Mobility network models of COVID-19 explain inequities and inform reopening.

The coronavirus disease 2019 (COVID-19) pandemic markedly changed human mobility patterns, necessitating epidemiological models that can capture the effects of these changes in mobility on the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)1. Here we introduce a metapopulation susceptible-exposed-infectious-removed (SEIR) model that integrates fine-grained, dynamic mobility networks to simulate the spread of SARS-CoV-2 in ten of the largest US metropolitan areas. Our mobility networks are derived from mobile phone data and map the hourly movements of 98 million people from neighbourhoods (or census block groups) to points of interest such as restaurants and religious establishments, connecting 56,945 census block groups to 552,758 points of interest with 5.4 billion hourly edges. We show that by integrating these networks, a relatively simple SEIR model can accurately fit the real case trajectory, despite substantial changes in the behaviour of the population over time. Our model predicts that a small minority of 'superspreader' points of interest account for a large majority of the infections, and that restricting the maximum occupancy at each point of interest is more effective than uniformly reducing mobility. Our model also correctly predicts higher infection rates among disadvantaged racial and socioeconomic groups2-8 solely as the result of differences in mobility: we find that disadvantaged groups have not been able to reduce their mobility as sharply, and that the points of interest that they visit are more crowded and are therefore associated with higher risk. By capturing who is infected at which locations, our model supports detailed analyses that can inform more-effective and equitable policy responses to COVID-19.

Encouraging the resumption of economic activity after COVID-19: Evidence from a large scale-field experiment in China.

As the COVID-19 pandemic comes to an end, governments find themselves facing a new challenge: motivating citizens to resume economic activity. What is an effective way to do so? We investigate this question using a field experiment in the city of Zhengzhou, China, immediately following the end of the city's COVID-19 lockdown. We assessed the effect of a descriptive norms intervention providing information about the proportion of participants' neighbors who have resumed economic activity. We find that informing individuals about their neighbors' plans to visit restaurants increases the fraction of participants visiting restaurants by 12 percentage points (37%), among those participants who underestimated the proportion of neighbors who resumed economic activity. Those who overestimated did not respond by reducing restaurant attendance (the intervention yielded no "boomerang" effect); thus, our descriptive norms intervention yielded a net positive effect. We explore the moderating role of risk preferences and the effect of the intervention on subjects' perceived risk of going to restaurants, as well as the contrast with an intervention for parks, which were already perceived as safe. All of these analyses suggest our intervention worked by reducing the perceived risk of going to restaurants.

Impact on wine sales of removing the largest serving size by the glass: An A-B-A reversal trial in 21 pubs, bars, and restaurants in England.

BACKGROUND: Interventions that alter aspects of the physical environments in which unhealthy behaviours occur have the potential to change behaviour at scale, i.e., across populations, and thereby decrease the risk of several diseases. One set of such interventions involves reducing serving sizes, which could reduce alcohol consumption. The effect of modifying the available range of serving sizes of wine in a real-world setting is unknown. We aimed to assess the impact on the volume of wine sold of removing the largest serving size by the glass from the options available in licensed premises. METHODS AND FINDINGS: The study was conducted between September 2021 and May 2022 in 21 licensed premises in England that sold wine by the glass in serving sizes greater than 125 ml (i.e., 175 ml or 250 ml) and used an electronic point of sale till system. It used an A-B-A reversal design, set over 3 four-weekly periods. "A" represented the nonintervention periods during which standard serving sizes were served and "B" the intervention period when the largest serving size for a glass of wine was removed from the existing range in each establishment: 250 ml (18 premises) or 175 ml (3 premises). The primary outcome was the daily volume of wine sold, extracted from sales data. Twenty-one premises completed the study, 20 of which did so per protocol and were included in the primary analysis. After adjusting for prespecified covariates, the intervention resulted in -420·8 millilitres (ml) (95% confidence intervals (CIs) -681·4 to -160·2 p = 0·002) or -7·6% (95% CI -12·3%, -2·9%) less wine being sold per day. There was no evidence that sales of beer and cider or total daily revenues changed but the study was not powered to detect differences in these outcomes. The main study limitation is that we were unable to assess the sales of other alcoholic drinks apart from wine, beer, and cider, estimated to comprise approximately 30% of alcoholic drinks sold in participating premises. CONCLUSIONS: Removing the largest serving size of wine by the glass from those available reduced the volume of wine sold. This promising intervention for decreasing alcohol consumption across populations merits consideration as part of alcohol licensing regulations. TRIAL REGISTRATION: ISRCTN https://doi.org/10.1186/ISRCTN33169631; OSF https://osf.io/xkgdb.

Impact on beer sales of removing the pint serving size: An A-B-A reversal trial in pubs, bars, and restaurants in England.

BACKGROUND: Smaller serving sizes could contribute towards reducing alcohol consumption across populations and thereby decrease the risk of 7 cancers and other diseases. To our knowledge, the current study is the first to assess the impact on beer, lager, and cider sales (hereafter, for ease, referred to just as "beer sales") of removing the largest draught serving size (1 imperial pint) from the options available in licensed premises under real-word conditions. METHODS AND FINDINGS: The study was conducted between February and May 2023, in 13 licensed premises in England. It used an A-B-A reversal design, set over 3 consecutive 4-weekly periods with "A" representing the nonintervention periods during which standard serving sizes were served, and "B" representing the intervention period when the largest serving size of draught beer (1 imperial pint (568 ml)) was removed from existing ranges so that the largest size available was two-thirds of a pint. Where two-third pints were not served, the intervention included introducing this serving size in conjunction with removing the pint serving size. The primary outcome was the mean daily volume of all beer sold, including draught, bottles, and cans (in ml), extracted from electronic sales data. Secondary outcomes were mean daily volume of wine sold (ml) and daily revenue (£). Thirteen premises completed the study, 12 of which did so per protocol and were included in the primary analysis. After adjusting for prespecified covariates, the intervention resulted in a mean daily change of -2,769 ml (95% CI [-4,188, -1,578] p < 0.001) or -9.7% (95% CI [-13.5%, -6.1%] in beer sold. The daily volume of wine sold increased during the intervention period by 232 ml (95% CI [13, 487], p = 0.035) or 7.2% (95% CI [0.4%, 14.5%]). Daily revenues decreased by 5.0% (95% CI [9.6%, -0.3%], p = 0.038). CONCLUSIONS: Removing the largest serving size (the imperial pint) for draught beer reduced the volume of beer sold. Given the potential of this intervention to reduce alcohol consumption, it merits consideration in alcohol control policies. TRIAL REGISTRATION: ISRCTN.com ISRCTN18365249.

Outbreak Linked to Morel Mushroom Exposure - Montana, 2023.

During March-April 2023, a total of 51 persons reported mild to severe gastrointestinal illness after eating at restaurant A in Bozeman, Montana. The outbreak resulted in multiple severe outcomes, including three hospitalizations and two deaths. After an inspection and temporary restaurant closure, the Montana Department of Public Health and Human Services and Montana's Gallatin City-County Health Department collaborated with CDC to conduct a matched case-control study among restaurant patrons to help identify the source of the outbreak. Consumption of morel mushrooms, which are generally considered edible, was strongly associated with gastrointestinal illness. A dose-response relationship was identified, and consumption of raw morel mushrooms was more strongly associated with illness than was consumption of those that were at least partially cooked. In response to the outbreak, educational public messaging regarding morel mushroom preparation and safety was shared through multiple media sources. The investigation highlights the importance of prompt cross-agency communication and collaboration, the utility of epidemiologic studies in foodborne disease outbreak investigations, and the need for additional research about the impact of morel mushroom consumption on human health. Although the toxins in morel mushrooms that might cause illness are not fully understood, proper preparation procedures, including thorough cooking, might help to limit adverse health effects.

Effects of changes in residential fast-food outlet exposure on Body Mass Index change: longitudinal evidence from 92,211 Lifelines participants.

BACKGROUND: Evidence on the association between fast-food outlet exposure and Body Mass Index (BMI) remains inconsistent and is primarily based on cross-sectional studies. We investigated the associations between changes in fast-food outlet exposure and BMI changes, and to what extent these associations are moderated by age and fast-food outlet exposure at baseline. METHODS: We used 4-year longitudinal data of the Lifelines adult cohort (N = 92,211). Participant residential addresses at baseline and follow-up were linked to a register containing fast-food outlet locations using geocoding. Change in fast-food outlet exposure was defined as the number of fast-food outlets within 1 km of the residential address at follow-up minus the number of fast-food outlets within 1 km of the residential address at baseline. BMI was calculated based on objectively measured weight and height. Fixed effects analyses were performed adjusting for changes in covariates and potential confounders. Exposure-moderator interactions were tested and stratified analyses were performed if p < 0.10. RESULTS: Participants who had an increase in the number of fast-food outlets within 1 km had a greater BMI increase (B(95% CI): 0.003 (0.001,0.006)). Decreases in fast-food outlet exposure were not associated with BMI change (B(95% CI): 0.001 (-0.001,0.004)). No clear moderation pattern by age or fast-food outlet exposure at baseline was found. CONCLUSIONS: Increases in residential fast-food outlet exposure are associated with BMI gain, whereas decreases in fast-food outlet exposure are not associated with BMI loss. Effect sizes of increases in fast-food outlet exposure on BMI change were small at individual level. However, a longer follow-up period may have been needed to fully capture the impact of increases in fast-food outlet exposure on BMI change. Furthermore, these effect sizes could still be important at population level considering the rapid rise of fast-food outlets across society. Future studies should investigate the mechanisms and changes in consumer behaviours underlying associations between changes in fast-food outlet exposure and BMI change.

Characteristics of built food environments associated with alternative protein food choices: a systematic review.

BACKGROUND: This systematic review contributes to the understanding of the characteristics of built food environments that may be associated with choices of alternative protein foods (APF). Using the built food environment typology proposed by Downs et al., we investigated various environmental structures (e.g., supermarkets, other retailers, farmers' markets, restaurants, schools, and online vendors) and the characteristics that may facilitate or hinder consumers' choices. For example, facilitators and barriers may refer to the physical characteristics of environmental structures, food presentation practices, the organizational strategies or policies operating in the setting, or the actions that retailers or consumers engage in while selling, serving, choosing, trying, or purchasing APF in these environmental structures. METHODS: A systematic review (PROSPERO database preregistration; no. CRD42023388700) was conducted by searching 13 databases for peer-reviewed journals focusing on the fields of economics and business, agriculture, medical sciences, and social sciences. Data searches, coding, and quality evaluations were conducted by at least 2 researchers. A total of 31 papers (36 original studies) were included. The risk of bias was evaluated with the Joanna Briggs Institute quality evaluation tool, with 24 publications presenting low risk of bias. RESULTS: The findings indicate that perceived and actual availability facilitate consumers' APF choices across a built food environment. Several barriers/facilitators were associated with APF choices in specific types of built food environments: the way food is presented in produce sections (supermarkets), consumer habits in terms of green and specialty shopping (grocery stores), and mismatches among retailer actions in regard to making APF available in one type of food environment structure (e-commerce) and consumers' preferences for APF being available in other food environment structures (supermarkets, grocery stores). The effect of a barrier/facilitator may depend on the APF type; for example, social norms regarding masculinity were a barrier affecting plant-based APF choices in restaurants, but these norms were not a barrier affecting the choice of insect-based APF in restaurants. CONCLUSIONS: Addressing barriers/facilitators identified in this review will help in developing environment-matching interventions that aim to make alternative proteins mainstream. TRIAL REGISTRATION: PROSPERO database registration: #CRD42023388700.

Eating out of home in Portugal: characterisation and effects on dietary intake.

This cross-sectional study aims to describe and compare energy, nutrient intake and food consumption according to eating location and by age groups using data from the National Food, Nutrition and Physical Activity Survey (IAN-AF 2015/2016). Dietary intake was estimated by two non-consecutive days of food diaries (children)/24-h recalls (other age groups), and four eating location categories were defined according to the proportion of meals consumed at out-of-home locations: Home (at least 80 % of meals at home), Other Homes, School or Work and Restaurants and Other Places. The majority of meals (69·1 %) were consumed at home. Meals were also often taken at school by children and adolescents and in restaurants and similar outlets by adults and elderly. Children and adolescents in the School or Work category ate more fruit, vegetables and pulses and cereals and starchy tubers, whereas adults in this category ate more red and processed meats, sugar-sweetened beverages and sweets. Compared with Home category, Restaurants and Other Places was associated with worse diet adequacies among children (ß = -1·0; 95 % CI = -2·0, -0·04), adolescents: (ß = -2·4; 95 % CI = -3·2, -1·5) and adults (ß = -1·3; 95 % CI = -1·6, -1·0) reflecting higher intakes of energy, fat, trans-fatty acids and SFA, and Na. The elderly consumed more free sugars and fat when eating out of home in general. Overall, findings reflect important variation in nutrient profiles by eating location, with meals taken at school or work contributing to higher consumption of nutrient-dense foods and those taken in restaurants and other similar settings implying higher consumption of energy-dense foods.

Feasibility and Acceptability of Standardizing Portions in Restaurants.

Most restaurants serve customers excess calories which significantly contributes to the obesity epidemic. This pilot study tested the feasibility and acceptability of offering customers standardized portions to reduce caloric consumption when dining out in three restaurants. Portions were developed to limit quantity of food served, with lunches and dinners ≤ 700 cal and breakfast ≤ 500 cal. Participating restaurants developed an alternative "Balanced Portions Menu." Training and instructions were provided with respect to the volume and weight of food to be plated following the standardized guidelines and providing at least one cup of vegetables per lunch/dinner. We invited local residents to help us evaluate the new menu. We monitored restaurant adherence to guidelines, obtained feedback from customers, and incentivized customers to complete dietary recalls to determine how the new menus might have impacted their daily caloric consumption. Of the three participating restaurants, all had a positive experience after creating the new menus and received more foot traffic. One restaurant that did not want to change portion sizes simply plated the appropriate amount and packed up the rest to-go, marketing the meals as "Dinner today, lunch tomorrow." Two of the restaurants followed the guidelines precisely, while one sometimes plated more rice than the three-fourths cup that was recommended. A significant number of customers ordered from the Balanced Portions menus. Two of the three restaurants have decided to keep offering the Balanced Portions menus indefinitely. Following standardized portions guidelines is both feasible for restaurants and acceptable to customers.

Fast food proximity and weight gain in childhood and adolescence: Evidence from Great Britain.

We study the relationship between proximity to fast food restaurants and weight gain from late childhood to early adolescence. We use the Millennium Cohort Study, a UK-wide nationally representative longitudinal study, linked with granular geocoded food outlet data to measure the presence of fast food outlets around children's homes and schools from ages 7 to 14. We find that proximity to fast food outlets is associated with increased weight (body mass index, overweight, obese, body fat, weight), but only among those with maternal education below degree level. Within this sample, those with lower levels of emotional regulation are at heightened risk of weight gain.

Local restrictions, population movement, and spillovers during the pandemic: Evidence from Japan's restaurant restriction.

We investigate how a local restaurant restriction aimed at containing the COVID-19 pandemic influenced population movement and COVID-19 prevalence within and outside the restricted districts. Using data on restaurant location and hourly population at the 500-m-mesh level and on COVID-19 prevalence at both prefecture and municipality level in Japan, we employ a triple-difference approach and a difference-in-differences approach with fixed effects. While the policy decreased population movement to restaurant areas in the restricted districts, it caused spillovers of increasing population movement to restaurant areas in the neighboring nonrestricted districts. Consequently, COVID-19 prevalence worsened in the neighboring nonrestricted districts but improved in the restricted districts. Our findings suggest that imposing such local restrictions in the context of the pandemic may contain the pandemic only in the restricted districts while sacrificing economic activities within these districts and public health in neighboring nonrestricted districts.

The Effects of Signal to Noise Ratio, T60 , Wide-Dynamic Range Compression Speed, and Digital Noise Reduction in a Virtual Restaurant Setting.

OBJECTIVES: Hearing aid processing in realistic listening environments is difficult to study effectively. Often the environment is unpredictable or unknown, such as in wearable aid trials with subjective report by the wearer. Some laboratory experiments create listening environments to exert tight experimental control, but those environments are often limited by physical space, a small number of sound sources, or room absorptive properties. Simulation techniques bridge this gap by providing greater experimental control over listening environments, effectively bringing aspects of the real-world into the laboratory. This project used simulation to study the effects of wide-dynamic range compression (WDRC) and digital noise reduction (DNR) on speech intelligibility in a reverberant environment with six spatialized competing talkers. The primary objective of this study was to determine the efficacy of WDRC and DNR in a complex listening environment using virtual auditory space techniques. DESIGN: Participants of greatest interest were listeners with hearing impairment. A group of listeners with clinically normal hearing was included to assess the effects of the simulation absent the complex effects of hearing loss. Virtual auditory space techniques were used to simulate a small restaurant listening environment with two different reverberation times (0.8 and 1.8 sec) in a range of signal to noise ratios (SNRs) (-8.5 to 11.5 dB SNR). Six spatialized competing talkers were included to further enhance realism. A hearing aid simulation was used to examine the degree to which speech intelligibility was affected by slow and fast WDRC in conjunction with the presence or absence of DNR. The WDRC and DNR settings were chosen to be reasonable estimates of hearing aids currently available to consumers. RESULTS: A WDRC × DNR × Hearing Status interaction was observed, such that DNR was beneficial for speech intelligibility when combined with fast WDRC speeds, but DNR was detrimental to speech intelligibility when WDRC speeds were slow. The pattern of the WDRC × DNR interaction was observed for both listener groups. Significant main effects of reverberation time and SNR were observed, indicating better performance with lower reverberation times and more positive SNR. CONCLUSIONS: DNR reduced low-amplitude noise before WDRC-amplified the low-intensity portions of the signal, negating one potential downside of fast WDRC and leading to an improvement in speech intelligibility in this simulation. These data suggest that, in some real-world environments that include both reverberation and noise, older listeners with hearing impairment may find speech to be more intelligible if DNR is activated when the hearing aid has fast compression time constants. Additional research is needed to determine the appropriate DNR strength and to confirm results in wearable hearing aids and a wider range of listening environments.

Smoke-free law compliance and predictive factors in Ethiopia: observational assessment of public places and workplaces.

OBJECTIVES: The primary objective of this observational study was to assess the status of public place and workplace compliance with smoke-free provisions in Ethiopia. METHODS: This study was conducted in four regions of Ethiopia (Oromia; Sidama; Harari; and Southern Nations, Nationalities, and Peoples' Region) from September to October 2021. Data were collected using a standardised smoke-free checklist. Χ2 tests were used to assess the association between categorical variables and the smoke-free status. Multivariable binary logistic regression analysis was used to identify factors associated with the presence of at least one person actively smoking. RESULTS: Approximately 97% (95% CI 93.1%, 98.8%) of government buildings, 92.5% (95% CI 85.7%, 96.2%) of educational institutions, 89.8% (95% CI 86.3%, 92.5%) of bars, restaurants and cafés, 88.4% (95% CI 82.9%, 92.3%) of food establishments and 84.0% of hotels (95% CI 79.5%, 87.6%) were non-compliant with the tobacco control law. Overall, only 12.3% of sites met the requirements of the current smoke-free law. The multivariable logistic regression models showed that transit facilities (adjusted OR (AOR)=26.66 (95% CI 7.53, 94.41)) and being located in the Harari region (AOR=4.14 (95% CI 2.30, 7.45)) were strongly associated with the presence of active smoking observed during the site visit. CONCLUSION: This study indicated that public place and workplace non-compliance level was very high in all sites. This calls for more effective implementation of complete smoke-free provisions across all government buildings and institutions in all regions, such as public educational campaigns about the laws and enforcement action for non-compliance. Furthermore, all regional states should adopt Federal Proclamation 1112/2019.

Benchmarking online food delivery applications against menu labelling laws: a cross-sectional observational analysis.

OBJECTIVE: It is unknown how well menu labelling schemes that enforce the display of kilojoule (kJ) labelling at point-of-sale have been implemented on online food delivery (OFD) services in Australia. This study aimed to examine the prevalence of kJ labelling on the online menus of large food outlets with more than twenty locations in the state or fifty locations nationally. A secondary aim was to evaluate the nutritional quality of menu items on OFD from mid-sized outlets that have fewer locations than what is specified in the current scheme. DESIGN: Cross-sectional analysis. Prevalence of kJ labelling by large food outlets on OFD from August to September 2022 was examined. Proportion of discretionary ('junk food') items on menus from mid-sized outlets was assessed. SETTING: Forty-three unique large food outlets on company (e.g. MyMacca's) and third party OFD (Uber Eats, Menulog, Deliveroo) within Sydney, Australia. Ninety-two mid-sized food outlets were analysed. PARTICIPANTS: N/A. RESULTS: On company OFD apps, 35 % (7/23) had complete kJ labelling for each menu item. In comparison, only 4·8 % (2/42), 5·3 % (2/38) and 3·6 % (1/28) of large outlets on Uber Eats, Menulog and Deliveroo had complete kJ labelling at all locations, respectively. Over three-quarters, 76·3 % (345/452) of menu items from mid-sized outlets were classified as discretionary. CONCLUSIONS: Kilojoule labelling was absent or incomplete on a high proportion of online menus. Mid-sized outlets have abundant discretionary choices and yet escape criteria for mandatory menu labelling laws. Our findings show the need to further monitor the implementation of nutrition policies on OFD.

Development and testing of two tools to assess point-of-sale food and beverage marketing to children in restaurants.

OBJECTIVE: To describe the development and testing of two assessment tools designed to assess exterior (including drive-thru) and interior food and beverage marketing in restaurants with a focus on marketing to children and teens. DESIGN: A scoping review on restaurant marketing to children was undertaken, followed by expert and government consultations to produce a draft assessment tool. The draft tool was mounted online and further refined into two separate tools: the Canadian Marketing Assessment Tool for Restaurants (CMAT-R) and the CMAT-Photo Coding Tool (CMAT-PCT). The tools were tested to assess inter-rater reliability using Cohen's Kappa and per cent agreement for dichotomous variables, and intra-class correlation coefficients (ICCs) for continuous or rank-order variables. SETTING: Waterloo, Ontario, Canada. PARTICIPANTS: Restaurants of all types were assessed using the CMAT-R (n 57), and thirty randomly selected photos were coded using the CMAT-PCT. RESULTS: The CMAT-R collected data on general promotions and restaurant features, drive-thru features, the children's menu and the dollar/value menu. The CMAT-PCT collected data on advertisement features, features considered appealing to children and teens, and characters. The inter-rater reliability of the CMAT-R tool was strong (mean per cent agreement was 92·4 %, mean Cohen's κ = 0·82 for all dichotomous variables and mean ICC = 0·961 for continuous/count variables). The mean per cent agreement for the CMAT-PCT across items was 97·3 %, and mean Cohen's κ across items was 0·91, indicating very strong inter-rater reliability. CONCLUSIONS: The tools assess restaurant food and beverage marketing. Both showed high inter-rater reliability and can be adapted to better suit other contexts.

Agreement between a web collaborative dataset and an administrative dataset to assess the retail food environment in Mexico.

BACKGROUND: Latin American countries are often limited in the availability of food outlet data. There is a need to use online search engines that allow the identification of food outlets and assess their agreement with field observations. We aimed to assess the agreement in the density of food outlets provided by a web collaborative data (Google) against the density obtained from an administrative registry. We also determined whether the agreement differed by type of food outlet and by area-level socioeconomic deprivation. METHODS: In this cross-sectional study, we analyzed 1,693 census tracts from the municipalities of Hermosillo, Leon, Oaxaca de Juarez, and Tlalpan. The Google service was used to develop a tool for the automatic acquisition of food outlet data. To assess agreement, we compared food outlet densities obtained with Google against those registered in the National Statistical Directory of Economic Units (DENUE). Continuous densities were assessed using Bland-Altman plots and concordance correlation coefficient (CCC), while agreement across tertiles of density was estimated using weighted kappa. RESULTS: The CCC indicated a strong correlation between Google and DENUE in the overall sample (0.75); by food outlet, most of the correlations were from negligible (0.08) to moderate (0.58). The CCC showed a weaker correlation as deprivation increased. Weighted kappa indicated substantial agreement between Google and DENUE across all census tracts (0.64). By type of food outlet, the weighted kappa showed substantial agreement for restaurants (0.69) and specialty food stores (0.68); the agreement was moderate for convenience stores/small food retail stores (0.49) and fair for candy/ice cream stores (0.30). Weighted kappa indicated substantial agreement in low-deprivation areas (0.63); in very high-deprivation areas, the agreement was moderate (0.42). CONCLUSIONS: Google could be useful in assessing fixed food outlet densities as a categorical indicator, especially for some establishments, like specialty food stores and restaurants. The data could also be informative of the availability of fixed food outlets, particularly in less deprived areas.

Exploring the sugar-sweetened beverage tax (SSBT) pass-through rate in the Irish hospitality sector.

BACKGROUND: The World Health Organization (WHO) supports the use of Sugar-Sweetened Beverage Taxes (SSBTs) as a fiscal lever to help reduce sugar consumption and tackle obesity. Obesity is associated with a range of adverse health outcomes. In response to increasing levels of obesity in Ireland, an SSBT was introduced in 2018. Previous research in Ireland has noted that the pass-through rate of the SSBT in retail (off-site consumption) settings was poor. However, to date, no research has examined the SSBT pass-through rate in hospitality (on-site consumption) venues in Ireland. METHODS: This research examines the SSBT pass-through rate on Coca-Cola versus diet versions of Coca-Cola in a convenience sample of 100 hospitality venues in two provincial Irish cities. RESULTS: Wilcoxon signed rank test analysis revealed that regular Coca-Cola was significantly more expensive compared to the price charged for diet versions of Coca-Cola. However, in 85.6% of cases the same price was charged for both full-sugar and sugar-free drinks. The mean pass-through rate of the SSBT was 33.8%. CONCLUSION: The effective functioning of the SSBT is premised on persistent price differences between soft drink prices based on sugar content. However, this is barely evident in the hospitality sector in Ireland. A number of recommendations are suggested, including both increasing the SSBT, and increasing it annually in line with inflation.

Impact of secondhand smoke on air quality in partially enclosed outdoor hospitality venues: a review.

BACKGROUND: Smoking is a leading cause of premature mortality and morbidity globally. The pollutants generated from smoke are not only harmful to smokers, but also to those exposed to secondhand smoke. As a result of increasingly restrictive indoor smoke-free policies in many countries, there is a tendency for tobacco smoking to move outdoors into partially enclosed settings in hospitality venues. The aim of this systematic review was to evaluate the impact of secondhand smoke on air quality in outdoor hospitality venues. METHODS: Two electronic databases PubMed and Scopus were searched from 1 January 2010 to 30 June 2022 for studies of air quality impacts from tobacco smoking in outdoor hospitality venues. A total of 625 studies were screened and 13 studies were included in this review. RESULTS: The majority (9 studies) of reviewed studies monitored PM2.5 concentration as an indicator of secondhand smoke. PM2.5 was reported from 10.9 µg/m3 to 91.0 µg/m3 in outdoor smoking areas, compared to 4.0 µg/m3 to 20.4 µg/m3 in outdoor control sites unaffected by smoking. Secondhand smoke can also drift into adjacent outdoor areas or infiltrate into indoor environments thus affecting air quality in spaces where smoking is not permitted. CONCLUSIONS: The reviewed studies indicated that air quality within outdoor hospitality venues where smoking is permitted is unlikely to meet current World Health Organization (WHO) ambient air quality guidelines for PM2.5. Customers and staff in outdoor hospitality venues with active smoking, and in adjacent outdoor and indoor non-smoking areas, are potentially exposed to secondhand smoke at levels exceeding WHO guidelines. Stronger smoking control policies are recommended for outdoor hospitality venues to protect the health of customers and staff from harmful secondhand smoke exposure. PROSPERO REGISTRATION: CRD42022342417.

The moderating effect of access to food facilities and recreational activity space on mHealth multiple health behavior change intervention.

OBJECTIVE: To evaluate whether the neighborhood social and built environment moderates response to a mobile health multiple health behavior change intervention targeting fruit/vegetable intake, sedentary behavior, and physical activity. METHODS: Participants were 156 Chicago-residing adults with unhealthy lifestyle behaviors. Using linear mixed models, we evaluated whether access to food facilities (fast food restaurants and grocery stores) and recreational activity spaces (gyms and parks) moderated the difference in behavior change between the active intervention condition relative to control. Using spatial data analysis (cross K functions), we also assessed whether participants who achieved goal levels of behaviors ("responders") were more or less likely than those who did not achieve intervention goals ("non-responders") to reside near fast food restaurants, grocery stores, gyms, or parks. RESULTS: According to linear mixed models, none of the neighborhood social and built environment factors moderated the difference in behavior change between the active intervention condition and the control condition (Likelihood Ratio (χ²[1] = 0.02-2.33, P-values > 0.05). Cross K functions showed that diet behavior change responders were more likely than non-responders to reside near fast food restaurants, but not grocery stores. The results for activity behavior change were more variable. Sedentary screen time responders were more likely to reside around recreational activity spaces than non-responders. Moderate-vigorous physical activity responders had greater and lesser clustering than non-responders around parks, dependent upon distance from the park to participant residence. CONCLUSIONS: A complex relationship was observed between residential proximity to Chicago facilities and response to multiple health behavior change intervention. Replication across diverse geographic settings and samples is necessary.

Effectively implementing healthy and sustainable food practices in out-of-home food service locations: The perspective of the catering staff members.

Restaurants, canteens, residential care, hospitals and other out-of-home food service locations can play an important role in improving people's diet quality by offering healthier and more sustainable food choices. However, the effectiveness of implementing sustainable and healthy food practices at these locations is, at least partly, dependent on the extent to which they are accepted and implemented by the staff members. This study aims to assess staff members' motivation, perceived capability, perceived opportunity and their readiness to change their behaviour (i.e., stages of change) in offering more healthy and sustainable food options to their customers or patients. Eleven out-of-home locations that wanted to adjust their assortment towards more healthy and sustainable product offerings participated in this study and were able to distribute a comparable questionnaire among their staff members to assess their perceived readiness to change. Results among 268 participants show that staff members find both a healthy and sustainable food assortment important and also seem to be motivated to improve their food assortment regarding health and sustainability. Perceived opportunity seems to be the largest barrier for staff members, although there is also room for improvement regarding their perceived capability. In addition, personal motivation seems to play the dominant role in staff members' readiness to change the health of the assortment, whereas perceived capability seems to play the dominant role in their perceived readiness to change the sustainability of the assortment. This study shows that taking into account the perspective of the catering staff members may help to effectively implement healthy and sustainable food practices in out-of-home food service locations.