Low-income consumers' attitudes and behaviour towards access, availability and motivation to eat fruit and vegetables

To determine low-income consumers' attitudes and behaviour towards fruit and vegetables, in particular issues of access to, affordability of and motivation to eat fruit and vegetables. Design and setting: Questionnaire survey mailed to homes owned by a large UK housing association. Participants: Participants were 680 low-income men and women, aged 17-100 years. Results: Age, employment, gender, smoking and marital status all affected attitudes towards access, affordability and motivation to eat fruit and vegetables. Few (7%) participants experienced difficulty in visiting a supermarket at least once a week, despite nearly half having no access to a car for shopping. Fruit and vegetables were affordable to this low-income group in the amounts they habitually bought; purchasing additional fruits and vegetables was seen as prohibitively expensive. Less than 5% felt they had a problem with eating healthily and yet only 18% claimed to eat the recommended 5 or more portions of fruit and vegetables every day. Conclusions: Supported by research, current UK Government policy is driven by the belief that low-income groups have difficulties in access to and affordability of fruit and vegetables. Findings from this particular group suggest that, of the three potential barriers, access and affordability were only a small part of the 'problem' surrounding low fruit and vegetable consumption. Thus, other possible determinants of greater consequence need to be identified. We suggest focusing attention on motivation to eat fruit and vegetables, since no dietary improvement can be achieved if people do not recognise there is a problem

A realist synthesis and evaluation of the role and impact of occupational therapists in reablement services

Reablement services aim to improve the ability of people experiencing poor health or disability to complete daily living tasks. Existing studies of reablement have identified the primary role of occupational therapists as providers of equipment. This study proposed that occupational therapists have a broader role working with both service users and carers, and reablement support workers. The study aimed to evaluate the role of occupational therapists in reablement from the perspective of occupational therapists in practice and managers and reablement support workers who work with them.A realist approach was taken, commencing with a realist synthesis review of the literature that identified four programme theories concerning occupational therapists in reablement services. These included: the recognition of occupational therapists by others; holistic approaches to assessment and goal setting; the provision of equipment; and working with support workers. The programme theories were tested, refined and expanded using a qualitative case study design. Each of the three case studies consisted of a reablement service that comprised two organisations. Methods of the study included observations and interviews with occupational therapists in practice, interviews with managers and focus groups with reablement support workers. This study contributes to knowledge of occupational therapists in reablement services with the presentation of a conceptual framework for practice, incorporating the original programme theories and two new theories identified in the case study phase, concerning a team approach to reablement. Findings conclude that occupational therapists make a positive contribution to reablement services. Advanced clinical reasoning skills support occupational therapists to undertake assessments, person centred goal setting and select from their toolbox of interventions to support service users. Occupational therapists’ informal and formal training with support workers encourages a reabling ethos. Effective policies, good communication and co-location were identified as factors supporting team working and a shared purpose of reablement

Associations between mothers’ perceptions of the cost of fruit and vegetables and children’s diets : Will children pay the price?

Background/Objectives: Perceptions that fruit and vegetables are expensive are more common among the socio-economically disadvantaged groups and are linked to poor dietary outcomes. Such perceptions may be exacerbated in countries recently affected by natural disasters, where devastation of fruit and vegetable crops has resulted in increase in prices of fruit and vegetables. Examining the associations of perceptions of fruit and vegetable affordability and children\u27s diets can offer insights into how the high prices of fruit and vegetables might have an impact on the diets of children.Subjects/Methods: We analysed the data from 546 socio-economically disadvantaged mother&ndash;child pairs to assess the relationship between maternal perceptions of fruit and vegetable affordability and the diets of their children.Results: Fruit consumption was lower among children whose mothers felt the cost of fruit was too high. Maternal perceptions of fruit and vegetable affordability were not associated with any other aspect of child\u27s diet.Conclusions: Our results suggest a possible role for maternal perceptions of fruit affordability in children\u27s diet, though further research is warranted.<br /

Food after deprivation rewards the earlier eating

Food intake can be increased by learning to anticipate the omission of subsequent meals. We present here a new theory that such anticipatory eating depends on an associative process of instrumental reinforcement by the nutritional repletion that occurs when access to food is restored. Our evidence over the last decade from a smooth-brained omnivore has been that food after deprivation rewards intake even when those reinforced ingestive responses occur long before the physiological signals from renewed assimilation. Effects of food consumed after self-deprivation might therefore reward extra eating in human beings, through brain mechanisms that could operate outside awareness. That would have implications for efforts to reduce body weight. This food reward mechanism could be contributing to the failure of the dietary component of interventions on obesity within controlled trials of the management or prevention of disorders such as hypertension, atherosclerosis and type 2 diabetes

Young adults and the 5 a day campaign: perceived benefits and barriers of eating more fruits and vegetables

Although consuming adequate amounts of fruits and vegetables reduces the risk of developing chronic diseases, it is widely recognized that young adults’ intakes are currently well below the Department of Health’s recommended five portions a day, with men consuming even less than women. One approach in the UK has been to introduce health campaigns such as the 5 A DAY programme; however, little is currently known about how well their messages are understood amongst young adults. This study examined current knowledge of the 5 A DAY message in young adults, as well as the perceived benefits and remaining barriers towards consuming more fruits and vegetables. In total, four focus groups were conducted using male (n = 22) and female (n = 18) students at the University of Reading. Content analysis revealed that while participants were aware of the 5 A DAY recommendation, there was widespread confusion regarding the detail. In addition, men were less accepting of the message than women, reporting greater disbelief and a lack of motivation to increase intake. Finally, a range of barriers was reported by participants of both genders, despite the perceived beneficial effects for health and appearance. The results illustrate a considerable gap between awareness and knowledge of the 5 A DAY message, and underscore the challenge that changing behaviour in young adults represents. As well as stepping up education- and skill-based health campaigns, more targeted gender specific interventions will be needed to achieve sustained increases in fruit and vegetable intake

Danish adolescents like their vegetables fresh rather than frozen or canned

Food choices in adolescence usually track into adulthood and are determinants of health outcome later in life. Efforts to promote vegetables consumption (as marker of healthy eating) have been implemented with limited success. Vegetables on top are perishable and their shelf life extended thanks to canning and freezing. The objective of this paper is to identify the influence that familiarity with and liking of vegetables may play in shaping attitudes towards canned and frozen vegetables among Danish adolescents. Ninety school age adolescents participated (57% girls, 15.7 y SD 1.17y). In this sample, majority of respondents were acquainted with vegetables (90%). Most liked vegetables were carrots, green salad, peas and corn. Lower liking levels were reported for squash, cauliflower and green beans. Most respondents showed a more positive attitude towards fresh vegetables rather than towards canned and frozen. Findings have implications for the provision of information through foodservice operations, and for the design of plant-based dishes and menus

Perceptions of the Community Food Environment and Related Influences on Food Choice Among Midlife Women Residing in Rural and Urban Areas: A Qualitative Analysis

Introduction—Qualitative research on food choice has rarely focused on individuals’ perceptions of the community food environment. Women remain gatekeepers of the family diet and food purchasing. Therefore we assessed midlife, Southern women's perceptions of the food environment. Related influences on food choices at work and at home were also examined. Methods—We recruited 28 low- and moderate-income, midlife (37-67 years) women from rural and urban areas of southeastern North Carolina, using typical case and snowball sampling. They responded to questions about multilevel influences on food choice in semi-structured, in-depth interviews. Results—Women perceived differences between urban and rural food environments, with rural areas having fewer supermarkets and fast food restaurants compared to urban areas, which had fewer produce stands. Workplace food choices were affected by the social environment (co-workers), personal health concerns, and the surrounding food environment. Food chosen at home was primarily influenced by family members, health concerns, and convenient food sources. Discussion—While future studies should explore findings in more representative populations, potential intervention strategies can be inferred, including emphasizing healthful aspects of the food environment. Intervention and advocacy efforts are needed to improve aspects of the food environment that make healthy choices difficult. Originally published in Women & Health Vol. 49, No. 2-3, 2009

'Shooting in the dark': implications of the research-practice gap for enhancing research use in adult social care

Background: Despite calls for greater use of research and an appetite to do so within adult social care, a gap persists between research and practice. Aims and objectives: To explore views of adult social care staff about research and its application to everyday practice. To understand how these might impact upon research use capacity-building initiatives within adult social care organisations. Methods: Thematic analysis of semi-structured qualitative interviews with 25 staff members working within the adult social care departments of three English local authorities. Findings: Participants characterised research as feeling separate from practice. They reflected on their use of it in relation to pressures affecting adult social care and identified a lack of relevant research. Research benefiting service users, supporting individual practice or informing organisational decision-making was considered useful. However, research could also be viewed as a luxury where its findings were felt to represent an ‘ideal’ rather than real world of practice or did not accord with practice knowledge or local experience. Discussion and conclusions: While participants feel positively towards research, there remains a gap between these perceptions and its use in practice. There remains a need to improve research relevance and accessibility and to clarify its role in decision-making in social care, including where there is no evidence, where evidence challenges existing practice, or where the evidence base is growing. Collaborative partnerships between adult social care organisations, researchers and service users could help to narrow the research–practice gap and support the routine translation of research to practice