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Dahl AA, Ademu L, Fandetti S, Harris R. University Food Environment Assessment Methods and Their Implications: Protocol for a Systematic Review. JMIR Res Protoc 2024; 13:e54955. [PMID: 39178404 PMCID: PMC11380064 DOI: 10.2196/54955] [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: 12/05/2023] [Revised: 04/26/2024] [Accepted: 06/25/2024] [Indexed: 08/25/2024] Open
Abstract
BACKGROUND While the retail food environment has been well studied, research surrounding the university food environment is still emerging. Existing research suggests that university food environments can influence behavioral outcomes such as students' dietary choices, which may be maintained long-term. Despite a growing interest in assessing university food environments, there is no standardized tool for completing this task. How researchers define "healthy" when assessing university food environments needs to be clarified. This paper describes the protocol for systematically reviewing literature involving university food environment assessments. OBJECTIVE This paper aimed to describe the protocol for a systematic review of the assessments of university food environments. The review will summarize previously used tools or methods and their implications. METHODS Electronic databases, including PubMed (NLM), Cochrane Library (Wiley), Web of Science (Clarivate), APA PsycINFO (EBSCO), CINAHL (Cumulative Index to Nursing & Allied Health) Complete (EBSCO), ProQuest Nursing and Allied Health, and Google Scholar were searched for papers published between 2012 and 2022 using combinations of related medical subject headings terms and keywords. The electronic databases were supplemented by reviewing the reference list for all included papers and systematic reviews returned with our search results. The review will include all study types, including randomized controlled trials, observational studies, and other pre-post designs. Papers that examine at least 1 aspect of the university food environment, such as cafeterias, campus convenience stores, and vending machines, were considered for inclusion. A total of 2 reviewers will independently screen titles and abstracts, complete a full-text review, extract data, and perform a quality assessment of included papers, with a third reviewer resolving any conflicts. The Quality Assessment for Diverse Studies (QuADS) tool was used to determine the methodological quality of selected studies. A narrative and tabular summary of the findings were presented. There will not be a meta-analysis due to the methodological heterogeneity of the included papers. RESULTS The initial queries of 4502 records have been executed, and papers have been screened for inclusion. Data extractions were completed in December 2023. The results of the review were accepted for publication in May 2024. The systematic review generated from this protocol will offer evidence for using different assessment tools to examine the campus food environment. CONCLUSIONS This systematic review will summarize the tools and methods used to assess university food environments where many emerging adults spend a significant part of their young adult lives. The findings will highlight variations in practice and how "healthy" has been defined globally. This review will provide an understanding of this unique organizational food environment with implications for practice and policy. TRIAL REGISTRATION PROSPERO CRD42023398073; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=398073. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54955.
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Affiliation(s)
- Alicia Anne Dahl
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Lilian Ademu
- Texas A&M Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Research Centre at El Paso, El Paso, TX, United States
| | - Stacy Fandetti
- Department of Epidemiology and Community Health, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Ryan Harris
- J. Murrey Atkins Library, University of North Carolina at Charlotte, Charlotte, NC, United States
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Dahl AA, Fandetti SM, Ademu LO, Harris R, Racine EF. Assessing the Healthfulness of University Food Environments: A Systematic Review of Methods and Tools. Nutrients 2024; 16:1426. [PMID: 38794664 PMCID: PMC11123862 DOI: 10.3390/nu16101426] [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: 04/16/2024] [Revised: 05/04/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
The availability, promotion, and price of healthy foods within the university food environment may impact students' dietary choices. This systematic review summarizes the tools and methods used to assess the healthfulness of university food environments where many students spend a significant portion of their emerging adulthood. Thirty-six global studies published between 2012 and 2022 were sourced from PubMed (NNLM), Cochrane Library (Wiley), Web of Science (Clarivate), APA PsycInfo (EBSCO), CINHAL Complete (EBSCO), ProQuest Nursing, and Allied Health, following PRISMA 2020 guidelines. Of the included studies, 58% were institutional-level audits, 17% examined individual-level perceptions, and 25% combined both. Most institutional-level audits focused on one aspect of the food environment (e.g., eateries, vending machines). For studies examining multiple spaces within the campus environment (38%), comprehensive assessments were limited, and most studies had to employ a combination of assessment tools. Surveys were most often used to gather individual perceptions about the food environment. The Nutrition Environment Measures Survey (NEMS) was the most commonly used tool across all studies. This review highlights the need for a standardized tool, method, or a "healthy" benchmark for specific use at universities to improve methodological rigor and comparability of findings across institutions.
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Affiliation(s)
- Alicia Anne Dahl
- Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | - Stacy M. Fandetti
- Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | - Lilian O. Ademu
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Research Center at El Paso, Texas A&M University, El Paso, TX 79927, USA
| | - Ryan Harris
- J. Murrey Atkins Library, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | - Elizabeth F. Racine
- Texas A&M AgriLife Research Center at El Paso, Texas A&M University, El Paso, TX 79927, USA;
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Fandetti SM, Dahl AA, Webster C, Bably MB, Coffman MJ, Racine EF. Healthy Food Policies Documented in University Food Service Contracts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6617. [PMID: 37623200 PMCID: PMC10454280 DOI: 10.3390/ijerph20166617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/07/2023] [Accepted: 08/19/2023] [Indexed: 08/26/2023]
Abstract
In the United States, there is an opportunity to improve the nutritional health of university students through the campus food environment. This project used a content analysis approach to investigate whether healthy food standards and policies were incorporated into the contract agreements between North Carolina (NC) public universities and their food service management companies. Food service contracts were collected from 14 NC public universities using food service management companies on campus. Each contract was evaluated using the 35-item North Carolina Food Service Policy Guidelines Assessment to examine four elements of the campus food environment: Beverages, Packaged Snacks, Prepared Foods, and Other (e.g., strategic placement of healthier food). Five university food service contracts incorporated no North Carolina Food Service Policy Guidelines, three university contracts included one to five guidelines, and six university contracts included six to nine guidelines. Altogether, 13 of the 35 guidelines were incorporated into at least one university food service contract. This project presents a cost and time-effective assessment method for determining if evidence-based nutrition guidelines have been included in university food service contracts. This approach and findings may lead to contract revisions to improve the campus food environment and, subsequently, the nutritional health of college populations.
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Affiliation(s)
- Stacy M. Fandetti
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA; (A.A.D.); (C.W.); (M.B.B.)
| | - Alicia Anne Dahl
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA; (A.A.D.); (C.W.); (M.B.B.)
| | - Caitlan Webster
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA; (A.A.D.); (C.W.); (M.B.B.)
| | - Morium Barakat Bably
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA; (A.A.D.); (C.W.); (M.B.B.)
| | - Maren J. Coffman
- School of Nursing, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA;
| | - Elizabeth F. Racine
- Texas A&M AgriLife Research, Texas A&M University, 1380 A and M Circle, El Paso, TX 79927, USA;
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Caruso OT, Schaafsma HN, McEachern LW, Gilliland JA. The campus food environment and postsecondary student diet: a systematic review. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-25. [PMID: 37437204 DOI: 10.1080/07448481.2023.2227725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/31/2023] [Accepted: 06/11/2023] [Indexed: 07/14/2023]
Abstract
Objective: Examine the impact of the campus food environment on postsecondary students' dietary behaviors (e.g., dietary intake) and food purchasing. Participants: Students currently attending a postsecondary institution, all ages and geographic locations included. Methods: A systematic search from January 2000-October 2022 was conducted in six databases using postsecondary education, food environment, and diet related keywords. Results: In total, 25 quantitative and 10 qualitative studies were extracted. All quantitative studies that conducted statistical analyses (n = 15) reported a statistically significant relationship between the campus food environment and dietary intake, including both positive and negative effects. All qualitative studies (n = 10) discussed students' experience of the campus food environment influencing their diet. Conclusions: This review found moderate evidence that the campus food environment has an impact on postsecondary students' dietary behaviors. A campus environment that has healthy foods accessible, affordable, and acceptable for postsecondary students may have a beneficial impact on students' dietary intake.
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Affiliation(s)
- Olivia T Caruso
- Human Environments Analysis Laboratory, Western University, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
- Department of Geography, Western University, London, Ontario, Canada
| | - Holly N Schaafsma
- Human Environments Analysis Laboratory, Western University, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
- School of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
| | - Louise W McEachern
- Human Environments Analysis Laboratory, Western University, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
- Department of Geography, Western University, London, Ontario, Canada
| | - Jason A Gilliland
- Human Environments Analysis Laboratory, Western University, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
- Department of Geography, Western University, London, Ontario, Canada
- Department of Pediatrics, Western University, London, Ontario, Canada
- School of Health Studies, Western University, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
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Rupp K, Schnoll R, Zigmont VA. Differences in health behaviors related to overweight/obesity by race/ethnicity in a diverse urban commuter college. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1696-1703. [PMID: 32924867 DOI: 10.1080/07448481.2020.1818757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 07/06/2020] [Accepted: 08/28/2020] [Indexed: 06/11/2023]
Abstract
Objective: To examine health behaviors associated with overweight/obesity by race/ethnicity at a diverse urban college. Participants: 270 undergraduates (77.0% female; 26.7% non-Hispanic white) and median body mass index (BMI) of 23.1 kg/m2. Methods: A questionnaire about health-related behaviors as part of the "Get Fruved" project was used to measure health behaviors (sugar sweetened beverage (SSB), fruit and vegetable consumption, physical activity, stress, and sleep) by race/ethnicity. Multivariable logistic regression was used to assess the adjusted odds of engaging in positive health-related behaviors. Results: Non-Hispanic black and Hispanic students were 64% and 59% less likely to consume lower amounts of SSB. Hispanic students were 83% and 81% less likely to meet vegetable and fruit recommendations. Non-Hispanic black and other (including biracial) had reduced odds of meeting vegetable recommendations (AOR = 0.18 and 0.28). Conclusions: Disparities in SSB, fruit, and vegetable consumption represent potential intervention targets to improve health behaviors among racial/ethnic minorities.
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Affiliation(s)
- Kristie Rupp
- Department of Health and Movement Sciences, Southern Connecticut State University, New Haven, Connecticut, USA
| | - Roseanne Schnoll
- Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York, Brooklyn, New York, USA
| | - Victoria A Zigmont
- Department of Public Health, Southern Connecticut State University, New Haven, Connecticut, USA
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Salarzadeh Jenatabadi H, Shamsi NA, Ng BK, Abdullah NA, Mentri KAC. Adolescent Obesity Modeling: A Framework of Socio-Economic Analysis on Public Health. Healthcare (Basel) 2021; 9:healthcare9080925. [PMID: 34442062 PMCID: PMC8392515 DOI: 10.3390/healthcare9080925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/15/2021] [Accepted: 07/17/2021] [Indexed: 02/07/2023] Open
Abstract
Bayesian Structural Equation Modeling (SEM-Bayesian) was applied across different research areas to model the correlation between manifest and latent variables. The primary purpose of this study is to introduce a new framework of complexity to adolescent obesity modeling based on adolescent lifestyle through the application of SEM-Bayesian. The introduced model was designed based on the relationships among several factors: household socioeconomic status, healthy food intake, unhealthy food intake, lifestyle, body mass index (BMI) and body fat. One of the main contributions of this study is from considering both BMI and body fat as dependent variables. To demonstrate the reliability of the model, especially in terms of its fitting and accuracy, real-time data were extracted and analyzed across 881 adolescents from secondary schools in Tehran, Iran. The output of this study may be helpful for researchers who are interested in adolescent obesity modeling based on the lifestyle and household socioeconomic status of adolescents.
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