Identifying Barriers to and Facilitators of Using a Mobile Fruit and Vegetable Market Intervention Delivered to Low-Income Housing Sites: A Concept Mapping Study.

BACKGROUND: Mobile fruit and vegetable (F&V) markets may be a promising strategy to improve F&V intake among low-income and racial/ethnic minority groups. However, challenges remain in terms of maximizing the reach and utilization of such markets. Therefore, this study identifies perceived barriers to and facilitators of utilizing a mobile F&V market among residents who lived in low-income housing that received the markets. Specifically, this article reports the results of the follow-up acceptability study of the "Live Well, Viva Bien" (LWVB) intervention. METHOD: We conducted concept mapping with residents in housing communities that received the Fresh to You (FTY) markets. Participants generated, sorted, and rated statements concerning barriers to and facilitators of market use. We compared the rating data by residents' level of market utilization and created a map representing how statements clustered into conceptual themes. RESULTS: We retained 66 unique participant-generated statements. Eight thematic clusters emerged; four pertained to barriers: financial/promotion, produce-related, scheduling/knowledge, and logistic/awareness barriers, and four related to facilitators: produce/staffing, promotion, accessibility, and multilevel market facilitators. There was a strong correlation in ratings between participants who more frequently versus less frequently shopped at the markets (r = 0.94). CONCLUSIONS: Participants identified financial barriers, market promotion, ease of market accessibility, produce variety and quality, and staffing as key factors influencing FTY market use. This study highlights the importance of identifying the perceived barriers to and facilitators of mobile F&V market use among target populations to inform future efforts to scale up such approaches.

Multilevel resilience resources and cardiovascular disease in the United States: A systematic review and meta-analysis.

Objective: This systematic review and meta-analysis aimed to quantify the relationship between resilience resources at the individual (e.g., optimism), interpersonal (e.g., social support), and neighborhood (e.g., social environment) levels, and cardiovascular outcomes among adults in the United States. Method: On 9/25/2020, electronic databases (PubMed, Embase, CINAHL, PsycINFO) were systematically searched for randomized controlled trials, nonrandomized intervention studies, and prospective cohort studies that examined the relationship between resilience resources at the individual, interpersonal, or neighborhood level and cardiovascular outcomes. Studies that met the eligibility criteria were summarized narratively and quantitatively. Because relevant search results yielded only observational studies, risk of bias was assessed using an adapted version of the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool. Results: From 4,103 unique records, 13 prospective cohort studies with a total of 310,906 participants met the eligibility criteria, and six of these studies were included in the meta-analyses. Most relevant studies found that higher levels of individual-level resilience resources were associated with lower incidence of adverse cardiovascular outcomes, with point estimates ranging from .46 to 1.18. Interpersonal-level resilience resources (i.e., social network) were associated with a lower coronary heart disease risk (risk ratio, .76; 95% CI [.56, 1.02]). Neighborhood-level resilience resources (i.e., perceived social cohesion and residential stability) were associated with a lower odds of stroke (odds ratio, .92; 95% CI [.84, 1.01]). Conclusions: Evidence suggests that higher levels of resilience resources are associated with better cardiovascular outcomes. However, more prospective studies with diverse populations are needed to strengthen the evidence. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Exercise is Medicine®: Knowledge and Awareness among Exercise Science and Medical School Students.

The purpose of this exploratory study was twofold: to determine whether exercise science and medical students are aware of the Exercise is Medicine® (EIM®) program and to construct a tool that would permit assessment of EIM® variables with students enrolled in both programs. The study consisted of a quantitative, cross-sectional design, using a self-report electronic questionnaire. An Exploratory Factor Analysis (EFA) using principal component analysis extraction method with Varimax factor rotation was employed to validate the survey instrument based on the expected constructs, which posited five (5) contending factors: Value, Familiarity, Preparedness, Curricular Perceptions, and Opinions. A pairwise comparison was then performed to compare elements of the EIM® scale identified from the factor analysis by student type (medical and exercise science student) using multiple independent sample t-tests. Based on the pairwise comparisons, there were statistically significant differences of all EIM® factors by student type with the exception of Opinions (p = 0.109). Based on the trends observed in the data, exercise science students had a more positive report for each EIM® factor compared to medical students. These findings suggest a discrepancy in the delivery, acceptance, and implementation of the EIM® initiative between exercise professionals and medical healthcare providers. Future investigation is warranted to validate this experimental instrument and study the differences in EIM® factors among current medical and exercise professionals.