A Rural and Urban Study of the Food Environment in Select Nevada Geographies

National and county level examination of urban and rural food environments has taken place, but primary validation of venue existence and in-venue data are lacking. The literature show disparities in access to healthy foods through low density of large grocers/supermarkets, low variety and quality of produce and higher prices for a healthy diet in rural versus urban geographies. Rural areas are of unique concern due to poor health indicators such as higher obesity rates, higher diabetes rates, lower incomes and lower educations than urban residents. The goal of this study was to explore differences in the community and consumer level food environments between two Nevada geographies. Evidence was sought to test the hypotheses of venue density, the availability and quality of produce, and the price difference between standard and healthy items between rural and urban Nevada geographies. A cross-sectional study took place through direct quantitative and descriptive data collection in two rural Nevada counties and two urban census tracts in Las Vegas, NV. A Kruskal–Wallis, Mann–Whitney and a Bonferroni correction were performed on the quantitative store audit data to compare produce availability and quality scores, and the price differences between standard and healthy items between geographies. Primary data show a greater per-capita density of grocery and convenience venues in the rural area than the urban. A greater per-capita density of fast-food venues was found in the urban sample area. The variety and quality of produce in the rural grocer venues were lower than the urban supermarkets. No significant or functional price difference was found between the standard and healthier versions of select items within commonly purchased food groups, between rural and urban geographies

The examination of mixing alcohol and energy drinks among college undergraduates using the Theory of Planned Behavior

The purpose of this study was two fold. First, the study examined whether constructs from the Theory of Planned Behavior (TPB: Ajzen, 1985, 1991) play a role in predicting consumption of alcohol mixed with energy drinks (AmED) among college undergraduates. Second, the study also estimated the prevalence of AmED consumption and provided a better understanding of the theoretical and demographic variables associated with AmED consumption among a large sample of college undergraduates located at a public university in the Southeastern United States. The study used a cross-sectional study design (n=676) to administer a 39-item survey assessing alcohol use, energy drink (ED) use, and the consumption of mixing alcohol with energy drinks (AmED). As part of this assessment, students responded to theoretical questions about AmED consumption in the last 30 days. Analyses exploring the univariate significance of theoretical and demographic predictors revealed that all of the TPB constructs were significant univariately. Additionally, the demographic predictors of class year and Panhellenic affiliation were also univariately significant (p<.05). However, when incorporated into a logistic regression model, the TPB constructs of behavioral intention and attitude were the only significant predictors (p<.05) of AmED consumption among undergraduate college students. Subjective norms and perceived behavioral control were no longer significant. Furthermore, logistic regression analyses also showed that the demographic variables of age, sex, place of residence, and Panhellenic affiliation also did not predict AmED consumption, while class year remained a significant predictor (p<.05) of AmED consumption. Lastly, a mediation analyses was conducted using logistic regression techniques. Results showed that behavioral intention is a complete mediator for the effect of subjective norms on AmED consumption and is also a partial mediator for the effect of attitudes on AmED consumption in the last 30 days. Despite the cross-sectional nature of this study, its primary strength was its application of theory to better understand AmED use among college undergraduates. Findings from this study have implications for future intervention development aimed at targeting preventive efforts among college populations. (Published By University of Alabama Libraries

Telehealth Utilization in Low Resource Settings

Chapter in Sustainable Community Health Systems and Practices in Diverse Settings, edited by Elias Mpofu. Chapter Description: In response to health access barriers, telehealth and telemedicine have grown as a supplemental healthcare delivery system to mainstream medical care. For rural and remote communities, which are mostly less well resourced, telehealth and telemedicine is increasingly a major system enabling health access and availability, bridging population health disparities by geography and socioeconomic gradients. People in low resources settings have less access to health care, while commuting for health services to the cities would be costly in terms of time, effort, and money, resulting in health inequities and social injustices on them. In this chapter, we examine the role of telehealth and telemedicine as health systems for providing sustainable community health in low resource settings. In doing so, we provide a historical overview of the research and practice in telehealth and telemedicine, followed by a discussion of current leading practices in telehealth and telemedicine. We consider the cultural and legal influences on telehealth and telemedicine services across jurisdictions highlighting responsiveness to local contexts and needs. Finally, we consider the issues for research and practice in telehealth and telemedicine, including security and privacy associated with telehealth; education for sustaining telehealth delivery; engaging high-risk populations from low-resource settings in telehealth services; and use of social networks to ensure telehealth care access for poor and remote regions. Book description: Applying a trans-disciplinary approach, this book provides a comprehensive, research-based guide to understanding, implementing, and strengthening sustainable community health in diverse international settings. By examining the interdependence of environmental, economic, public health, community wellbeing, and development factors, the authors address the systemic factors impacting health disparities, inequality, and social justice issues. The book analyzes strategies based on a partnership view of health, in which communities determine their health and wellness working alongside local, state, and federal health agencies. Crucially, it demonstrates that communities are themselves health systems and their wellbeing capabilities affect the health of individuals and the collective alike. It identifies health indicators and tools that communities and policy makers can utilize to sustain truly inclusive health systems. This book offers a unique resource for researchers and practitioners working across psychology, mental health, rehabilitation, public health, epidemiology, social policy, healthcare, and allied health.https://digitalcommons.usm.maine.edu/facbooks/1554/thumbnail.jp