Examining food purchasing patterns from sales data at a full-service grocery store intervention in a former food desert

AbstractBackgroundThe Good Food Junction Grocery Store was opened in a former food desert in the inner city of Saskatoon, Canada.ObjectiveThe purpose of this research was to examine, using grocery store sales data, healthy and less healthful food purchasing over a one-year period beginning eight months after opening by shoppers' neighborhood of residence.DesignA multilevel cross sectional design was used. The sample consisted of members of the Good Food Junction with a valid address in Saskatoon, Saskatchewan. All purchases made by members who reported their postal code of residence from May 15, 2013 to April 30, 2014 were analyzed. The outcome variable was the total amount spent on foods in 11 food groups. Linear random intercept models with three levels were fit to the data.ResultsShoppers who were residents of former food desert neighborhoods spent $0.7 (95$1.2 (95% CI: −1.8 to −0.6) less on meat, and $1.1 (95% CI: −2.0 to −0.3) less on prepared foods than shoppers who did not reside in those neighborhoods.ConclusionsWhen given geographical access to healthy food, people living in disadvantaged former food desert neighborhoods will take advantage of that access

The Saskatchewan/New Brunswick Healthy Start-Départ Santé intervention: implementation cost estimates of a physical activity and healthy eating intervention in early learning centers

Training sessions by year and community size (large, medium, small and rural) in Saskatchewan. Table S2. Training sessions by year and community size (large, medium, small and rural) in New Brunswick. Table S3. Booster Sessions by year and community size (large, medium, small and rural) in Saskatchewan.Table S4. Booster Sessions by year and community size (large, medium, small and rural) in New Brunswick. (PDF 271 kb

Inequalities in the psychological well-being of employed, single and partnered mothers: the role of psychosocial work quality and work-family conflict

<p>Abstract</p> <p>Background</p> <p>A large body of international research reveals that single mothers experience poorer mental health than their partnered counterparts, with socioeconomic disadvantage identified as an important contributory factor in understanding this health disparity. Much less research, however, has focused specifically on the psychological well-being of single mothers who are employed, despite their growing presence in the labor force. Of the research which has considered employment, the focus has been on employment status <it>per se </it>rather than on other important work-related factors which may impact psychological health, such as psychosocial work quality and work-family conflict. The aim of this study was to: (1) compare employed single mothers and employed partnered mothers on measures of psychological distress, psychosocial work quality and work-family conflict; and (2) explore the potential role of work-family conflict and psychosocial work quality as explanations for any observed differences in psychological distress based on partner status.</p> <p>Method</p> <p>Analysis of data obtained from a cross-sectional telephone survey of employed parents in a mid-sized Western Canadian city. Analyses were based on 674 employed mothers (438 partnered and 236 single), who were 25-50 years old, with at least one child in the household.</p> <p>Results</p> <p>Compared to employed single mothers, employed partnered mothers were older, had more education and reported fewer hours of paid work. Single mothers reported higher levels of psychological distress, financial hardship, work-family conflict and poor psychosocial work quality. Statistical adjustment for income adequacy, psychosocial work quality and work-family conflict each independently resulted in single motherhood no longer being associated with psychological distress.</p> <p>Conclusions</p> <p>While single employed mothers did experience higher levels of psychological distress than their partnered counterparts, differences between these groups of women in income adequacy, psychosocial work quality, and work-family conflict were found to explain this relationship. Future research employing a longitudinal design and subject to lower selection biases is required to tease out the interrelationship of these three life strains and to point to the most appropriate economic and social policies to support single mothers in the workforce.</p

The community and consumer food environment and children’s diet: a systematic review

Background: While there is a growing body of research on food environments for children, there has not been a published comprehensive review to date evaluating food environments outside the home and school and their relationship with diet in children. The purpose of this paper is to review evidence on the influence of the community and consumer nutrition environments on the diet of children under the age of 18 years

Effectiveness of Home Visiting Programs on Child Outcomes: A Systematic Review

http://www.biomedcentral.com/1471-2458/13/17Background: The effectiveness of paraprofessional home-visitations on improving the circumstances of disadvantaged families is unclear. The purpose of this paper is to systematically review the effectiveness of paraprofessional home-visiting programs on developmental and health outcomes of young children from disadvantaged families. Methods: A comprehensive search of electronic databases (e.g., CINAHL PLUS, Cochrane, EMBASE, MEDLINE) from1990 through May 2012 was supplemented by reference lists to search for relevant studies. Through the use of reliable tools, studies were assessed in duplicate. English language studies of paraprofessional home-visiting programs assessing specific outcomes for children (0-6 years) from disadvantaged families were eligible for inclusion in the review. Data extraction included the characteristics of the participants, intervention, outcomes and quality of the studies. Results: Studies that scored 13 or greater out of a total of 15 on the validity tool (n = 21) are the focus of this review. All studies are randomized controlled trials and most were conducted in the United States. Significant improvements to the development and health of young children as a result of a home-visiting program are noted for particular groups. These include: (a) prevention of child abuse in some cases, particularly when the intervention is initiated prenatally; (b) developmental benefits in relation to cognition and problem behaviours, and less consistently with language skills; and (c) reduced incidence of low birth weights and health problems in older children, and increased incidence of appropriate weight gain in early childhood. However, overall home-visiting programs are limited in improving the lives of socially high-risk children who live in disadvantaged families. Conclusions: Home visitation by paraprofessionals is an intervention that holds promise for socially high-risk families with young children. Initiating the intervention prenatally and increasing the number of visits improves development and health outcomes for particular groups of children. Future studies should consider what dose of the intervention is most beneficial and address retention issues.</p

Applying the WHO ICD-PM classification system to stillbirths in a major referral Centre in Northeast Nigeria: a retrospective analysis from 2010-2018.

BACKGROUND: Lack of a unified and comparable classification system to unravel the underlying causes of stillbirth hampers the development and implementation of targeted interventions to reduce the unacceptably high stillbirth rates (SBR) in sub-Saharan Africa. Our aim was to track the SBR and the predominant maternal and fetal causes of stillbirths using the WHO ICD-PM Classification system. METHODS: This was a retrospective observational study in a major referral centre in northeast Nigeria between 2010 and 2018. Specialist Obstetricians and Gynaecologists assigned causes of stillbirths after an extensive audit of available stillbirths' records. Cause of death was assigned via consensus using the ICD-PM classification system. RESULTS: There were 21,462 births between 1 January 2010 and 31 December 2018 in our study setting; of these, 1177 culminated in stillbirths with a total hospital SBR of 55 per 1000 births (95% CI: 52, 58). There were two peaks of stillbirths in 2012 [62 per 1000 births (95% CI: 53, 71)], and 2015 [65 per 1000 births (95% CI, 55, 76)]. Antepartum and intrapartum stillbirths were almost equally prevalent (48% vs 52%). Maternal medical and surgical conditions (M4) were the commonest (69.3%) cause of antepartum stillbirths while complications of placenta, cord and membranes (M3) accounted for the majority (45.8%) of intrapartum stillbirths and the trends were similar between 2010 and 2018. Antepartum and intrapartum fetal causes of stillbirths were mainly due to prematurity which is a disorder of fetal growth (A5 and I6). CONCLUSIONS: Most causes of stillbirths in our setting are due to preventable causes and the trends have remained unabated between 2010 and 2018. Progress toward global SBR targets are off-track, requiring more interventions to halt and reduce the high SBR

Does social capital flatten the social gradient in early childhood development? An ecological study of two provinces in Canada

Social capital is thought to buffer the negative effects of low income on health and thereby flatten the social gradient. Child development research on social capital has suggested that social networks of adults and children in a neighborhood may play a protective role in children's outcomes. Yet little is known about how this relationship applies to diverse developmental outcomes in early childhood. This study examines whether the presence of role model adults and the willingness of neighbors to help keep children safe moderates the relationship between neighborhood income and five developmental outcomes for children in kindergarten: (1) physical health and well-being, (2) social competence, (3) emotional maturity, (4) language and cognitive development, and (5) communication and general knowledge. We linked neighborhood-level data on child development from two Canadian provinces, British Columbia (BC, n = 100) and Ontario (n = 482), to neighborhood-level data on social capital from the Ontario Kindergarten Parent Survey, and the BC Social Capital Study; and income data from the 2006 Canadian Census. Multiple regression analyses were conducted to examine the main and interaction effects of social capital and income in relation to child development outcomes. In Ontario, higher levels of social capital were associated with better child outcomes on all five developmental domains. Similar trends were observed in BC. Higher levels of social capital flattened the income gradient in language and cognitive development in both provinces, and social competence in Ontario. Implications for research and practice are discussed

Understanding maternity waiting home uptake and scale-up within low-income and middle-income countries: a programme theory from a realist review and synthesis

From BMJ via Jisc Publications RouterHistory: received 2022-05-13, ppub 2022-09, accepted 2022-09-01, epub 2022-09-30Peer reviewed: TrueAcknowledgements: We gratefully acknowledge members of the advisory group including Anayda Portela, Denise Kouri, Jessie Forsyth, João Paulo Souza and Tami Waldron. We also extend sincere thanks to the 12 MWH implementers and policy makers who were interviewed during the PT refinement process, including, Abebe Mamo G/tsadik, Bwalya Misheck, Chipo Chimamise, Cristalina Mahumane, Esther Ngaru, Faith Akovi Cooper, Fernanda Andre, Gebeyehu Bulcha and Thandiwe Ngoma.Publication status: PublishedFunder: University of Saskatchewan; FundRef: http://dx.doi.org/10.13039/100008920Funder: Mozambique-Canada Maternal Health Project; Grant(s): D-002085Introduction: Maternity waiting homes (MWHs) link pregnant women to skilled birth attendance at health facilities. Research suggests that some MWH-facility birth interventions are more success at meeting the needs and expectations of their intended users than others. We aimed to develop theory regarding what resources work to support uptake and scale-up of MHW-facility birth interventions, how, for whom, in what contexts and why. Methods: A four-step realist review was conducted which included development of an initial programme theory; searches for evidence; selection, appraisal and extraction of data; and analysis and data synthesis. Results: A programme theory was developed from 106 secondary sources and 12 primary interviews with MWH implementers. The theory demonstrated that uptake and scale-up of the MWH-facility birth intervention depends on complex interactions between three adopter groups: health system stakeholders, community gatekeepers and pregnant women and their families. It describes relationships between 19 contexts, 11 mechanisms and 31 outcomes accross nine context-mechanism-outcome configurations (CMOCs) which were grouped into 3 themes: (1) Engaging stakeholders to develop, integrate, and sustain MWH-facility birth interventions, (2) Promoting and enabling MWH-facility birth utilisation and (3) Creating positive and memorable MWH-facility birth user experiences. Belief, trust, empowerment, health literacy and perceptions of safety, comfort and dignity were mechanisms that supported diffusion and adoption of the intervention within communities and health systems. Examples of resources provided by implementers to trigger mechanisms associated with each CMOC were identified. Conclusions: Implementers of MWHs cannot merely assume that communities will collectively value an MWH-facility birth experience over delivery at home. We posit that MWH-facility birth interventions become vulnerable to under-utilisation when implementers fail to: (1) remove barriers that hinder women’s access to MWH and (2) ensure that conditions and interactions experienced within the MWH and its affiliated health facility support women to feel treated with compassion, dignity and respect. PROSPERO registration number: CRD42020173595

The Shape of the Socioeconomic Gradient: Testing to Functional Form of the Relationship between Socioeconomic Status and Early Child Development

Introduction The literature provides abundant evidence of socioeconomic gradients in health outcomes. However, it is unclear, and particularly understudied in early child development research, whether these observed gradients are linear, whether they diminish as socioeconomic status (SES) increases, and if they ultimately reverse in slope at the highest SES values. Objectives and Approach We linked neighbourhood-level Census and Tax Filer data with Early Development Instrument (EDI) data across Canada. The EDI is a kindergarten teacher-completed measure of five domains of early child development. We used this linked database to statistically compare and choose the most appropriate functional form of the relationship between each of the EDI domains (dependent variables), and the Canadian Neighbourhoods and Early Child Development (CanNECD) study's SES index (predictor) in regression models. Model comparison approaches included: visual checks of lines fitted using Generalized Additive Models, Akaike and Bayesian Information Criterions, Ramsay’s RESET, J and Cox tests. Results The results indicate the optimal functional form of the gradient varies across domains of the EDI. The best model for the Physical Health and Well-Being domain was quadratic, suggesting there may be some reversal in slope at higher values of SES. The best models for the Social Competence and Language and Cognitive Development domains were logarithmic, indicating diminishing returns to SES but with no slope reversal. The best model for the Emotional Maturity domain was linear, suggesting the gradient was consistent across all values of SES. The best fit for the Communication Skills and General Knowledge domain was a cubic ‘S’ curve, suggesting the curve is positive and concave for lower levels of SES but curves upwards beyond a certain SES threshold. Conclusion/Implications The results demonstrate the importance of examining functional forms when modeling socioeconomic gradients. Assuming linear relationships between SES and health outcomes (early child development, in this case) may distort and bias the true nature of the relationships, thus leading to misinterpretations, especially at the highest and lowest values of SES