Substantial improvements not seen in health behaviors following corner store conversions in two Latino food swamps.

BackgroundThe effectiveness of food retail interventions is largely undetermined, yet substantial investments have been made to improve access to healthy foods in food deserts and swamps via grocery and corner store interventions. This study evaluated the effects of corner store conversions in East Los Angeles and Boyle Heights, California on perceived accessibility of healthy foods, perceptions of corner stores, store patronage, food purchasing, and eating behaviors.MethodsHousehold data (n = 1686) were collected at baseline and 12- to 24-months post-intervention among residents surrounding eight stores, three of which implemented a multi-faceted intervention and five of which were comparisons. Bivariate analyses and logistic and linear regressions were employed to assess differences in time, treatment, and the interaction between time and treatment to determine the effectiveness of this intervention.ResultsImprovements were found in perceived healthy food accessibility and perceptions of corner stores. No changes were found, however, in store patronage, purchasing, or consumption of fruits and vegetables.ConclusionsResults suggest limited effectiveness of food retail interventions on improving health behaviors. Future research should focus on other strategies to reduce community-level obesity

Depression and alcohol misuse among older adults: exploring mechanisms and policy impacts using agent-based modelling

Purpose: To: (1) explore how multi-level factors impact the longitudinal prevalence of depression and alcohol misuse among urban older adults (≥ 65 years), and (2) simulate the impact of alcohol taxation policies and targeted interventions that increase social connectedness among excessive drinkers, socially isolated and depressed older adults; both alone and in combination. Methods: An agent-based model was developed to explore the temporal co-evolution of depression and alcohol misuse prevalence among older adults nested in a spatial network. The model was based on Los Angeles and calibrated longitudinally using data from the Multi-Ethnic Study of Atherosclerosis. Results: Interventions with a social component targeting depressed and socially isolated older adults appeared more effective in curbing depression prevalence than those focused on excessive drinkers. Targeting had similar impacts on alcohol misuse, though the effects were marginal compared to those on depression. Alcohol taxation alone had little impact on either depression or alcohol misuse trajectories. Conclusions: Interventions that improve social connectedness may reduce the prevalence of depression among older adults. Targeting considerations could play an important role in determining the success of such efforts

Examining the possible impact of daily transport on depression among older adults using an agent-based model

_Objectives:_ Daily transport may impact depression risk among older adults through several pathways including facilitating the ability to meet basic needs, enabling and promoting contact with other people and nature, and promoting physical activity (e.g. through active transportation such as walking or walking to public transit). Both daily transport and depression are influenced by the neighborhood environment. To provide insights into how transport interventions may affect depression in older adults, we developed a pilot agent-based model to explore the contribution of daily transport and neighborhood environment to older adults’ depression in urban areas. _Method:_ The model includes about 18,500 older adults (i.e. agents) between the ages of 65 and 85 years old, living in a hypothetical city. The city has a grid space with a number of neighborhoods and locations. Key dynamic processes in the model include aging, daily transport use and feedbacks, and the development of depression. Key parameters were derived from US data sources. The model was validated using empirical studies. _Results:_ An intervention that combines a decrease in bus fares, shorter bus waiting times, and more bus lines and stations is most effective at reducing depression. Lower income groups are likely to be more sensitive to the public transit-oriented intervention. _Conclusion:_ Preliminary results suggest that promoting public transit use may be a promising strategy to increase daily transport and decrease depression. Our results may have implications for transportation policies and interventions to prevent depression in older adults

Artículo originAl Consumption and expenditure on food prepared away from home among Mexican adults in 2006

Abstract Objective. To describe food expenditure and consumption of foods prepared away from home among Mexican adults. Materials and methods. Data were from 45 241 adult participants in the National Health and Nutrition Survey 2006, a nationally-representative, cross-sectional survey of Mexican households. Descriptive statistics and multivariable linear and logistic regression were used to assess the relationship between location of residence, educational attainment, socioeconomic status and the following: 1) expenditure on all food and at restaurants, and 2) frequency of consumption of comida corrida or restaurant food and street food. Results. Food expenditure and consumption of food prepared away from home were positively associated with socioeconomic status, educational attainment, and urban vs. rural residence (p<0.001 for all relationships in bivariate analyses). Conclusions. Consumption of food prepared outside home may be an important part of the diet among urban Mexican adults and those with high socioeconomic status and educational attainment

An agent-based simulation of persistent inequalities in health behavior: Understanding the interdependent roles of segregation, clustering, and social influence

Health inequalities are conspicuously persistent through time and often durable even in spite of interventions. In this study, I use agent-based simulation models (ABMs) to understand how the complex interrelationships between residential segregation, social network formation, group-level preferences, and social influence may contribute to this persistence. I use a more-stylized ABM, Bubblegum Village (BV), to understand how initial inequalities in bubblegum-chewing behaviors either endure, increase, or decrease over time given group-level differences in preferences, neighborhood-level barriers or facilitators of bubblegum chewing (e.g., access to bubblegum shops), and agents’ preferences for segregation, homophily, and clustering (i.e., the ‘tightness’ of social networks). I further use BV to understand whether segregation and social network characteristics impact whether the effects of a bubblegum-reduction intervention that is very effective in the short term are durable over time, as well as to identify intervention strategies to reduce attenuation of the intervention effects. In addition to BV, I also present results from an ABM based on the distribution and social characteristics of the population in Philadelphia, PA. This model explores similar questions to BV, but examines racial/ethnic inequalities in soda consumption based on agents’ social characteristics and baseline soda consumption probabilities informed by the 2007–2010 National Health and Nutrition Examination Survey. Collectively, the models suggest that residential segregation is a fundamental process for the production and persistence of health inequalities. The other major conclusion of the study is that, for behaviors that are subject to social influence and that cluster within social groups, interventions that are randomly-targeted to individuals with ‘bad’ behaviors will likely experience a large degree of recidivism to pre-intervention behaviors. In contrast, interventions that target multiple members of the same network, as well as multilevel interventions that include a neighborhood-level component, can reduce recidivism. Keywords: Diet, Health inequalities, Complex systems, Social influence, Segregatio

Consumption and expenditure on food prepared away from home among Mexican adults in 2006

Objective. To describe food expenditure and consumption of foods prepared away from home among Mexican adults. Materials and methods. Data were from 45 241 adult participants in the National Health and Nutrition Survey 2006, a nationally-representative, cross-sectional survey of Mexican households. Descriptive statistics and multivariable linear and logistic regression were used to assess the relationship between location of residence, educational attainment, socioeconomic status and the following: 1) expenditure on all food and at restaurants, and 2) frequency of consumption of comida corrida or restaurant food and street food. Results. Food expenditure and consumption of food prepared away from home were positively associated with socioeconomic status, educational attainment, and urban vs. rural residence (p menor que 0.001 for all relationships in bivariate analyses). Conclusions. Consumption of food prepared outside home may be an important part of the diet among urban Mexican adults and those with high socioeconomic status and educational attainment

Corner Store Inventories, Purchases, and Strategies for Intervention: A Review of the Literature

Introduction: An increasingly popular strategy to improve the food retail environment and promote healthy eating in low-income and minority communities is the corner store conversion. This approach involves partnering with small ‘corner’ food stores to expand access to high-quality fruits, vegetables, and other healthy foods. Methods: We conducted a structured review of the literature to assess inventories and sales in corner stores, as well as to identify intervention strategies employed by corner store conversions. Results: Our review returned eight descriptive studies that discussed corner store inventories and sales, as well as ten intervention studies discussing six unique corner store conversion interventions in the United States, the Marshall Islands, and Canada. Common intervention strategies included: 1) partnering with an existing store, 2) stocking healthy foods, and 3) social marketing and nutrition education. We summarize each strategy and review the effectiveness of overall corner store conversions at changing peoples’ food purchasing, preparation, and consumption behaviors. Conclusions: Consumption of fresh, healthy, affordable foods could be improved by supporting existing retailers to expand their selection of healthy foods and promoting healthy eating at the neighborhood level. Additional corner store conversions should be conducted to determine the effectiveness and importance of specific intervention strategies