Consumers' Perceptions of Edible Marijuana Products for Recreational Use: Likes, Dislikes, and Reasons for Use.

BACKGROUND: Edible marijuana products have become extremely popular in states that have legalized marijuana for recreational use. OBJECTIVES: The goal of this research was to provide a better understanding of consumer perceptions of edible marijuana products, including why they prefer edibles relative to other forms of marijuana (e.g., smoking) and their concerns regarding the consumption of edibles. METHODS: We conducted eight focus groups (four groups in Denver, Colorado, and four groups in Seattle, Washington) in February 2016 with 62 adult consumers of edibles. Focus group transcripts were coded in QSR NVivo 10.0 qualitative analysis software, and coding reports identified trends across participants. RESULTS: Most participants preferred edibles to smoking marijuana because there is no smell from smoke and no secondhand smoke. Other reasons participants like edibles included convenience, discreetness, longer-lasting highs, less intense highs, and edibles' ability to aid in relaxation and reduce anxiety more so than smoking marijuana. Concerns and dislikes about edibles included delayed effects, unexpected highs, the unpredictability of the high, and inconsistency of distribution of marijuana in the product. No participants in either location mentioned harmful health effects from consuming edibles as a concern. Conclusions/Importance: The present study was qualitative in nature and provides a good starting point for further research to quantify through surveys how consumers understand and use edibles. Such information will help guide policy makers and regulators as they establish regulations for edibles. Also, such research can help inform educational campaigns on proper use of edibles for recreational purposes.

Adding a Social Marketing Campaign to a School-Based Nutrition Education Program Improves Children's Dietary Intake: A Quasi-Experimental Study.

BACKGROUND: Evidence supports the use of social marketing campaigns to improve nutrition knowledge and reinforce the effects of nutrition education programs. However, the additional effects of parent-focused social marketing with nutrition education have received little attention. OBJECTIVE: Our aim was to assess the impact of the Iowa Nutrition Network's school-based nutrition education program (Building and Strengthening Iowa Community Support for Nutrition and Physical Activity [BASICS]) and the benefits of adding a multichannel social marketing intervention (BASICS Plus) to increase parent-directed communication. DESIGN AND INTERVENTION: A quasi-experimental design with three study conditions compared a school-based nutrition education program (BASICS) with a school-based and social marketing intervention (BASICS Plus) and a no-treatment comparison group. PARTICIPANTS/SETTING: The study included 1,037 third-grade students attending 33 elementary schools and their parents. MAIN OUTCOME MEASURES: Measures included parents' reports of their children's in-home consumption of fruits and vegetables (F/V) and use of low-fat/fat-free milk. Data on F/V were collected using a modified version of the University of California Cooperative Extension Food Behavior Checklist; and data on milk use were collected using two questions from the National Health and Nutrition Examination Survey. STATISTICAL ANALYSES: Multilevel, mixed-effect regression models that account for correlation within repeated measures and children within school were used to compare the mean change over time in the outcome variable for one study group with the mean change over time for another study group. RESULTS: Children in BASICS increased mean consumption of fruit by 0.16 cups (P=0.04) compared with children in the comparison group. Children in BASICS Plus increased mean consumption of fruit by 0.17 cups (P=0.03) and mean consumption of vegetables by 0.13 cups (P=0.02). Children in BASICS Plus were 1.3 times (P=0.05) more likely to use low-fat/fat-free milk than children in either the BASICS group or the comparison group. CONCLUSIONS: Gaining parents' attention and engaging them in healthy eating practices for their children can be a useful way to increase the effectiveness of school-based nutrition education programs. This study demonstrates the benefits of incorporating a parent-focused social marketing campaign in nutrition education interventions.

Tasty THC: Promises and Challenges of Cannabis Edibles.

Food products containing cannabis extract (edibles) have emerged as a popular and lucrative facet of the legalized market for both recreational and medicinal cannabis. The many formulations of cannabis extracts used in edibles present a unique regulatory challenge for policy makers. Though edibles are often considered a safe, discreet, and effective means of attaining the therapeutic and/or intoxicating effects of cannabis without exposure to the potentially harmful risks of cannabis smoking, little research has evaluated how ingestion differs from other methods of cannabis administration in terms of therapeutic efficacy, subjective effects, and safety. The most prominent difference between ingestion and inhalation of cannabis extracts is the delayed onset of drug effect with ingestion. Consumers often do not understand this aspect of edible use and may consume a greater than intended amount of drug before the drug has taken effect, often resulting in profoundly adverse effects. Written for the educated layperson and for policy makers, this paper explores the current state of research regarding edibles, highlighting the promises and challenges that edibles present to both users and policy makers, and describes the approaches that four states in which recreational cannabis use is legal have taken regarding regulating edibles.

Consumer practices for purchase, storage, and preparation of poultry and eggs in selected north and South American countries: a pilot study / Comportamiento de los consumidores durante la compra, almacenamiento y preparación de carne de ave y huevos en países seleccionados de Norte y Sur América: un estudio piloto

Background: Poultry, eggs, and their products represent a potential food safety hazard. Although consumer practices related to these foods have been studied in various countries, little data exists from Latin America. Objective: The objective of this pilot study was to provide initial data to characterize consumers' purchase, storage, handling, and preparation of poultry products and eggs in three countries: Argentina, Colombia, and USA. Methods: Consumers (n = 425 total) in each location completed a questionnaire about poultry products and egg purchase locations, storage conditions (i.e. refrigerator or freezer), preparation and handling practices, and managing leftovers. Results: The results indicated that in the USA most surveyed consumers purchased refrigerated eggs, whereas in Argentina (91%) and Colombia (84%) eggs typically were purchased at room temperature. Furthermore, almost all consumers in the USA stored eggs in the refrigerator, but 23% of Argentinian and 45.9% of Colombian consumers stored eggs at room temperature, which is potentially an unsafe practice. Some practices supported possible cross-contamination, for example washing raw eggs and poultry prior to cooking. Conclusions: These results are a first comparison across countries in the Americas of consumer poultry and egg practices and can serve as the basis for further research and development of food safety educational messages.

Antecedentes: Aves de corral, huevos, y sus productos representan un potencial peligro en la seguridad alimentaria. Prácticas de consumo relacionadas con estos alimentos han sido estudiadas en varios países, pero pocos datos existen de Latinoamérica. Objetivo: El objetivo de este estudio piloto fue proveer información de manera de caracterizar la compra, almacenaje, y preparación de aves de corral y huevos en tres países: Argentina, Colombia, y Estados Unidos. Métodos: Consumidores (n=425 en total) en cada locación, completaron cuestionarios acerca del comercio de compra de aves de corral y huevos, condiciones de almacenamiento (e.j. refrigerador o freezer), preparación y prácticas de manipulación, y manipulación de sobras. Resultados: Los resultados indicaron que en Estados Unidos, la mayoría de los consumidores encuestados adquiere huevos almacenados en refrigeración, mientras que en Argentina (91%) y Colombia (84%) los huevos adquiridos estaban almacenados a temperatura ambiente. Asimismo, casi la totalidad de los consumidores en Estados Unidos almacenan los huevos en refrigeración, mientras que un 23% y un 45.9% de consumidores Argentinos y Colombianos, respectivamente almacenan huevos a temperatura ambiente, lo cual potencialmente significa una práctica no segura. Algunas prácticas sostienen posible contaminación cruzada, por ejemplo el lavado de aves y huevos previos a la cocción. Conclusiones: Los resultados muestran una primera comparación entre países de América sobre las prácticas de consumo de aves de corral y huevos, que servirán como base para futuras investigaciones y desarrollos de mensajes educacionales sobre seguridad alimentaria.

Eat Smart, Live Strong intervention increases fruit and vegetable consumption among low-income older adults.

This study evaluated the impact of a four-session interactive nutrition education program-Eat Smart, Live Strong (ESLS)-on the consumption of fruit and vegetables by low-income older adults. A pre-post quasi-experimental design study was conducted with a longitudinal sample of 614 low-income Supplemental Nutrition Assistance Program (SNAP) participants and those eligible for SNAP, aged 60 to 80 years, in 17 intervention and 16 comparison senior centers in Michigan. The study compared participants' self-reports of their consumption of fruit and vegetables using a modified version of the University of California Cooperative Extension Food Behavior Checklist. ESLS increased participants' average daily consumption of fruit by 0.2 cups (P < 0.05) and vegetables by 0.31 cups (P < 0.01). ESLS, a four-session, cognitive-behavioral nutrition education program is an effective curriculum for helping low-income older adults eat more fruit and vegetables.

Consumer education needed on norovirus prevention and control: findings from a nationally representative survey of U.S. adults.

Noroviruses (NoVs) are the leading cause of foodborne disease in the United States; however, little is known about consumers' knowledge of NoV infection and their understanding of how to prevent and control associated illness. A nationally representative Web-enabled panel survey of U.S. adults (n = 1,051) was conducted to collect information on consumers' awareness and knowledge of NoVs. Respondents who had heard of NoVs were asked 22 true-and-false questions on the transmission, prevention, and control of NoVs. Forty-seven percent of respondents reported awareness of NoVs, and 85% of respondents had heard of the terms "cruise ship virus," "the stomach bug," or "the stomach flu," which are commonly used to describe NoVs. Of those respondents who had previously heard of NoV or other terms used by consumers to describe NoV (n = 948), 36% correctly answered 11 or more of the 22 true-and-false questions, suggesting that consumers have limited knowledge on how to prevent and control NoV infection. Most consumers do not understand that the primary mode of transmission for NoV infection is fecal to oral, and many have the misperception that meat and poultry are sources of NoV infection. There is the need to educate consumers about how to prevent and control NoV infection. Although there is a proliferation of food safety education materials available, most focus on foodborne bacteria rather than viruses. The survey results will be used to revise existing consumer food safety educational materials to include information on NoV prevention and control.

Evaluating the Impact of Six Supplemental Nutrition Assistance Program Education Interventions on Children's At-Home Diets.

BACKGROUND: Nutrition education in the Supplemental Nutrition Assistance Program Education (SNAP-Ed) is designed to promote healthy eating behaviors in a low-income target population. PURPOSE: To evaluate the effectiveness of six SNAP-Ed interventions delivered in child care centers or elementary school settings in increasing participating children's at-home fruit and vegetable (F/V) consumption by 0.3 cups per day and use of fat-free or low-fat milk instead of whole or reduced-fat milk during the prior week. METHOD: Clustered randomized or quasi-experimental clustered trials took place in child care centers or elementary schools between 2010 and 2012. Parents of children at intervention and control sites completed baseline and follow-up surveys about their child's at home F/V consumption and other dietary behaviors. RESULTS: One of the six interventions was successful in meeting the objective of increasing children's F/V consumption by 0.3 cups per day. For three of the six interventions, there was a small but statistically significant increase in F/V consumption and/or use of low-fat or fat-free milk. CONCLUSION: Although not all interventions were effective, these findings suggest that it is possible for some SNAP-Ed interventions to improve dietary habits among low-income children among some families. The effective interventions appear to have benefited from implementation experience and sustained efforts at intervention refinement and improvement.

Nutrition-education program improves preschoolers' at-home diet: a group randomized trial.

OBJECTIVE: This study evaluated whether a nutrition-education program in child-care centers improved children's at-home daily consumption of fruits and vegetables, at-home use of low-fat/fat-free milk, and other at-home dietary behaviors. MATERIALS AND METHODS: Twenty-four child-care centers serving low-income families were matched by region, type, and size, and then randomly assigned to either an intervention or control condition. In the 12 intervention centers, registered dietitian nutritionists provided nutrition education to children and parents separately during a 6- to 10-week period. They also held two training sessions for center staff, to educate them on healthy eating and physical activity policies at the centers, and distributed weekly parent newsletters that included activities and recipes. Parents (n=1,143) completed a mail or telephone survey at baseline and follow-up to report information on their child's fruit, vegetable, and milk consumption and other dietary behaviors at home. This study used general and generalized linear mixed models to evaluate program impacts, while accounting for the clustering of children within centers. This study included child age, child sex, household size, respondent race/ethnicity, respondent age, and respondent sex as covariates. RESULTS: The program had a substantial impact on children's at-home daily consumption of vegetables and use of low-fat/fat-free milk. This study also found a significant increase in the frequency of child-initiated vegetable snacking, which might have contributed to the significant increase in vegetable consumption. The program did not have a significant impact on fruit consumption or parental offerings of fruits and vegetables, child-initiated fruit snacking, or child fruit consumption. CONCLUSIONS: This intervention in child-care settings that emphasized children, parents, and teachers significantly increased at-home vegetable and low-fat/fat-free milk consumption among low-income preschoolers.

Effectiveness of educational interventions to improve food safety practices among older adults.

The purpose of the study was to develop and evaluate the effectiveness of using Web-based and print materials for improving food safety practices to reduce the risk of foodborne illness among older adults. The study used a randomized controlled design, with participants assigned to an intervention group or control group. Although we observed small improvements in both groups, the difference in the changes between the two groups was nonsignificant, suggesting the educational materials did not impact participant behavior. We did, however, observe a trend improvement in one measure: the recommendation to avoid eating cold (not reheated) deli meats. The lack of program impact may be attributable to limitations of the evaluation (e.g., measurement effects) or the intervention (e.g., lack of personal contact). Based on the survey findings, improvements in older adults' food safety practices regarding reheating deli meats to steaming hot and cooking eggs until the yolks and whites are firm are needed. The current study and previous research suggest that current cohorts of older adults may be more receptive to print materials than Web-based materials. To improve retention and adoption of recommended food safety practices among older adults, future educational interventions should focus on a limited number of practices and combine print materials with personal contact.

Pregnant women and listeriosis: preferred educational messages and delivery mechanisms.

OBJECTIVE: To characterize pregnant women's food safety practices, to evaluate the impact of existing educational messages on the risks and prevention of listeriosis, and to identify preferred delivery methods for educational initiatives. DESIGN: Eight focus group discussions conducted with pregnant women in 4 locations. SETTING: Focus group discussions led by moderators using a prepared moderator guide. PARTICIPANTS: Purposeful sampling was used to select the 63 pregnant women who participated in this study. The focus groups were segmented by location and education level. PHENOMENON OF INTEREST: Food safety knowledge and food-handling practices, food safety practices during pregnancy, attitudes toward listeriosis brochure, and preferred delivery methods. ANALYSIS: Focus group discussions were videotaped and audiorecorded. Detailed summaries of each discussion were prepared and systematically analyzed to identify common themes within and across groups. RESULTS: Participants were not aware of the risks of listeriosis and recommended practices for listeriosis prevention; thus, they were not taking precautions during their pregnancy to prevent listeriosis. CONCLUSIONS AND IMPLICATIONS: The study identified the need to develop educational materials on listeriosis targeted specifically to pregnant women and to partner with obstetricians and other health care providers to deliver these materials to pregnant women.