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Grummon AH, Lazard AJ, Taillie LS, Hall MG. Should messages discourage sugary drinks, encourage water, or both? A randomized experiment with U.S. parents. Prev Med 2023; 167:107417. [PMID: 36592673 PMCID: PMC9898202 DOI: 10.1016/j.ypmed.2022.107417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/12/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
Campaigns to improve beverage consumption typically focus on discouraging unhealthy beverages (e.g., soda), encouraging healthy beverages (e.g., water), or both. It remains unclear which of these strategies is most effective. We recruited a national convenience sample of U.S. parents of children ages 2-12 (n = 1078, 48% Latino[a]) to complete an online survey in 2019. We randomly assigned participants to view: 1) a control message, 2) a soda discouragement message, 3) a water encouragement message, or 4) both soda discouragement and water encouragement messages shown side-by-side in random arrangement. Intervention messages mimicked New York City's "Pouring on the Pounds" campaign. Participants rated messages on perceived effectiveness for discouraging soda consumption and encouraging water consumption (1-5 response scales) and reported feelings and intentions about drinking soda and water (1-7 scales). Compared to those with no exposure, participants who viewed the soda discouragement message reported higher perceived discouragement from drinking soda (Average Differential Effect [ADE] = 1.18), more negative feelings toward drinking soda (ADE = 0.83) and stronger intentions to avoid drinking soda (ADE = 0.45) (ps < 0.001). The soda discouragement message also exerted beneficial effects on perceived effectiveness, feelings, and intentions related to water consumption (ADEs = 0.33-0.68; ps < 0.001). Exposure to the water encouragement message had beneficial effects on outcomes related to water consumption (ADEs = 0.28-0.81, ps < 0.001), but limited impact on outcomes related to soda consumption. Across outcomes, results indicated diminishing returns from exposure to both message types. Messaging campaigns discouraging unhealthy beverages may be more promising for improving beverage consumption than messages only promoting healthier beverages.
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Affiliation(s)
- Anna H Grummon
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, United States of America; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States of America; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States of America.
| | - Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Marissa G Hall
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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Zhu L, Kim EJ, González E, Fraser MA, Zhu S, Rubio-Torio N, Ma GX, Yeh MC, Tan Y. Reducing Liver Cancer Risk through Dietary Change: Positive Results from a Community-Based Educational Initiative in Three Racial/Ethnic Groups. Nutrients 2022; 14:4878. [PMID: 36432564 PMCID: PMC9698707 DOI: 10.3390/nu14224878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/28/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
Dietary behaviors and alcohol consumption have been linked to liver disease and liver cancer. So far, most of the liver cancer awareness campaigns and behavioral interventions have focused on preventive behaviors such as screening and vaccination uptake, while few incorporated dietary aspects of liver cancer prevention. We implemented a community-based education initiative for liver cancer prevention among the African, Asian, and Hispanic populations within the Greater Philadelphia and metropolitan New York City areas. Data from the baseline and the 6-month follow-up surveys were used for the assessment of changes in dietary behaviors and alcohol consumption among participants. In total, we recruited 578 participants through community-/faith-based organizations to participate in the educational workshops. The study sample included 344 participants who completed both baseline and follow-up survey. The Hispanic subgroup was the only one that saw an overall significant change in dietary behaviors, with the Mediterranean dietary score increasing significantly from 30.000 at baseline survey to 31.187 at 6-month follow-up assessment (p < 0.05), indicating a trend towards healthier dietary habit. In the African Americans participants, the consumption scores of fruits and poultry increased significantly, while vegetables and red meats decreased. In Asian Americans, the consumption of non-refined cereals, red meats, and dairy products decreased. Alcohol consumption decreased significantly among Hispanics while it did not change significantly among the other two communities. This community-based educational initiative generated different impacts in the three populations, further highlighting the needs for more targeted, culturally tailored efforts in health promotion among these underprivileged communities.
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Affiliation(s)
- Lin Zhu
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
- Department of Urban Health and Population Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Ellen Jaeseon Kim
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Evelyn González
- Office of Community Outreach, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA 19111, USA
| | | | - Steven Zhu
- Pennsylvania United Chinese Coalition, Philadelphia, PA 19107, USA
| | | | - Grace X. Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
- Department of Urban Health and Population Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Ming-Chin Yeh
- Nutrition Program, Hunter College, City University of New York, New York, NY 10017, USA
| | - Yin Tan
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
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Yeh PG, Reininger BM, Mitchell-Bennett LA, Lee M, Xu T, Davé AC, Park SK, Ochoa-Del Toro AG. Evaluating the Dissemination and Implementation of a Community Health Worker-Based Community Wide Campaign to Improve Fruit and Vegetable Intake and Physical Activity among Latinos along the U.S.-Mexico Border. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4514. [PMID: 35457382 PMCID: PMC9025101 DOI: 10.3390/ijerph19084514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 11/17/2022]
Abstract
This study evaluated the dissemination and implementation of a culturally tailored community-wide campaign (CWC), Tu Salud ¡Si Cuenta! (TSSC), to augment fruit and vegetable (FV) consumption and physical activity (PA) engagement among low-income Latinos of Mexican descent living along the U.S.-Mexico Border in Texas. TSSC used longitudinal community health worker (CHW) home visits as a core vehicle to enact positive change across all socioecological levels to induce behavioral change. TSSC's reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) was examined. A dietary questionnaire and the Godin-Shepherd Exercise Questionnaire measured program effectiveness on mean daily FV consumption and weekly PA engagement, respectively. Participants were classified based on CHW home visits into "low exposure" (2-3 visits) and "high exposure" (4-5 visits) groups. The TSSC program reached low-income Latinos (n = 5686) across twelve locations. TSSC demonstrated effectiveness as, compared to the low exposure group, the high exposure group had a greater FV intake (mean difference = +0.65 FV servings daily, 95% CI: 0.53-0.77) and an increased PA (mean difference = +185.6 MET-minutes weekly, 95% CI: 105.9-265.4) from baseline to the last follow-up on a multivariable linear regression analysis. Multivariable logistic regression revealed that the high exposure group had higher odds of meeting both FV guidelines (adjusted odds ratio (AOR) = 2.03, 95% CI: 1.65-2.47) and PA guidelines (AOR = 1.36, 95% CI: 1.10-1.68) at the last follow-up. The program had a 92.3% adoption rate, with 58.3% of adopting communities meeting implementation fidelity, and 91.7% of communities maintaining TSSC. TSSC improved FV consumption and PA engagement behaviors among low-income Latinos region wide. CHW delivery and implementation funding positively influenced reach, effectiveness, adoption, and maintenance, while lack of qualified CHWs negatively impacted fidelity.
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Affiliation(s)
- Paul Gerardo Yeh
- Division of Health Promotion & Behavioral Sciences, Brownsville Regional Campus, School of Public Health, University of Texas Health Science Center, 80 Fort Brown, Brownsville, TX 78520, USA; (B.M.R.); (L.A.M.-B.)
- Department of Physician Assistant, College of Health Professions, University of Texas Rio Grande Valley, 1201 West University Blvd., Edinburg, TX 78539, USA
- Postdoctoral Fellow, National Cancer Institute Cancer Control Research Training Program, School of Public Health, University of Texas Health Science Center, 1200 Pressler Street, Houston, TX 77030, USA
| | - Belinda M. Reininger
- Division of Health Promotion & Behavioral Sciences, Brownsville Regional Campus, School of Public Health, University of Texas Health Science Center, 80 Fort Brown, Brownsville, TX 78520, USA; (B.M.R.); (L.A.M.-B.)
| | - Lisa A. Mitchell-Bennett
- Division of Health Promotion & Behavioral Sciences, Brownsville Regional Campus, School of Public Health, University of Texas Health Science Center, 80 Fort Brown, Brownsville, TX 78520, USA; (B.M.R.); (L.A.M.-B.)
- Hispanic Health Research Center, School of Public Health, University of Texas Health Science Center, 1 West University Blvd., Brownsville, TX 78520, USA; (A.C.D.); (A.G.O.-D.T.)
| | - Minjae Lee
- Division of Biostatistics, Department of Population & Data Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, USA;
| | - Tianlin Xu
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center, 1200 Pressler Street, Houston, TX 77030, USA; (T.X.); (S.K.P.)
| | - Amanda C. Davé
- Hispanic Health Research Center, School of Public Health, University of Texas Health Science Center, 1 West University Blvd., Brownsville, TX 78520, USA; (A.C.D.); (A.G.O.-D.T.)
| | - Soo Kyung Park
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center, 1200 Pressler Street, Houston, TX 77030, USA; (T.X.); (S.K.P.)
| | - Alma G. Ochoa-Del Toro
- Hispanic Health Research Center, School of Public Health, University of Texas Health Science Center, 1 West University Blvd., Brownsville, TX 78520, USA; (A.C.D.); (A.G.O.-D.T.)
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Jenneson VL, Pontin F, Greenwood DC, Clarke GP, Morris MA. A systematic review of supermarket automated electronic sales data for population dietary surveillance. Nutr Rev 2021; 80:1711-1722. [PMID: 34757399 PMCID: PMC9086796 DOI: 10.1093/nutrit/nuab089] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Context Most dietary assessment methods are limited by self-report biases, how long they take for participants to complete, and cost of time for dietitians to extract content. Electronically recorded, supermarket-obtained transactions are an objective measure of food purchases, with reduced bias and improved timeliness and scale. Objective The use, breadth, context, and utility of electronic purchase records for dietary research is assessed and discussed in this systematic review. Data sources Four electronic databases (MEDLINE, EMBASE, PsycINFO, Global Health) were searched. Included studies used electronically recorded supermarket transactions to investigate the diet of healthy, free-living adults. Data extraction Searches identified 3422 articles, of which 145 full texts were retrieved and 72 met inclusion criteria. Study quality was assessed using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Data analysis Purchase records were used in observational studies, policy evaluations, and experimental designs. Nutrition outcomes included dietary patterns, nutrients, and food category sales. Transactions were linked to nutrient data from retailers, commercial data sources, and national food composition databases. Conclusion Electronic sales data have the potential to transform dietary assessment and worldwide understanding of dietary behavior. Validation studies are warranted to understand limits to agreement and extrapolation to individual-level diets. Systematic Review Registration PROSPERO registration no. CRD42018103470
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Affiliation(s)
- Victoria L Jenneson
- V.L. Jenneson, F. Pontin, D.C. Greenwood, and M.A. Morris are with the Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom. V.L. Jenneson, F. Pontin, and G.P. Clarke are with the School of Geography, Faculty of Environment, University of Leeds, Leeds, United Kingdom. D.C. Greenwood and M.A. Morris are with the School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Francesca Pontin
- V.L. Jenneson, F. Pontin, D.C. Greenwood, and M.A. Morris are with the Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom. V.L. Jenneson, F. Pontin, and G.P. Clarke are with the School of Geography, Faculty of Environment, University of Leeds, Leeds, United Kingdom. D.C. Greenwood and M.A. Morris are with the School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Darren C Greenwood
- V.L. Jenneson, F. Pontin, D.C. Greenwood, and M.A. Morris are with the Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom. V.L. Jenneson, F. Pontin, and G.P. Clarke are with the School of Geography, Faculty of Environment, University of Leeds, Leeds, United Kingdom. D.C. Greenwood and M.A. Morris are with the School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Graham P Clarke
- V.L. Jenneson, F. Pontin, D.C. Greenwood, and M.A. Morris are with the Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom. V.L. Jenneson, F. Pontin, and G.P. Clarke are with the School of Geography, Faculty of Environment, University of Leeds, Leeds, United Kingdom. D.C. Greenwood and M.A. Morris are with the School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Michelle A Morris
- V.L. Jenneson, F. Pontin, D.C. Greenwood, and M.A. Morris are with the Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom. V.L. Jenneson, F. Pontin, and G.P. Clarke are with the School of Geography, Faculty of Environment, University of Leeds, Leeds, United Kingdom. D.C. Greenwood and M.A. Morris are with the School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
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Glanz K, Chung A, Morales KH, Kwong PL, Wiebe D, Giordano DP, Brensinger CM, Karpyn A. The healthy food marketing strategies study: design, baseline characteristics, and supermarket compliance. Transl Behav Med 2020; 10:1266-1276. [PMID: 33421079 DOI: 10.1093/tbm/ibaa078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Identifying effective strategies to promote healthy eating and reduce obesity is a priority in the USA, especially among low-income and minority groups, who often have less access to healthy food and higher rates of obesity. Efforts to improve food access have led to more supermarkets in low-income, ethnically diverse neighborhoods. However, this alone may not be enough to reduce food insecurity and improve residents' diet quality and health. This paper summarizes the design, methods, baseline findings, and supermarket in-store marketing strategy compliance for a randomized trial of the impact of healthy food marketing on the purchase of healthier "target" food items. Thirty-three supermarkets in low-income, high-minority neighborhoods in the metropolitan Philadelphia area were matched on store size and percentage of sales from government food assistance programs and randomly assigned to the intervention or control group. Healthy marketing strategies, including increased availability of healthier "target" products, prime shelf-placement and call-out promotion signs, and reduced availability of regular "comparison" products, were implemented in 16 intervention stores for an 18 month period for over 100 individual food items. Six product categories were studied: bread, checkout cooler beverages, cheese, frozen dinners, milk, and salty snacks. The primary outcome measure was weekly sales per store in each product category for 1 year preintervention and 18 months during the intervention. Compliance with the marketing strategies was assessed twice per month for the first 6 months and once a month thereafter. Store and neighborhood characteristics were not significantly different between control and intervention stores. Intercept surveys with customers to assess shopping habits and grocery marketing environment assessments to examine the food promotion environment were completed in the same six food categories. In intercept surveys, 51.0% of shoppers self-identified as overweight and 60.6% wanted to change their weight. Shoppers who typically purchased one type of food over another commonly did so out of habit or because the item was on sale. Findings revealed that preintervention sales of healthier "target" or regular "comparison" items did not differ between intervention and control stores for 1 year prior to intervention implementation. Rates of compliance with the healthy marketing strategies were high, averaging 76.5% over the first 12 months in all 16 stores. If healthy in-store marketing interventions are effective in this scaled-up, longer-term study, they should be translated into wider use in community supermarkets.
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Affiliation(s)
- Karen Glanz
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Annie Chung
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Knashawn H Morales
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Pui L Kwong
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Douglas Wiebe
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Donna Paulhamus Giordano
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Center for Research in Education and Social Policy, University of Delaware, Newark, DE, USA
| | | | - Allison Karpyn
- Center for Research in Education and Social Policy, University of Delaware, Newark, DE, USA
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Keane L, Kite J, Grunseit A, Vineburg J, Tawil V, Thomas M. "Perceived fit," "understanding," and "communication": Key factors underpinning stakeholder and partnership engagement with the Make Healthy Normal campaign. Health Promot J Austr 2019; 32:117-125. [PMID: 31660658 DOI: 10.1002/hpja.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/23/2019] [Accepted: 10/24/2019] [Indexed: 11/11/2022] Open
Abstract
ISSUE ADDRESSED Published evaluations of population-level social marketing campaigns predominantly focus on impact and outcome evaluation. Evaluation of complementary locally implemented activities and programs, despite being common and important components of social marketing campaigns are rarely published. This study sought to examine the drivers of engagement of local implementers in the Make Healthy Normal campaign, implemented in New South Wales (NSW), Australia from 2015 to 2018, and to describe their engagement with the campaign as well as the scope and extent of complementary activities. METHODS We conducted 13 in-depth semi-structured qualitative interviews with health and nonhealth stakeholders from a range of urban, regional and rural settings across NSW. We analysed the interviews thematically, using an inductive and iterative approach. RESULTS We found stakeholder engagement (ie decision to buy into and commit resources) to the campaign was underpinned by two main drivers: "understanding", or how well they understood the campaign and their role in it, and "perceived fit", or how appropriate it was to their context. A third factor, "communication" functioned to enhance both understanding and perceived fit. CONCLUSION Our results suggest that stakeholders would engage with the campaign more where they had a sound understanding of the campaign objectives and content, and an appreciation of how the campaign fits their strategic and procedural context. SO WHAT?: Campaign managers should incorporate clear, regular and efficient communication with local implementers and work with these groups early in the campaign development process. Organisers should also support and promote a "community of practice" approach to capitalise on the innovations of those promoting campaign messages at the community level.
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Affiliation(s)
- Lewis Keane
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - James Kite
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Anne Grunseit
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.,The Australian Prevention Partnership Centre, based at Level 6, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - John Vineburg
- Centre for Population Health, NSW Ministry of Health, North Sydney, NSW, Australia
| | - Victor Tawil
- Centre for Population Health, NSW Ministry of Health, North Sydney, NSW, Australia
| | - Margaret Thomas
- Prevention Research Collaboration, Sydney School of Public Health and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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Heredia NI, Lee M, Mitchell-Bennett L, Reininger BM. Tu Salud ¡Sí Cuenta! Your Health Matters! A Community-wide Campaign in a Hispanic Border Community in Texas. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:801-809.e1. [PMID: 28818489 PMCID: PMC5682211 DOI: 10.1016/j.jneb.2017.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 06/15/2017] [Accepted: 06/16/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To evaluate a community-wide campaign, Tu Salud ¡Si Cuenta! (TSSC), in improving eating behaviors and anthropometric outcomes in Hispanic border communities. DESIGN A quasi-experimental study with matched intervention and comparison communities. Cross-sectional assessments with randomly sampled adults, examined by actual exposure and site (unexposed intervention, exposed intervention, and unexposed comparison). SETTING AND PARTICIPANTS Predominately Mexican Americans located in Brownsville, TX (intervention) and Laredo, TX (control). INTERVENTION The TSSC campaign included television and radio segments, community health worker discussions, and newsletters delivered in Brownsville from 2005 to 2010. MAIN OUTCOME MEASURES Healthy and unhealthy eating indices and average hip and waist circumferences. ANALYSIS Univariable and multivariable regression models. RESULTS The sample (n = 799; 400 comparison and 399 intervention) was 98% of Mexican origin; 54% had completed grade 9 or higher. Exposure to any TSSC component was associated with a lower rate of unhealthy food consumption. Compared with the unexposed intervention group, the exposed intervention for the newsletter had a higher rate of healthy eating (adjusted rate ratio = 1.18; P < .01). Compared with the unexposed intervention, the exposed intervention for the community health worker discussion had a smaller hip circumference (adjusted mean difference = -5.77 cm; P < .05) and a smaller waist circumference (adjusted mean difference = -5.25 cm; P < .05). CONCLUSIONS AND IMPLICATIONS This study provides evidence for the use of community-wide campaigns for nutrition and obesity-related outcomes in Hispanic communities.
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Affiliation(s)
- Natalia I Heredia
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Houston, TX.
| | - MinJae Lee
- Division of Clinical and Translational Sciences, Department of Internal Medicine, McGovern Medical School at UTHealth, Houston, TX
| | | | - Belinda M Reininger
- Bownsville Regional Campus, UTHealth School of Public Health, Brownsville, TX
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Research to Understand Milk Consumption Behaviors in a Food-Insecure Low-Income SNAP Population in the US. BEVERAGES 2017. [DOI: 10.3390/beverages3030046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Milk, due to its affordability and nutritional value, can fortify the diets of families that experience food insecurity or find a high-quality diet cost-prohibitive. However, it can also be a leading source of excess calories and saturated fat. Yet, little is known about what influences consumer behavior of Supplemental Nutrition Assistance Program (SNAP) recipients toward the type of milk used or the prevalence of low-fat milk use among this population. This cross-sectional telephone survey of SNAP recipients (n = 520) documented that 7.5% of this population usually consumes low-fat milk, a prevalence that lags behind national figures (34.4%) for the same time-period. There was a weak association between sociodemographic characteristics of SNAP recipients and low-fat milk use. Instead, less low-fat milk consumption was associated with a knowledge gap and misperceptions of the nutritional properties of the different types of milk. Promoting low-fat milk use by correcting these misperceptions can improve the diet of America’s low-income population and reduce food insecurity by maximizing the nutritional value of the foods consumed.
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Finnell KJ, John R. A Social Marketing Approach to 1% Milk Use: Resonance Is the Key. Health Promot Pract 2017; 19:437-444. [PMID: 28399676 DOI: 10.1177/1524839917699594] [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: 11/17/2022]
Abstract
The U.S. Dietary Guidelines recommend low-fat milk consumption, and Supplemental Nutrition Assistance Program Education (SNAP-Ed) programs follow these guidelines to develop health education programs for SNAP recipients. This study evaluated a multilevel media intervention promoting low-fat milk use among Oklahoma SNAP recipients, a population often missed. Behavior change was measured with pre- and postintervention telephone interviews with SNAP recipients ( n = 860). Immediately following the intervention, self-reported purchases of 1% milk, the focus of behavior change, significantly increased to 7.9% from 4.1%-a relative improvement of 92.7%, χ2(1, n = 824) = 5.8, p = .02. Milk nutrition knowledge scores significantly improved as well, t(846) = 2.9, p = .004, and low-fat milk users exhibited more milk nutrition knowledge than high-fat milk users, t(437) = 4.0, p = .000. The intervention, which resonated with the priority audience, was well received ( Mdn = 6, 1, 7). Factors contributing to its success included a gain-based message strategy and clearly articulating the desired behavior. Salient messages personalized the issues and concerns raised by the priority audience-all the vitamins and minerals without the fat. Findings suggest that matching gender and ethnicity mediated the effect among those most resistant to substituting low-fat for high-fat milk.
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Affiliation(s)
| | - Robert John
- 1 University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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10
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Finnell KJ, John R, Thompson DM. 1% low-fat milk has perks!: An evaluation of a social marketing intervention. Prev Med Rep 2016; 5:144-149. [PMID: 28018841 PMCID: PMC5175990 DOI: 10.1016/j.pmedr.2016.11.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 11/22/2016] [Accepted: 11/24/2016] [Indexed: 11/28/2022] Open
Abstract
This study evaluated the effect of a 12-week social marketing intervention conducted in 2012 promoting 1% milk use relying on paid advertising. Weekly milk sales data by type of milk (whole, 2%, 1%, and nonfat milk) were collected from 80 supermarkets in the Oklahoma City media market, the intervention market, and 66 supermarkets in the Tulsa media market (TMM), the comparison market. The effect was measured with a paired t-test. A mixed segmented regression model, controlling for the contextual difference between supermarkets and data correlation, identified trends before, during, and after the intervention. Results show the monthly market share of 1% milk sales changed from 10.0% to 11.5%, a 15% increase. Evaluating the volume sold, the monthly mean number of gallons of 1% milk sold increased from 890.5 gal (SD = 769.8) per supermarket from before the intervention to 1070.7 gal (SD = 922.5) following the intervention (t(79) = 9.4, p = 0.000). Moreover, average weekly sales of 1% milk were stable prior to the intervention (b = − 0.2 gal/week, 95% CI [− 0.6 gal/week, 0.3 gal/week]). During each additional week of the intervention, 1% milk sales increased by an average of 4.1 gal in all supermarkets (95% CI [3.5 gal/week, 4.6 gal/week]). Three months later, albeit attenuated, a significant increase in 1% milk sales remained. In the comparison market, no change in the market share of 1% milk occurred. Paid advertising, using the principles of social marketing, can be effective in changing an entrenched and habitual nutrition habit. Most Americans consume high-fat milk, a pattern the Dietary Guidelines for Americans seeks to change. An intervention, applying social marketing, led to a significant increase in 1% milk sales. Promotion was based on paid advertising alone, without community activities or public relations. This change occurred in a geographically dispersed area and among a large, diverse population. A segmented regression model is an effective means of evaluating changes in nutrition behavior.
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Affiliation(s)
- Karla Jaye Finnell
- University of Oklahoma Health Sciences Center, College of Public Health, 801 Northeast 13th Street, Room 445, Post Office Box 26901, Oklahoma City, OK 73126-0901, United States
| | - Robert John
- University of Oklahoma Health Sciences Center, College of Public Health, 801 Northeast 13th Street, Room 445, Post Office Box 26901, Oklahoma City, OK 73126-0901, United States
| | - David M Thompson
- University of Oklahoma Health Sciences Center, College of Public Health, 801 Northeast 13th Street, Room 321, Post Office Box 26901, Oklahoma City, OK 73126-0901, United States
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Liberato SC, Bailie R, Brimblecombe J. Nutrition interventions at point-of-sale to encourage healthier food purchasing: a systematic review. BMC Public Health 2014; 14:919. [PMID: 25192584 PMCID: PMC4180547 DOI: 10.1186/1471-2458-14-919] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 08/28/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Point-of-sale is a potentially important opportunity to promote healthy eating through nutrition education and environment modification. The aim of this review was to describe and review the evidence of effectiveness of various types of interventions that have been used at point-of-sale to encourage purchase and/or eating of healthier food and to improve health outcomes, and the extent to which effectiveness was related to intensity, duration and intervention setting. METHODS Records from searches in databases were screened and assessed against inclusion criteria. Included studies had risk of bias assessed. Intervention effectiveness was assessed for two outcomes: i) purchase and/or intake of healthier food options and/or nutrient intake; and ii) mediating factors that might effect the primary outcome. RESULTS The search identified 5635 references. Thirty-two papers met the inclusion criteria. Twelve studies had low risk of bias and were classified as strong, nine were moderate and 11 were weak. Six intervention types and a range of different outcome measures were described in these papers: i) nutrition education and promotion alone through supermarkets/stores; ii) nutrition education plus enhanced availability of healthy food; iii) monetary incentive alone; iv) nutrition education plus monetary incentives; v) nutrition intervention through vending machines; and vi) nutrition intervention through shopping online. The evidence of this review indicates that monetary incentives offered to customers for a short-term look promising in increasing purchase of healthier food options when the intervention is applied by itself in stores or supermarkets. There was a lack of good quality studies addressing all other types of relevant point-of-sale interventions examining change in purchase and/or intake of healthier food options. There were few studies that examined mediating factors that might mediate the effect on the primary outcomes of relevant interventions. CONCLUSIONS A range of intervention types have been used at point-of-sale to encourage healthy purchasing and/or intake of healthier food options and to improve health outcomes. There is a need for more well designed studies on the effectiveness of a range of point-of-sale interventions to encourage healthier eating and improve health outcomes, and of the mediating factors that might impact these interventions.
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Affiliation(s)
- Selma C Liberato
- Menzies School of Health Research, Charles Darwin University, John Mathews Building, Casuarina, NT, Australia.
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Foster GD, Karpyn A, Wojtanowski AC, Davis E, Weiss S, Brensinger C, Tierney A, Guo W, Brown J, Spross C, Leuchten D, Burns PJ, Glanz K. Placement and promotion strategies to increase sales of healthier products in supermarkets in low-income, ethnically diverse neighborhoods: a randomized controlled trial. Am J Clin Nutr 2014; 99:1359-68. [PMID: 24695894 DOI: 10.3945/ajcn.113.075572] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The greater presence of supermarkets in low-income, high-minority neighborhoods has the potential to positively affect diet quality among those at greatest risk of obesity. In-store marketing strategies that draw attention to healthier products may be effective, sustainable, and scalable for improving diet quality and health. Few controlled studies of in-store marketing strategies to promote sales of healthier items in low-income, high-minority neighborhoods have been conducted. OBJECTIVE The objective of this study was to evaluate the effects of in-store marketing strategies to promote the purchase of specific healthier items in 5 product categories: milk, ready-to-eat cereal, frozen meals, in-aisle beverages, and checkout cooler beverages. DESIGN The design was a cluster-randomized controlled trial conducted from 2011 to 2012. Eight urban supermarkets in low-income, high-minority neighborhoods were the unit of randomization, intervention, and analysis. Stores were matched on the percentage of sales from government food-assistance programs and store size and randomly assigned to an intervention or control group. The 4 intervention stores received a 6-mo, in-store marketing intervention that promoted the sales of healthier products through placement, signage, and product availability strategies. The 4 control stores received no intervention and were assessment-only controls. The main outcome measure was weekly sales of the targeted products, which was assessed on the basis of the stores' sales data. RESULTS Intervention stores showed significantly greater sales of skim and 1% milk, water (in aisle and at checkout), and 2 of 3 types of frozen meals compared with control store sales during the same time period. No differences were found between the stores in sales of cereal, whole or 2% milk, beverages, or diet beverages. CONCLUSIONS These data indicate that straightforward placement strategies can significantly enhance the sales of healthier items in several food and beverage categories. Such strategies show promise for significant public health effects in communities with the greatest risk of obesity.
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Affiliation(s)
- Gary D Foster
- From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL)
| | - Allison Karpyn
- From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL)
| | - Alexis C Wojtanowski
- From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL)
| | - Erica Davis
- From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL)
| | - Stephanie Weiss
- From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL)
| | - Colleen Brensinger
- From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL)
| | - Ann Tierney
- From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL)
| | - Wensheng Guo
- From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL)
| | - Jeffery Brown
- From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL)
| | - Carly Spross
- From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL)
| | - Donna Leuchten
- From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL)
| | - Patrick J Burns
- From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL)
| | - Karen Glanz
- From the Center for Obesity Research and Education, Temple University, Philadelphia, PA (GDF and ACW); The Food Trust, Philadelphia, PA (AK and SW); the University of Pennsylvania, Philadelphia, PA (ED, CB, AT, WG, and KG); Brown's Super Stores Inc, Westville, NJ (JB); The Fresh Grocer, Drexel Hill, PA (CS and PJB); and Uplift Solutions, Westville, NJ (DL)
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Escaron AL, Meinen AM, Nitzke SA, Martinez-Donate AP. Supermarket and grocery store-based interventions to promote healthful food choices and eating practices: a systematic review. Prev Chronic Dis 2013; 10:E50. [PMID: 23578398 PMCID: PMC3625444 DOI: 10.5888/pcd10.120156] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction Increasingly high rates of obesity have heightened interest among researchers and practitioners in identifying evidence-based interventions to increase access to healthful foods and beverages. Because most food purchasing decisions are made in food stores, such settings are optimal for interventions aimed at influencing these decisions. The objective of this review was to synthesize the evidence on supermarket and grocery store interventions to promote healthful food choices. Methods We searched PubMed through July 2012 to identify original research articles evaluating supermarket and grocery store interventions that promoted healthful food choices. We categorized each intervention by type of intervention strategy and extracted and summarized data on each intervention. We developed a scoring system for evaluating each intervention and assigned points for study design, effectiveness, reach, and availability of evidence. We averaged points for each intervention category and compared the strength of the evidence for each category. Results We identified 58 articles and characterized 33 interventions. We found 7 strategies used alone or in combination. The most frequently used strategy was the combination of point-of-purchase and promotion and advertising (15 interventions); evidence for this category was scored as sufficient. On average, of 3 points possible, the intervention categories scored 2.6 for study design, 1.1 for effectiveness, 0.3 for reach, and 2 for availability of evidence. Three categories showed sufficient evidence; 4 showed insufficient evidence; none showed strong evidence. Conclusion More rigorous testing of interventions aimed at improving food and beverage choices in food stores, including their effect on diet and health outcomes, is needed.
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Affiliation(s)
- Anne L Escaron
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726-2397, USA.
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15
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George DR, Kraschnewski JL, Rovniak LS. Public health potential of farmers' markets on medical center campuses: a case study from Penn State Milton S. Hershey Medical Center. Am J Public Health 2011; 101:2226-32. [PMID: 22021298 DOI: 10.2105/ajph.2011.300197] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
There are currently 7175 farmers' markets in the United States, and these organizations are increasingly viewed as one facet of the solution to national health problems. There has been a recent trend toward establishing markets on medical center campuses, and such partnerships can augment a medical center's ability to serve community health. However, to our knowledge no studies have described the emergence of a market at a medical center, the barriers and challenges such an initiative has faced, or the nature of programming it may foster. We provide a qualitative description of the process of starting a seasonal, once-a-week, producers-only market at the Pennsylvania State Hershey Medical Center, and we call for greater public health attention to these emerging community spaces.
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Affiliation(s)
- Daniel R George
- Department of Humanities, Pennsylvania State College of Medicine, Hershey, USA.
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Abstract
Mass media campaigns are widely used to expose high proportions of large populations to messages through routine uses of existing media, such as television, radio, and newspapers. Exposure to such messages is, therefore, generally passive. Such campaigns are frequently competing with factors, such as pervasive product marketing, powerful social norms, and behaviours driven by addiction or habit. In this Review we discuss the outcomes of mass media campaigns in the context of various health-risk behaviours (eg, use of tobacco, alcohol, and other drugs, heart disease risk factors, sex-related behaviours, road safety, cancer screening and prevention, child survival, and organ or blood donation). We conclude that mass media campaigns can produce positive changes or prevent negative changes in health-related behaviours across large populations. We assess what contributes to these outcomes, such as concurrent availability of required services and products, availability of community-based programmes, and policies that support behaviour change. Finally, we propose areas for improvement, such as investment in longer better-funded campaigns to achieve adequate population exposure to media messages.
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Affiliation(s)
- Melanie A Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Carlton, Australia.
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Watson JM, Tomar SL, Dodd V, Logan HL, Choi Y. Effectiveness of a social marketing media campaign to reduce oral cancer racial disparities. J Natl Med Assoc 2009; 101:774-82. [PMID: 19715040 DOI: 10.1016/s0027-9684(15)31005-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose of this study was to provide a systematic evaluation of a theory-driven oral cancer awareness media campaign. METHODS We surveyed a cohort of residents in an intervention city (250) and a control city (250) immediately prior to and after the media campaign. Participants (125 black/African American and 125 white) in each city completed surveys at baseline and follow-up. Oral cancer campaign awareness was assessed in both cities, along with 4 hypothetical health campaigns. Oral cancer awareness, oral cancer exam awareness, intent to receive an oral cancer exam, interest in exam, and receipt of exam were also assessed in both cities, both at baseline and follow-up. RESULTS Intervention city residents showed a significant increase in recognition of the campaign, awareness of the oral cancer exam, and interest in getting an exam, while no significant changes in those topics were found for the control city. Blacks/African Americans in the intervention city were significantly more likely than whites to demonstrate increases in awareness of the campaign, oral cancer awareness, and interest in receiving an oral cancer exam. CONCLUSIONS A theory-driven media campaign was successful in increasing awareness of the oral cancer exam and interest in the exam among blacks/African Americans.
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Affiliation(s)
- Jennifer M Watson
- University of Florida, Department of Community Dentistry and Behavioral Science, PO Box 103628, Gainesville, FL 32610-3628, USA.
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Mays VM, Ly L, Allen E, Young S. Engaging student health organizations in reducing health disparities in underserved communities through volunteerism: developing a student health corps. J Health Care Poor Underserved 2009; 20:914-28. [PMID: 19648716 DOI: 10.1353/hpu.0.0190] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
One underutilized method for reducing health disparities and training culturally competent health care workers is the engagement of undergraduate student health organizations in conducting health screenings, promotion, and health education outreach activities in in underserved racial/ethnic communities. We conducted a needs assessment of 14 predominantly racial/ethnic minority undergraduate student-run health organizations. The 14 organizations annually served approximately 12,425 people (67% Hispanic, 25% African American, 6.33% Asian Pacific Islander), predominantly at health fairs within Los Angeles County (averaging 138 attendees). Student organizations provided screenings on general health conditions and diseases, with less emphasis on behavioral risk factors (e.g., drinking, smoking). Organizations indicated a need for increased and affordable training in preventive health screenings and help in understanding target populations' needs. Universities are in an excellent position to train, supervise, and organize volunteer health corps in order to engage students in reducing health disparities and to train culturally competent health care providers.
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Affiliation(s)
- Vickie M Mays
- Department of psychology, University of California - Los Angeles, CA, USA.
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Booth-Butterfield S, Welbourne JL, Ott S, Hartley T, Thomas KC, Lawryk NJ. A communication matrix intervention to increase adoption of federal government safety recommendations. HEALTH COMMUNICATION 2008; 23:307-312. [PMID: 18701995 DOI: 10.1080/10410230802229696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A 3-year, multichannel intervention project assessed adoption of federal government workplace safety testing methods among 3 randomly drawn samples of industrial hygienists. A communication matrix (McGuire, 1985, 1989) framework focusing on stages of reception, processing, and response was used to create, implement, and evaluate the intervention. Participants were interviewed by phone during 3 waves: baseline, immediately following year 1 of the intervention, and immediately following year 2 of the intervention. Results indicate a gain in reception over the course of the intervention. Increases in attitudes, control beliefs, intentions, and self-reported behavior were found between baseline and the 1st year of the intervention, and were maintained (although not increased) during the 2nd year of the intervention. Strengths and weaknesses of the intervention are viewed through the scope of the communication matrix.
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Sturm AC, Sweet K, Schwirian PM, Koenig C, Westman J, Kelly KM. Lessons Learned while Developing a Cancer Family History Campaign in the Columbus, Ohio Metropolitan Area. ACTA ACUST UNITED AC 2008; 11:304-10. [DOI: 10.1159/000121402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Pinto M, Lunet N, Williams L, Barros H. Billboard Advertising of Food and Beverages is Frequent in Maputo, Mozambique. Food Nutr Bull 2007; 28:365-6. [DOI: 10.1177/156482650702800313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Marta Pinto
- Department of Hygiene and Epidemiology, Porto University Medical School, Porto, Portugal
| | - Nuno Lunet
- Department of Hygiene and Epidemiology, Porto University Medical School, Porto, Portugal
| | - Lucílio Williams
- Department of Hygiene and Epidemiology, Porto University Medical School, Porto, Portugal
| | - Henrique Barros
- Department of Hygiene and Epidemiology, Porto University Medical School, Porto, Portugal
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22
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A systematic review of population and community dietary interventions to prevent cancer. Nutr Res Rev 2007; 20:74-88. [DOI: 10.1017/s0954422407733073] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Diet is an important factor in the causation of cancer. Previous systematic reviews of one-to-one interventions to encourage dietary change have found that such interventions can achieve modest improvements in diet. However, such interventions are resource intensive and unlikely to be good value for money at a population level. Interventions that address groups, communities or whole populations may be less resource intensive and effect change in a wider population. We report a systematic review of such interventions. We set wide inclusion criteria, including before-and-after studies and studies with a non-randomized comparison group as well as randomized trials. We found eighteen studies based in the community, seventeen based on worksites, five based in churches and one based in a supermarket. Interventions which targeted fruit and vegetable intake were most likely to be successful, particularly in worksites and churches. There was also evidence of small positive effects on reducing fat intake in worksites and churches. Overall the community-based interventions showed little effect. The studies included in the present review were generally poorly reported. Dietary changes are reported in the relatively short-term studies reviewed here but may not be sustained in the long term. The effects that we have identified are small but the reach is potentially very wide, in some cases as wide as a whole country. The cost effectiveness of such strategies remains to be evaluated.
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Kannan S, Menotti E, Scherer HK, Dickinson J, Larson K. Folic acid and the prevention of neural tube defects: A survey of awareness among Latina women of childbearing age residing in southeast Michigan. Health Promot Pract 2006; 8:60-8. [PMID: 16840767 DOI: 10.1177/1524839905278934] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Periconceptional intake of folic acid is known to reduce the risk for neural tube defects (NTDs). To inform southeast Michigan Latina women of childbearing age about the benefits of food and supplemental sources of the micronutrient in the prevention of NTDs, Spanish-English bilingual health educators carried out 20 education events in supermarkets and community organizations serving Latina women. One hundred and sixty Latina women ages 19 to 50 years indicated their current folic acid awareness and stated their future intentions regarding folic acid. Of 160 women surveyed, 114 (71%) had heard of folic acid, 84 (74%) knew that folic acid prevents birth defects, 63 (55%) knew the critical time to take folic acid, and 76 (67%) identified at least one source of folic acid. After participating in the education events, 136 women (85%) reported planning to eat more folate and/or folic acid-rich foods. Although general folic acid awareness is fairly high, health promotion efforts must be coordinated at community locations serving Latina women to share folic acid's specific protective effects in the prevention of NTDs, the critical timing of intake, and its food and supplement sources.
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Affiliation(s)
- Srimathi Kannan
- Department of Environmental Health Sciences, Human Nutrition Program, University of Michigan School of Public Health, Ann Arbor, Michigan 48109-2029, USA.
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Noar SM. A 10-year retrospective of research in health mass media campaigns: where do we go from here? JOURNAL OF HEALTH COMMUNICATION 2006; 11:21-42. [PMID: 16546917 DOI: 10.1080/10810730500461059] [Citation(s) in RCA: 253] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Mass media campaigns have long been a tool for promoting public health. How effective are such campaigns in changing health-related attitudes and behaviors, however, and how has the literature in this area progressed over the past decade? The purpose of the current article is threefold. First, I discuss the importance of health mass media campaigns and raise the question of whether they are capable of effectively impacting public health. Second, I review the literature and discuss what we have learned about the effectiveness of campaigns over the past 10 years. Finally, I conclude with a discussion of possible avenues for the health campaign literature over the next 10 years. The overriding conclusion is the following: The literature is beginning to amass evidence that targeted, well-executed health mass media campaigns can have small-to-moderate effects not only on health knowledge, beliefs, and attitudes, but on behaviors as well, which can translate into major public health impact given the wide reach of mass media. Such impact can only be achieved, however, if principles of effective campaign design are carefully followed.
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Affiliation(s)
- Seth M Noar
- Department of Communication, University of Kentucky, Lexington, 40506, USA.
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Abstract
OBJECTIVES To provide an overview of public education efforts in tobacco, obesity, environmental health, and cancer screening. DATA SOURCES Cochrane, AHRQ, the CDC's Guide to Community Preventive Services, and other reviews. CONCLUSION Major changes in rates of smoking and cancer screening attest to the effectiveness of public education efforts. Diet and physical activity have more resistant behaviors. Communication technologies offer possibilities for connecting people with the education they need. IMPLICATIONS FOR NURSING PRACTICE Nurses can play important roles in public education by helping to overcome people's misperceptions and biases related to cancer. There also may be an important role for nurses as information brokers.
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Affiliation(s)
- Barbara K Rimer
- Department of Health Behavior and Health Education, School of Public Health, University of North Carolina at Chapel Hill, NC 27599, USA.
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Verheijden MW, Kok FJ. Public health impact of community-based nutrition and lifestyle interventions. Eur J Clin Nutr 2005; 59 Suppl 1:S66-75; discussion S76. [PMID: 16052198 DOI: 10.1038/sj.ejcn.1602176] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Community-based interventions have increasingly received attention since researchers and public health professionals have come to acknowledge the importance of an environment that makes the healthy choice the easy choice. All stakeholders including the target community are involved to achieve changes in legislation, in people's social and physical context, and in individual characteristics that support healthy diets and other lifestyles. Some early large-scale community-based heart health interventions showed promising results. The Stanford Five City Project, for example, showed net improvements in knowledge of coronary heart disease risk factors of approximately 12%. Net declines in smoking prevalence (14%), cholesterol (2%), and systolic (3%) and diastolic (5%) blood pressure were also observed. Most later studies did not replicate these findings and it was therefore suggested that community-based interventions, which require substantial commitment and resources, may be less effective than approaches targeting high-risk groups. We present the rationale and theories for community-based interventions, and then elaborate on the methodological challenges in the design and the outcome and process evaluation of community-based interventions. We provide an overview of some of the evidence on the effectiveness of community-based heart health interventions and conclude with the perspectives for community-based interventions in future research and practice.
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Affiliation(s)
- M W Verheijden
- TNO Quality of Life/Work and Employment, Hoofddorp, The Netherlands.
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Reger-Nash B, Bauman A, Booth-Butterfield S, Cooper L, Smith H, Chey T, Simon KJ. Wheeling walks: evaluation of a media-based community intervention. FAMILY & COMMUNITY HEALTH 2005; 28:64-78. [PMID: 15625507 DOI: 10.1097/00003727-200501000-00009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Mass media community-wide physical activity intervention to promote and sustain changes in walking was assessed using a 2-community longitudinal design. The intervention targeted sedentary 50- to 65-year-old residents of Wheeling, West Virginia. Telephone surveys of a probability sample followed cohorts at baseline and at 3-, 6-, and 12-month post-intervention with comparison communities. The intervention, consisting of paid advertisements, public relations, and community participatory planning, attained high levels of awareness and effected significant sustained population-wide changes among the most sedentary in Wheeling.
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Affiliation(s)
- Bill Reger-Nash
- Department of Community Medicine, West Virginia University, Morgantown, 26506-9190, USA.
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Booth-Butterfield S, Reger B. The message changes belief and the rest is theory: the "1% or less" milk campaign and reasoned action. Prev Med 2004; 39:581-8. [PMID: 15313098 DOI: 10.1016/j.ypmed.2004.02.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Theory-based approaches to public health interventions are useful for designing, implementing, and evaluating research. This paper describes and presents data to support the theoretical force behind the "1% or less" nutrition intervention studies. METHODS Using the Theory of Reasoned Action (TRA), high-fat (whole and 2%) milk users were targeted. Supermarket milk sale data were collected, and randomly selected intervention and comparison community residents were surveyed via telephone to assess milk use. TRA constructs were used in the surveys that were conducted immediately before and after a 6-week mass media campaign. Campaign messages were aimed at changing behavioral rather than normative beliefs. RESULTS We found significant and predicted changes in intervention participants on intention, attitude, and behavioral beliefs, but not subjective norm outcomes. A path model showed support that TRA variables mediated significant changes in self-reported milk use. CONCLUSIONS The analysis further validates the TRAs and supports a template using both the Principle of Compatibility and TRA to aid development and implementation of messages for effective behavior change field interventions.
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Horowitz CR, Colson KA, Hebert PL, Lancaster K. Barriers to buying healthy foods for people with diabetes: evidence of environmental disparities. Am J Public Health 2004; 94:1549-54. [PMID: 15333313 PMCID: PMC1448492 DOI: 10.2105/ajph.94.9.1549] [Citation(s) in RCA: 342] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES A community coalition compared the availability and cost of diabetes-healthy foods in a racial/ethnic minority neighborhood in East Harlem, with those in the adjacent, largely White and affluent Upper East Side in New York City. METHODS We documented which of 173 East Harlem and 152 Upper East Side grocery stores stocked 5 recommended foods. RESULTS Overall, 18% of East Harlem stores stocked recommended foods, compared with 58% of stores in the Upper East Side (P <.0001). Only 9% of East Harlem bodegas (neighborhood stores) carried all items (vs 48% of Upper East Side bodegas), though East Harlem had more bodegas. East Harlem residents were more likely than Upper East Side residents (50% vs 24%) to have stores on their block that did not stock recommended foods and less likely (26% vs 30%) to have stores on their block that stocked recommended foods. CONCLUSIONS A greater effort needs to be made to make available stores that carry diabetes-healthy foods.
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Affiliation(s)
- Carol R Horowitz
- Department of Health Policy, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Randolph W, Viswanath K. Lessons learned from public health mass media campaigns: marketing health in a crowded media world. Annu Rev Public Health 2004; 25:419-37. [PMID: 15015928 DOI: 10.1146/annurev.publhealth.25.101802.123046] [Citation(s) in RCA: 279] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Every year, new public health mass media campaigns are launched attempting to change health behavior and improve health outcomes. These campaigns enter a crowded media environment filled with messages from competing sources. Public health practitioners have to capture not only the attention of the public amid such competition, but also motivate them to change health behaviors that are often entrenched or to initiate habits that may be new or difficult. In what ways are public health mass media campaigns now attempting to succeed in a world crowded with media messages from a myriad of sources? What are the conditions that are necessary for a media campaign to successfully alter health behaviors and alter outcomes in the long term? To what extent can the successes and failures of previous campaigns be useful in teaching important lessons to those planning campaigns in the future? In this chapter we attempt to answer these questions, drawing from recent literature on public health mass media campaigns.
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Affiliation(s)
- Whitney Randolph
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, 6130 Executive Blvd., Bethesda, Maryland 20892-7368, USA.
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Abstract
Changing dietary behaviors to prevent chronic disease has been an important research focus for the last 25 years. Here we present a review of published articles on the results of research to identify methods to change key dietary habits: fat intake, fiber intake, and consumption of fruits and vegetables. We divided the research reviewed into sections, based on the channel through which the intervention activities were delivered. We conclude that the field is making progress in identifying successful dietary change strategies, but that more can be learned. Particularly, we need to transfer some of the knowledge from the individual-based trials to community-level interventions. Also, more research with rigorous methodology must be done to test current and future intervention options.
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Affiliation(s)
- Deborah J Bowen
- Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, MP 900, Seattle, Washington 98109-1024, USA.
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Haber D. Wellness general of the United States: a creative approach to promote family and community health. FAMILY & COMMUNITY HEALTH 2002; 25:71-82. [PMID: 12802144 DOI: 10.1097/00003727-200210000-00011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This article offers a creative approach to promote family and community health, beginning with the conversion of the office of Surgeon General of the United States into the Wellness General of the United States. The content ranges from federal initiatives to promote quality health research to individuals and families who will be the beneficiaries at medical clinics and community health programs. The proposal recommends changes to institutions and policies, including junk food taxes, the National Institutes of Health, the United States Preventive Services Task Force, the Healthy People 2010 initiative, the Health Plan Employer Data and Information Set, the Medicare Coverage Advisory Committee, state health mandates, local health plans, community medical clinics, and community health programs. The goal is to stimulate ideas and actions among policymakers, researchers, practitioners, educators, and students.
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Affiliation(s)
- David Haber
- Wellness and Gerontology, Fisher Institute for Wellness and Gerontology, Ball State University, Muncie, Indiana, USA
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Reger B, Cooper L, Booth-Butterfield S, Smith H, Bauman A, Wootan M, Middlestadt S, Marcus B, Greer F. Wheeling Walks: a community campaign using paid media to encourage walking among sedentary older adults. Prev Med 2002; 35:285-92. [PMID: 12202072 DOI: 10.1006/pmed.2002.1074] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Mass media may effect communitywide changes in health awareness, attitude, and behavior, but the approach remains unproven for physical activity. METHODS Wheeling Walks promoted walking among sedentary 50- to 65-year-old adults in a West Virginia city of 31,420 people. This quasi-experimental communication intervention used theory of planned behavior and transtheoretical model constructs to change behavior by promoting 30 min of daily walking through paid media, public relations, and public health activities. Impact was determined by pre- and postintervention telephone surveys with 719 adults in the intervention community and 753 adults in the comparison community and observations of walkers at 10 community sites. RESULTS Behavior observation showed a 23% increase in the number of walkers in the intervention community versus no change in the comparison community (OR = 1.31, 95% CI = 1.14-1.50). Thirty-two percent (32.2) of the baseline sedentary population in the intervention community reported meeting the CDC/ACSM/Surgeon General recommendation for moderate-intensity physical activity by walking at least 30 min at least five times per week versus 18.0% in the comparison community (OR = 2.12, 95% CI = 1.41-2.24). The intervention community also realized a pre to post increase in positive stage change (P < 0.001). CONCLUSIONS This theory-based mass media campaign demonstrated increases in those meeting the recommended standard for moderate-intensity physical activity through walking and significant positive stage change.
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Affiliation(s)
- Bill Reger
- Department of Community Medicine, West Virginia University, Morgantown, WV 26506-9190, USA.
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Ades PA, Kottke TE, Miller NH, McGrath JC, Record NB, Record SS. Task force #3--getting results: who, where, and how? 33rd Bethesda Conference. J Am Coll Cardiol 2002; 40:615-30. [PMID: 12204491 DOI: 10.1016/s0735-1097(02)02084-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Philip A Ades
- Division of Cardiology, Medical Center Hospital Vermont, Burlington 05401, USA
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