Food for teens: how social media is associated with adolescent eating outcomes.

OBJECTIVE: To assess the relationship between exposure to social media food messages and self-reported adolescent eating outcomes (including food intake, perceived norms and food literacy). DESIGN: A cross-sectional survey was used to assess reported exposure to core and non-core food messages (including marketing messages) on social media, as well as reported food intake, perceived norms, food literacy, attitudes, self-regulation, among others. SETTING: 18 secondary schools across Flanders, Belgium. PARTICIPANTS: 1002 adolescents 11-19 years of age. RESULTS: Self-reported exposure to food marketing and overall food messages on social media was positively associated with eating attitudes, behaviours, perceived norms and food literacy among adolescents. Interestingly, the relationship between food exposure and intake was shaped differently depending on food type; descriptive norms mediated the positive relationship between non-core food social media exposure and non-core food intake (e.g. indirect effect estimate on self-reported sweets consumption is 0·005, se 0·002, P < 0·01), while food literacy mediated the positive relationship between core food social media exposure and core food intake (e.g. indirect effect estimate on self-reported vegetable consumption is 0·01, se 0·003, P < 0·000). CONCLUSIONS: This study highlights the significance of social media in relation to adolescent eating. There is an opportunity for health professionals to use social media in the promotion of core food among adolescents. We call for relevant policy actions to regulate the marketing of non-core food to adolescents on social media.

Willingness to participate in genome testing: a survey of public attitudes from Qatar.

Genomics has the potential to revolutionize medical approaches to disease prevention, diagnosis, and treatment, but it does not come without challenges. The success of a national population-based genome program, like the Qatar Genome Program (QGP), depends on the willingness of citizens to donate samples and take up genomic testing services. This study explores public attitudes of the Qatari population toward genetic testing and toward participating in the QGP. A representative sample of 837 adult Qataris was surveyed in May 2016. Approximately 71% of respondents surveyed reported that they were willing to participate in the activities of the QGP. Willingness to participate was significantly associated with basic literacy in genetics, a family history of genetic diseases, and previous experience with genetic testing through premarital screening. Respondents cited the desire to know more about their health status as the principle motivation for participating, while lack of time and information were reported as the most important barriers. With QGP plans to ramp up the scale of its national operation toward more integration into clinical care settings, it is critical to understand public attitudes and their determinants. The results demonstrate public support but also identify the need for more education and individual counseling that not only provide information on the process, challenges, and benefits of genomic testing, but that also address concerns about information security.

Human and economic resources for empowerment and pregnancy-related mental health in the Arab Middle East: a systematic review.

This systematic review synthesizes research on the influence of human and economic resources for women's empowerment on their pre- and postnatal mental health, understudied in the Arab world. We include articles using quantitative methods from PubMed and Web of Science. Two researchers reviewed databases and selected articles, double reviewing 5% of articles designated for inclusion. Twenty-four articles met inclusion criteria. All 24 articles measured depression as an outcome, and three included additional mental health outcomes. Nine of 17 studies found an inverse association between education and depression; two of 12 studies found contradictory associations between employment and depression, and four of six studies found a positive association between financial stress and depression. These results suggest that there is a negative association between education and depression and a positive association between financial stress and depression among women in the Arab world. Firm conclusions warrant caution due to limited studies meeting inclusion criteria and large heterogeneity in mental health scales used, assessment measures, and definitions of human and economic resources for women's empowerment. It is likely that education reduces depression among postpartum women and that financial stress increases their depression. These findings can be used to aid in the design of interventions to improve mother and child outcomes. However, more research in the Arab world is needed on the relationship between human and economic resources for women's empowerment and perinatal mental health, and more consistency is needed in how resources and mental health are measured.

Community-based participatory research in complex settings: clean mind-dirty hands.

Despite the abundance of the literature which discusses factors supporting or inhibiting effective participation of community members in community-based research, there is a paucity of publications analysing challenges to participation in complex settings. This manuscript describes an intervention built on researcher-community partnership amid complex social conditions which challenged participation of community members at different stages of the research process. The research took place in a Palestinian refugee camp in Beirut, Lebanon and 1 of 12 in Lebanon which suffer from deteriorating social, economic and physical conditions perpetuated by state-imposed restrictions. The research team developed a community coalition which was involved in all stages of planning, designing, implementation and dissemination. In all those stages the aim was to maintain rigorous research, to follow a 'clean mind' approach to research, but maintain principles of community participation which necessitate 'a dirty hand'. Despite commitment to the principles of community-based participatory research, participation of community members (including youth, parents and teachers) was affected to a great extent by the social, physical and structural conditions of the community context. Characteristics of the context where research is conducted and how it affects community members should not be overlooked since multiple factors beyond the researchers' control could interfere with the rigour of scientific research. Researchers need to develop a plan for participation with the community from the beginning with an understanding of the community forces that affect meaningful participation and address possible deterrence.

That's My Cue to Eat: A Systematic Review of the Persuasiveness of Front-of-Pack Cues on Food Packages for Children vs. Adults.

Packaging is increasingly recognized as an essential component of any marketing strategy. Visual and informational front-of-pack cues constitute salient elements of the environment that may influence what and how much someone eats. Considering their overwhelming presence on packaging of non-core foods, front-of-pack cues may contribute to the growing rates of overweight and obesity in children and adults. We conducted a systematic review to summarize the evidence concerning the impact of front-of-pack cues on choices and eating behaviors. Four electronic databases were searched for experimental studies (2009-present). This resulted in the inclusion of 57 studies (in 43 articles). We identified studies on children (3-12 years) and adults (≥ 18 years), but no studies on adolescents (12-18 years). The results suggest that children and adults are susceptible to packaging cues, with most evidence supporting the impact of visual cues. More specifically, children more often choose products with a licensed endorser and eat more from packages portraying the product with an exaggerated portion size. Adults' eating behaviors are influenced by a range of other visual cues, mainly, package size and shape, and less so by informational cues such as labels.

Media food marketing and eating outcomes among pre-adolescents and adolescents: A systematic review and meta-analysis.

The media marketing's effect on child and adult eating has been extensively researched, yet, little is known about its effect on adolescents. The aim of this review is to synthesize available research on the relation between media food marketing and eating-related cognitions, attitudes, and behaviors among pre-adolescents (8-11) and adolescents (12-19). We systematically screened and retrieved 9324 articles, of which 28 were included in the review-analysis and 19 in the meta-analysis. Robust variance estimation with random effect weights indicated a positive small standard effect size (d = 0.26, P < .001) of media food marketing on all unhealthy eating outcomes, and a subgroup analysis revealed a small effect size (d = 0.26, P < .001) on unhealthy eating behaviors specifically. Another subgroup analysis among adolescents revealed an effect of marketing (d = 0.22, P < .05) on unhealthy eating outcomes. This review demonstrates the significance of media marketing on eating in pre-adolescents and adolescents, and highlights limitations in the food marketing and adolescent eating literature specific to eating outcomes and marketing media studied and research designs utilized. We call for properly designed food marketing research exploring digital media's effect on eating attitudes and cognitions, especially among older adolescents.

What Do Adolescents See on Social Media? A Diary Study of Food Marketing Images on Social Media.

Food marketing influences eating preferences and choices, especially among adolescents, contributing to the rise of overweight, obesity, and other chronic health disorders. Recent social media advancements have provided food marketers with platforms to reach out to many in more personal and authentic ways as compared to classical media advertising. Such personalized and borderless social media platforms allow marketers to easily use owned, paid, and earned (word-of -mouth) marketing strategies, including paid and non-paid influencers to reach younger target audiences. This study therefore aims to explore food messages adolescents (12-18 years old) encounter on social media, and assess these messages for their sources, the presence of core and non-core food, and the marketing strategies employed. To attain an in-depth understanding of the food messages that adolescents are continuously exposed to, we carried out a diary study with 21 Flemish adolescents who took screenshots of food images they encountered on their social media platforms for the duration of one week. A quantitative and qualitative content analysis of 611 images revealed that adolescents are mostly exposed to messages of non-core (67% of images) and branded (49% of images) food, often (49% of images) presented in association with a social context such as hanging around with friends, eating at restaurants and celebrating with food. Adolescents often encounter branded food images through peers and social media influencers, the majority of which are part of earned (49% of branded images) or paid (40% of branded images) media food marketing. This research provides an in-depth understanding of the social media messages that adolescents encounter on a daily basis and sheds light on food norms typically communicated on social media by marketers, peers, and influencers. Study findings highlight prominent social media food messages that should be tested for their persuasiveness, providing insights for future research that aims to assess the effects of social media food marketing on adolescents. Based on the study findings, we call for relevant policy actions that address current social media marketing strategies targeted at adolescents.

Social resources and Arab women's perinatal mental health: A systematic review.

BACKGROUND: Women's mental health in the perinatal period is understudied worldwide and in Arab countries especially. AIM: This systematic review explores evidence of the association between women's social resources for empowerment in the Arab World and their mental health in the prenatal and postnatal (≤1year postpartum) periods. METHODS: Guided by Kabeer's framework of empowerment, the authors applied a search string in PubMed and Web of Science databases to identify studies in countries of the Arab League (hereafter the Arab World) that address mental health and social resources for women's empowerment in the perinatal period. FINDINGS: Of 1865 electronically retrieved articles, 23 met the inclusion criteria. Overall, the majority of studies found a positive association between social resources for empowerment and perinatal mental health. Seven studies explored the relationship between familial or general social support and prenatal mental health in Arab women, and found a significant positive association. Sixteen of the 18 studies of women in the postnatal period found that enabling familial, extra-familial, and/or general social support was positively associated with mental health. CONCLUSION: This review demonstrates an association between social resources and perinatal mental health, but there is a dearth of research in this area. We call for additional research on Arab women in the perinatal period using context-specific but standardized tools to assess social resources and mental health. Evidence on positive mental health, resilience, and the influence of social resources can guide the improvement of prenatal and postpartum care services.

The Practice of Research Ethics in Lebanon and Qatar: Perspectives of Researchers on Informed Consent.

Informed consent requirements for conducting research with human participants are set by institutional review boards (IRBs) following established guidelines. Despite this, researchers continue to face challenges in seeking and obtaining informed consent. This study discusses researchers' views of such problems in Lebanon and Qatar, which vary in research regulation. We conducted in-depth interviews with 52 academic researchers from various fields of research in both countries and analyzed them using thematic analysis. Important disjunctions emerged between IRB requirements and actual practice. Variations in obtaining informed consent were affected by the research context, type of research, and the prevalent cultural norms and values. Regulatory systems and guidelines for informed consent do not necessarily ensure ethical research conduct. Implications for improvement are presented.

"Protecting" or "Policing": Academic Researchers' View of IRBs in an Arab Context.

A recent surge of research universities and human subjects research funding in the Arab world raises concerns about applied research ethics and oversight. In-depth interviews conducted with 52 researchers in Lebanon and Qatar about their research conduct and the problems they face while conducting it indicate that although researchers admit to the added value of institutional review board (IRB) functions, the researchers have several complaints, such as rigid and contextually insensitive requirements, delays, and inadequate resources at IRBs, and a lack of outreach and effective communication with researchers. The study discusses these challenges pointing to the need for socioculturally adaptive regulations and forms and strengthening outreach and communication between IRBs and their users to improve ethical practices. Implications for future research are also presented.