RESUMO
Background: Little is known about barriers to and perceptions of participation in the in Women, Infants, and Children (WIC) program in rural Appalachia. Purpose: To gain a deeper understanding of maternal barriers and perceptions related to WIC participation in rural Appalachia. Methods: Pregnant women and mothers were recruited in-person and via flyers from WIC offices in three counties in Appalachian North Carolina. Four semi-structured focus groups were conducted between May to July 2018. Each focus group was approximately 60 minutes long and included open-ended questions about the overall WIC experience in rural Appalachia. Focus groups were audio-recorded, transcribed verbatim, and content analysis of transcripts was performed by two trained researchers. Identified themes were discussed and consensus was reached by the researchers to generate final themes for four areas of interest: (1) most valued aspects of WIC program, (2) barriers to program participation and benefit redemption, (3) experiences during appointments, and (4) suggestions for improving experiences in program. Results: The most valued aspects of participation were financial benefits and support/resources provided by WIC staff. In contrast, lack of variety of WIC-approved foods and social stigma were perceived as major barriers to participation and redeeming benefits. Implications: This study contributes to a better understanding of the barriers and perceptions related to WIC participation in this geographically and culturally unique area of rural Appalachia. Findings are valuable for informing WIC state-agencies and policymakers whose efforts focus on the identification and development of effective recruitment and retention strategies for WIC-eligible families in rural Appalachia.
RESUMO
Evidence suggests that berries contain bioactive compounds, which reduce certain cancers and hypertension. Our hypothesis was that daily blueberry (BB) consumption would increase natural killer (NK) cells and plasma redox capacity and reduce blood pressure, augmentation index (AIx), central pulse wave velocity, and aortic systolic pressures (ASPs). Twenty-five men and postmenopausal women aged 18 to 50 years were recruited and randomized to BB (n, 13) or placebo groups (n, 12). Participants were provided with BB (equivalent to 250 g berries) or placebo powders each day for 6 weeks. Blood pressure, vascular performance testing, and blood samples were taken at baseline (presupplementation). Participants returned after 6 weeks and repeated all procedures. Presupplementation to postsupplementation comparisons for the main effects of treatment, time, and treatment-time interaction were made using a 2 (treatment) × 2 (times) repeated-measures analysis of variance for all vascular measures, redox status, and NK cell counts. Anthropometric measures were compared using t tests. Body mass, composition, and overall blood pressures were not affected in either group. Overall, AIx and ASPs were decreased in BB (treatment effect, P = .024 and P = .046, respectively). Plasma redox was not affected. Absolute NK cells were increased in BB (time, P = .001 and interaction, P = .012). Subjects (n, 9) with prehypertensive pressures (≥120/80 mm Hg, respectively) were examined as a subset using t tests and exhibited significant reductions in diastolic pressure (P = .038) from presupplementation to postsupplementation in BB. We conclude that BB ingestion for 6 weeks increases NK cells and reduces AIx, ASP, and diastolic pressures in sedentary males and females.