Practicing what they preach: Health behaviors of those who provide health advice to extensive social networks

As a way of identifying a conduit to disseminate health information, this study aims to explore health behaviors and attitudes of a unique group of extensively socially-networked individuals who regularly are asked for their health advice. Respondents from a population-based consumer opinion panel (n=2,639) were categorized as extensively socially-networked (75+ friends and acquaintances, and almost daily giving friends advice on general issues) vs. non-networked. The networked respondents were further divided into health-networked (regularly asked for health advice) versus only-socially- networked groups (asked for general advice, not health). Chi-square analyses, ANOVA tests, and multivariate regressions controlling for sociodemographic variables compared health behaviors and attitudes between groups. Results indicated that health-networked individuals reported more positive health behaviors (e.g., fruit and vegetable consumption) and attitudes than only-socially-networked and non-networked individuals. Future research is warranted to elucidate how providing health advice to a large network contributes to the positive health of health-networked individuals. Exploratory analyses revealed that doctors and health/fitness magazines were main sources of health and nutrition information for health-networked respondents. Through their advice and word-of-mouth, health-networked individuals have the potential to influence the health information of large groups of people and, therefore, may serve as valuable change agents to disseminate health and nutrition information

Fruit and Vegetable Intake Among Participants in a District of Columbia Farmers\u27 Market Incentive Programme.

© Copyright The Authors 2017. Objective Limited research is available on whether participation in healthy food incentive programmes is associated with higher fruit and vegetable intake. The objective of the present study was to determine fruit and vegetable intake among participants in the Produce Plus Program, a farmers\u27 market-based healthy food incentive programme in Washington, DC, and identify demographic and behavioural factors associated with higher fruit and vegetable intake. Design Using a cross-sectional survey, programme participants were interviewed at markets across DC between June and September 2015. Questions included the Behavioral Risk Factor Surveillance System (BRFSS) fruit and vegetable module. Fruit and vegetable intake among 2013 DC BRFSS participants reporting annual household incomes of ≤$US 35 000 was calculated for context. Setting Washington, DC, USA. Subjects Participants (n 288) in the Produce Plus Program. Results On average, participants reported consuming both fruits (interquartile range: 1·0-3·0) and vegetables (interquartile range: 1·3-3·5) two times/d. Participants who reported eating home-cooked meals ≥3 times/week also reported higher median fruit (2·0 v. 0·8) and vegetable (2·3 v. 1·3) intake compared with those eating home-cooked meals less frequently. No statistically significant differences in reported median fruit or vegetable intake were observed over the course of the farmers\u27 market (June v. August/September) season. Conclusions Produce Plus Program participants reported higher median fruit and vegetable intake compared with DC BRFSS respondents with similar incomes, but still below recommended levels. More frequent home-cooked meals were associated with higher fruit and vegetable intake. Thus, efforts to increase home cooking may represent an opportunity to increase fruit and vegetable intake among healthy food incentive participants

The role of the school food environment in improving the healthiness of school canteens and readiness to reopen post COVID-19 pandemic: A study conducted in Indonesia

Background: Indonesian school children spend one-third of their time in school, where they are exposed to a variety of foods at school canteens. However, the healthiness of school canteens is not yet well understood. This study was conducted to characterize the healthiness and quality of management of school canteens, and measure readiness of school canteens to reopen following COVID-19 closures. Design and methods: Mixed methods were used to conduct a cross-sectional study. Data were collected from schools located in the Bantul District of Indonesia. Primary schools (n=152) were randomly selected, with a final sample size of 147. Data were collected using Google Forms, delivered via WhatsApp or e-mail. School canteens were classified as healthy if they had a Healthy Canteen Score (HCS) ≥10, or unhealthy if they had a HCS\u3c10. Results: Less than half (43.5%) of school canteens were deemed to be healthy. School canteens were more likely to be healthy if the canteen manager had a formal decision letter (OR=15.2; 95% CI=3.7-62.5); used print material messaging (OR=3.2 to 4.6 times); or received inspection by external officers periodically (OR=2.8; 95% CI=1.04-7.5). Readiness to reopen was 4.5 (OR=4.5; 95%CI: 1.1-17.9) times higher among schools that had their own canteen, and 4 (OR=3.9; 95% CI=1.1-13.8) times higher among schools located in rural areas, adjusting for the remaining variables. Conclusions: School canteen healthiness can be improved by implementing national food policy and healthy school canteen standards accompanied by the existence of good management practices within schools, particularly following the COVID-19 pandemic

Behavioral correlates of fruit and vegetable intake in Puerto Rico: Results from the Health Information National Trends Survey

OBJECTIVE: A diet high in fruit and vegetables (FV) is associated with a decreased risk for chronic diseases, such as cancer. Limited information exists regarding the factors associated with FV intake in persons living in Puerto Rico. The objective of this study was to examine sociodemographic, behavioral, and health-belief factors associated with dietary habits in Puerto Rico. METHODS: Secondary data analysis of adults aged 18 years and older from the Puerto Rico Health Information National Trends Survey (HINTS-PR) conducted in 2009. Multivariate logistic regression models were used to identify factors associated with meeting the established recommendations for FV consumption. RESULTS: Only 14.5% of the adults in Puerto Rico met the recommendations for daily FV intake, and the vast majority (90.9%) were unaware of current recommendations. Bivariate analyses demonstrated that being obese, having lower than a high school education, and not knowing the recommendations were significantly associated with not meeting these recommendations. In the multivariate logistic regression analysis, being obese (OR = 3.77; 95% CI = 1.41-10.08) and not being aware of the current dietary recommendations (OR = 9.26; 95% CI = 3.77-22.73) continued to be significantly associated with not meeting the FV intake recommendations. CONCLUSION: The Puerto Rican population is far from meeting FV consumption recommendations, with prevalence estimates of consumption that are below the US median. Low FV intake might put the population in Puerto Rico at increased risk of developing cancer as well as a number of other chronic diseases that are secondary both to improper nutrition and to obesity

Balancing Mission and Margins: What Makes Healthy Community Food Stores Successful

Mission-driven, independently-owned community food stores have been identified as a potential solution to improve access to healthy foods, yet to date there is limited information on what factors contribute to these stores\u27 success and failure. Using a multiple case study approach, this study examined what makes a healthy community food store successful and identified strategies for success in seven community stores in urban areas across the United States. We used Stake\u27s multiple case study analysis approach to identify the following key aims that contributed to community store success across all cases: (1) making healthy food available, (2) offering healthy foods at affordable prices, and (3) reaching community members with limited economic resources. However, stores differed in terms of their intention, action, and achievement of these aims. Key strategies identified that enabled success included: (1) having a store champion, (2) using nontraditional business strategies, (3) obtaining innovative external funding, (4) using a dynamic sourcing model, (5) implementing healthy food marketing, and (6) engaging the community. Stores did not need to implement all strategies to be successful, however certain strategies, such as having a store champion, emerged as critical for all stores. Retailers, researchers, philanthropy, and policymakers can utilize this definition of success and the identified strategies to improve healthy food access in their communities

Reduced Food Intake Among Tuberculosis Patients Within an Urban Setting in Panama (P10-023-19).

Objectives The aim of our study is to characterize the dietary factors and food items intake of people living with pulmonary tuberculosis in an urban and high disease incidence city in Panama. Methods We recruited 41 participants newly diagnosed with pulmonary tuberculosis. We applied a culturally adapted version of the NHANES Food Screener to estimate dietary median intakes and to evaluate daily and weekly frequencies of consumption. All frequencies reported were converted to daily frequency to describe the dietary patterns and make estimations. Direct observed anti-tuberculosis therapy was provided to all participants. Results Among the participants, 20% were female, the average age was 38.9 years old, the average body mass index was 20.4 and 16% were patients living with HIV. When comparing the consumption frequency reported by the TB patients with the Panamanian Dietary recommendations, these patients did not meet the minimal frequency intake of fruit and whole grain. Only 30% of participants achieved the recommended fruit frequency intake. We also found that only 37% of participants meet the recommended consumption of at least 3 times a week of beans and legumes. In contrast, a high number of these TB patients (34/41) reported a daily vegetable intake frequency and a mean of 25 teaspoons of added sugar daily intake. For sugar-sweetened beverages intake, we found a mean frequency intake of twice a day and 73% of our participants had a daily consumption of any dairy product. A total of 63% of our participants reported consumption of processed meat more than twice a week. Conclusions The food intake pattern in patients suffering tuberculosis includes daily consumption of vegetables, frequent consumption of dairy products and sport or fruit drinks, but a low frequency of fruits, beans, and legumes. These findings suggest that the protective dietary factors including fruits and whole grain are not consumed at the minimum requirement intake to improve general health in our patient group. We recommend decreasing processed meat intake among patients suffering tuberculosis. Also, we recommend the use of diet supplementation programs to improve anti-tuberculosis treatment success rates. Food security investigations to determine the extent of limitations to access healthy food remain key for improving disease control.Objectives The aim of our study is to characterize the dietary factors and food items intake of people living with pulmonary tuberculosis in an urban and high disease incidence city in Panama. Methods We recruited 41 participants newly diagnosed with pulmonary tuberculosis. We applied a culturally adapted version of the NHANES Food Screener to estimate dietary median intakes and to evaluate daily and weekly frequencies of consumption. All frequencies reported were converted to daily frequency to describe the dietary patterns and make estimations. Direct observed anti-tuberculosis therapy was provided to all participants. Results Among the participants, 20% were female, the average age was 38.9 years old, the average body mass index was 20.4 and 16% were patients living with HIV. When comparing the consumption frequency reported by the TB patients with the Panamanian Dietary recommendations, these patients did not meet the minimal frequency intake of fruit and whole grain. Only 30% of participants achieved the recommended fruit frequency intake. We also found that only 37% of participants meet the recommended consumption of at least 3 times a week of beans and legumes. In contrast, a high number of these TB patients (34/41) reported a daily vegetable intake frequency and a mean of 25 teaspoons of added sugar daily intake. For sugar-sweetened beverages intake, we found a mean frequency intake of twice a day and 73% of our participants had a daily consumption of any dairy product. A total of 63% of our participants reported consumption of processed meat more than twice a week. Conclusions The food intake pattern in patients suffering tuberculosis includes daily consumption of vegetables, frequent consumption of dairy products and sport or fruit drinks, but a low frequency of fruits, beans, and legumes. These findings suggest that the protective dietary factors including fruits and whole grain are not consumed at the minimum requirement intake to improve general health in our patient group. We recommend decreasing processed meat intake among patients suffering tuberculosis. Also, we recommend the use of diet supplementation programs to improve anti-tuberculosis treatment success rates. Food security investigations to determine the extent of limitations to access healthy food remain key for improving disease control

Forms of Community Engagement in Neighborhood Food Retail: Healthy Community Stores Case Study Project

Community engagement is well established as a key to improving public health. Prior food environment research has largely studied community engagement as an intervention component, leaving much unknown about how food retailers may already engage in this work. The purpose of this study was to explore the community engagement activities employed by neighborhood food retailers located in lower-income communities with explicit health missions to understand the ways stores involve and work with their communities. A multiple case study methodology was utilized among seven retailers in urban U.S. settings, which collected multiple sources of data at each retailer, including in-depth interviews, store manager sales reports, store observations using the Nutrition Environment Measures Survey for Stores, public documents, and websites. Across-case analysis was performed following Stake\u27s multiple case study approach. Results indicated that retailers employed a wide variety of forms of community engagement within their communities, including Outreach, Building Relationships through Customer Relations, Giving Back, Partnering with Community Coalitions, and Promoting Community Representation and Inclusiveness. Strategies that built relationships through customer relations were most common across stores; whereas few stores demonstrated community inclusiveness where members participated in store decision making. Findings provide a more comprehensive view of the ways local food retailers aim to develop and sustain authentic community relationships. Additional research is needed to evaluate the impact of community engagement activities on improving community health