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Taniguchi T, Williams-Nguyen J, Muller CS, Fyfe-Johnson A, Henderson A, Umans JG, Standridge J, Shackleford T, Rosenman R, Buchwald D, Jernigan VB. Pilot study of a heart-healthy food box intervention for Native Americans with uncontrolled hypertension: methods and results from the Chickasaw Healthy Eating Environments Research Study. HEALTH EDUCATION RESEARCH 2024:cyae023. [PMID: 38965030 DOI: 10.1093/her/cyae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/30/2024] [Accepted: 06/21/2024] [Indexed: 07/06/2024]
Abstract
We sought to evaluate the acceptability and feasibility of a culturally tailored food box intervention for improving blood pressure (BP), food security and Body Mass Index (BMI) among Chickasaw Nation adults with uncontrolled hypertension. As part of the Chickasaw Healthy Eating Environments Research Study (CHEERS), we administered a group randomized pilot study in four tribal communities (two intervention, two control). Participants in the intervention communities received six heart-healthy food boxes, culturally tailored to traditional Chickasaw diet and current food context. Outcomes were measured over 6 months. We enrolled 262 participants, and 204 with complete data on key variables were included in the analysis. The food boxes were very popular, and we achieved high retention for follow-up data collection. Intervention community participants had 2.6 mmHg lower mean systolic BP and improved diet quality and BMI compared with control participants, although, as expected for a pilot study, the differences were not statistically significant. The culturally tailored diet intervention and randomized trial study design were acceptable and feasible for Chickasaw Nation adults with uncontrolled hypertension. Our findings support the value of tribal-food bank partnerships as a potential approach for reducing food insecurity and hypertension-related disparities in Native American communities.
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Affiliation(s)
- Tori Taniguchi
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Jessica Williams-Nguyen
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Clemma S Muller
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Amber Fyfe-Johnson
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Austin Henderson
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Jason G Umans
- MedStar Health Research Institute, Hyattsville, MD, USA
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA
| | | | | | - Robert Rosenman
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | | | - Valarie Bluebird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Batioja K, Elenwo C, Hendrix-Dicken A, Ali L, Wetherill MS, Hartwell M. Associations of social determinants of health and childhood obesity: a cross-sectional analysis of the 2021 National Survey of Children's Health. J Osteopath Med 2024; 124:231-239. [PMID: 38190347 DOI: 10.1515/jom-2023-0239] [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: 10/20/2023] [Accepted: 12/04/2023] [Indexed: 01/10/2024]
Abstract
CONTEXT Childhood obesity is a growing health problem in the United States, with those affected having an increased likelihood of developing chronic diseases at a younger age. Social determinants of health (SDOH) are known to influence overall health. Families who are of low socioeconomic status (SES) have also been shown to be more likely to experience food insecurity. OBJECTIVES Our primary objective was to utilize the National Survey of Children's Health (NSCH) 2021 data to determine the current associations between childhood obesity and SDOH. Secondarily, we estimated the prevalence of select SDOH among children with obesity. METHODS We conducted a cross-sectional analysis of 2021 NSCH to extract data related to the SDOH domains. We extracted sociodemographic variables to utilize as controls and constructed logistic regression models to determine associations, via odds ratios, between SDOH and childhood obesity. RESULTS Within the binary regression models, children with obesity (≥95th percentile) were more likely than children without obesity to experience SDOH in all domains. After controlling for sociodemographic variables, children with obesity were significantly more likely to experience food insecurity when compared to children without obesity (adjusted odds ratio [AOR]=1.39; 95 % confidence interval [CI]: 1.13-1.17). CONCLUSIONS In line with the current American Academy of Pediatrics (AAP) Clinical Practice Guidelines (CPG), improving policies for nutrition programs and addressing the lack of access to nutritious foods may alleviate some food insecurity. Ensuring that children have access to sufficient nutritious foods is critical in addressing childhood obesity and thus decreasing risk of chronic disease.
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Affiliation(s)
- Kelsi Batioja
- Oklahoma State University Center for Health Sciences, Tulsa, OK 74107, USA
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Tahlequah, OK, USA
| | - Covenant Elenwo
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Tahlequah, OK, USA
| | - Amy Hendrix-Dicken
- Department of Pediatrics, University of Oklahoma School of Community Medicine, Tulsa, OK, USA
| | - Lamiaa Ali
- Department of Pediatrics, University of Oklahoma School of Community Medicine, Tulsa, OK, USA
| | - Marianna S Wetherill
- College of Public Health - Schusterman Center, University of Oklahoma Health Sciences Center, Tulsa, OK, USA
| | - Micah Hartwell
- Oklahoma State University Center for Health Sciences, Tulsa, OK 74107, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Henderson A, Rosenman R, Fyfe-Johnson AL, Taniguchi T, Standridge J, Shackleford T, Muller CJ, Umans JG, Jernigan VBB. The cost-efficacy of a healthy food box for managing hypertension within a native American population: a group randomized controlled trial. Arch Public Health 2024; 82:59. [PMID: 38671533 PMCID: PMC11046939 DOI: 10.1186/s13690-024-01274-9] [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: 01/26/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Dietary interventions are used for the treatment of hypertension. We evaluated the cost-efficacy of delivering boxes of healthy, culturally tailored foods and checks that can only be spent on produce in a Native American population. METHODS We conducted a group randomized controlled trial from 2018 to 2020 with N = 2 treatment counties and N = 2 control counties and a total of N = 160 Native American adults with baseline stage 1 or stage 2 hypertension. Participants in the intervention group received monthly boxes of food that adheres to the Dietary Approaches to Stop Hypertension diet as well as checks that could only be spent on produce for 6 months. We measured blood pressure and quality of life at baseline and at a 6-month follow-up in both intervention and control groups. We used ordered logistic regression to estimate the effect of treatment on probability of blood pressure improvements. We then conducted a cost-efficacy analysis. RESULTS We found that treatment was effective in reducing blood pressure in women with stage 1 hypertension at baseline. Based on this finding, we also estimate that this intervention satisfies normative cost-effectiveness thresholds, even when lifetime treatment is needed to preserve the impact, so long as treatment is only continued in those who respond to treatment. CONCLUSIONS Direct delivery of healthy foods and checks that can only be spent on produce are a potentially cost-effective intervention for the management of hypertension among Native American women with stage 1 hypertension. Further research is needed to understand why we found an impact only for this group.
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Affiliation(s)
- Austin Henderson
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, Washington, United States of America.
| | - Robert Rosenman
- School of Economic Sciences, Washington State University, Pullman, Washington, United States of America
| | - Amber L Fyfe-Johnson
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, Washington, United States of America
| | - Tori Taniguchi
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Stillwater, Oklahoma, United States of America
| | - Joy Standridge
- Nutrition Services Department, Chickasaw Nation, Ada, Oklahoma, United States of America
| | - Tyra Shackleford
- Nutrition Services Department, Chickasaw Nation, Ada, Oklahoma, United States of America
| | - Clemma J Muller
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, Washington, United States of America
| | - Jason G Umans
- Hyattsville MD and Georgetown-Howard Universities Center for Clinical and Translational Science, MedStar Health Research Institute, Washington DC, United States of America
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Stillwater, Oklahoma, United States of America
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Lee AJ, Herron LM, Rainow S, Wells L, Kenny I, Kenny L, Wells I, Kavanagh M, Bryce S, Balmer L. Improving economic access to healthy diets in first nations communities in high-income, colonised countries: a systematic scoping review. Nutr J 2024; 23:10. [PMID: 38225569 PMCID: PMC10790425 DOI: 10.1186/s12937-023-00895-0] [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: 03/29/2023] [Accepted: 11/23/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Affordability of healthy food is a key determinant of the diet-related health of First Nations Peoples. This systematic scoping review was commissioned by the Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women's Council (NPYWC) in Central Australia to identify interventions to improve economic access to healthy food in First Nations communities in selected high-income, colonised countries. METHODS Eight databases and 22 websites were searched to identify studies of interventions and policies to improve economic access to healthy food in First Nations communities in Australia, Canada, the United States or New Zealand from 1996 to May 2022. Data from full text of articles meeting inclusion criteria were extracted to a spreadsheet. Results were collated by descriptive synthesis. Findings were examined with members of the NPYWC Anangu research team at a co-design workshop. RESULTS Thirty-five publications met criteria for inclusion, mostly set in Australia (37%) or the US (31%). Interventions (n = 21) were broadly categorised as price discounts on healthy food sold in communities (n = 7); direct subsidies to retail stores, suppliers and producers (n = 2); free healthy food and/or food vouchers provided to community members (n = 7); increased financial support to community members (n = 1); and other government strategies (n = 4). Promising initiatives were: providing a box of food and vouchers for fresh produce; prescriptions for fresh produce; provision/promotion of subsidised healthy meals and snacks in community stores; direct funds transfer for food for children; offering discounted healthy foods from a mobile van; and programs increasing access to traditional foods. Providing subsidies directly to retail stores, suppliers and producers was least effective. Identified enablers of effective programs included community co-design and empowerment; optimal promotion of the program; and targeting a wide range of healthy foods, particularly traditional foods where possible. Common barriers in the least successful programs included inadequate study duration; inadequate subsidies; lack of supporting resources and infrastructure for cooking, food preparation and storage; and imposition of the program on communities. CONCLUSIONS The review identified 21 initiatives aimed at increasing affordability of healthy foods in First Nations communities, of which six were deemed promising. Five reflected the voices and experiences of members of the NPYWC Anangu research team and will be considered by communities for trial in Central Australia. Findings also highlight potential approaches to improve economic access to healthy foods in First Nations communities in other high-income colonised countries. TRIAL REGISTRATION PROSPERO CRD42022328326.
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Affiliation(s)
- Amanda J Lee
- School of Public Health, The University of Queensland, 288 Herston Rd, Herston, QLD, 4029, Australia.
| | - Lisa-Maree Herron
- School of Public Health, The University of Queensland, 288 Herston Rd, Herston, QLD, 4029, Australia
| | - Stephan Rainow
- Nganampa Health Council, 3 Wilkinson St, Alice Springs, NT, 0871, Australia
| | - Lisa Wells
- Anangu research team, Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) Women's Council, 3 Wilkinson St, Alice Springs, NT, 0871, Australia
| | - Ingrid Kenny
- Anangu research team, Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) Women's Council, 3 Wilkinson St, Alice Springs, NT, 0871, Australia
| | - Leon Kenny
- Anangu research team, Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) Women's Council, 3 Wilkinson St, Alice Springs, NT, 0871, Australia
| | - Imogen Wells
- Anangu research team, Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) Women's Council, 3 Wilkinson St, Alice Springs, NT, 0871, Australia
| | - Margaret Kavanagh
- Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) Women's Council, 3 Wilkinson St, Alice Springs, NT, 0871, Australia
| | - Suzanne Bryce
- Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) Women's Council, 3 Wilkinson St, Alice Springs, NT, 0871, Australia
| | - Liza Balmer
- Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) Women's Council, 3 Wilkinson St, Alice Springs, NT, 0871, Australia
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Riccardi M, Pettinicchio V, Di Pumpo M, Altamura G, Nurchis MC, Markovic R, Šagrić Č, Stojanović M, Rosi L, Damiani G. Community-based participatory research to engage disadvantaged communities: Levels of engagement reached and how to increase it. A systematic review. Health Policy 2023; 137:104905. [PMID: 37716190 DOI: 10.1016/j.healthpol.2023.104905] [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: 01/28/2022] [Revised: 05/12/2023] [Accepted: 09/02/2023] [Indexed: 09/18/2023]
Abstract
Community-based participatory research (CBPR) is one of the most used community engagement frameworks to promote health changes in vulnerable populations. The more a community is engaged, the more a program can impact the social determinants of health. The present study aims to measure the level of engagement reached in randomized controlled trials (RCTs) using CBPR in disadvantaged populations, and to find out the CBPR components that better correlate with a higher level of engagement. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Embase, Web of Science, MEDLINE, Cochrane and Scopus databases were queried. Engagement level was assessed using the revised version of IAP2 spectrum, ranging from "inform" to "shared leadership" . Fifty-one RCTs were included, belonging to 36 engagement programs. Fourteen CBPR reached the highest level of engagement. According to the multivariate logistic regression, a pre-existing community intervention was associated with a higher engagement level (OR = 10.08; p<0.05). The variable "institutional funding" was perfectly correlated with a higher level of engagement. No correlation was found with income status or type of preventive programs. A history of collaboration seems to influence the effectiveness in involving communities burdened with social inequities, so starting new partnerships remains a public health priority to invest on. A strong potentiality of CBPR was described in engaging disadvantaged communities, addressing social determinants of health. The key findings described above should be taken into account when planning a community engagement intervention, to build up an effective collaborative field between researchers and population.
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Affiliation(s)
- MariaTeresa Riccardi
- Department of Health Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | | | - Marcello Di Pumpo
- Department of Health Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gerardo Altamura
- Department of Health Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Mario Cesare Nurchis
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Roberta Markovic
- University of Niš, Faculty of Medicine, Niš, Serbia; Public Health Institute Niš, Niš, Serbia
| | | | - Miodrag Stojanović
- University of Niš, Faculty of Medicine, Niš, Serbia; Public Health Institute Niš, Niš, Serbia
| | - Luca Rosi
- Department of Infectious Diseases, National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Gianfranco Damiani
- Department of Health Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
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Nguyen CJ, Wilbur RE, Henderson A, Sowerwine J, Mucioki M, Sarna-Wojcicki D, Ferguson GL, Maudrie TL, Moore-Wilson H, Wark K, Jernigan VBB. Framing an Indigenous Food Sovereignty Research Agenda. Health Promot Pract 2023; 24:1117-1123. [PMID: 37877643 DOI: 10.1177/15248399231190362] [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] [Indexed: 10/26/2023]
Abstract
Access to healthy and appealing food is essential for individuals to be able to live a healthy and quality life. For decades, food security has been a priority issue for public health professionals. Food sovereignty expands upon the concept of food insecurity (i.e., having access to nutritious and culturally relevant food) by incorporating people's rights to define their own food system. The expanded focus of food sovereignty on food systems prioritizes public health professionals' role in supporting environmental- and systems-level initiatives and evaluating their implications for health, economics, and the natural environment. Food sovereignty is of particular importance for Indigenous peoples (i.e., American Indian, Alaska Native, Native Hawaiian, and Pacific Islander communities). Colonization had demonstrable consequences, with many Indigenous communities being forcibly relocated from traditional lands, alongside the destruction of traditional food sources. Indigenous food sovereignty aligns with the sovereign nation status that American Indian tribes and Alaska Native communities have with the United States. Furthermore, the worldviews that incorporate Indigenous communities' relational responsibilities to care for their food systems, according to their traditional practices and beliefs (Coté, 2016; Morrison, 2011), uniquely positions Indigenous peoples to lead food sovereignty initiatives. In this article, we explore what is currently known regarding food sovereignty and health. We then discuss opportunities to expand the evidence on Indigenous food sovereignty's relationships with (1) health and well being, (2) economics, (3) the natural environment, and (4) programming facilitators and barriers.
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Affiliation(s)
| | | | | | | | - Megan Mucioki
- Pennsylvania State University, State College, PA, USA
| | | | | | - Tara L Maudrie
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Kyle Wark
- Southcentral Foundation, Anchorage, AK, USA
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
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Nguyen CJ, French BF, Maudrie TL, Ferguson GL, Blue Bird Jernigan V, Sinclair KIA. Measuring Food Security among American Indian and Alaska Native Adults: Validity Evidence Supports the Use of the US Department of Agriculture Module. J Acad Nutr Diet 2023; 123:S76-S88. [PMID: 37730308 DOI: 10.1016/j.jand.2023.02.017] [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: 08/22/2022] [Revised: 02/17/2023] [Accepted: 02/28/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Inequities in access, availability, and affordability of nutritious foods produced by settler colonialism contribute to high rates of food insecurity among American Indian and Alaska Native (AI/AN) households. Efforts to understand the influences of food security programming among AI/AN individuals in the United States are constrained by the absence of validity evidence for food security assessments for this population. OBJECTIVE This study assessed whether AI/AN adult responses on the Food Security Survey Module provide an accurate assessment of food security prevalence, especially when compared with other racial and ethnic groups. DESIGN A correlational design with the cross-sectional 2019 National Health Interview Survey was used to address the research objective. PARTICIPANTS AND SETTING The 2019 National Health Interview Survey contains a sample (N = 30,052) representative of the resident civilian noninstitutionalized population. MAIN OUTCOME MEASURES The primary outcome was food security, as characterized by the 10-item US Department of Agriculture Adult Food Security Survey Module. The module evaluates whether insufficient finances result in perceived food shortages and a reduction in the quantity and/or quality of food intake during the prior 30 days. STATISTICAL ANALYSES PERFORMED Data were analyzed by racial and ethnic subsamples to assess scale dimensionality (confirmatory factor analysis), Item Response Theory item analysis, differential item functioning, and external validity (χ2 tests). RESULTS Results supported the use of the 10-item module for racial and ethnic groups. However, differential item functioning effect sizes exceeded criteria for the Asian, AI/AN, and Hispanic respondents when compared with White respondents. Food security was not significantly related to all expected correlates in the AI/AN subsample. CONCLUSIONS Compelling evidence is presented for validity of the FSSM scores in determining food security status of AI/AN adults. Qualitative inquiry that explores how culture influences the way food security is conceptualized and experienced is warranted.
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Affiliation(s)
- Cassandra J Nguyen
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, Washington; Elson S. Floyd College of Medicine, Washington State University, Seattle, Washington.
| | - Brian F French
- College of Education, Washington State University, Pullman, Washington
| | - Tara L Maudrie
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Gary L Ferguson
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, Washington
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Ka Imi A Sinclair
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, Washington; College of Nursing, Washington State University, Seattle, Washington
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Thomas VE, Metlock FE, Hines AL, Commodore-Mensah Y, Brewer LC. Community-Based Interventions to Address Disparities in Cardiometabolic Diseases Among Minoritized Racial and Ethnic Groups. Curr Atheroscler Rep 2023; 25:467-477. [PMID: 37428390 DOI: 10.1007/s11883-023-01119-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE OF REVIEW Cardiometabolic diseases (CMDs) are leading causes of death and disproportionally impact historically marginalized racial/ethnic groups in the United States. The American Heart Association developed the Life's Essential 8 (LE8) to promote optimal cardiovascular health (CVH) through eight health behaviors and health factors. The purpose of this review is to summarize contemporary community-engaged research (CER) studies incorporating the LE8 framework among racial/ethnic groups. REVIEW OF FINDINGS Limited studies focused on the interface of CER and LE8. Based on synthesis of articles in this review, the application of CER to individual/collective LE8 metrics may improve CVH and reduce CMDs at the population level. Effective strategies include integration of technology, group activities, cultural/faith-based practices, social support, and structural/environmental changes. CER studies addressing LE8 factors in racial/ethnic groups play an essential role in improving CVH. Future studies should focus on broader scalability and health policy interventions to advance health equity.
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Affiliation(s)
- Victoria E Thomas
- Division of Cardiovascular Medicine, Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Faith E Metlock
- John Hopkins University School of Nursing, Baltimore, MD, USA
| | - Anika L Hines
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Yvonne Commodore-Mensah
- John Hopkins University School of Nursing, Baltimore, MD, USA
- Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - LaPrincess C Brewer
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
- Mayo Clinic Center for Health Equity and Community Engagement Research, Rochester, MN, USA.
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Glanz K, Fultz AK, Sallis JF, Clawson M, McLaughlin KC, Green S, Saelens BE. Use of the Nutrition Environment Measures Survey: A Systematic Review. Am J Prev Med 2023:S0749-3797(23)00068-5. [PMID: 36990939 DOI: 10.1016/j.amepre.2023.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION The Nutrition Environment Measurement Survey (NEMS) measures were developed to assess the consumer food environment in stores and restaurants. NEMS tools have been widely used in research and adapted for diverse settings and populations in the 15 years since they were created. This systematic review examines the use and adaptations of these measures and what can be learned from published studies using NEMS tools. METHODS A comprehensive search of bibliographic databases was conducted from 2007 to September 2021, supplemented by backward searches and communications with authors, to identify research articles using NEMS tools. Data on purpose, key findings, sample characteristics, NEMS characteristics, and modifications were abstracted. Articles were categorized on the basis of study goals, NEMS tool(s) used, variables measured, and common themes. RESULTS A total of 190 articles from 18 countries were identified. Most studies (69.5%, n=123) used a modified version of NEMS tools. There were 23 intervention studies that used measures from NEMS tools or adaptations as outcomes, moderators, or process assessments. A total of 41% (n=78) of the articles evaluated inter-rater reliability, and 17% (n=33) evaluated test-retest reliability. DISCUSSION NEMS measures have played an important role in the growth of research on food environments and have helped researchers to explore the relationships among healthy food availability, demographic variables, eating behaviors, health outcomes, and intervention-driven changes in food environments. The food environment is constantly changing, so NEMS measures should continue to evolve. Researchers should document data quality of modifications and use in new settings.
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Affiliation(s)
- Karen Glanz
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Amanda K Fultz
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, California
| | - Margaret Clawson
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kelly C McLaughlin
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Sarah Green
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Brian E Saelens
- Department of Pediatrics, University of Washington, Seattle, Washington; Seattle Children's Research Institute, Seattle, Washington
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10
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Dong L, D'Amico EJ, Dickerson DL, Brown RA, Palimaru AI, Johnson CL, Troxel WM. Food insecurity, sleep, and cardiometabolic risks in urban American Indian/Alaska Native youth. Sleep Health 2023; 9:4-10. [PMID: 36328921 PMCID: PMC9991968 DOI: 10.1016/j.sleh.2022.10.003] [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: 12/08/2021] [Revised: 09/13/2022] [Accepted: 10/02/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Food insecurity contributes to racial/ethnic disparities in health. This is the first study to examine associations among food insecurity, sleep, and cardiometabolic outcomes in urban American Indian/Alaska Native (AI/AN) youth. DESIGN Participants were 142 urban AI/AN youth (mean age = 14 years, 58% female). Food insecurity and self-reported sleep disturbance were measured using validated surveys. A multi-dimensional sleep health composite was derived using questionnaires (ie, satisfaction, alertness) and actigraphy-derived indices (ie, duration, efficiency, regularity, timing). Cardiometabolic measures included body mass index, blood pressure, glycosylated hemoglobin, waist circumference, cholesterol, and triglycerides. Covariates were sex, age, and single-parent household. RESULTS Greater food insecurity was significantly associated with greater body mass index (b = 0.12, p = .015), higher systolic blood pressure (b = 0.93, p = .03), and greater sleep disturbance (b = 1.49, p < .001), and marginally associated with lower sleep health composite scores (b = -0.09, p = .08). There was a significant indirect path from greater food insecurity to greater waist circumference through poorer sleep health (0.11, 95% bootstrapping CI: [0.01, 0.30]). CONCLUSION Food insecurity is an important correlate of sleep and cardiometabolic health among urban AI/AN youth and should be addressed to reduce emerging health risks during this important developmental period. Policies to reduce food insecurity and increase access to healthy foods as well as sleep interventions for these youth could help, as preliminary findings suggest that sleep health may mediate the negative impact of food insecurity on cardiometabolic risks.
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Affiliation(s)
- Lu Dong
- RAND Corporation, Santa Monica, California, USA.
| | | | - Daniel L Dickerson
- UCLA Integrated Substance Abuse Program, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA
| | | | | | - Carrie L Johnson
- Sacred Path Indigenous Wellness Center, Los Angeles, California, USA
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Doustmohammadian A, Mohammadi-Nasrabadi F, Keshavarz-Mohammadi N, Hajjar M, Alibeyk S, Hajigholam-Saryazdi M. Community-based participatory interventions to improve food security: A systematic review. Front Nutr 2022; 9:1028394. [PMID: 36601081 PMCID: PMC9807164 DOI: 10.3389/fnut.2022.1028394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction This systematic review aimed to evaluate community-based participatory (CBP) interventions to improve food security and/or its dimensions to highlight the scope and characteristics of interventions and extract the characteristics of effective interventions. Methods The electronic databases, including PubMed/MEDLINE, SCOPUS, EMBASE, Web of Science, and Google Scholar, were searched from 1980 to 30 August 2022 for relevant studies. We included randomized controlled trials (RCTs), cluster randomized controlled trials (cRCTs), controlled before and after studies (CBAs), non-randomized controlled trials (nRCT), and interrupted time series (ITS) studies to identify the community-based participatory interventions. The indicators of food and nutrition security into four dimensions, as well as food insecurity measured as score and/or prevalence of food insecurity based on validated perception-based measures were considered outcome. Two reviewers independently evaluated the studies for eligibility, extracted data, and evaluated the risk of bias in the included studies using the Effective Public Health Practice Project (EPHPP). The quality of included reports was categorized as strong (when there were no weak ratings), moderate (when one factor was rated as weak), or weak (when two or more factors were rated as weak). A descriptive analysis of the findings was performed. Results A total of twelve studies were included. The quality of all eligible studies (n = 12) was rated as moderate/weak. Most CBP interventions were guided by formative research (n = 9, 75%). Two main groups for utilized strategies were identified: agricultural and nutrition strategies. Agricultural strategies included agricultural education, preparing and improving soil and seeds, promoting and supporting gardening/harvesting utilizing traditional skills based on the local culture, and agroecological practices. Nutrition strategies included store and shopping programs, farmers' markets, fresh fruit and vegetable programs, nutrition education programs for mothers, and food vouchers. The main outcomes improved in the CBP interventions were food security (n = 2) and its dimensions, including availability (n = 3), access (n = 5), and utilization (n = 2). All agroecological practices achieved statistically significant outcomes in the intended food security target(s). However, nutritional interventions were not effective for some access components such as mean adequacy ratio, fruit and vegetable intake, and nutrition environment of the stores. No studies evaluated stability outcome components of food security. Discussion CBP interventions guided by formative research data and agroecological practices were promising strategies to improve food security and its dimensions. Insufficient data on the stability components of food security and weak design studies were the considerable gaps in the research evidence reviewed. More research employing randomized experimental designs with adequate sample size and high retention rates is required. Systematic review registration [https://www.crd.york.ac.uk/prospero/], identifier [CRD42020189477].
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Affiliation(s)
- Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mohammadi-Nasrabadi
- Research Department of Food and Nutrition Policy and Planning, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran,*Correspondence: Fatemeh Mohammadi-Nasrabadi, ,
| | - Nastaran Keshavarz-Mohammadi
- School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Nastaran Keshavarz-Mohammadi,
| | - Melika Hajjar
- Department of Community Nutrition, School of Nutrition Sciences and Food Technology, Student Research Committee, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Alibeyk
- Faculty of Nutrition Sciences and Food Technology, Library, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Hajigholam-Saryazdi
- Faculty of Nutrition Sciences and Food Technology, Library, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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Wolgast H, Halverson MM, Kennedy N, Gallard I, Karpyn A. Encouraging Healthier Food and Beverage Purchasing and Consumption: A Review of Interventions within Grocery Retail Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16107. [PMID: 36498181 PMCID: PMC9737366 DOI: 10.3390/ijerph192316107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
This review identifies the most promising intervention strategies for promoting the purchase and consumption of healthier items within U.S. grocery retail settings, with a particular focus on those strategies that may be most effective when implemented within SNAP-authorized retail settings. Searches of nine electronic databases, as well as forward and backward searches, yielded 1942 studies. After being screened, 73 peer-reviewed academic articles were identified for inclusion. Of these, 33 analyzed single-component interventions, while 40 assessed multi-component interventions. The following unique intervention types were considered as evaluated in these studies for their ability to increase healthy item purchasing and consumption: (1) nutrition scoring, (2) nutritional messaging, (3) non-nutritional messaging, (4) endcaps and secondary placement, (5) point-of-sale interventions, (6) increased stocking, (7) food tasting and demonstrations, (8) nutrition education, and (9) placement on shelf interventions. Nutritional scoring and nutritional messaging emerged as the most rigorously tested and effective intervention strategies. Other strategies warrant more research attention. Simple intervention strategies, as opposed to complex ones, yield the most successful results and minimize shopper burden. Therefore, these strategies should be reviewed for policy implementation within SNAP-authorized grocery retailers.
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Affiliation(s)
- Henry Wolgast
- Center for Research in Education and Social Policy, University of Delaware, Newark, DE 19716, USA
| | - McKenna M. Halverson
- Center for Research in Education and Social Policy, University of Delaware, Newark, DE 19716, USA
| | - Nicole Kennedy
- Center for Research in Education and Social Policy, University of Delaware, Newark, DE 19716, USA
| | | | - Allison Karpyn
- Center for Research in Education and Social Policy, University of Delaware, Newark, DE 19716, USA
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13
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Commodore-Mensah Y, Metlock FE, Cooper LA. Rethinking, Reimagining, and Reigniting Community-Engaged Research to Promote Cardiovascular Health Equity. Circ Cardiovasc Qual Outcomes 2022; 15:e009519. [PMID: 36378771 PMCID: PMC9716750 DOI: 10.1161/circoutcomes.122.009519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yvonne Commodore-Mensah
- Associate Professor, Johns Hopkins School of Nursing and Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.C.M.)
| | | | - Lisa A Cooper
- Johns Hopkins School of Medicine, Johns Hopkins Bloomberg School of Public Health, and Johns Hopkins School of Nursing, Baltimore, MD (L.A.C.)
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14
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Middel CN, Schuitmaker-Warnaar TJ, Mackenbach JD, Broerse JE. Designing a Healthy Food-Store Intervention; A Co-Creative Process Between Interventionists and Supermarket Actors. Int J Health Policy Manag 2022; 11:2175-2188. [PMID: 34634882 PMCID: PMC9808264 DOI: 10.34172/ijhpm.2021.110] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 08/17/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Without consideration for the food system in which healthy food-store interventions (HFIs) are implemented, their effects are likely to be unsustainable. Co-creation of HFIs by interventionists and food-store actors may improve contextual fit and therefore the effectiveness and sustainability of interventions, but there are few case studies on the topic. This study aims to provide insights into the integration of knowledge from contextual actors into HFI designs, through a co-creative process, to illustrate potential challenges, advantages, and outcomes. METHODS We describe the co-creative design of an HFI in a Dutch supermarket chain, conducted through three increasingly in-depth design phases. Each phase consisted of a cycle of theorizing (gather insights from literature, feedback, and pilot studies), building (develop intervention designs), and evaluating (interviews or workshops with supermarket actors, to explore barriers and facilitators for sustainable implementation), feeding back into the next phase (drafting adapted intervention designs, based on feedback, and research input). Interview transcripts underwent a qualitative content analysis. RESULTS We co-creatively designed four types of interventions to promote healthier food choices in supermarkets: (1) price strategies, (2) product presentation and positioning, (3) signage, and (4) interactive messaging. Interventions were aligned with the culture, structures and practices of the supermarket chain, while simultaneously challenging these system characteristics. For example, the idea of price promotions on healthy foods was well-received and encountered only practical barriers, which were easily resolved. However, the specification of tax-like price increases on unhealthy foods led to substantial resistance on cultural and commercial grounds, which were resolved through support from a key supermarket actor. CONCLUSION Our results illustrate the potential benefits of co-creation approaches in HFI design. We reflect on the value of more easily accepted interventions to develop collaborative momentum and more radical interventions to drive more substantial changes.
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Affiliation(s)
- Cédric N.H. Middel
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Joreintje D. Mackenbach
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Upstream Team, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jacqueline E.W. Broerse
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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15
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Vargas C, Whelan J, Brimblecombe J, Brock J, Christian M, Allender S. Co-creation of healthier food retail environments: A systematic review to explore the type of stakeholders and their motivations and stage of engagement. Obes Rev 2022; 23:e13482. [PMID: 35670030 PMCID: PMC9540769 DOI: 10.1111/obr.13482] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/17/2022] [Accepted: 05/25/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To synthesize peer-reviewed literature that utilize co-creation principles in healthy food retail initiatives. METHODS Systematic review of six databases from inception to September 2021. Screening and quality assessment were carried out by two authors independently. Studies were included if they were conducted in food retail stores, used a collaborative model, and aimed to improve the healthiness of the food retail environment. Studies excluded were implemented in restaurants, fast food chains, or similar or did not utilize some form of collaboration. Extracted data included the type of stakeholders engaged, level of engagement, stakeholder motivation, and barriers and enablers of the co-creation process. FINDINGS After screening 6951 articles by title and abstract, 131 by full text, 23 manuscripts that describe 20 separate studies from six countries were included. Six were implemented in low-income communities and eight among Indigenous people groups. A common aim was to increase access to, and availability of, healthy products. A diverse range of co-creation approaches, theoretical perspectives, and study designs were observed. The three most common stakeholders involved were researchers, corporate representatives or store owners, and governments. CONCLUSIONS Some evidence exists of the benefits of co-creation to improve the healthiness of food retail environments. The field may benefit from structured guidance on the theory and practice of co-creation.
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Affiliation(s)
- Carmen Vargas
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Jillian Whelan
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Julie Brimblecombe
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University Clayton, Melbourne, Victoria, Australia
| | - Jessica Brock
- Centre for Food Policy, City University of London, London, UK
| | - Meaghan Christian
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University Clayton, Melbourne, Victoria, Australia
| | - Steven Allender
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
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Julian McFarlane S, Occa A, Peng W, Awonuga O, Morgan SE. Community-Based Participatory Research (CBPR) to Enhance Participation of Racial/Ethnic Minorities in Clinical Trials: A 10-Year Systematic Review. HEALTH COMMUNICATION 2022; 37:1075-1092. [PMID: 34420460 DOI: 10.1080/10410236.2021.1943978] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
There has not been a significant improvement in the rate of clinical trial accrual in more than 20 years. Worse, the challenge of inadequate representation among racial and ethnic minorities also persists, deepening disparities in health. Community-Based Participatory Research (CBPR) is a participatory communication method that centers on effective dialogue between researchers and community stakeholders with the goal of creating an equitable partnership for health and social change. The objective of the current study was to provide an update since a systematic review in 2012, on the current status of the empirical research, with a particular focus on the elements of CBPR methods used to improve the rate of accrual of members of racial and ethnic minority communities for clinical trials. Our systematic review found a large increase in the number of CBPR related studies and studies related to racial and ethnic representation in research. More than 85% of studies employing CBPR methods saw statistically positive outcomes. Specifically, the elements of CBPR that are associated with these positive outcomes include community partner participation in (1) a study advisory committee, (2) data collection, (3) the development of interventions, and (4) participant recruitment. However, the results of our study indicate that researchers need to be more transparent about the extent of community participation as well as more thoroughly and accurately describe the nature of the partnership with members of minority communities in order to build upon the scientific literature on community-engaged methods.
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Affiliation(s)
| | - Aurora Occa
- Department of Communication, University of Kentucky
| | - Wei Peng
- Murrow College of Communication, Washington State University
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17
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Haslam A, Nikolaus CJ, Sinclair KA. Association of Food Environment Characteristics with Health Outcomes in Counties with a High Proportion of Native American Residents. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2101414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Alyson Haslam
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Cassandra J. Nikolaus
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, Washington, USA
| | - Ka’Imi A. Sinclair
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, Washington, USA
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18
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Community-Based Participatory Research to Improve Cardiovascular Health Among US Racial and Ethnic Minority Groups. CURR EPIDEMIOL REP 2022; 9:212-221. [PMID: 36003088 PMCID: PMC9392701 DOI: 10.1007/s40471-022-00298-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 11/11/2022]
Abstract
Purpose of Review This review aims to assess the contemporary community-based participatory research (CBPR) literature seeking to improve the cardiovascular health of racial and ethnic minority groups in the USA with a higher burden of cardiovascular risk factors and social determinants of health. It summarizes recent CBPR studies based on the American Heart Association Life's Simple 7 (LS7) framework, delineating seven modifiable health behaviors and clinical factors to promote cardiovascular health. Recent Findings Although limited in quantity, studies demonstrated preliminary effectiveness in improving individual and a composite of LS7 indicators by employing strategies centered around fortifying social networks, integrating group activities, leveraging technology, incorporating faith-based and spiritual practices, and implementing changes to the built environment. Summary Future directions for investigators engaged in CBPR include building on the existing body of evidence through more comprehensive studies, scaling effective interventions, and translating CBPR findings to influence health policy to better address health disparities.
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19
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Fultz AK, Sundermeir SM, Katz S, Robson SM. More Frequent Food Shopping May Promote Fruit and Vegetable Intake: A Systematic Review. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:957-965. [PMID: 34452830 DOI: 10.1016/j.jneb.2021.07.010] [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: 02/03/2021] [Revised: 07/19/2021] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Food shopping frequency may be an important modifiable factor related to increasing fruit and vegetable (FV) intake. Because of mixed findings of individual studies of shopping frequency, a systematic review is needed to examine findings across studies and store types. OBJECTIVE To conduct a systematic review of articles examining the relationship between frequency of food shopping and FV intake including examination of participation in federal nutrition assistance programs on FV intake, if reported. METHODS A search, guided by the Preferred Reported Items for Systematic Reviews and Metanalyses, using terms related to FV consumption and food shopping across 4 online databases, was conducted. Studies conducted in the US and published through October, 2020, included adults, and had a cross-sectional, longitudinal, cohort, or randomized study design were eligible for inclusion. RESULTS Twenty-four articles were included. The majority of studies found at least 1 positive finding between the frequency of food shopping and FV intake, indicating that as the frequency of food shopping increased, FV intake increased. In studies with 100% participation in government/federal nutrition assistance programs, participation was associated with FV intake. Studies that included participation as a subset found participation not associated with FV intake. IMPLICATIONS FOR FUTURE RESEARCH AND PRACTICE The frequency of shopping may be modifiable to increase FV intake. Experimental research is needed to test the directionality and causality of the relationship. Federal nutrition assistance programs may be a logical place to test the relationship through the adjustment of fund disbursements.
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Affiliation(s)
- Amanda K Fultz
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE; Center for Health Behavior Research, University of Pennsylvania, Philadelphia, PA.
| | - Samantha M Sundermeir
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE; Department of International Health, Johns Hopkins University, Baltimore, MD
| | - Sarah Katz
- Health Science Librarian, University of Delaware Library, Museums and Press, Newark, DE
| | - Shannon M Robson
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE
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20
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Shannon J, Reese AM, Ghosh D, Widener MJ, Block DR. More Than Mapping: Improving Methods for Studying the Geographies of Food Access. Am J Public Health 2021; 111:1418-1422. [PMID: 34464170 PMCID: PMC8489630 DOI: 10.2105/ajph.2021.306339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Jerry Shannon
- Jerry Shannon is with the Departments of Geography/Financial Planning, Housing, and Consumer Economics, University of Georgia, Athens. Ashantè M. Reese is with the Department of African and African Diaspora Studies, University of Texas at Austin. Debarchana Ghosh is with the Department of Geography, University of Connecticut, Storrs. Michael J. Widener is with the Department of Geography and Planning, University of Toronto, Toronto, ON, Canada. Daniel R. Block is with the Department of Geography, Sociology, History, and African-American Studies, Chicago State University, Chicago, IL
| | - Ashantè M Reese
- Jerry Shannon is with the Departments of Geography/Financial Planning, Housing, and Consumer Economics, University of Georgia, Athens. Ashantè M. Reese is with the Department of African and African Diaspora Studies, University of Texas at Austin. Debarchana Ghosh is with the Department of Geography, University of Connecticut, Storrs. Michael J. Widener is with the Department of Geography and Planning, University of Toronto, Toronto, ON, Canada. Daniel R. Block is with the Department of Geography, Sociology, History, and African-American Studies, Chicago State University, Chicago, IL
| | - Debarchana Ghosh
- Jerry Shannon is with the Departments of Geography/Financial Planning, Housing, and Consumer Economics, University of Georgia, Athens. Ashantè M. Reese is with the Department of African and African Diaspora Studies, University of Texas at Austin. Debarchana Ghosh is with the Department of Geography, University of Connecticut, Storrs. Michael J. Widener is with the Department of Geography and Planning, University of Toronto, Toronto, ON, Canada. Daniel R. Block is with the Department of Geography, Sociology, History, and African-American Studies, Chicago State University, Chicago, IL
| | - Michael J Widener
- Jerry Shannon is with the Departments of Geography/Financial Planning, Housing, and Consumer Economics, University of Georgia, Athens. Ashantè M. Reese is with the Department of African and African Diaspora Studies, University of Texas at Austin. Debarchana Ghosh is with the Department of Geography, University of Connecticut, Storrs. Michael J. Widener is with the Department of Geography and Planning, University of Toronto, Toronto, ON, Canada. Daniel R. Block is with the Department of Geography, Sociology, History, and African-American Studies, Chicago State University, Chicago, IL
| | - Daniel R Block
- Jerry Shannon is with the Departments of Geography/Financial Planning, Housing, and Consumer Economics, University of Georgia, Athens. Ashantè M. Reese is with the Department of African and African Diaspora Studies, University of Texas at Austin. Debarchana Ghosh is with the Department of Geography, University of Connecticut, Storrs. Michael J. Widener is with the Department of Geography and Planning, University of Toronto, Toronto, ON, Canada. Daniel R. Block is with the Department of Geography, Sociology, History, and African-American Studies, Chicago State University, Chicago, IL
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21
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Blue Bird Jernigan V, Maudrie TL, Nikolaus CJ, Benally T, Johnson S, Teague T, Mayes M, Jacob T, Taniguchi T. Food Sovereignty Indicators for Indigenous Community Capacity Building and Health. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2021. [DOI: 10.3389/fsufs.2021.704750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Food insecurity, defined as a lack of stable access to sufficient and nutritious food, is a global public health priority due to its relationships with diminished mental and physical human health. Indigenous communities experience disproportionality high rates of food insecurity as a byproduct of settler-colonial activities, which included forced relocation to rural reservation lands and degradation of traditional subsistence patterns. Many Indigenous communities have worked to revitalize their local food systems by pursuing food sovereignty, regularly expressed as the right and responsibility of people to have access to healthy and culturally appropriate foods, while defining their own food systems. Food sovereignty is a promising approach for improving health. However, limited literature is available that identifies the diverse practices of food sovereignty or strategies communities can implement to strengthen their food sovereignty efforts. This article reviews the scientific literature and highlights key indicators that may support community capacity building for food sovereignty and health. The seven indicators are: (1) access to resources, (2) production, (3) trade, (4) food consumption, (5) policy, (6) community involvement, and (7) culture. A total of 25 sub-indicators are outlined to allow communities to understand how an indicator is operationalized as well as explore their own community's progress within each indicator. It is not expected that every indicator and their subcategories will apply fully to any given Indigenous community, and the application of these indicators must be adapted for each community's local context, however the indicators may provide support for building and assessing efforts to create more sustainable Indigenous food systems.
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22
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Nutrition Interventions in Low-Income Rural and Urban Retail Environments: A Systematic Review. J Acad Nutr Diet 2021; 121:1087-1114. [PMID: 33589382 DOI: 10.1016/j.jand.2020.12.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/24/2020] [Accepted: 12/18/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Nutrition interventions promoting healthy food choices aim to address health challenges of residents in low-income environments. Research about the effectiveness of nutrition interventions in low-income populations is limited, particularly for those in rural areas. Behavioral economics (BE) strategies demonstrate effectiveness for improving eating behaviors in some settings. However, the efficacy of BE interventions in retail food stores serving low-income populations residing in rural and urban geographies is nascent. OBJECTIVE This systematic literature review aims to identify and compare nutrition interventions implemented in rural and urban low-income retail food stores, including BE strategies when applied. METHODS This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Reviewers searched five databases for peer-reviewed publications from October 2010 to October 2019. Included studies implemented a nutrition intervention in low-income retail food stores and provided a quantitative outcome evaluation with results separated by rural and urban geography. BE interventions were analyzed based on the MINDSPACE framework for behavior change. RESULTS Forty-six separate publications (n = 20 rural, n = 26 urban) in the United States, Canada, Europe, New Zealand, and Australia were included. Researchers independently rated publications as low risk of bias (n = 4), moderate (n = 18), or high risk of bias (n = 24) using the Quality Assessment Tool for Quantitative Studies. Studies (n = 18) demonstrated positive outcomes for customer purchases, store sales, or participant intake of targeted healthy foods. Overall, most effective interventions included point-of-purchase signage (n = 16) and product placement strategies (n = 4 urban). Rural studies included financial incentives combined with participant education (n = 2) and incorporated culturally appropriate messengers and/or symbols (n = 5) to improve healthy food purchases and intake. CONCLUSIONS Improved research quality and tailored evidence-based interventions, including BE strategies, are necessary in retail food environments to promote healthy eating behaviors in low-income populations.
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Kenny TA, Little M, Lemieux T, Griffin PJ, Wesche SD, Ota Y, Batal M, Chan HM, Lemire M. The Retail Food Sector and Indigenous Peoples in High-Income Countries: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238818. [PMID: 33261090 PMCID: PMC7730644 DOI: 10.3390/ijerph17238818] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 02/06/2023]
Abstract
Indigenous Peoples in high-income countries experience higher burdens of food insecurity, obesity, and diet-related health conditions compared to national averages. The objective of this systematic scoping review is to synthesize information from the published literature on the methods/approaches, findings, and scope for research and interventions on the retail food sector servicing Indigenous Peoples in high-income countries. A structured literature search in two major international databases yielded 139 relevant peer-reviewed articles from nine countries. Most research was conducted in Oceania and North America, and in rural and remote regions. Several convergent issues were identified across global regions including limited grocery store availability/access, heightened exposure to unhealthy food environments, inadequate market food supplies (i.e., high prices, limited availability, and poor quality), and common underlying structural factors including socio-economic inequality and colonialism. A list of actions that can modify the nature and structure of retailing systems to enhance the availability, accessibility, and quality of healthful foods is identified. While continuing to (re)align research with community priorities, international collaboration may foster enhanced opportunities to strengthen the evidence base for policy and practice and contribute to the amelioration of diet quality and health at the population level.
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Affiliation(s)
- Tiff-Annie Kenny
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, QC G1V 0A6, Canada;
- Centre de recherche du CHU de Québec, Université Laval, Axe santé des populations et pratiques optimales en santé, Quebec, QC G1E 6W2, Canada
- Correspondence: or
| | - Matthew Little
- School of Public Health and Social Policy, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Tad Lemieux
- Department of English Language and Literature, Carleton University, Ottawa, ON K1S 5B6, Canada;
| | - P. Joshua Griffin
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA 98105, USA; (P.J.G.); (Y.O.)
- Department of American Indian Studies, University of Washington, Seattle, WA 98195, USA
| | - Sonia D. Wesche
- Department of Geography, Environment and Geomatics, Faculty of Arts, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Yoshitaka Ota
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA 98105, USA; (P.J.G.); (Y.O.)
- Nippon Foundation Ocean Nexus Center, EarthLab, University of Washington; Seattle, WA 98195, USA
| | - Malek Batal
- Département de nutrition, Faculté de médecine, Université de Montréal, Montreal, QC H3T 1J4, Canada;
- Centre de recherche en santé publique (CReSP), Montreal, Quebec, QC H3N 1X9, Canada
| | - Hing Man Chan
- Department of Biology, University of Ottawa, Ottawa, ON K1N 9A7, Canada;
| | - Melanie Lemire
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, QC G1V 0A6, Canada;
- Centre de recherche du CHU de Québec, Université Laval, Axe santé des populations et pratiques optimales en santé, Quebec, QC G1E 6W2, Canada
- Institut de biologie intégrative et des systèmes (IBIS), Université Laval, Quebec, QC G1V 0A6, Canada
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Yoder AD, Proaño GV, Handu D. Retail Nutrition Programs and Outcomes: An Evidence Analysis Center Scoping Review. J Acad Nutr Diet 2020; 121:1866-1880.e4. [PMID: 33229206 DOI: 10.1016/j.jand.2020.08.080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/05/2020] [Accepted: 08/18/2020] [Indexed: 02/06/2023]
Abstract
As nutrition-related diseases contribute to rising health care costs, food retail settings are providing a unique opportunity for registered dietitian nutritionists (RDNs) to address the nutritional needs of consumers. Food as Medicine interventions play a role in preventing and/or managing many chronic conditions that drive health care costs. The objective of this scoping review was to identify and characterize literature examining Food as Medicine interventions within food retail settings and across consumer demographics. An electronic literature search of 8 databases identified 11,404 relevant articles. Results from the searches were screened against inclusion criteria, and intervention effectiveness was assessed for the following outcomes: improvement in health outcomes and cost-effectiveness. One-hundred and eighty-six papers and 25 systematic reviews met inclusion criteria. Five categories surfaced as single interventions: prescription programs, incentive programs, medically tailored nutrition, path-to-purchase marketing, and personalized nutrition education. Multiple combinations of intervention categories, reporting of health outcomes (nutritional quality of shopping purchases, eating habits, biometric measures), and cost-effectiveness (store sales, health care dollar savings) also emerged. The intervention categories that produced both improved health outcomes and cost-effectiveness included a combination of incentive programs, personalized nutrition education, and path-to-purchase marketing. Food as Medicine interventions in the food retail setting can aid consumers in navigating health through diet and nutrition by encompassing the following strategic focus areas: promotion of health and well-being, managing chronic disease, and improving food security. Food retailers should consider the target population and desired focus areas and should engage registered dietitian nutritionists when developing Food as Medicine interventions.
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Improving Consumption and Purchases of Healthier Foods in Retail Environments: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207524. [PMID: 33081130 PMCID: PMC7588922 DOI: 10.3390/ijerph17207524] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/08/2020] [Accepted: 10/10/2020] [Indexed: 12/21/2022]
Abstract
This review examines current research on manipulations of U.S. food retail environments to promote healthier food purchasing and consumption. Studies reviewed use marketing strategies defined as the 4Ps (product, price, placement, promotion) to examine results based on single- and multi-component interventions by study design, outcome, and which of the “Ps” was targeted. Nine electronic databases were searched for publications from 2010 to 2019, followed by forward and backward searches. Studies were included if the intervention was initiated by a researcher or retailer, conducted in-store, and manipulated the retail environment. Of the unique 596 studies initially identified, 64 studies met inclusion criteria. Findings show that 56 studies had at least one positive effect related to healthier food consumption or purchasing. Thirty studies used single-component interventions, while 34 were multi-component. Promotion was the most commonly utilized marketing strategy, while manipulating promotion, placement, and product was the most common for multi-component interventions. Only 14 of the 64 studies were experimental and included objective outcome data. Future research should emphasize rigorous designs and objective outcomes. Research is also needed to understand individual and additive effects of multi-component interventions on sales outcomes, substitution effects of healthy food purchases, and sustainability of impacts.
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Brimblecombe J, McMahon E, Ferguson M, De Silva K, Peeters A, Miles E, Wycherley T, Minaker L, Greenacre L, Gunther A, Chappell E, Chatfield MD, Mah CL. Effect of restricted retail merchandising of discretionary food and beverages on population diet: a pragmatic randomised controlled trial. Lancet Planet Health 2020; 4:e463-e473. [PMID: 33038320 DOI: 10.1016/s2542-5196(20)30202-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 08/07/2020] [Accepted: 08/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The effectiveness of healthy food promotion on food and beverage sales in real-world food retail settings has been shown in randomised trials. The effectiveness of restrictions on the promotion of unhealthy food is, however, less clear. We aimed to assess the effect of restricted unhealthy food promotion, specifically those items contributing most to free sugar sales, on food and beverage sales. METHODS In this community-level pragmatic, partially randomised, parallel group trial, stores were randomly assigned by a statistician using a single sequence of random assignments to the intervention group, in which a co-designed strategy restricted merchandising of unhealthy food, or to a control group of usual retail practice. The trial was done in partnership with an organisation operating 25 stores in remote Australia. The primary analysis was based on difference in weekly sales with the strategy compared with no strategy in free sugar from all foods and beverages (g/total MJ; primary outcome), targeted food or beverages (weight and free sugars; g/total MJ), and gross profit (AU$) using mixed models. This trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12618001588280. FINDINGS Between June 13 and Aug 15, 2018, 20 stores were recruited; ten stores were randomly assigned to the intervention group and ten stores to the control group. The trial was done between Sept 2 and Dec 2, 2018. The Healthy Stores 2020 strategy resulted in a reduction in sales of free sugar of 2·8% (95% CI -4·9 to -0·7). Targeted beverages were reduced by 8·4% (-12·3 to -4·3) and associated free sugar by 6·8% (-10·9 to -2·6), sugar-sweetened soft drinks by 13·2% (-18·5 to -7·6), and associated free sugar by 13·4% (-18·7 to -7·7). Reductions in sales of free sugar from confectionery of 7·5% (-14·3 to -0·2) and in weight sold (-4·6%, -11·1 to 2·3) resulted; however, the reduction in weight was not statistically significant. No differences in sales of table sugar and sweet biscuits were observed. Gross profit was not impacted adversely; a small increase resulted (5·3%, 0·3 to 10·5). INTERPRETATION Restricted merchandising of unhealthy foods and beverages, while allowing for complementary merchandising of healthier foods and beverages in a real-world store setting and co-designed with retailers, can achieve both public health and business relevant gains. FUNDING Australian National Health and Medical Research Council.
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Affiliation(s)
- Julie Brimblecombe
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia; Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia.
| | - Emma McMahon
- Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia
| | - Megan Ferguson
- Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia; School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Khia De Silva
- Arnhem Land Progress Aboriginal Corporation, Darwin, NT, Australia
| | - Anna Peeters
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Edward Miles
- Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia
| | - Thomas Wycherley
- Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia; Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, SA, Australia
| | - Leia Minaker
- School of Planning, University of Waterloo, Waterloo, ON, Canada
| | - Luke Greenacre
- Business School, Monash University, Melbourne, VIC, Australia
| | - Anthony Gunther
- Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia
| | - Emma Chappell
- Arnhem Land Progress Aboriginal Corporation, Darwin, NT, Australia
| | - Mark D Chatfield
- Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia; School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Catherine L Mah
- Faculty of Health, Dalhousie University, Halifax, NS, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Williams MB, Wang W, Taniguchi T, Salvatore AL, Groover WK, Wetherill M, Love C, Cannady T, Grammar M, Standridge J, Fox J, Jernigan VBB. Impact of a Healthy Retail Intervention on Fruits and Vegetables and Total Sales in Tribally Owned Convenience Stores: Findings From the THRIVE Study. Health Promot Pract 2020; 22:796-805. [PMID: 32912007 DOI: 10.1177/1524839920953122] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Healthy retail interventions are a recommended intervention strategy to address diet-related diseases, such as obesity and diabetes; however, retail managers are concerned about their bottom line. This study's aim was to assess the impact of a healthy retail intervention on fruits and vegetables (FV) sales, as well as total sales, in tribally owned convenience stores where grocery stores are scarce. METHOD We analyzed weekly sales data over the first 6 months of a healthy retail intervention. We assessed the proportion of sales from two FV baskets. The FV basket included all fresh, canned, and dried FV sold at stores; while the fruits, vegetables, and salads (FVS) basket included all FV items as well as all salads sold. We compared mean weekly sales rates in intervention and control stores over the 6-month period using generalized estimating equations models to account for repeated measures. RESULTS Mean weekly FV basket sales rates were higher in intervention stores than control stores in both Nations. Mean weekly FVS baskets sales were significantly higher in intervention stores than control stores in one Nation and were higher, but not statistically significant, in intervention stores in the other Nation. Total sales remained steady throughout the intervention period. CONCLUSIONS The THRIVE (Tribal Health and Resilience in Vulnerable Environments) intervention increased FV sales without negatively affecting total sales. Policy and Practice Implications. Healthy retail interventions in tribal convenience stores, where many Native Americans living in rural areas shop due to scarcity of grocery stores, could improve diet-related disparities without reducing total sales.
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Affiliation(s)
- Mary B Williams
- University of Oklahoma Health Sciences Center, Tulsa, OK, USA
| | - Wenyu Wang
- University of Oklahoma Health Sciences Center, Tulsa, OK, USA
| | - Tori Taniguchi
- Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | | | | | | | - Charlotte Love
- Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | | | | | | | - Jill Fox
- The Chickasaw Nation, Ada, OK, USA
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Luongo G, Skinner K, Phillipps B, Yu Z, Martin D, Mah CL. The Retail Food Environment, Store Foods, and Diet and Health among Indigenous Populations: a Scoping Review. Curr Obes Rep 2020; 9:288-306. [PMID: 32780322 DOI: 10.1007/s13679-020-00399-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE OF THE REVIEW Describe the state of knowledge on how the retail food environment contributes to diet-related health and obesity among Indigenous populations, and assess how the literature incorporates Indigenous perspectives, methodologies and engagement throughout the research process. Outcomes included dietary behaviour (purchasing, intakes and diet quality) and diet-related health outcomes (weight-related outcomes, non-communicable diseases and holistic health or definitions of health as defined by Indigenous populations involved in the study). RECENT FINDINGS Of fifty included articles (1996-2019), the largest proportions described Indigenous communities in Canada (20 studies, 40%), the USA (16, 32%) and Australia (9, 18%). Among articles that specified the Indigenous population of focus (42 studies, 84%), the largest proportion (11 studies, 26%) took place in Inuit communities, followed by Aboriginal and Torres Strait Islander communities (8 studies, 19%). The included literature encompassed four main study designs: type A, dietary intakes of store foods (14 studies, 28%), and type B, store food environments (16, 32%), comprised the greatest proportion of articles; the remainder were type C, store food environments and diet (7, 14%), and type D, store food environment interventions (13, 26%). Of the studies that assessed diet or health outcomes (36, 72%), 22 (61%) assessed dietary intakes; 16 (44%) sales/purchasing; and 8 (22%) weight-related outcomes. Store foods tended to contribute the greatest amount of dietary energy to the diets of Indigenous peoples and increased non-communicable disease risk as compared to traditional foods. Multi-pronged interventions appeared to have positive impacts on dietary behaviours, food purchasing and nutrition knowledge; promotion and nutrition education alone had more mixed effects. Of the nine studies which were found to have strong engagement with Indigenous populations, eight had moderate or high methodological quality. Eighteen studies (36%) did not mention any engagement with Indigenous populations. The literature confirmed the importance of store foods to the total energy intake of the contemporary diets of Indigenous people, the gaps in accessing both retail food environments and traditional foods and the potential for both new dietary assessment research and retail food environment intervention strategies to better align with and privilege Indigenous Ways of Knowing.
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Affiliation(s)
- Gabriella Luongo
- School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd floor, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Kelly Skinner
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Breanna Phillipps
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Ziwa Yu
- School of Nursing, Dalhousie University, 5869 University Avenue, PO BOX 15000, Halifax, NS, B3H 4R2, Canada
| | - Debbie Martin
- School of Health and Human Performance, Dalhousie University, Stairs House, 6230 South Street, PO Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Catherine L Mah
- School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd floor, PO Box 15000, Halifax, NS, B3H 4R2, Canada
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Browne J, Lock M, Walker T, Egan M, Backholer K. Effects of food policy actions on Indigenous Peoples' nutrition-related outcomes: a systematic review. BMJ Glob Health 2020; 5:e002442. [PMID: 32816952 PMCID: PMC7437701 DOI: 10.1136/bmjgh-2020-002442] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 06/12/2020] [Accepted: 06/18/2020] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Indigenous Peoples worldwide endure unacceptable health disparities with undernutrition and food insecurity often coexisting with obesity and chronic diseases. Policy-level actions are required to eliminate malnutrition in all its forms. However, there has been no systematic synthesis of the evidence of effectiveness of food and nutrition policies for Indigenous Peoples around the world. This review fills that gap. METHODS Eight databases were searched for peer-reviewed literature, published between 2000 and 2019. Relevant websites were searched for grey literature. Articles were included if they were original studies, published in English and included data from Indigenous Peoples from Western colonised countries, evaluated a food or nutrition policy (or intervention), and provided quantitative impact/outcome data. Study screening, data extraction and quality assessment were undertaken independently by two authors, at least one of whom was Indigenous. A narrative synthesis was undertaken with studies grouped according to the NOURISHING food policy framework. RESULTS We identified 78 studies from Canada, Australia, Aotearoa/New Zealand and the USA. Most studies evaluated targeted interventions, focused on rural or remote Indigenous communities. The most effective interventions combined educational strategies with policies targeting food price, composition and/or availability, particularly in retail and school environments. Interventions to reduce exposure to unhealthy food advertising was the only area of the NOURISHING framework not represented in the literature. Few studies examined the impact of universal food policies on Indigenous Peoples' diets, health or well-being. CONCLUSION Both targeted and universal policy action can be effective for Indigenous Peoples. Actions that modify the structures and systems governing food supply through improved availability, access and affordability of healthy foods should be prioritised. More high-quality evidence on the impact of universal food and nutrition policy actions for Indigenous Peoples is required, particularly in urban areas and in the area of food marketing.
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Affiliation(s)
- Jennifer Browne
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong, Victoria, Australia
| | - Mark Lock
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong, Victoria, Australia
| | - Troy Walker
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong, Victoria, Australia
| | - Mikaela Egan
- Victorian Aboriginal Community Controlled Health Organisation, Melbourne, Victoria, Australia
| | - Kathryn Backholer
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong, Victoria, Australia
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Beckelman T, Sinclair-White BM, McGurk MD, Donohoe-Mather C, Vu U, Ching LK, Pirkle CM, Sentell TL, Keliikoa LB. Encouraging Adults to Choose Healthy Now: A Hawai'i Convenience Store Intervention. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:330-334. [PMID: 31902691 DOI: 10.1016/j.jneb.2019.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 11/25/2019] [Accepted: 11/29/2019] [Indexed: 06/10/2023]
Affiliation(s)
| | | | - Meghan D McGurk
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI
| | | | - Uyen Vu
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI
| | | | | | - Tetine L Sentell
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI
| | - L Brooke Keliikoa
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI.
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Taniguchi TE, Salvatore AL, Williams MB, Love CV, Noonan CJ, Cannady TK, Standridge J, Fox J, Spiegel J, Owens J, Grammar M, Wiley A, Jernigan VBB. Process Evaluation Tool Development and Fidelity of Healthy Retail Interventions in American Indian Tribally Owned Convenience Stores: the Tribal Health Resilience in Vulnerable Environments (THRIVE) Study. Curr Dev Nutr 2020; 4:33-41. [PMID: 32258997 PMCID: PMC7101486 DOI: 10.1093/cdn/nzz073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/16/2019] [Accepted: 06/17/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Tribal Health Resilience in Vulnerable Environments (THRIVE) study aimed to increase healthy food access in 2 rural American Indian communities. The intervention sought to increase fruit and vegetable availability, variety, and convenience through placement, promotion, and pricing of healthy foods and beverages in tribal convenience stores. OBJECTIVE The aim of this study was to describe the development and implementation of the study process evaluation tool to assess intervention fidelity as part of this cluster-controlled trial. METHODS Eight stores (2 intervention and 2 control stores per Nation) participated in the study, implemented from May 2016 to May 2017. A web-based survey tailored to store layouts and intervention components assessed how often intervention items were available, approximate quantity available, and whether placement of healthier food items and promotional materials were implemented as designed. After pilot testing the survey, tribal staff members implemented it to collect process evaluation data in the 8 stores during a period of 9-12 mo, assessing study implementation and potential changes in control stores. RESULTS Promotional materials were available ≥75% of the time for most intervention locations. Fruit availability was similar in Nation A and Nation B intervention stores (79-100% compared with 70-100%), whereas fresh vegetable availability was higher in Nation B compared with Nation A (95-96% compared with 55-75%). Both control stores in Nation A and 1 control store in Nation B had moderate fruit and vegetable availability, ranging from 45% to 52%. No control stores in either Nation used intervention promotional materials. CONCLUSIONS Process evaluation data indicate that the study was implemented with moderate to high fidelity. The development and implementation of the tool can inform future healthy retail interventions that aim to improve rural and tribal food environments.
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Affiliation(s)
- Tori E Taniguchi
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Alicia L Salvatore
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center College of Public Health, Oklahoma City, OK, USA
| | - Mary B Williams
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center College of Public Health, Oklahoma City, OK, USA
| | - Charlotte V Love
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Carolyn J Noonan
- Initiative for Research and Education to Advance Community Health, Washington State University, Pullman, WA, USA
| | - Tamela K Cannady
- Choctaw Nation of Oklahoma Health Services Authority, Durant, OK, USA
| | - Joy Standridge
- Chickasaw Nation Nutrition Services Department, Purcell, OK, USA
| | - Jill Fox
- Chickasaw Nation Nutrition Services Department, Purcell, OK, USA
| | - Jennifer Spiegel
- Chickasaw Nation Nutrition Services Department, Purcell, OK, USA
| | - JoAnna Owens
- Chickasaw Nation Nutrition Services Department, Purcell, OK, USA
| | - Mandy Grammar
- Choctaw Nation of Oklahoma Health Services Authority, Durant, OK, USA
| | - AnDina Wiley
- Chickasaw Nation Nutrition Services Department, Purcell, OK, USA
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Huyser KR, Rockell J, Jernigan VBB, Taniguchi T, Wilson C, Manson SM, O'Connell J. Sex Differences in Diabetes Prevalence, Comorbidities, and Health Care Utilization among American Indians Living in the Northern Plains. Curr Dev Nutr 2020; 4:42-48. [PMID: 32258998 PMCID: PMC7101481 DOI: 10.1093/cdn/nzz089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 06/21/2019] [Accepted: 07/23/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The American Indian (AI) population experiences significant diet-related health disparities including diabetes and cardiovascular disease (CVD). Owing to the relatively small sample size of AIs, the population is rarely included in large national surveys such as the NHANES. This exclusion hinders efforts to characterize potentially important differences between AI men and women, track the costs of these disparities, and effectively treat and prevent these conditions. OBJECTIVE We examined the sex differences in diabetes prevalence, comorbidity experience, health care utilization, and treatment costs among AIs within a Northern Plains Indian Health Service (IHS) service unit. METHODS We assessed data from a sample of 11,144 persons using an IHS service unit in the Northern Plains region of the United States. Detailed analyses were conducted for adults (n = 7299) on prevalence of diabetes by age and sex. We described sex differences in comorbidities, health care utilization, and treatment costs among the adults with diabetes. RESULTS In our sample, adult men and women had a similar prevalence of diabetes (10.0% and 11.0%, respectively). The prevalence of CVD among men and women with diabetes was 45.7% and 34.0%, respectively. Among adults with diabetes, men had a statistically higher prevalence of hypertension and substance use disorders than women. The men were statistically less likely to have a non-substance use mental health disorder. Although men had higher utilization and costs for hospital inpatient services than women, the differences were not statistically significant. CONCLUSIONS In this AI population, there were differences in comorbidity profiles between adult men and women with diabetes, which have differential mortality and cost consequences. Appropriate diabetes management addressing gender-specific comorbidities, such as substance use disorders for men and non-substance use mental health disorders for women, may help reduce additional comorbidities or complications to diabetes.
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Affiliation(s)
- Kimberly R Huyser
- Department of Sociology, University of New Mexico, Albuquerque, NM, USA
| | | | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Tori Taniguchi
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | | | - Spero M Manson
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Joan O'Connell
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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