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Hassen HY, Sisay BG, Van Geertruyden JP, Le Goff D, Ndejjo R, Musinguzi G, Abrams S, Bastiaens H. Dietary outcomes of community-based CVD preventive interventions: a systematic review and meta-analysis. Public Health Nutr 2023; 26:2480-2491. [PMID: 37191001 DOI: 10.1017/s1368980023000976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE We aimed to synthesise available evidence on the effects of community-based interventions in improving various dietary outcome measures. DESIGN Systematic review and meta-analysis. SETTING We searched databases including Medline, EMBASE, PSYCINFO, CINAHL and the Cochrane registry for studies reported between January 2000 and June 2022. The methodological quality of the included studies was evaluated using the Cochrane risk of bias tools for each study type. For some of the outcomes, we pooled the effect size using a random-effects meta-analysis. PARTICIPANTS A total of fifty-one studies, thirty-three randomised and eighteen non-randomised, involving 100 746 participants were included. RESULTS Overall, thirty-seven studies found a statistically significant difference in at least one dietary outcome measure favouring the intervention group, whereas fourteen studies found no statistically significant difference. Our meta-analyses indicated that, compared with controls, interventions were effective in decreasing daily energy intake (MJ/d) (mean difference (MD): -0·25; 95 % CI: -0·37, -0·14), fat % of energy (MD: -1·01; 95 % CI: -1·76, -0·25) and saturated fat % of energy (MD: -1·54; 95 % CI: -2·01, -1·07). Furthermore, the interventions were effective in improving fibre intake (g/d) (MD: 1·08; 95 % CI: 0·39, 1·77). Effective interventions use various strategies including tailored individual lifestyle coaching, health education, health promotion activities, community engagement activities and/or structural changes. CONCLUSION This review shows the potential of improving dietary patterns through community-based CVD preventive interventions. Thus, development and implementation of context-specific preventive interventions could help to minimise dietary risk factors, which in turn decrease morbidity and mortality due to CVD and other non-communicable diseases.
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Affiliation(s)
- Hamid Y Hassen
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp2610, Belgium
| | - Binyam G Sisay
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jean-Pierre Van Geertruyden
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp2610, Belgium
| | - Delphine Le Goff
- Department of General Practice, University of Western Brittany, Brest, France
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda
| | - Geofrey Musinguzi
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda
| | - Steven Abrams
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp2610, Belgium
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Data Science Institute, Hasselt University, Diepenbeek, Belgium
| | - Hilde Bastiaens
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp2610, Belgium
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Whelan J, Brimblecombe J, Christian M, Vargas C, Ferguson M, McMahon E, Lee A, Bell C, Boelsen-Robinson T, Blake MR, Lewis M, Alston L, Allender S. CO-Creation and Evaluation of Food Environments to Advance Community Health (COACH). AJPM FOCUS 2023; 2:100111. [PMID: 37790671 PMCID: PMC10546519 DOI: 10.1016/j.focus.2023.100111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction Food environments are a key determinant of food intake and diet-related health. This paper describes the development of an iterative, adaptive, context-specific framework for health-enabling food environments embedded in cocreation theory. Methods A 3-stage multimethod framework for the coproduction and prototyping of public health interventions was followed in an iterative manner during the development of the framework. These 3 stages were (1) evidence review, including systematic review, consultation with experts, and observation of current work; (2) codesign of the framework prototype with multiple stakeholders; and (3) coproduction through refinement of the prototype through stakeholder workshops and expert reviews with incorporation of researcher notes and workshop evaluation. We use the term prototype during the development phase and the term framework to report on the final product. Results COACH (CO-creation and evaluation of food environments to Advance Community Health) is a process framework that describes what best practice application of cocreation in health-enabling food retail environments should involve. COACH consists of 10 interdependent factors within a 4-phase continuous quality improvement cycle. The 4 phases of the cycle are engagement and governance establishment, communication and policy alignment, codesign and implementation, and monitoring and evaluation. Conclusions Utilizing cocreation theory represents an innovative step in research and practice to improve the healthiness of food retail environments. COACH provides a specific, unique, and comprehensive guide to the utilization of cocreation to improve the healthiness of food environments in practice.
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Affiliation(s)
- Jillian Whelan
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute of Health Transformation, School of Medicine, Deakin University, Geelong, Australia
| | - Julie Brimblecombe
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Science, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Meaghan Christian
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Science, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Carmen Vargas
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute of Health Transformation, School of Health and Social Development, Deakin University, Geelong, Australia
| | - Megan Ferguson
- School of Public Health, The University of Queensland, Brisbane, Australia
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Darwin, Australia
| | - Emma McMahon
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Darwin, Australia
| | - Amanda Lee
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Colin Bell
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute of Health Transformation, School of Medicine, Deakin University, Geelong, Australia
| | - Tara Boelsen-Robinson
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute of Health Transformation, School of Health and Social Development, Deakin University, Geelong, Australia
| | - Miranda R. Blake
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute of Health Transformation, School of Health and Social Development, Deakin University, Geelong, Australia
| | - Meron Lewis
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Laura Alston
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute of Health Transformation, School of Health and Social Development, Deakin University, Geelong, Australia
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Australia
| | - Steven Allender
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute of Health Transformation, School of Health and Social Development, Deakin University, Geelong, Australia
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Kipke MD, Karimipour N, Wolfe N, Orechwa A, Stoddard L, Rubio-Diaz M, North G, Dezfuli G, Murphy S, Phelps A, Kagan J, De La Haye K, Perry C, Baezconde-Garbanati L. Community-Based Public Health Vaccination Campaign (VaccinateLA) in Los Angeles' Black and Latino Communities: Protocol for a Participatory Study. JMIR Res Protoc 2023; 12:e40161. [PMID: 36757953 PMCID: PMC9989912 DOI: 10.2196/40161] [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: 06/08/2022] [Revised: 10/27/2022] [Accepted: 02/07/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has significantly affected Los Angeles County and disproportionately impacted Black and Latino populations who experienced disparities in rates of infection, hospitalizations, morbidity, and mortality. The University of Southern California (USC), USC Keck School of Medicine, Southern California Clinical and Translational Science Institute, USC Mann School of Pharmacy and Pharmaceutical Sciences, Annenberg School for Journalism and Communication, and Children's Hospital Los Angeles will launch a collaborative public health campaign called VaccinateLA. OBJECTIVE VaccinateLA will implement a community-based, community-partnered public health campaign that (1) delivers culturally tailored information about COVID-19 and available vaccines; and (2) addresses misinformation and disinformation, which serves as a barrier to vaccine uptake. The campaign will be targeted to communities in Los Angeles with the highest rates of COVID-19 infection and the lowest vaccination rates. Using these criteria, the campaign will be targeted to neighborhoods located in 34 zip codes in the Eastside and South Los Angeles. The primary aim of VaccinateLA will be to design and deliver an evidence-based multimedia public health campaign tailored for Black and Latino populations. A secondary aim will be to train and deploy community vaccine navigators to deliver COVID-19 education, help individuals overcome barriers to getting vaccinated (eg, transportation and challenges registering), and assist with delivering vaccinations in our targeted communities. METHODS We will use a community-based, participatory research approach to shape VaccinateLA's public health campaign to address community members' attitudes and concerns in developing campaign content. We will conduct focus groups, establish a community advisory board, and engage local leaders and stakeholders to develop and implement a broad array of educational, multimedia, and field-based activities. RESULTS As of February 2023, target communities have been identified. The activities will be initiated and evaluated over the course of this year-long initiative, and dissemination will occur following the completion of the project. CONCLUSIONS Engaging the community is vital to developing culturally tailored public health messages that will resonate with intended audiences. VaccinateLA will serve as a model for how an academic institution can quickly mobilize to address a pressing public health crisis, particularly in underrepresented and underresourced communities. Our work has important implications for future public health campaigns. By leveraging community partnerships and deploying community health workers or promotores into the community, we hope to demonstrate that urban universities can successfully partner with local communities to develop and deliver a range of culturally tailored educational, multimedia, and field-based activities, which in turn may change the course of an urgent public health crisis, such as the COVID-19 pandemic. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/40161.
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Affiliation(s)
- Michele D Kipke
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
- Department of Pediatrics, Keck School of Medicine of University of Southern California, Children's Hospital Los Angeles, Los Angeles, CA, United States
- Office of the Senior Vice President of Health Affairs, University of Southern California, Los Angeles, CA, United States
| | - Nicki Karimipour
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | - Nicole Wolfe
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | - Allison Orechwa
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | - Laura Stoddard
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | - Mayra Rubio-Diaz
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | - Gemma North
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | - Ghazal Dezfuli
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | - Sheila Murphy
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, United States
| | - Ashley Phelps
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, United States
| | - Jeremy Kagan
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, United States
| | - Kayla De La Haye
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | - Christina Perry
- Department of Population and Public Health Science, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States
| | - Lourdes Baezconde-Garbanati
- Department of Population and Public Health Science, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States
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Chan-Golston A, Banerjee S, Belin TR, Roth SE, Prelip ML. Bayesian finite-population inference with spatially correlated measurements. JAPANESE JOURNAL OF STATISTICS AND DATA SCIENCE 2022. [DOI: 10.1007/s42081-022-00178-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AbstractCommunity-based public health interventions often rely on representative, spatially referenced outcome data to draw conclusions about a finite population. To estimate finite-population parameters, we are posed with two challenges: to correctly account for spatial association among the sampled and nonsampled participants and to correctly model missingness in key covariates, which may be also spatially associated. To accomplish this, we take inspiration from the preferential sampling literature and develop a general Bayesian framework that can specifically account for preferential non-response. This framework is first applied to three missing data scenarios in a simulation study. It is then used to account for missing data patterns seen in reported annual household income in a corner-store intervention project. Through this, we are able to construct finite-population estimates of the percent of income spent on fruits and vegetables. Such a framework provides a flexible way to account for spatial association and complex missing data structures in finite populations.
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5
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Kaur R, Winkler MR, John S, DeAngelo J, Dombrowski RD, Hickson A, Sundermeir SM, Kasprzak CM, Bode B, Hill AB, Lewis EC, Colon-Ramos U, Munch J, Witting LL, Odoms-Young A, Gittelsohn J, Leone LA. Forms of Community Engagement in Neighborhood Food Retail: Healthy Community Stores Case Study Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6986. [PMID: 35742235 PMCID: PMC9222525 DOI: 10.3390/ijerph19126986] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/05/2022] [Accepted: 06/05/2022] [Indexed: 11/16/2022]
Abstract
Community engagement is well established as a key to improving public health. Prior food environment research has largely studied community engagement as an intervention component, leaving much unknown about how food retailers may already engage in this work. The purpose of this study was to explore the community engagement activities employed by neighborhood food retailers located in lower-income communities with explicit health missions to understand the ways stores involve and work with their communities. A multiple case study methodology was utilized among seven retailers in urban U.S. settings, which collected multiple sources of data at each retailer, including in-depth interviews, store manager sales reports, store observations using the Nutrition Environment Measures Survey for Stores, public documents, and websites. Across-case analysis was performed following Stake's multiple case study approach. Results indicated that retailers employed a wide variety of forms of community engagement within their communities, including Outreach, Building Relationships through Customer Relations, Giving Back, Partnering with Community Coalitions, and Promoting Community Representation and Inclusiveness. Strategies that built relationships through customer relations were most common across stores; whereas few stores demonstrated community inclusiveness where members participated in store decision making. Findings provide a more comprehensive view of the ways local food retailers aim to develop and sustain authentic community relationships. Additional research is needed to evaluate the impact of community engagement activities on improving community health.
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Affiliation(s)
- Ravneet Kaur
- Department of Family and Community Medicine, University of Illinois College of Medicine, Rockford, IL 61107, USA
| | - Megan R. Winkler
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA;
| | - Sara John
- Center for Science in the Public Interest, 1250 I St NW, Floor 5, Washington, DC 20005, USA; (S.J.); (A.H.)
| | - Julia DeAngelo
- Departments of Health Policy Management & Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA;
| | - Rachael D. Dombrowski
- Division of Kinesiology, Health and Sport Studies, College of Education, Wayne State University, Detroit, MI 48202, USA; (R.D.D.); (B.B.)
| | - Ashley Hickson
- Center for Science in the Public Interest, 1250 I St NW, Floor 5, Washington, DC 20005, USA; (S.J.); (A.H.)
| | - Samantha M. Sundermeir
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (S.M.S.); (E.C.L.); (J.G.)
| | - Christina M. Kasprzak
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY 14260, USA; (C.M.K.); (L.A.L.)
| | - Bree Bode
- Division of Kinesiology, Health and Sport Studies, College of Education, Wayne State University, Detroit, MI 48202, USA; (R.D.D.); (B.B.)
| | - Alex B. Hill
- Urban Studies and Planning and Detroit Food Map Initiative, Wayne State University, Detroit, MI 48202, USA;
| | - Emma C. Lewis
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (S.M.S.); (E.C.L.); (J.G.)
| | - Uriyoan Colon-Ramos
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC 20052, USA; (U.C.-R.); (L.L.W.)
| | - Jake Munch
- School of Natural Sciences and Mathematics, The University of Texas at Dallas, Richardson, TX 75080, USA;
| | - Lillian L. Witting
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC 20052, USA; (U.C.-R.); (L.L.W.)
| | - Angela Odoms-Young
- Division of Nutritional Science, College of Human Ecology, Cornell University, Ithaca, NY 14853, USA;
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; (S.M.S.); (E.C.L.); (J.G.)
| | - Lucia A. Leone
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY 14260, USA; (C.M.K.); (L.A.L.)
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Ayala GX, Pickrel JL, Baquero B, Sanchez-Flack J, Lin SF, Belch G, Rock CL, Linnan L, Gittelsohn J, Ji M, Elder JP, Mayer J. The El Valor de Nuestra Salud clustered randomized controlled trial store-based intervention to promote fruit and vegetable purchasing and consumption. Int J Behav Nutr Phys Act 2022; 19:19. [PMID: 35177070 PMCID: PMC8851758 DOI: 10.1186/s12966-021-01220-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 10/25/2021] [Indexed: 12/14/2022] Open
Abstract
Background Modifying the environment to promote healthy foods is a population-based approach for improving diet. This study evaluated the outcome effectiveness of a food store intervention that used structural and social change strategies to promote fruits and vegetables. It was hypothesized that intervention versus control store customers would improve their consumption of fruits and vegetables at 6 months. Trial design Clustered randomized controlled trial Methods Sixteen pair-matched stores were randomized to an intervention or wait-list control condition. With the research team’s support, intervention stores modified the availability, accessibility, and promotion of fruits and vegetables, including augmenting produce displays within the store and building employees’ capacity to place and promote fruits and vegetables throughout the store (Phase 1), followed by the delivery of a customer-directed marketing campaign for 6 months (Phase 2). From months 7 to 12, stores were encouraged to maintain strategies on their own (Phase 3). Customer-reported daily fruit and vegetable consumption (cups/day) were collected by blinded research assistants at three time-points (baseline, 6 months and 12 months post-baseline) from 369 participating customers (an average of 23/store). Secondary outcomes included customer-reported fruit and vegetable purchasing and other behaviors. Results The study retained the 16 stores and most customers at 6 (91%) and 12 (89%) months. Although significant differences were not observed in the overall sample for vegetable consumption, male customers of intervention versus control stores consumed significantly more fruit daily at 6 months [mean (standard deviation) cups at baseline and six months; intervention: 1.6 (1.5) to 1.6 (1.5) vs. control: 1.4 (1.2) to 1.1 (0.8)]. However, this difference was not observed at 12 months, or among females. There was an overall increase in dollars spent at the targeted store in the intervention versus control condition among male versus female customers at 6 months; however, no change was observed in the percent of dollars spent on fruits and vegetables at the targeted store. Frequency of shopping at the targeted store did not modify intervention effects. Conclusions Structural and social change interventions can modify customers’ behavior in the short-term. Future research should consider methods for achieving longer-term changes, and potential generalizability to other products (e.g., energy-dense sweet and savory products). Trial registration NCT01475526 Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01220-w.
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Affiliation(s)
- Guadalupe X Ayala
- Division of Health Promotion and Behavioral Sciences, School of Public Health, San Diego State University, San Diego, USA. .,Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA.
| | - Julie L Pickrel
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
| | - Barbara Baquero
- Health System and Population Health, School of Public Health, University of Washington, Box 35480, Seattle, WA, 98195, USA
| | - Jennifer Sanchez-Flack
- Department of Pediatrics, University of Illinois Cancer Center, Chicago, USA.,Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, WROB 478, Chicago, IL, 60608, USA
| | - Shih-Fan Lin
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
| | - George Belch
- Marketing Department, Fowler College of Business, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Cheryl L Rock
- Department of Family Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive #0901, La Jolla, CA, 92093, USA
| | - Laura Linnan
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 359 Rosenau Hall, 135 Dauer Drive, Campus Box 7440, Chapel Hill, NC, 27599, USA
| | - Joel Gittelsohn
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St, Baltimore, MD, 21205-2179, USA
| | - Ming Ji
- College of Nursing, University of South Florida, Tampa, FL, 12901, USA
| | - John P Elder
- Division of Health Promotion and Behavioral Sciences, School of Public Health, San Diego State University, San Diego, USA.,Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
| | - Joni Mayer
- Division of Health Promotion and Behavioral Sciences, School of Public Health, San Diego State University, San Diego, USA.,Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
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7
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Sirsat SA, Mohammad ZH, Raschke I. Safety and Quality of Romaine Lettuce Accessible to Low Socioeconomic Populations Living in Houston, TX. J Food Prot 2021; 84:2123-2127. [PMID: 34383915 DOI: 10.4315/jfp-21-250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/11/2021] [Indexed: 11/11/2022]
Abstract
ABSTRACT Previous empirical evidence has demonstrated that low-socioeconomic status (SES) communities have higher rates of gastroenteritis; however, there is a paucity of literature on the safety and quality of food (fresh produce) accessible to these communities. The overarching goal of this study was to investigate the microbial safety and quality of romaine lettuce from low- and high-SES neighborhoods in the Houston, TX, area. Loose-leaf romaine lettuce was purchased from low- and high-SES neighborhood retailers, and aerobic plate count, coliform, Escherichia coli, yeast, and mold assays were conducted. In addition, enrichment was performed on all samples for Listeria monocytogenes, Staphylococcus aureus, Salmonella spp., and E. coli O157:H7, and reverse transcriptase PCR analysis was carried out. The results showed that E. coli, coliform, yeast, and mold were present in significantly higher counts (P < 0.05) in produce obtained from low-SES neighborhoods compared with high-SES neighborhoods. The reverse transcriptase PCR results showed that 38% of samples from high-SES areas were positive for S. aureus versus 87% of samples from low-SES areas. None of the samples from high-SES areas were positive for the other pathogens. The samples from low-SES areas were positive for E. coli O157:H7 (4%), Salmonella spp. (53%), L. monocytogenes (13%), and S. aureus (87%). These results demonstrate a significant disparity in the quality and safety of romaine lettuce accessible to low- versus high-SES populations. Future studies can be designed to identify the specific cause of this challenge by investigating the food supply chain. HIGHLIGHTS
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Affiliation(s)
- Sujata A Sirsat
- Conrad N. Hilton College of Hotel and Restaurant Management, University of Houston, Houston, Texas 77204-3028, USA
| | - Zahra H Mohammad
- Conrad N. Hilton College of Hotel and Restaurant Management, University of Houston, Houston, Texas 77204-3028, USA
| | - Isabella Raschke
- Conrad N. Hilton College of Hotel and Restaurant Management, University of Houston, Houston, Texas 77204-3028, USA
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8
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Honório OS, Pessoa MC, Gratão LHA, Rocha LL, de Castro IRR, Canella DS, Horta PM, Mendes LL. Social inequalities in the surrounding areas of food deserts and food swamps in a Brazilian metropolis. Int J Equity Health 2021; 20:168. [PMID: 34289857 PMCID: PMC8293554 DOI: 10.1186/s12939-021-01501-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 06/28/2021] [Indexed: 12/18/2022] Open
Abstract
Background Food deserts are neighborhoods with little or no access to healthy food, whereas food swamps are neighborhoods where unhealthy food options prevail over healthy ones. The main aims of the current study are to feature and compare the neighborhoods of food deserts and food swamps based on social inequality. Methods Ecological study carried out in Belo Horizonte City, Minas Gerais State, Brazil. Information about commercial food establishments derived from two different databases. It was measured by secondary governmental databases, which were virtually conferred in the present study. Census tracts were considered as analysis units and classified as food deserts and food swamps, based on the Brazilian methodology. Take into consideration the density of establishments classified as selling fresh or minimally-processed food, mixed establishments, and establishments selling ultra-processed food. The Brazilian methodology evaluates food deserts by the density of healthy establishments (establishments classified as mostly selling fresh or minimally-processed food and mixed establishments) per 10 thousand inhabitants. And the metric to evaluate food swamps considers the density of unhealthy establishments (establishments mostly selling ultra-processed food) per 10 thousand inhabitants. Information about social inequalities comprised aspects such as income, population count, number of households, number of literate individuals, race, water and energy supply, and garbage collection. The Health Vulnerability Index (HVI) was used as a synthetic social vulnerability indicator. Results Neighborhoods of food deserts presented worse essential service availability, lower income per capita, and smaller mean number of literate individuals. Census tracts classified as food swamps presented better socio-demographic conditions than those areas food deserts. Neighborhoods simultaneously classified as food deserts and food swamps presented lower income per capita and were more often observed in census sectors presenting medium and high HVI. Conclusion The food environment in Belo Horizonte was featured by the strong presence of food deserts and food swamps. However, the potential influence of these areas on food intake has changed depending on social inequalities. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-021-01501-7.
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Affiliation(s)
- Olivia Souza Honório
- Departamento de Nutrição, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena,190, Santa Efigênia, Belo Horizonte, 30130-090, Brazil
| | - Milene Cristine Pessoa
- Departamento de Nutrição, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena,190, Santa Efigênia, Belo Horizonte, 30130-090, Brazil
| | - Lucia Helena Almeida Gratão
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena,190, Santa Efigênia, Belo Horizonte, 30130-090, Brazil
| | - Luana Lara Rocha
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena,190, Santa Efigênia, Belo Horizonte, 30130-090, Brazil
| | - Inês Rugani Ribeiro de Castro
- Universidade do Estado do Rio de Janeiro, Instituto de Nutrição, Rua São Francisco Xavier,524,Maracanã, Rio de Janeiro, 20550-170, Brazil
| | - Daniela Silva Canella
- Universidade do Estado do Rio de Janeiro, Instituto de Nutrição, Rua São Francisco Xavier,524,Maracanã, Rio de Janeiro, 20550-170, Brazil
| | - Paula Martins Horta
- Departamento de Nutrição, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena,190, Santa Efigênia, Belo Horizonte, 30130-090, Brazil
| | - Larissa Loures Mendes
- Departamento de Nutrição, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena,190, Santa Efigênia, Belo Horizonte, 30130-090, Brazil.
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9
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Powell-Wiley TM, Dey AK, Rivers JP, Chaturvedi A, Andrews MR, Ceasar JN, Claudel SE, Mitchell VM, Ayers C, Tamura K, Gutierrez-Huerta CA, Teague HL, Oeser SG, Goyal A, Joshi AA, Collins BS, Baumer Y, Chung ST, Sumner AE, Playford MP, Tawakol A, Mehta NN. Chronic Stress-Related Neural Activity Associates With Subclinical Cardiovascular Disease in a Community-Based Cohort: Data From the Washington, D.C. Cardiovascular Health and Needs Assessment. Front Cardiovasc Med 2021; 8:599341. [PMID: 33778019 PMCID: PMC7988194 DOI: 10.3389/fcvm.2021.599341] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 02/08/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Psychosocial stress correlates with cardiovascular (CV) events; however, associations between physiologic measures of stressors and CVD remain incompletely understood, especially in racial/ethnic minority populations in resource-limited neighborhoods. We examined associations between chronic stress-related neural activity, measured by amygdalar 18Fluorodeoxyglucose (18FDG) uptake, and aortic vascular FDG uptake (arterial inflammation measure) in a community-based cohort. Methods: Forty participants from the Washington, DC CV Health and Needs Assessment (DC-CHNA), a study of a predominantly African-American population in resource-limited urban areas and 25 healthy volunteers underwent detailed phenotyping, including 18FDG PET/CT for assessing amygdalar activity (AmygA), vascular FDG uptake, and hematopoietic (leukopoietic) tissue activity. Mediation analysis was used to test whether the link between AmygA and vascular FDG uptake was mediated by hematopoietic activity. Results: AmygA (1.11 ± 0.09 vs. 1.05 ± 0.09, p = 0.004) and vascular FDG uptake (1.63 ± 0.22 vs. 1.55 ± 0.17, p = 0.05) were greater in the DC-CHNA cohort compared to volunteers. Within the DC-CHNA cohort, AmygA associated with vascular FDG uptake after adjustment for Framingham score and body mass index (β = 0.41, p = 0.015). The AmygA and aortic vascular FDG uptake relationship was in part mediated by splenic (20.2%) and bone marrow (11.8%) activity. Conclusions: AmygA, or chronic stress-related neural activity, associates with subclinical CVD risk in a community-based cohort. This may in part be mediated by the hematopoietic system. Our findings of this hypothesis-generating study are suggestive of a potential relationship between chronic stress-related neural activity and subclinical CVD in an African American community-based population. Taken together, these findings suggest a potential mechanism by which chronic psychosocial stress, such as stressors that can be experienced in adverse social conditions, promotes greater cardiovascular risk amongst resource-limited, community-based populations most impacted by cardiovascular health disparities. However, larger prospective studies examining these findings in other racially and ethnically diverse populations are necessary to confirm and extend these findings.
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Affiliation(s)
- Tiffany M Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States.,Intramural Research Program, National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health, Bethesda, MD, United States
| | - Amit K Dey
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Joshua P Rivers
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States.,Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Abhishek Chaturvedi
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Marcus R Andrews
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Joniqua N Ceasar
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Sophie E Claudel
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Valerie M Mitchell
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Colby Ayers
- Division of Cardiology, UT Southwestern Medical Center, Dallas, TX, United States
| | - Kosuke Tamura
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Cristhian A Gutierrez-Huerta
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Heather L Teague
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Steffen G Oeser
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Aditya Goyal
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Aditya A Joshi
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Billy S Collins
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Yvonne Baumer
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Stephanie T Chung
- Section on Ethnicity and Health, Diabetes Endocrinology and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, Bethesda, MD, United States
| | - Anne E Sumner
- Intramural Research Program, National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health, Bethesda, MD, United States.,Section on Ethnicity and Health, Diabetes Endocrinology and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, Bethesda, MD, United States
| | - Martin P Playford
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
| | - Ahmed Tawakol
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.,Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Nehal N Mehta
- Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, United States
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10
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Patel MI, Lopez AM, Blackstock W, Reeder-Hayes K, Moushey A, Phillips J, Tap W. Cancer Disparities and Health Equity: A Policy Statement From the American Society of Clinical Oncology. J Clin Oncol 2020; 38:3439-3448. [PMID: 32783672 PMCID: PMC7527158 DOI: 10.1200/jco.20.00642] [Citation(s) in RCA: 146] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2020] [Indexed: 01/06/2023] Open
Abstract
ASCO strives, through research, education, and promotion of the highest quality of patient care, to create a world where cancer is prevented and every survivor is healthy. In this pursuit, cancer health equity remains the guiding institutional principle that applies to all its activities across the cancer care continuum. In 2009, ASCO committed to addressing differences in cancer outcomes in its original policy statement on cancer disparities. Over the past decade, despite novel diagnostics and therapeutics, together with changes in the cancer care delivery system such as passage of the Affordable Care Act, cancer disparities persist. Our understanding of the populations experiencing disparate outcomes has likewise expanded to include the intersections of race/ethnicity, geography, sexual orientation and gender identity, sociodemographic factors, and others. This updated statement is intended to guide ASCO's future activities and strategies to achieve its mission of conquering cancer for all populations. ASCO acknowledges that much work remains to be done, by all cancer stakeholders at the systems level, to overcome historical momentum and existing social structures responsible for disparate cancer outcomes. This updated statement affirms ASCO's commitment to moving beyond descriptions of differences in cancer outcomes toward achievement of cancer health equity, with a focus on improving equitable access to care, improving clinical research, addressing structural barriers, and increasing awareness that results in measurable and timely action toward achieving cancer health equity for all.
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Affiliation(s)
| | | | | | | | - Allyn Moushey
- American Society of Clinical Oncology, Alexandria, VA
| | | | - William Tap
- Memorial Sloan Kettering Cancer Center, New York, NY
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11
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The complexities of selling fruits and vegetables in remote Navajo Nation retail outlets: perspectives from owners and managers of small stores. Public Health Nutr 2020; 23:1638-1646. [PMID: 32019628 DOI: 10.1017/s1368980019003720] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Navajo Nation residents experience extreme rates of poverty, food insecurity and diet-related diseases. While many residents travel far to shop at grocery stores, there are small stores closer to home that could provide more healthy options, like fruits and vegetables (F&V). Little is known from the perspective of store owners and managers regarding the barriers and facilitators to offering F&V; the present study contributes to filling that gap. DESIGN Data were collected through structured interviews from a sampling frame of all store owners or managers in the setting (n 29). SETTING Small stores in Navajo Nation, New Mexico, USA. Navajo Nation is predominantly rural and the largest federally recognized Native American tribe in the USA. PARTICIPANTS Sixteen managers and six owners at twenty-two stores. RESULTS When asked about the types of foods that were most commonly purchased at their stores, most participants reported snacks and drinks (82 and 68 %, respectively). Many participants reported they would like to offer more fresh F&V. However, barriers included varying perceived customer demand, limited F&V choices from distributors and (for some managers) limited authority over product selection. CONCLUSIONS Findings contribute to the discussion on engaging store owners and managers in providing quality, healthy foods close to home in low-income, rural regions.
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12
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Westfall M, Roth SE, Gill M, Chan-Golston AM, Rice LN, Crespi CM, Prelip ML. Exploring the Relationship Between MyPlate Knowledge, Perceived Diet Quality, and Healthy Eating Behaviors Among Adolescents. Am J Health Promot 2020; 34:713-721. [DOI: 10.1177/0890117120901430] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: MyPlate is the current dietary guidance icon meant to communicate healthy eating patterns. The purpose of this study is to evaluate knowledge of MyPlate nutrition education messages among middle school students and its association with dietary intake and perceived diet quality. Design: Secondary analysis of cross-sectional data. Settings: Survey of eighth-grade students from 16 middle schools in California. Subjects: A total of 3521 eighth-grade students. Measures: MyPlate knowledge was assessed with 3 questions asking how much of the plate in a typical meal should be (1) fruits and vegetables, (2) grains, and (3) proteins. A brief food frequency questionnaire measured intake of fruits, vegetables, sweets, salty snacks, fast-food, and sugar-sweetened beverages (SSBs) over the past 7 days. Students self-rated their diet quality as poor, fair, good, or excellent. Analysis: Hierarchical logistic regression models controlling for gender, ethnicity, and socioeconomic status. Results: Only 11% of students answered all MyPlate questions correctly. MyPlate knowledge was associated with 65% higher odds of not consuming SSBs, but 46% lower odds of not consuming sweets. MyPlate knowledge was not associated with adolescents’ perceived diet quality or intake of salty snacks, fruits, or vegetables. Conclusion: Knowledge of nutrition education messages communicated by the MyPlate dietary guidance icon is limited among adolescents. The association between MyPlate knowledge and lower consumption of SSBs is encouraging, given the strong association between SSBs and childhood obesity.
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Affiliation(s)
- Miranda Westfall
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Sarah E. Roth
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Monique Gill
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Alec M. Chan-Golston
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Lindsay N. Rice
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Catherine M. Crespi
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Michael L. Prelip
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
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13
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Robles B, Barragan N, Smith B, Caldwell J, Shah D, Kuo T. Lessons learned from implementing the Supplemental Nutrition Assistance Program Education Small Corner Store Project in Los Angeles County. Prev Med Rep 2019; 16:100997. [PMID: 31737469 PMCID: PMC6849416 DOI: 10.1016/j.pmedr.2019.100997] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/05/2019] [Accepted: 09/23/2019] [Indexed: 12/03/2022] Open
Abstract
Corner store conversions (CSCs) are a popular nutrition strategy among funders. CSCs often require major staff capacity, time, and resource investments to do well. CSC implementation in the real world is challenging (e.g., higher staffing needs).
As part of the federal Supplemental Nutrition Assistance Program Education (SNAP-Ed) in Los Angeles County (LAC), corner store conversions (CSCs) were an integral part of a broader, more coordinated effort to improve nutrition and to prevent obesity in low-income populations. To date, little is known about this experience in LAC. The present study addresses this gap by describing lessons learned from implementing the SNAP-Ed Small Corner Store Project (SCSP) in this region. The project, which began in 2013, sought to scale CSCs in underserved communities of LAC, employing behavioral economics (e.g., prominently displaying healthy foods at checkout aisles or using in-store signage to promote healthy options) to encourage patron selection of healthier food items. Results from an assessment of the SCSP suggest that for CSCs to do well, careful considerations should be given to factors such as time (e.g., amount of staff time dedicated to the effort), staff capacity (e.g., # staff available to assist), and available resources that can be leveraged (e.g., support from community-based organizations). For some stores, inadequate food distribution or a lack of capital improvement infrastructure (e.g., refrigeration for fresh produce/storage of excess food that can be repurposed) were key barriers that required additional funding. Although local efforts that incentivize small businesses to undergo CSCs may initially nudge store owners to participate, increasing overall consumer demand for healthier food products (i.e., so as to help maintain sales volume) remains a key to sustaining store conversions long after SNAP-Ed resources are gone.
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Key Words
- CDPH, California Department of Public Health
- CSCs, Corner store conversions
- CX3, Communities of Excellence in Nutrition, Physical Activity and Obesity Prevention
- Corner store conversions
- DPH, Los Angeles County Department of Public Health
- LAC, Los Angeles County
- LHD, Local health department
- Obesity prevention
- PSEs, Policy, systems, and environmental change interventions
- Project assessment
- Project implementation
- SCSP, Small Corner Store Project in Los Angeles County
- SNAP-Ed, Supplemental Nutrition Assistance Program Education
- Supplemental Nutrition Assistance Program Education
- U.S., United States
- USDA, United States Department of Agriculture
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Affiliation(s)
- Brenda Robles
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA 90010, USA
| | - Noel Barragan
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA 90010, USA
| | - Brenda Smith
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA 90010, USA
| | - Julia Caldwell
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA 90010, USA
| | - Dipa Shah
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA 90010, USA
| | - Tony Kuo
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA 90095, USA.,Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA.,Population Health Program, UCLA Clinical and Translational Science Institute, Los Angeles, CA 90095, USA
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14
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Cross-Country Comparison of School Neighborhood Food Environments in Houston, Texas and Guadalajara, Mexico. J Prim Prev 2019; 40:591-606. [PMID: 31655950 DOI: 10.1007/s10935-019-00568-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Studies in the U.S. and Mexico have observed the clustering of food resources around schools, which may promote the use of these resources. Our study characterized and compared school neighborhood food environments in Guadalajara, Jalisco, and Houston, Texas, and examined socioeconomic disparities in food resource availability across school neighborhoods. We used the Goods and Services Inventory to document the frequency and type of resources within each school neighborhood. School neighborhoods in Guadalajara had significantly more food resources than those in Houston. We found that convenience stores and table service restaurants were the most prevalent food resources in school neighborhoods in both cities. Guadalajara school neighborhoods had a higher prevalence of supermarkets and grocery stores than Houston. Low-income school neighborhoods in Guadalajara with poorly educated residents had significantly more food carts than high-income neighborhoods with more educated residents. In Houston, we found significantly more fast food restaurants and convenience stores in school neighborhoods with more educated residents than school neighborhoods with less educated residents. The influence of food resources within school neighborhoods on the dietary habits of schoolchildren should be further explored in both the U.S. and Mexico. The characterization of school neighborhood food environments can inform policymakers, city planners, and school officials who seek to implement policies to create healthier food environments.
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15
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Cassetti V, Powell K, Barnes A, Sanders T. A systematic scoping review of asset-based approaches to promote health in communities: development of a framework. Glob Health Promot 2019; 27:15-23. [PMID: 31319777 DOI: 10.1177/1757975919848925] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Asset-based approaches to health promotion have become increasingly popular as a way to tackle health inequalities by empowering people in more disadvantaged communities to use local resources and increase control over health and its determinants. However, questions remain about how they work in practice. This article presents the findings from a systematic scoping review of the empirical literature on asset-based approaches in communities. The aim was to identify the key elements of asset-based approaches, and how they are operationalised in interventions aimed at promoting health and reducing inequalities in local communities. Four databases were searched (Medline, PsycINFO, CINAHL, ASSIA) and papers were included if they described interventions explicitly adopting an asset-based approach but excluded if limited to asset identification. Thirty articles were included in the review. Data were extracted on the type of assets that the intervention built upon, how assets were mobilised, the expected outcomes and evaluation methods. A framework is presented that synthesises the key characteristics of asset-based interventions to promote health in communities. Three main approaches to mobilising assets were identified in the literature: (A) connecting assets, (B) raising awareness of assets and (C) enabling assets to thrive. It is argued that asset-based approaches to health promotion take a wide variety of forms, making it difficult to anticipate outcomes and to evaluate interventions. The framework presented here can be used to better understand the processes through which asset-based approaches work in practice to promote health and reduce inequalities.
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Affiliation(s)
- Viola Cassetti
- School of Health and Related Research (ScHARR), University of Sheffield, United Kingdom
| | - Katie Powell
- School of Health and Related Research (ScHARR), University of Sheffield, United Kingdom
| | - Amy Barnes
- School of Health and Related Research (ScHARR), University of Sheffield, United Kingdom
| | - Tom Sanders
- School of Health and Related Research (ScHARR), University of Sheffield, United Kingdom.,Health and Life Sciences, Northumbria University, United Kingdom
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16
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Paskett E, Thompson B, Ammerman AS, Ortega AN, Marsteller J, Richardson D. Multilevel Interventions To Address Health Disparities Show Promise In Improving Population Health. Health Aff (Millwood) 2018; 35:1429-34. [PMID: 27503968 DOI: 10.1377/hlthaff.2015.1360] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Multilevel interventions are those that affect at least two levels of influence-for example, the patient and the health care provider. They can be experimental designs or natural experiments caused by changes in policy, such as the implementation of the Affordable Care Act or local policies. Measuring the effects of multilevel interventions is challenging, because they allow for interaction among levels, and the impact of each intervention must be assessed and translated into practice. We discuss how two projects from the National Institutes of Health's Centers for Population Health and Health Disparities used multilevel interventions to reduce health disparities. The interventions, which focused on the uptake of the human papillomavirus vaccine and community-level dietary change, had mixed results. The design and implementation of multilevel interventions are facilitated by input from the community, and more advanced methods and measures are needed to evaluate the impact of the various levels and components of such interventions.
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Affiliation(s)
- Electra Paskett
- Electra Paskett is a professor of internal medicine at the Ohio State University College of Medicine, in Columbus
| | - Beti Thompson
- Beti Thompson is a professor in the Cancer Prevention Program at the Fred Hutchinson Cancer Research Center, in Seattle, Washington
| | - Alice S Ammerman
- Alice S. Ammerman is a professor of nutrition in the Gillings School of Global Public Health and director of the Center for Health Promotion and Disease Prevention, both at the University of North Carolina at Chapel Hill
| | - Alexander N Ortega
- Alexander N. Ortega is a professor in and chair of the Department of Health Management and Policy, Dornsife School of Public Health, at Drexel University, in Philadelphia, Pennsylvania
| | - Jill Marsteller
- Jill Marsteller is an associate professor at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland
| | - DeJuran Richardson
- DeJuran Richardson is a professor of mathematics at Lake Forest College, in Lake Forest, Illinois, and an adjunct professor of biostatistics at Rush University Medical Center, in Chicago, Illinois
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17
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Thornton RLJ, Glover CM, Cené CW, Glik DC, Henderson JA, Williams DR. Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health. Health Aff (Millwood) 2018; 35:1416-23. [PMID: 27503966 DOI: 10.1377/hlthaff.2015.1357] [Citation(s) in RCA: 312] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The opportunities for healthy choices in homes, neighborhoods, schools, and workplaces can have decisive impacts on health. We review scientific evidence from promising interventions focused on the social determinants of health and discuss how such interventions can improve population health and reduce health disparities. We found sufficient evidence of successful outcomes to support disparity-reducing policy interventions targeted at education and early childhood; urban planning and community development; housing; income enhancements and supplements; and employment. Cost-effectiveness evaluations show that these interventions lead to long-term societal savings, but the interventions require more routine attention to cost considerations. We discuss challenges to implementation, including the need for long-term financing to scale up effective interventions for implementation at the local, state, and national levels.
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Affiliation(s)
- Rachel L J Thornton
- Rachel L. J. Thornton is an assistant professor in the Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, at the Johns Hopkins School of Medicine, in Baltimore, Maryland
| | - Crystal M Glover
- Crystal M. Glover is an assistant professor and BMO Harris Bank Health Disparities Research Fellow at the Rush University Medical School, in Chicago, Illinois
| | - Crystal W Cené
- Crystal W. Cené is an associate professor in the Division of General Medicine and Clinical Epidemiology, Department of Medicine, at the Chapel Hill School of Medicine, University of North Carolina
| | - Deborah C Glik
- Deborah C. Glik is a professor of community health sciences at the UCLA Fielding School of Public Health, University of California, Los Angeles
| | - Jeffrey A Henderson
- Jeffrey A. Henderson is president and CEO of the Black Hills Center for American Indian Health, in Rapid City, South Dakota
| | - David R Williams
- David R. Williams is the Florence and Laura Norman Professor of Public Health in the Department of Social and Behavioral Sciences at the Harvard T. H. Chan School of Public Health, in Boston, Massachusetts, and a professor in the Department of African and African American Studies at Harvard University, in Cambridge, Massachusetts
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18
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Rushakoff JA, Zoughbie DE, Bui N, DeVito K, Makarechi L, Kubo H. Evaluation of Healthy2Go: A country store transformation project to improve the food environment and consumer choices in Appalachian Kentucky. Prev Med Rep 2017; 7:187-192. [PMID: 28706778 PMCID: PMC5501879 DOI: 10.1016/j.pmedr.2017.06.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 06/22/2017] [Accepted: 06/24/2017] [Indexed: 11/20/2022] Open
Abstract
Rates of obesity and type 2 diabetes in Kentucky's Cumberland Valley region are among the highest in the United States and limited access to healthy food contributes to these epidemics. The aim of Healthy2Go (H2G), a country store transformation project launched by Spread the Health Appalachia (STHA), was to improve awareness and availability of healthy options in small, rural stores. Ten country stores participated in H2G and received training and technical assistance to increase availability and awareness of healthy foods. Stores made inventory changes; installed point-of-purchase educational and in-store marketing materials directing shoppers to healthier options; provided nutrition education such as healthy recipes; and altered the display and location of healthy items. To measure changes within stores and the potential impact on resident eating and purchasing habits, STHA used four instruments: a modified version of the Nutrition Environs Measures Survey - Corner Stores at baseline and follow-up, a bimonthly store inventory assessment, a final store owner survey, and a Community Nutrition Survey at baseline (n = 287) and follow-up (n = 281). The stores in the H2G program (n = 10) had a 40% increase in stocking fresh produce, a 20% increase in produce variety, and trends towards increasing healthy inventory. During the same period, surveyed residents reported a statistically significant increase in the frequency of healthy food consumption. Small store transformation programs can improve availability of and access to healthy food in rural settings and influence local purchasing patterns.
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Affiliation(s)
| | | | - Nancy Bui
- Microclinic International, San Francisco, CA, United States
| | | | | | - Hitomi Kubo
- Microclinic International, San Francisco, CA, United States
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19
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Harnessing Implementation Science to Increase the Impact of Health Equity Research. Med Care 2017; 55 Suppl 9 Suppl 2:S16-S23. [PMID: 28806362 DOI: 10.1097/mlr.0000000000000769] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Health disparities are differences in health or health care between groups based on social, economic, and/or environmental disadvantage. Disparity research often follows 3 steps: detecting (phase 1), understanding (phase 2), and reducing (phase 3), disparities. Although disparities have narrowed over time, many remain. OBJECTIVES We argue that implementation science could enhance disparities research by broadening the scope of phase 2 studies and offering rigorous methods to test disparity-reducing implementation strategies in phase 3 studies. METHODS We briefly review the focus of phase 2 and phase 3 disparities research. We then provide a decision tree and case examples to illustrate how implementation science frameworks and research designs could further enhance disparity research. RESULTS Most health disparities research emphasizes patient and provider factors as predominant mechanisms underlying disparities. Applying implementation science frameworks like the Consolidated Framework for Implementation Research could help disparities research widen its scope in phase 2 studies and, in turn, develop broader disparities-reducing implementation strategies in phase 3 studies. Many phase 3 studies of disparity-reducing implementation strategies are similar to case studies, whose designs are not able to fully test causality. Implementation science research designs offer rigorous methods that could accelerate the pace at which equity is achieved in real-world practice. CONCLUSIONS Disparities can be considered a "special case" of implementation challenges-when evidence-based clinical interventions are delivered to, and received by, vulnerable populations at lower rates. Bringing together health disparities research and implementation science could advance equity more than either could achieve on their own.
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Sharif MZ, Albert SL, Chan-Golston AM, Lopez G, Kuo AA, Prelip ML, Ortega AN, Glik DC. Community Residents' Beliefs About Neighborhood Corner Stores in 2 Latino Communities: Implications for Interventions to Improve the Food Environment. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2017; 12:342-351. [PMID: 29147455 DOI: 10.1080/19320248.2017.1315329] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We assessed community residents' perceptions of corner stores to better understand what facilitates and deters patronage at these food outlets. Data came from 978 household interviews in 2 Latino communities undergoing corner store interventions. Chi-square tests, an independent sample t test, and a multivariate logistic regression were conducted to assess the relationship between residents' perceptions about corner stores and their reported patronage at these food outlets. Residents reported that corner stores do not sell a variety of fruits and vegetables and are not places where one can get information about healthy eating. Convenience, cleanliness, positive customer service, availability of culturally appropriate items, and availability of quality fresh fruit increased the odds of store patronage. Simply providing healthy foods will not incentivize patrons to purchase them. Corner store interventions can be more effective if they address the characteristics that community residents prioritize.
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Affiliation(s)
- Mienah Z Sharif
- Department of Community Health Sciences, Fielding School of Public Health, UCLA Center for Population Health and Health Disparities, Los Angeles, California, USA
| | - Stephanie L Albert
- Department of Community Health Sciences, Fielding School of Public Health, UCLA Center for Population Health and Health Disparities, Los Angeles, California, USA
| | - Alec M Chan-Golston
- Department of Biostatistics, Fielding School of Public Health, UCLA Center for Population Health and Health Disparities, Los Angeles, California, USA
| | - Gilberto Lopez
- UCLA Center for Population Health and Health Disparities, Los Angeles, California, USA
| | - Alice A Kuo
- Department of Health Policy and Management, Fielding School of Public Health, UCLA Center for Population Health and Health Disparities, Los Angeles, California, USA
| | - Michael L Prelip
- Department of Community Health Sciences, Fielding School of Public Health, UCLA Center for Population Health and Health Disparities, Los Angeles, California, USA
| | - Alexander N Ortega
- UCLA Center for Population Health and Health Disparities Department of Health Management & Policy, Drexel University, Philadelphia, Pennsylvania, USA
| | - Deborah C Glik
- Department of Community Health Sciences, Fielding School of Public Health, UCLA Center for Population Health and Health Disparities, Los Angeles, California, USA
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Caspi CE, Lenk K, Pelletier JE, Barnes TL, Harnack L, Erickson DJ, Laska MN. Association between store food environment and customer purchases in small grocery stores, gas-marts, pharmacies and dollar stores. Int J Behav Nutr Phys Act 2017; 14:76. [PMID: 28583131 PMCID: PMC5460502 DOI: 10.1186/s12966-017-0531-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 05/26/2017] [Indexed: 12/19/2022] Open
Abstract
Background Purchases at small/non-traditional food stores tend to have poor nutritional quality, and have been associated with poor health outcomes, including increased obesity risk The purpose of this study was to examine whether customers who shop at small/non-traditional food stores with more health promoting features make healthier purchases. Methods In a cross-sectional design, data collectors assessed store features in a sample of 99 small and non-traditional food stores not participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Minneapolis/St. Paul, MN in 2014. Customer intercept interviews (n = 594) collected purchase data from a bag check and demographics from a survey. Store measures included fruit/vegetable and whole grain availability, an overall Healthy Food Supply Score (HFSS), healthy food advertisements and in-store placement, and shelf space of key items. Customer nutritional measures were analyzed using Nutrient Databases System for Research (NDSR), and included the purchase of ≥1 serving of fruits/vegetables; ≥1 serving of whole grains; and overall Healthy Eating Index-2010 (HEI-2010) score for foods/beverages purchased. Associations between store and customer measures were estimated in multilevel linear and logistic regression models, controlling for customer characteristics and store type. Results Few customers purchased fruits and vegetables (8%) or whole grains (8%). In fully adjusted models, purchase HEI-2010 scores were associated with fruit/vegetable shelf space (p = 0.002) and the ratio of shelf space devoted to healthy vs. less healthy items (p = 0.0002). Offering ≥14 varieties of fruit/vegetables was associated with produce purchases (OR 3.9, 95% CI 1.2–12.3), as was having produce visible from the store entrance (OR 2.3 95% CI 1.0 to 5.8), but whole grain availability measures were not associated with whole grain purchases. Conclusions Strategies addressing both customer demand and the availability of healthy food may be necessary to improve customer purchases. Trial registration ClinialTrials.gov: NCT02774330. Registered May 4, 2016 (retrospectively registered). Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0531-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Caitlin E Caspi
- Department of Family Medicine and Community Health, Program in Health Disparities Research, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN, 55414, USA.
| | - Kathleen Lenk
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, 55454, USA
| | - Jennifer E Pelletier
- Statewide Health Improvement Program, Minnesota Department of Health, Saint Paul, MN, 55164, USA
| | - Timothy L Barnes
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, 55454, USA
| | - Lisa Harnack
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, 55454, USA
| | - Darin J Erickson
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, 55454, USA
| | - Melissa N Laska
- Division of Epidemiology and Community Health, Suite 300, University of Minnesota, 1300 South 2nd St, Minneapolis, MN, 55454, USA
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A corner store intervention to improve access to fruits and vegetables in two Latino communities. Public Health Nutr 2017; 20:2249-2259. [PMID: 28578744 DOI: 10.1017/s1368980017001008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Investments have been made to alter the food environment of neighbourhoods that have a disproportionate number of unhealthy food venues. Corner store conversions are one strategy to increase access to fruits and vegetables (F&V). Although the literature shows modest success, the effectiveness of these interventions remains equivocal. The present paper reports on the evaluation of Proyecto MercadoFRESCO, a corner store conversion intervention in two Latino communities. DESIGN A repeated cross-sectional design was employed. Data were stratified by intervention arm and bivariate tests assessed changes over time. Logistic and multiple regression models with intervention arm, time and the interaction of intervention and time were conducted. Supplementary analyses account for clustering of patrons within stores and staggering of store conversions. SETTING Three stores were converted and five stores served as comparisons in East Los Angeles and Boyle Heights, California, USA. SUBJECTS Store patrons were interviewed before (n550) and after (n407) the intervention. RESULTS Relative to patrons of comparison stores, patrons of intervention stores demonstrated more favourable perceptions of corner stores and increased purchasing of F&V during that store visit. Changes were not detected in store patronage, percentage of weekly dollars spent on food for F&V or daily consumption of F&V. CONCLUSIONS Consistent with some extant food environment literature, findings demonstrate limited effects. Investments should be made in multilevel, comprehensive interventions that target a variety retail food outlets rather than focusing on corner stores exclusively. Complementary policies limiting the availability, affordability and marketing of energy-dense, nutrient-poor foods should also be pursued.
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Choi B, Schnall P, Dobson M, Yang H, Baker D, Seo Y. A socioecological framework for research on work and obesity in diverse urban transit operators based on gender, race, and ethnicity. Ann Occup Environ Med 2017; 29:15. [PMID: 28529756 PMCID: PMC5436435 DOI: 10.1186/s40557-017-0171-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/10/2017] [Indexed: 12/18/2022] Open
Abstract
Urban transit (bus and rail) operators, totaling nearly 700,000 persons, are one of the heaviest occupational groups in the United States (US). Little is known about occupational risk factors for weight gain and obesity and their interrelationship with health-related behaviors, particularly among female minority (African Americans and Hispanics) transit operators who are at greater risk for obesity. As a step towards developing successful obesity interventions among urban transit operators, this paper aims to present a new socioecological framework for studying working conditions, chronic strain, health-related behaviors, weight gain/obesity, and obesity disparity in diverse urban transit operators based on gender, race, and ethnicity. Our framework is a synthesis of several different theories and disciplines: the resource-work load model (work stress), occupational ergonomics, the theory of intersectionality, and worksite health promotion. The framework was developed utilizing an extensive literature review, results from our on-going research on obesity, input from focus groups conducted with Los Angeles transit operators as well as interviews and meetings with transit operator stakeholders (management, unions, and worksite transit wellness program), and ride-along observations. Our hypotheses highlighted in the framework (see Fig. 1) are that adverse working conditions, largely characterized as a combination of high demands and low resources, will increase the risk for weight gain/obesity among transit operators directly through chronic strain and hypothalamic dysfunction (hyper-and hypo-activations), and indirectly through health-related behaviors and injuries/chronic severe pain. We also hypothesize that the observed increase in adiposity among female minority operators is due to their greater exposure to adverse occupational and non-occupational conditions that reflect their intersecting social identities of lower social class and being a minority woman in the US. Our proposed framework could greatly facilitate future transit worksite obesity studies by clarifying the complex and important roles of adverse working conditions in the etiology of weight gain/obesity and obesity disparity among transit operators and other working populations.
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Affiliation(s)
- BongKyoo Choi
- Center for Occupational and Environmental Health, University of California Irvine, 100 Theory, Suite 100, Irvine, CA 92617 USA
| | - Peter Schnall
- Center for Occupational and Environmental Health, University of California Irvine, 100 Theory, Suite 100, Irvine, CA 92617 USA
| | - Marnie Dobson
- Center for Occupational and Environmental Health, University of California Irvine, 100 Theory, Suite 100, Irvine, CA 92617 USA
| | - Haiou Yang
- Center for Occupational and Environmental Health, University of California Irvine, 100 Theory, Suite 100, Irvine, CA 92617 USA
| | - Dean Baker
- Center for Occupational and Environmental Health, University of California Irvine, 100 Theory, Suite 100, Irvine, CA 92617 USA
| | - YoungJu Seo
- Department of Sociology, University of Massachusetts Amherst, 200 Hicks Way, Amherst, MA 01003 USA
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24
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Chan-Golston AM, Friedlander S, Glik DC, Prelip ML, Belin TR, Brookmeyer R, Santos R, Chen J, Ortega AN. Comparing Lay Community and Academic Survey Center Interviewers in Conducting Household Interviews in Latino Communities. Prog Community Health Partnersh 2017; 10:435-442. [PMID: 28230551 DOI: 10.1353/cpr.2016.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The employment of professional interviewers from academic survey centers to conduct surveys has been standard practice. Because one goal of community-engaged research is to provide professional skills to community residents, this paper considers whether employing locally trained lay interviewers from within the community may be as effective as employing interviewers from an academic survey center with regard to unit and item nonresponse rates and cost. METHODS To study a nutrition-focused intervention, 1035 in-person household interviews were conducted in East Los Angeles and Boyle Heights, 503 of which were completed by lay community interviewers. A chi-square test was used to assess differences in unit nonresponse rates between professional and community interviewers and Welch's t tests were used to assess differences in item nonresponse rates. A cost comparison analysis between the two interviewer groups was also conducted. RESULTS Interviewers from the academic survey center had lower unit nonresponse rates than the lay community interviewers (16.2% vs. 23.3%; p < 0.01). However, the item nonresponse rates were lower for the community interviewers than the professional interviewers (1.4% vs. 3.3%; p < 0.01). Community interviewers cost approximately $415.38 per survey whereas professional interviewers cost approximately $537.29 per survey. CONCLUSIONS With a lower cost per completed survey and lower item nonresponse rates, lay community interviewers are a viable alternative to professional interviewers for fieldwork in community-based research. Additional research is needed to assess other important aspects of data quality interviewer such as interviewer effects and response error.
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Choice architecture to promote fruit and vegetable purchases by families participating in the Special Supplemental Program for Women, Infants, and Children (WIC): randomized corner store pilot study. Public Health Nutr 2016; 20:1297-1305. [PMID: 27890020 DOI: 10.1017/s1368980016003074] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To conduct a pilot study to determine if improving the visibility and quality of fresh produce (choice architecture) in corner stores would increase fruit/vegetable purchases by families participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). DESIGN Six stores were randomly assigned to choice architecture intervention or control. Store-level WIC sales data were provided by the state. Primary outcomes were WIC fruit/vegetable voucher and non-fruit/vegetable voucher sales, comparing trends from baseline (December 2012-October 2013) with the five-month intervention period (December 2013-April 2014). Secondary outcomes were differences in customer self-reported fruit/vegetable purchases between baseline and end of the intervention. SETTING Chelsea, MA, USA, a low-income urban community. SUBJECTS Adult customers (n 575) completing store exit interviews. RESULTS During baseline, WIC fruit/vegetable and non-fruit/vegetable sales decreased in both intervention and control stores by $US 16/month. During the intervention period, WIC fruit/vegetable sales increased in intervention stores by $US 40/month but decreased in control stores by $US 23/month (difference in trends: $US 63/month; 95 % CI 4, 121 $US/month; P=0·036); WIC non-fruit/vegetable sales were not different (P=0·45). Comparing baseline and intervention-period exit interview responses by customers participating in WIC (n 134), intervention store customers reported increased fruit/vegetable purchases compared with control store customers (18 v. -2 %), but this did not achieve statistical significance (P=0·11). CONCLUSIONS Placement of fruits/vegetables near the front of corner stores increased purchase of produce by customers using WIC. New policies that incentivize stores to stock and prominently display good-quality produce could promote healthier food choices of low-income families.
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Kuo AA, Sharif MZ, Prelip ML, Glik DC, Albert SL, Belin T, McCarthy WJ, Roberts CK, Garcia RE, Ortega AN. Training the Next Generation of Latino Health Researchers: A Multilevel, Transdisciplinary, Community-Engaged Approach. Health Promot Pract 2016; 18:497-504. [PMID: 27609622 DOI: 10.1177/1524839916665091] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Reducing health disparities is a national public health priority. Latinos represent the largest racial/ethnic minority group in the United States and suffer disproportionately from poor health outcomes, including cardiovascular disease risk. Academic training programs are an opportunity for reducing health disparities, in part by increasing the diversity of the public health workforce and by incorporating training designed to develop a skill set to address health disparities. This article describes the Training and Career Development Program at the UCLA Center for Population Health and Health Disparities: a multilevel, transdisciplinary training program that uses a community-engaged approach to reduce cardiovascular disease risk in two urban Mexican American communities. Results suggest that this program is effective in enhancing the skill sets of traditionally underrepresented students to become health disparities researchers and practitioners.
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Affiliation(s)
- Alice A Kuo
- 1 UCLA Center for Population Health and Health Disparities, Los Angeles, CA, USA.,2 David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Mienah Z Sharif
- 1 UCLA Center for Population Health and Health Disparities, Los Angeles, CA, USA
| | - Michael L Prelip
- 1 UCLA Center for Population Health and Health Disparities, Los Angeles, CA, USA
| | - Deborah C Glik
- 1 UCLA Center for Population Health and Health Disparities, Los Angeles, CA, USA
| | - Stephanie L Albert
- 1 UCLA Center for Population Health and Health Disparities, Los Angeles, CA, USA
| | - Thomas Belin
- 1 UCLA Center for Population Health and Health Disparities, Los Angeles, CA, USA
| | - William J McCarthy
- 1 UCLA Center for Population Health and Health Disparities, Los Angeles, CA, USA
| | | | - Rosa Elena Garcia
- 1 UCLA Center for Population Health and Health Disparities, Los Angeles, CA, USA
| | - Alexander N Ortega
- 1 UCLA Center for Population Health and Health Disparities, Los Angeles, CA, USA.,4 Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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Thornton RLJ, Glover CM, Cené CW, Glik DC, Henderson JA, Williams DR. Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health. HEALTH AFFAIRS (PROJECT HOPE) 2016. [PMID: 27503966 DOI: 10.1377/hlthaff.2015.1357.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The opportunities for healthy choices in homes, neighborhoods, schools, and workplaces can have decisive impacts on health. We review scientific evidence from promising interventions focused on the social determinants of health and discuss how such interventions can improve population health and reduce health disparities. We found sufficient evidence of successful outcomes to support disparity-reducing policy interventions targeted at education and early childhood; urban planning and community development; housing; income enhancements and supplements; and employment. Cost-effectiveness evaluations show that these interventions lead to long-term societal savings, but the interventions require more routine attention to cost considerations. We discuss challenges to implementation, including the need for long-term financing to scale up effective interventions for implementation at the local, state, and national levels.
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Affiliation(s)
- Rachel L J Thornton
- Rachel L. J. Thornton is an assistant professor in the Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, at the Johns Hopkins School of Medicine, in Baltimore, Maryland
| | - Crystal M Glover
- Crystal M. Glover is an assistant professor and BMO Harris Bank Health Disparities Research Fellow at the Rush University Medical School, in Chicago, Illinois
| | - Crystal W Cené
- Crystal W. Cené is an associate professor in the Division of General Medicine and Clinical Epidemiology, Department of Medicine, at the Chapel Hill School of Medicine, University of North Carolina
| | - Deborah C Glik
- Deborah C. Glik is a professor of community health sciences at the UCLA Fielding School of Public Health, University of California, Los Angeles
| | - Jeffrey A Henderson
- Jeffrey A. Henderson is president and CEO of the Black Hills Center for American Indian Health, in Rapid City, South Dakota
| | - David R Williams
- David R. Williams is the Florence and Laura Norman Professor of Public Health in the Department of Social and Behavioral Sciences at the Harvard T. H. Chan School of Public Health, in Boston, Massachusetts, and a professor in the Department of African and African American Studies at Harvard University, in Cambridge, Massachusetts
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28
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Sharif MZ, Rizzo S, Marino E, Belin TR, Glik DC, Kuo AA, Ortega AN, Prelip ML. The association between self-rated eating habits and dietary behavior in two Latino neighborhoods: Findings from Proyecto MercadoFRESCO. Prev Med Rep 2016; 3:270-5. [PMID: 27419025 PMCID: PMC4929149 DOI: 10.1016/j.pmedr.2016.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 02/02/2016] [Accepted: 03/07/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Latinos are the largest racial and ethnic minority group in the United States and bear a disproportionate burden of obesity related chronic disease. Despite national efforts to improve dietary habits and prevent obesity among Latinos, obesity rates remain high. The objective of this study is to explore the relationship between self-rated dietary quality and dietary behavior among Latinos and how this may vary by socio-demographics to help inform future public health efforts aiming to improve eating habits and obesity rates. DESIGN Cross-sectional study using a series of chi-square tests, the non-parametric Wilcoxon-Mann-Whitney test and logistic regression to explore self-rated eating habits. SETTING Two urban, low-income, predominantly Latino neighborhoods in Los Angeles County. SUBJECTS 1000 adults who self-identified as their household's primary food purchaser and preparer were interviewed from 2012 to 2013. Households were randomly selected based on their proximity to corner stores participating in a project to improve the food environment. RESULTS Most respondents (59%) report "good" eating habits. Significant associations between "good" eating habits and overall health, fruit and vegetable consumption were observed (p < 0.001). Despite these promising findings, we also find high levels of regular soda and energy-dense food consumption. CONCLUSION This study revealed a general understanding that healthy dietary habits are associated with fruit and vegetable consumption among Latinos in two urban neighborhoods. However, there is a need for more targeted health promotion and nutrition education efforts on the risks associated with soda and energy-dense food consumption to help improve dietary habits and obesity levels in low-income Latino communities.
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Affiliation(s)
- Mienah Z. Sharif
- UCLA Center for Population Health and Health Disparities (CPHHD), United States
- UCLA Fielding School of Public Health, Department of Community Health Sciences, United States
| | - Shemra Rizzo
- UCLA Center for Population Health and Health Disparities (CPHHD), United States
- UC Riverside, Department of Statistics, United States
| | - Enrique Marino
- UCLA Center for Population Health and Health Disparities (CPHHD), United States
- UCLA Fielding School of Public Health, Department of Biostatistics, United States
| | - Thomas R. Belin
- UCLA Center for Population Health and Health Disparities (CPHHD), United States
- UCLA Fielding School of Public Health, Department of Biostatistics, United States
| | - Deborah C. Glik
- UCLA Center for Population Health and Health Disparities (CPHHD), United States
- UCLA Fielding School of Public Health, Department of Community Health Sciences, United States
| | - Alice A. Kuo
- UCLA Center for Population Health and Health Disparities (CPHHD), United States
- UCLA Fielding School of Public Health, Department of Health Policy and Management, United States
- David Geffen School of Medicine at UCLA, Departments of Pediatrics and Internal Medicine, United States
| | - Alexander N. Ortega
- UCLA Center for Population Health and Health Disparities (CPHHD), United States
- Drexel University, Dornsife School of Public Health, Department of Health Management & Policy, United States
| | - Michael L. Prelip
- UCLA Center for Population Health and Health Disparities (CPHHD), United States
- UCLA Fielding School of Public Health, Department of Community Health Sciences, United States
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Abstract
Increasing attention has been given to the role of retail food environments in shaping dietary behavior and obesity risk. Studies have generally shown an association between living in a neighborhood with or in close proximity to certain types of food outlets and/or the availability of healthy food options and better dietary quality, higher fruit/vegetable intakes, and a lower risk of overweight, even after controlling for individual/family level characteristics. However, research in this area has yielded mixed results, overall. Future research needs to identify consistent approaches for defining and measuring food retail environments.
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Affiliation(s)
- Angela Odoms-Young
- College of Applied Health Sciences, Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor MC 517, Chicago, Illinois, 60612, USA.
- Office of Community Engagement and Neighborhood Health Partnerships, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA.
- The Cancer Education and Cancer Development Program, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA.
| | - Chelsea R Singleton
- The Cancer Education and Cancer Development Program, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Sparkle Springfield
- College of Applied Health Sciences, Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor MC 517, Chicago, Illinois, 60612, USA
- The Cancer Education and Cancer Development Program, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Leilah McNabb
- College of Applied Health Sciences, Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor MC 517, Chicago, Illinois, 60612, USA
| | - Terry Thompson
- Public Health and Health Sciences, University of Michigan-Flint, Flint, MI, USA
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30
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Ortega AN, Albert SL, Chan-Golston AM, Langellier BA, Glik DC, Belin TR, Garcia RE, Brookmeyer R, Sharif MZ, Prelip ML. Substantial improvements not seen in health behaviors following corner store conversions in two Latino food swamps. BMC Public Health 2016; 16:389. [PMID: 27169514 PMCID: PMC4864998 DOI: 10.1186/s12889-016-3074-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 05/04/2016] [Indexed: 11/23/2022] Open
Abstract
Background The effectiveness of food retail interventions is largely undetermined, yet substantial investments have been made to improve access to healthy foods in food deserts and swamps via grocery and corner store interventions. This study evaluated the effects of corner store conversions in East Los Angeles and Boyle Heights, California on perceived accessibility of healthy foods, perceptions of corner stores, store patronage, food purchasing, and eating behaviors. Methods Household data (n = 1686) were collected at baseline and 12- to 24-months post-intervention among residents surrounding eight stores, three of which implemented a multi-faceted intervention and five of which were comparisons. Bivariate analyses and logistic and linear regressions were employed to assess differences in time, treatment, and the interaction between time and treatment to determine the effectiveness of this intervention. Results Improvements were found in perceived healthy food accessibility and perceptions of corner stores. No changes were found, however, in store patronage, purchasing, or consumption of fruits and vegetables. Conclusions Results suggest limited effectiveness of food retail interventions on improving health behaviors. Future research should focus on other strategies to reduce community-level obesity. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3074-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexander N Ortega
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, 3215 Market Street, Nesbitt Hall, Room 335, Philadelphia, PA, 19104, USA.
| | - Stephanie L Albert
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Alec M Chan-Golston
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Brent A Langellier
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, 3215 Market Street, Nesbitt Hall, Room 335, Philadelphia, PA, 19104, USA
| | - Deborah C Glik
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Thomas R Belin
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Rosa Elena Garcia
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Ron Brookmeyer
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Mienah Z Sharif
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Michael L Prelip
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095, USA
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Alcalá HE, Albert SL, Trabanino SK, Garcia RE, Glik DC, Prelip ML, Ortega AN. Access to and Use of Health Care Services Among Latinos in East Los Angeles and Boyle Heights. FAMILY & COMMUNITY HEALTH 2016; 39:62-71. [PMID: 26605956 PMCID: PMC4662077 DOI: 10.1097/fch.0000000000000090] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study examined differences in access, utilization, and barriers to health care by nativity, language spoken at home, and insurance status in East Los Angeles and Boyle Heights, California. Data from household interviews of neighborhood residents conducted as part of a corner store intervention project were used. Binary and multinomial logistic regression models were fitted. Results showed that uninsured and foreign-born individuals were differentially affected by lack of access to and utilization of health care. While the Affordable Care Act may ameliorate some disparities, the impact will be limited because of the exclusion of key groups, like the undocumented, from benefits.
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Sharif MZ, Garza JR, Langellier BA, Kuo AA, Glik DC, Prelip ML, Ortega AN. Mobilizing Young People in Community Efforts to Improve the Food Environment: Corner Store Conversions in East Los Angeles. Public Health Rep 2015; 130:406-15. [PMID: 26347230 DOI: 10.1177/003335491513000421] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mienah Z Sharif
- Mienah Sharif is a Research Assistant at the UCLA Center for Population Health and Health Disparities (CPHHD) in Los Angeles, California, and a Doctor of Philosophy Student in the Department of Community Health Sciences at the UCLA Fielding School of Public Health in Los Angeles. Jeremiah Garza is a Doctor of Public Health Candidate in the Department of Health Policy and Management at the UCLA Fielding School of Public Health. Brent Langellier is an Assistant Professor in the Division of Health Promotion Sciences at the University of Arizona Mel & Enid Zuckerman College of Public Health in Tucson, Arizona. Alice Kuo is a Co-Investigator at the UCLA CPHHD, an Associate Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health, and an Associate Professor in the Department of Pediatrics at the UCLA David Geffen School of Medicine in Los Angeles. Deborah Glik is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Michael Prelip is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Alexander Ortega is Director of the UCLA CPHHD and a Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health
| | - Jeremiah R Garza
- Mienah Sharif is a Research Assistant at the UCLA Center for Population Health and Health Disparities (CPHHD) in Los Angeles, California, and a Doctor of Philosophy Student in the Department of Community Health Sciences at the UCLA Fielding School of Public Health in Los Angeles. Jeremiah Garza is a Doctor of Public Health Candidate in the Department of Health Policy and Management at the UCLA Fielding School of Public Health. Brent Langellier is an Assistant Professor in the Division of Health Promotion Sciences at the University of Arizona Mel & Enid Zuckerman College of Public Health in Tucson, Arizona. Alice Kuo is a Co-Investigator at the UCLA CPHHD, an Associate Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health, and an Associate Professor in the Department of Pediatrics at the UCLA David Geffen School of Medicine in Los Angeles. Deborah Glik is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Michael Prelip is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Alexander Ortega is Director of the UCLA CPHHD and a Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health
| | - Brent A Langellier
- Mienah Sharif is a Research Assistant at the UCLA Center for Population Health and Health Disparities (CPHHD) in Los Angeles, California, and a Doctor of Philosophy Student in the Department of Community Health Sciences at the UCLA Fielding School of Public Health in Los Angeles. Jeremiah Garza is a Doctor of Public Health Candidate in the Department of Health Policy and Management at the UCLA Fielding School of Public Health. Brent Langellier is an Assistant Professor in the Division of Health Promotion Sciences at the University of Arizona Mel & Enid Zuckerman College of Public Health in Tucson, Arizona. Alice Kuo is a Co-Investigator at the UCLA CPHHD, an Associate Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health, and an Associate Professor in the Department of Pediatrics at the UCLA David Geffen School of Medicine in Los Angeles. Deborah Glik is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Michael Prelip is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Alexander Ortega is Director of the UCLA CPHHD and a Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health
| | - Alice A Kuo
- Mienah Sharif is a Research Assistant at the UCLA Center for Population Health and Health Disparities (CPHHD) in Los Angeles, California, and a Doctor of Philosophy Student in the Department of Community Health Sciences at the UCLA Fielding School of Public Health in Los Angeles. Jeremiah Garza is a Doctor of Public Health Candidate in the Department of Health Policy and Management at the UCLA Fielding School of Public Health. Brent Langellier is an Assistant Professor in the Division of Health Promotion Sciences at the University of Arizona Mel & Enid Zuckerman College of Public Health in Tucson, Arizona. Alice Kuo is a Co-Investigator at the UCLA CPHHD, an Associate Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health, and an Associate Professor in the Department of Pediatrics at the UCLA David Geffen School of Medicine in Los Angeles. Deborah Glik is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Michael Prelip is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Alexander Ortega is Director of the UCLA CPHHD and a Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health
| | - Deborah C Glik
- Mienah Sharif is a Research Assistant at the UCLA Center for Population Health and Health Disparities (CPHHD) in Los Angeles, California, and a Doctor of Philosophy Student in the Department of Community Health Sciences at the UCLA Fielding School of Public Health in Los Angeles. Jeremiah Garza is a Doctor of Public Health Candidate in the Department of Health Policy and Management at the UCLA Fielding School of Public Health. Brent Langellier is an Assistant Professor in the Division of Health Promotion Sciences at the University of Arizona Mel & Enid Zuckerman College of Public Health in Tucson, Arizona. Alice Kuo is a Co-Investigator at the UCLA CPHHD, an Associate Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health, and an Associate Professor in the Department of Pediatrics at the UCLA David Geffen School of Medicine in Los Angeles. Deborah Glik is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Michael Prelip is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Alexander Ortega is Director of the UCLA CPHHD and a Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health
| | - Michael L Prelip
- Mienah Sharif is a Research Assistant at the UCLA Center for Population Health and Health Disparities (CPHHD) in Los Angeles, California, and a Doctor of Philosophy Student in the Department of Community Health Sciences at the UCLA Fielding School of Public Health in Los Angeles. Jeremiah Garza is a Doctor of Public Health Candidate in the Department of Health Policy and Management at the UCLA Fielding School of Public Health. Brent Langellier is an Assistant Professor in the Division of Health Promotion Sciences at the University of Arizona Mel & Enid Zuckerman College of Public Health in Tucson, Arizona. Alice Kuo is a Co-Investigator at the UCLA CPHHD, an Associate Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health, and an Associate Professor in the Department of Pediatrics at the UCLA David Geffen School of Medicine in Los Angeles. Deborah Glik is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Michael Prelip is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Alexander Ortega is Director of the UCLA CPHHD and a Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health
| | - Alexander N Ortega
- Mienah Sharif is a Research Assistant at the UCLA Center for Population Health and Health Disparities (CPHHD) in Los Angeles, California, and a Doctor of Philosophy Student in the Department of Community Health Sciences at the UCLA Fielding School of Public Health in Los Angeles. Jeremiah Garza is a Doctor of Public Health Candidate in the Department of Health Policy and Management at the UCLA Fielding School of Public Health. Brent Langellier is an Assistant Professor in the Division of Health Promotion Sciences at the University of Arizona Mel & Enid Zuckerman College of Public Health in Tucson, Arizona. Alice Kuo is a Co-Investigator at the UCLA CPHHD, an Associate Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health, and an Associate Professor in the Department of Pediatrics at the UCLA David Geffen School of Medicine in Los Angeles. Deborah Glik is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Michael Prelip is a Project Co-Leader at the UCLA CPHHD and a Professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Alexander Ortega is Director of the UCLA CPHHD and a Professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health
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McGuirt JT, Pitts SBJ, Ammerman A, Prelip M, Hillstrom K, Garcia RE, McCarthy WJ. A Mixed Methods Comparison of Urban and Rural Retail Corner Stores. AIMS Public Health 2015; 2:554-582. [PMID: 29546125 PMCID: PMC5690250 DOI: 10.3934/publichealth.2015.3.554] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Indexed: 11/18/2022] Open
Abstract
Efforts to transform corner stores to better meet community dietary needs have mostly occurred in urban areas but are also needed in rural areas. Given important contextual differences between urban and rural areas, it is important to increase our understanding of the elements that might translate successfully to similar interventions involving stores in more rural areas. Thus, an in-depth examination and comparison of corner stores in each setting is needed. A mixed methods approach, including windshield tours, spatial visualization with analysis of frequency distribution, and spatial regression techniques were used to compare a rural North Carolina and large urban (Los Angeles) food environment. Important similarities and differences were seen between the two settings in regards to food environment context, spatial distribution of stores, food products available, and the factors predicting corner store density. Urban stores were more likely to have fresh fruits (Pearson chi2 = 27.0423; p < 0.001) and vegetables (Pearson chi2 = 27.0423; p < 0.001). In the urban setting, corner stores in high income areas were more likely to have fresh fruit (Pearson chi2 = 6.00; p = 0.014), while in the rural setting, there was no difference between high and low income area in terms of fresh fruit availability. For the urban area, total population, no vehicle and Hispanic population were significantly positively associated (p < 0.05), and median household income (p < 0.001) and Percent Minority (p < 0.05) were significantly negatively associated with corner store count. For the rural area, total population (p < 0.05) and supermarket count were positively associated (p < 0.001), and median household income negatively associated (P < 0.001), with corner store count. Translational efforts should be informed by these findings, which might influence the success of future interventions and policies in both rural and urban contexts.
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Affiliation(s)
- Jared T McGuirt
- Department of Nutrition, Gillings School of Global Public Health, UNC Center for Health Promotion and Disease Prevention, University of North Carolina-Chapel Hill, 2200 McGavran-Greenberg Hall, Chapel Hill NC
| | | | - Alice Ammerman
- Department of Nutrition, Gillings School of Global Public Health, UNC Center for Health Promotion and Disease Prevention, University of North Carolina-Chapel Hill, 2200 McGavran-Greenberg Hall, Chapel Hill NC
| | - Michael Prelip
- UCLA Fielding School of Public Health, University of California, Los Angeles, CA
| | - Kathryn Hillstrom
- Department of Kinesiology & Nutritional Science, California State University, Los Angeles, CA
| | - Rosa Elena Garcia
- UCLA Fielding School of Public Health, University of California, Los Angeles, CA
| | - William J McCarthy
- UCLA Fielding School of Public Health, University of California, Los Angeles, CA
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Alcalá HE, Albert SL, Roby DH, Beckerman J, Champagne P, Brookmeyer R, Prelip ML, Glik DC, Inkelas M, Garcia RE, Ortega AN. Access to Care and Cardiovascular Disease Prevention: A Cross-Sectional Study in 2 Latino Communities. Medicine (Baltimore) 2015; 94:e1441. [PMID: 26313803 PMCID: PMC4602927 DOI: 10.1097/md.0000000000001441] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading killer of Americans. CVD is understudied among Latinos, who have high levels of CVD risk factors. This study aimed to determine whether access to health care (ie, insurance status and having a usual source of care) is associated with 4 CVD prevention factors (ie, health care utilization, CVD screening, information received from health care providers, and lifestyle factors) among Latino adults and to evaluate whether the associations depended on CVD clinical risk/disease.Data were collected as part of a community-engaged food environment intervention study in East Los Angeles and Boyle Heights, CA. Logistic regressions were fitted with insurance status and usual source of care as predictors of the 4 CVD prevention factors while controlling for demographics. Analyses were repeated with interactions between self-reported CVD clinical risk/disease and access to care measures.Access to health care significantly increased the odds of CVD prevention. Having a usual source of care was associated with all factors of prevention, whereas being insured was only associated with some factors of prevention. CVD clinical risk/disease did not moderate any associations.Although efforts to reduce CVD risk among Latinos through the Affordable Care Act could be impactful, they might have limited impact in curbing CVD among Latinos, via the law's expansion of insurance coverage. CVD prevention efforts must expand beyond the provision of insurance to effectively lower CVD rates.
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Affiliation(s)
- Héctor E Alcalá
- From the UCLA Fielding School of Public Health, Los Angeles, CA
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Cooper LA, Ortega AN, Ammerman AS, Buchwald D, Paskett ED, Powell LH, Thompson B, Tucker KL, Warnecke RB, McCarthy WJ, Viswanath KV, Henderson JA, Calhoun EA, Williams DR. Calling for a bold new vision of health disparities intervention research. Am J Public Health 2015; 105 Suppl 3:S374-6. [PMID: 25905830 DOI: 10.2105/ajph.2014.302386] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Lisa A Cooper
- All of the authors are affiliated with the National Cancer Institute and the National Heart, Lung, and Blood Institute Centers for Population Health and Health Disparities. Lisa Cooper is with Johns Hopkins University, Baltimore, MD. Alexander N. Ortega and William J. McCarthy are with the University of California, Los Angeles. Alice S. Ammerman is with the University of North Carolina, Chapel Hill. Dedra Buchwald is with the University of Washington, Seattle. Electra D. Paskett is with The Ohio State University, Columbus. Lynda H. Powell is with Rush University, Chicago, IL. Katherine L. Tucker is with the University of Massachusetts, Lowell. Beti Thompson is with the Fred Hutchinson Cancer Research Center, Seattle, WA. Richard B. Warnecke is with University of Illinois, Chicago. K. Vish Viswanath and David R. Williams are with Harvard University, Cambridge, MA. Jeffrey A. Henderson is with Black Hills Center for American Indian Health, Rapid City, SD. Elizabeth A. Calhoun is with the University of Arizona, Tucson
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