes and Partners in Obesity Debates in Bioethics. JOURNAL OF BIOETHICAL INQUIRY 2020; 17:435-448. [PMID: 32964353 DOI: 10.1007/s11673-020-10047-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 09/10/2020] [Indexed: 06/11/2023]
Abstract
Debates about obesity in bioethics tend to unfold in predictable epicycles between individual choices and behaviours (e.g., restraint, diet, exercise) and the oppressive socio-economic structures constraining them (e.g., food deserts, advertising). Here, we argue that recent work from two cutting-edge research programmes in microbiology and social psychology can advance this conceptual stalemate in the literature. We begin in section 1 by discussing two promising lines of obesity research involving the human microbiome and relationship partners. Then, in section 2, we show how this research has made viable novel strategies for fighting obesity, including microbial therapies and dyad-level interventions. Finally, in section 3, we consider objections to our account and conclude by arguing that attention to the most immediate features of our biological and social environment offers a middle ground solution, while also raising important new issues for bioethicists.
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Affiliation(s)
- Nicolae Morar
- University of Oregon, Environmental Studies Program and Department of Philosophy, 1295 University of Oregon, Eugene, OR, 97403, USA
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Food marketing to children in the United States: Can industry voluntarily do the right thing for children's health? Physiol Behav 2020; 227:113139. [PMID: 32810480 DOI: 10.1016/j.physbeh.2020.113139] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 01/09/2023]
Abstract
Food marketing is a major contributor to high rates of obesity and diet-related disease among children. Researchers, advocates, and policymakers have called for improvements in the nutrition quality of foods marketed to children to improve children's health. In the United States, for over 10 years, the food and beverage industry has responded with self-regulatory initiatives, touting the success of these efforts. However, public health researchers have documented very limited improvements. As a product of conference proceedings, we briefly summarize US self-regulation of food and beverage marketing to children, argue that reliance on industry self-regulation limits meaningful change, and explain why existing food companies cannot market truly healthy foods to children. After over a decade of self-regulation, industry continues to exploit loopholes and bombard children with marketing for foods that can negatively impact their health. Still, the political will to advocate for effective government regulation remains a challenge. Shifts in parents' attitudes toward supporting policies to protect children from food marketing and local government actions to improve the food environment are promising indicators of increasing demand for action. However, sustained and well-publicized research and advocacy are necessary to generate broader support to enact such policies at the state and federal level in order to effectively address this public health crisis.
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Brown RCH, Maslen H, Savulescu J. Responsibility, prudence and health promotion. J Public Health (Oxf) 2020; 41:561-565. [PMID: 30007299 PMCID: PMC6785701 DOI: 10.1093/pubmed/fdy113] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 05/11/2018] [Accepted: 06/14/2018] [Indexed: 11/24/2022] Open
Abstract
This article considers the role of responsibility in public health promotion. Efforts to tackle non-communicable diseases which focus on changing individual behaviour and reducing risk factor exposure sometimes invoke individual responsibility for adopting healthy lifestyles. We provide a critical discussion of this tendency. First, we outline some key distinctions in the philosophical literature on responsibility, and indicate how responsibility is incorporated into health promotion policies in the UK. We argue that the use of some forms of responsibility in health promotion is inappropriate. We present an alternative approach to understanding how individuals can ‘take responsibility’ for their health, based on the concept of prudence (i.e. acting in one’s interests). In this discussion, we do not prescribe or proscribe specific health promotion policies. Rather, we encourage public health professionals to consider how underlying assumptions (in this case, relating to responsibility) can shape health promotion policy, and how alternative framings (such as a shift from encouraging individual responsibility to facilitating prudence) may justify different kinds of action, for instance, shaping environments to make healthy behaviours easier, rather than using education as a tool to encourage responsible behaviour.
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Affiliation(s)
- R C H Brown
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
| | - H Maslen
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
| | - J Savulescu
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
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Chiang J, Arons A, Pomeranz JL, Siddiqi A, Hamad R. Geographic and Longitudinal Trends in Media Framing of Obesity in the United States. Obesity (Silver Spring) 2020; 28:1351-1357. [PMID: 32475076 PMCID: PMC7311269 DOI: 10.1002/oby.22845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/02/2020] [Accepted: 04/17/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The media's framing of public health issues is closely linked to public opinion on these issues and support for interventions to address them. This study characterized geographic and temporal variation in the US media's framing of obesity across states from 2006 to 2015. METHODS Newspaper articles that mentioned the term obesity were drawn from Access World News (NewsBank, Inc., Naples, Florida), a comprehensive online database (N = 364,288). This study employed automated content analysis, a machine learning technique, to categorize articles as (1) attributing obesity to individual-level causes (e.g., lifestyle behaviors), (2) attributing obesity to environmental/systemic causes (e.g., neighborhood walkability), (3) attributing obesity to both individual-level causes and environmental/systemic causes, or (4) articles without any such attribution framework. RESULTS Nationwide across all years, a higher proportion of articles focused on individual-level attribution of obesity than environmental-level attribution or both. Missouri and Idaho had the highest proportions of articles with an individual framework, and Nevada, Arkansas, and Wisconsin had the highest proportions of articles with an environmental framework. CONCLUSIONS This analysis demonstrates that US media sources heavily focus on an individual framing of obesity, which may be informing public perceptions of obesity. By highlighting differences in obesity media portrayal, this study could inform research to understand why particular states represent outliers and how this may affect obesity policy making.
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Affiliation(s)
- Jonathan Chiang
- Stanford University, Department of Medicine, Stanford, California
| | - Abigail Arons
- University of California Los Angeles, Departments of Internal Medicine and Pediatrics, Los Angeles, California
| | - Jennifer L. Pomeranz
- New York University College of Global Public Health, Department of Public Health Policy and Management, New York, NY
| | - Arjumand Siddiqi
- University of Toronto, Dalla Lana School of Public Health, Division of Epidemiology, Toronto, Ontario, Canada and University of North Carolina – Chapel Hill, Gillings School of Global Public Health, Department of Health Behavior, Chapel Hill, North Carolina
| | - Rita Hamad
- University of California San Francisco, Philip R. Lee Institute for Health Policy Studies, Department of Family & Community Medicine, San Francisco, California
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