Comparing shopper characteristics by online grocery ordering use among households in low-income communities in Maine.

OBJECTIVE: Online grocery shopping could improve access to healthy food, but it may not be equally accessible to all populations - especially those at higher risk for food insecurity. The current study aimed to compare the socio-demographic characteristics of families who ordered groceries online v. those who only shopped in-store. DESIGN: We analysed enrollment survey and 44 weeks of individually linked grocery transaction data. We used univariate χ2 and t-tests and logistic regression to assess differences in socio-demographic characteristics between households that only shopped in-store and those that shopped online with curbside pickup (online only or online and in-store). SETTING: Two Maine supermarkets. PARTICIPANTS: 863 parents or caregivers of children under 18 years old enrolled in two fruit and vegetable incentive trials. RESULTS: Participants had a total of 32 757 transactions. In univariate assessments, online shoppers had higher incomes (P < 0 0001), were less likely to participate in Special Supplemental Nutrition Program for Women, Infants, and Children or Supplemental Nutrition Assistance Program (SNAP; P < 0 0001) and were more likely to be female (P = 0·04). Most online shoppers were 30-39 years old, and few were 50 years or older (P = 0·003). After controlling for age, gender, race/ethnicity, number of children, number of adults, income and SNAP participation, female primary shoppers (OR = 2·75, P = 0·003), number of children (OR = 1·27, P = 0·04) and income (OR = 3·91 for 186-300 % federal poverty line (FPL) and OR = 6·92 for >300 % FPL, P < 0·0001) were significantly associated with likelihood of shopping online. CONCLUSIONS: In the current study of Maine families, low-income shoppers were significantly less likely to utilise online grocery ordering with curbside pickup. Future studies could focus on elucidating barriers and developing strategies to improve access.

Phenotypic assessment and ligand screening of ETA/ETB receptors with label-free dynamic mass redistribution assay.

Endothelin receptors, consisting of two subtypes, ETA and ETB, are expressed in various tissues and widely regulate cardiovascular systems. The two receptors show distinct biological characteristics and are involved in different downstream pathways. Hence, to evaluate the ETA and ETB receptors on the same platform is helpful to display their pharmacological features. In this study, we developed a label-free dynamic mass redistribution (DMR) assay to investigate the phenotypic features of the ETA and ETB receptors in native cell lines. Meanwhile, specific agonists and antagonists were investigated for their pharmacological parameters. Results indicated that the DMR response of endothelin 1 (ET-1, an endogenous ETA/ETB agonist) was cell line dependent on ETA receptors and this ligand generated a biphasic dose-response curve in SH-SY5Y as well as PC3 cell lines. ET-1 and IRL 1620 (an ETB agonist) showed different DMR responses in U251 cells. IC50 values of antagonists were consistent with the Ki values previously reported. Furthermore, a list of compounds was screened on the ETA and ETB receptor models established by the high-throughput DMR assays. This study demonstrated that the DMR assay had great potential in the phenotypic-based investigation and ligand screening of GPCRs.

Supermarket Purchases Over the Supplemental Nutrition Assistance Program Benefit Month: A Comparison Between Participants and Nonparticipants.

INTRODUCTION: The Supplemental Nutrition Assistance Program provides financial assistance for food and beverage purchases to approximately 1 in 7 Americans, with benefits distributed once monthly. Most Supplemental Nutrition Assistance Program benefits are spent early in the month, leading to decreased caloric intake later in the month. The effects of this early benefit depletion on the types of foods and beverages purchased over the course of the month is unclear. METHODS: Using individually tracked sales data from 950 participants enrolled in 2 supermarket-based RCTs in Maine (October 2015-April 2016 and October 2016-June 2017), purchases of selected food categories by Supplemental Nutrition Assistance Program participants (n=248) versus nonparticipants (n=702) in the first 2 weeks compared with the last 2 weeks of the Supplemental Nutrition Assistance Program benefit month were examined. Analyses were completed in 2019. RESULTS: For Supplemental Nutrition Assistance Program participants, adjusted mean food spending decreased 37% from the first 2 weeks to the last 2 weeks of the Supplemental Nutrition Assistance Program benefit month (p<0.0001) compared with a 3% decrease (p=0.02) for nonparticipants. The decline in spending by Supplemental Nutrition Assistance Program participants occurred in all examined categories: vegetables (-25%), fruits (-27%), sugar-sweetened beverages (-30%), red meat (-37%), convenience foods (-40%), and poultry (-48%). Difference-in-difference estimators comparing Supplemental Nutrition Assistance Program participants with nonparticipants were statistically significant (p<0.05) for all examined categories. CONCLUSIONS: In the second half of the Supplemental Nutrition Assistance Program benefit month, individuals reduced purchases of all examined categories. More research is needed to understand the impact of these fluctuations in spending patterns on the dietary quality of Supplemental Nutrition Assistance Program participants.

Highly Effective and Low-Cost MicroRNA Detection with CRISPR-Cas9.

MicroRNAs have been reported as related to multiple diseases and have potential applications in diagnosis and therapeutics. However, detection of miRNAs remains improvable, given their complexity, high cost, and low sensitivity as of currently. In this study, we attempt to build a novel platform that detects miRNAs at low cost and high efficacy. This detection system contains isothermal amplification, detecting and reporting process based on rolling circle amplification, CRISPR-Cas9, and split-horseradish peroxidase techniques. It is able to detect trace amount of miRNAs from samples with mere single-base specificity. Moreover, we demonstrated that such scheme can effectively detect target miRNAs in clinical serum samples and significantly distinguish patients of non-small cell lung cancer from healthy volunteers by detecting the previously reported biomarker: circulating let-7a. As the first to use CRISPR-Cas9 in miRNA detection, this method is a promising approach capable of being applied in screening, diagnosing, and prognosticating of multiple diseases.

Transactions at a Northeastern Supermarket Chain: Differences by Supplemental Nutrition Assistance Program Use.

INTRODUCTION: Although one in seven Americans receives Supplemental Nutrition Assistance Program (SNAP) benefits, little is known about how these benefits for food are spent because individual-level sales data are not publicly available. The purpose of this study is to compare transactions made with and without SNAP benefits at a large regional supermarket chain. METHODS: Sales data were obtained from a large supermarket chain in the Northeastern U.S. for a period of 2 years (April 2012-April 2014). Multivariate multiple regression models were used to quantify relative differences in dollars spent on 31 predefined SNAP-eligible food categories. Analyses were completed in 2016. RESULTS: Transactions with SNAP benefit use included higher spending on less healthful food categories, including sugar-sweetened beverages ($1.08), red meat ($1.55), and convenience foods ($1.34), and lower spending on more healthful food categories, such as fruits (-$1.51), vegetables (-$1.35), and poultry (-$1.25) compared to transactions without SNAP benefit use. CONCLUSIONS: These findings provide objective data to compare purchases made with and without SNAP benefits. Next steps should be to test proposed SNAP modifications to determine whether they would have the intended effect of promoting healthier purchasing patterns among SNAP beneficiaries.

Ecological Risk Assessment of EDTA-Assisted Phytoremediation of Cd Under Different Cultivation Systems.

A long-term field experiment was designed to assess remediation efficiency and ecological risk of phytoremediation of Cd under different cultivation systems with or without ethylene diamine tetraacetic acid (EDTA). EDTA can significantly improve the phytoremediation effectiveness of a historically polluted e-waste dismantling site through enhancing Cd uptake by plants in all cultivation systems along with higher ecological risks to different receptors especially in the presence of Cicer arietinum (chickpea). Moisture content at each layer of soil profile under Eucalyptus globules L. cultivated sites was consistently lower than under chickpea monoculture as a result of E. globules' high water use efficiency. Besides low soil moisture, E. globules can intercept more Cd-rich leachate than chickpea regardless of the presence of EDTA. E. globules could be used for Cd phytoremediation as they can take full advantage of EDTA and decrease ecological risk caused by the chelator.

Impact of pre-conception health care: evaluation of a social determinants focused intervention.

The purpose of this study was to evaluate the outcomes of the social determinants component of a multiple determinants model of pre- and inter-conception care. Health department vital statistics and infectious disease data on birth and factors influencing birth outcomes were analyzed for participants in a program designed to mitigate the effects of social class and stress in contrast to a matched comparison group and other relevant populations. The program showed promising results related to reducing infant mortality and reducing other high-risk factors for poor birth outcomes, including low birth weight and sexually transmitted disease. Social determinant interventions, designed to mitigate the impact of social class and stress, should be considered with efforts to reduce infant mortality, particularly the disparities associated with infant mortality. Additional research should be conducted to refine replicable social determinant focused interventions and confirm and generalize these results.

A longitudinal study of a pediatric practice-based versus an agency-based model of care coordination for children and youth with special health care needs.

BACKGROUND: Care coordination has been shown to improve the quality of care for children and youth with special health care needs (CYSHCN). However, there are different models for structuring care coordination in relation to the medical home and most Title V agencies use an agency-based model of care coordination. No studies have prospectively compared a practice-based care coordination model to a Title V agency-based care coordination model. OBJECTIVE: Report the results of a prospective cohort study comparing a practice-based nurse care coordinator model with Title V agency-based care coordination model. DESIGN/METHODS: Three pediatric practices received the intervention, placement of a nurse care coordinator onsite within the practice, along with training and quality improvement on the principles of the medical home. Three practices continued to rely on agency-based care coordination services. CYSHCN in the practices were identified, interviewed at baseline, and re-interviewed after 18 months. We interviewed 262 families/children at baseline and 144 families/children (76 in the intervention and 68 in the comparison group) at 18 months. Families rated the quality of services they received from the care coordinator and the pediatric practice, and their experience of barriers to services for their CYSHCN. RESULTS: Families in the practice-based care coordination group were more likely to report improvement in their experience with the care coordinator (P = 0.02), fewer barriers to needed services (P = 0.003), higher overall satisfaction with care coordination (P = 0.03), and better treatment by office staff (P = 0.04). CONCLUSIONS: We found that for families of CYSHCN, practice-based care coordination in the medical home led to increased satisfaction with the quality of care they received and a reduction of barriers to care. The practice-based care coordination model is utilized by a minority of State Title V agencies and should be considered as a potentially more effective model than the agency-based approach.

A multi-method assessment of satisfaction with services in the medical home by parents of children and youth with special health care needs (CYSHCN).

OBJECTIVE: To assess satisfaction of parents of children with special health care needs with treatment by office staff, communication with the pediatrician, involvement in decision-making and coordination of services outside the practice. PATIENTS AND METHODS: We used a mixed-method (qualitative and quantitative) approach to collect parental perceptions of the Medical Home services provided by their pediatricians. Six practices were selected to participate in the study based on geographic and patient demographic characteristics. In total, 262 (75% response rate) families completed surveys, and 28 families of these participated in focus groups. The Family Survey collected information (corroborated and enriched with focus group interviews) on parent and child demographics, severity of the child's condition and the burden on parents. We assessed parental satisfaction with treatment by office staff, communication with the pediatrician, involvement in decision-making, and connection to services outside the practice. Survey responses were analyzed using SAS with all associations considered significant at the P < 0.05 level. Focus groups were recorded, transcribed into EZ-Text and analyzed by a team of three researchers to identify patterns and themes inherent in the data. RESULTS: Families reported in focus group interviews that they experienced significant stress due to the demands of caring for a child with special health care needs. Overall, only a small percentage of families reported being dissatisfied with their treatment by office staff (13-14%), communication with the pediatrician (10%), and involvement in decision-making (15-16%). However, a majority of families (approximately 58%) were dissatisfied with the ability of the pediatrician and his/her office to connect the families with resources outside the pediatric office. Families whose children had more severe conditions, or whose conditions had more of an impact on the families, reported being less satisfied with all aspects of communication and care coordination Families of youth with special health care needs (>12 years of age) were less satisfied than families of younger children with the practice's ability to connect them to resources outside the practice. CONCLUSIONS: Both the focus groups and surveys demonstrated that families of children with special needs are under very significant stress. Pediatricians must become better equipped to identify and communicate more proactively with families of CYSHCN that are experiencing significant parent burden. Pediatricians and their staff also need to improve their knowledge of community resources and proactively make referrals to community services needed by families of CYSHCN.

Immunization levels among inner city children enrolled in subsidized childcare.

PURPOSE: Measure immunization rates in subsidized child care and determine whether the population is representative of inner city preschool children. METHODS: We identified 156 children, ages 0-60 months, in 14 inner-city child care centers enrolled in subsidized care and obtained demographic and immunization information. ZIP-code distribution of sample children was correlated with similarly aged children from the 2000 Census (family incomes .150% of poverty). RESULTS: The overall subsidized child care population was geographically similar to all low-income children, ages 0-5, in Jacksonville (r.0.94). Only 73.3% were up-to-date at 3 months and 44.2% at 12 months of age (3 DTaP, 2 HIB, 2 IPV, 3 Hep B). DISCUSSION: Our findings support the contention that children in subsidized child care are geographically representative of low-income, inner city preschool children. This study suggests that children enrolled in subsidized child care are both potentially underserved and an accessible window into the inner-city preschool population.

Patterns in primary health care utilization among individuals with intellectual and developmental disabilities in Florida.

Individuals living with intellectual and developmental disabilities face complex medical problems. Primary care physicians tend to provide basic medical care, serving as a base through which other forms of care can be accessed. In this study we describe patterns of primary care utilization among adults enrolled on the Florida Medicaid's Home and Community-Based Services Waiver. About 40% of the adults on the Waiver did not see a primary care provider between 1999 and 2003. Primary health care utilization was higher in the northern parts of Florida and conversely lower in the southeast. The establishment of a medical home can ensure the timely receipt of preventive care as well as help coordinate the complex care that many individuals with disabilities need.

Assessing the status of partnerships between academic institutions and public health agencies.

We identified, described, and defined models of academic institution-public health agency partnerships in Florida. The study involved a mixed-method research design using data collected from a survey of 67 county health department (CHD) administrators and directors in Florida, in-depth interviews of key informants, and reviews of relevant Florida statutes and other archival data providing context for the partnerships. Fifty-one of the CHDs (76%) participated in the survey. Most reported formal agreements involving 50 different academic institutions. The partnerships were perceived to enhance the local public health system's capacity. Recommendations focus on the need for a multitiered system for recognition of the partnerships and expansion of federal support for partnership beyond existing approaches.