Can Latino food trucks (loncheras) serve healthy meals? A feasibility study.

OBJECTIVE: To conduct a pilot study to assess the feasibility of modifying food truck meals to meet the My Plate guidelines as well as the acceptability of healthier meals among consumers. DESIGN: We recruited the owners of Latino food trucks (loncheras) in 2013-2014 and offered an incentive for participation, assistance with marketing and training by a bilingual dietitian. We surveyed customers and we audited purchases to estimate sales of the modified meals. SETTING: City of Los Angeles, CA, USA. SUBJECTS: Owners or operators of Latino food trucks (loncheras) and their customers. RESULTS: We enrolled twenty-two lonchera owners and eleven completed the intervention, offering more than fifty new menu items meeting meal guidelines. Sales of the meals comprised 2 % of audited orders. Customers rated the meals highly; 97 % said they would recommend and buy them again and 75 % of participants who completed the intervention intended to continue offering the healthier meals. However, adherence to guidelines drifted after several months of operation and participant burden was cited as a reason for dropout among three of eleven lonchera owners who dropped out. CONCLUSIONS: Lonchera owners/operators who participated reported minimal difficulty in modifying menu items. Given the difficulty in enrolment, expanding this programme and ensuring adherence would likely need to be accomplished through regulatory requirements, monitoring and feedback, similar to the methods used to achieve compliance with sanitary standards. A companion marketing campaign would be helpful to increase consumer demand.

Healthy passages. A multilevel, multimethod longitudinal study of adolescent health.

PURPOSE: To provide an overview of a multisite, long-term study that focuses on risk and protective factors, health behaviors (e.g., dietary practices, physical inactivity, tobacco use, and violent activity), and health outcomes (e.g., diabetes, obesity, and sexually transmitted diseases) for a fifth-grade cohort to be followed biennially from ages 10 to 20 years. METHODS: A two-stage probability sampling procedure was used to select 5250 fifth-grade students from schools in Birmingham AL, Houston TX, and Los Angeles CA to ensure a sufficient sample size of African Americans, Hispanics, and non-Hispanic whites, to support precise statistical inferences. Computer-assisted technology was used to collect data from children and their primary caregivers. Teachers and other school personnel responded to questionnaires, and observational procedures were used to obtain information about schools and neighborhoods. RESULTS: To exploit the multilevel, multimethod structure of the data, statistical models include latent-growth mixture modeling, multilevel modeling, time-series analysis, survival analysis, latent transition analysis, and structural equation modeling. Analyses focus both on the co-occurrence and predictors of growth trajectories for different health behaviors across time. CONCLUSIONS: By using a prospective research design and studying the predictors and time course of multiple health behaviors with a multilevel, multimethod assessment protocol, this research project could provide an empirical basis for effective social and educational policies and intervention programs that foster positive health and well-being during both adolescence and adulthood.

Responsiveness of the National Eye Institute Refractive Error Quality of Life instrument to surgical correction of refractive error.

OBJECTIVE: Refractive error and the means by which it is corrected may impact substantially on quality of vision and health-related quality of life in ways not captured adequately by standard measures of visual acuity. The goal of this analysis was to evaluate the responsiveness of the National Eye Institute Refractive Error Quality of Life (NEI-RQL) instrument to surgical correction of refractive error. DESIGN: Prospective, multicenter cohort study. PARTICIPANTS: The NEI-RQL, a 42-item measure with 13 scales, was self-administered by 185 patients before and after undergoing surgical correction of myopic or hyperopic refractive error. Preoperative and postoperative clinical information was collected, including refractive error and corrected visual acuity. METHODS: Differences between preoperative and postoperative NEI-RQL scores were examined. Responsiveness was assessed using the standardized response mean and the responsiveness statistic. We also compared scales using relative efficiency estimates. MAIN OUTCOME MEASURES: Changes in NEI-RQL scales (clarity of vision, expectations, near vision, far vision, diurnal fluctuations, activity limitations, glare, symptoms, dependence on correction, worry, suboptimal correction, appearance, and satisfaction with correction). RESULTS: For myopes and hyperopes combined, refractive surgical correction was associated with statistically significant (P<0.05) improvements in scores for 11 of 13 scales. The largest improvements, ranging from 26 to 58 points on the 0 to 100 possible score range, were seen in expectations, activity limitations, dependence on correction, appearance, and satisfaction with correction. Separate analysis of myopes and hyperopes revealed similar effects in the 2 groups. Baseline scores were found to be predictive of change after surgery. CONCLUSIONS: The NEI-RQL is responsive to changes in vision-targeted health-related quality of life resulting from keratorefractive surgery. This instrument may prove useful for evaluating the beneficial and adverse impacts of surgical and nonsurgical methods of refractive error correction.