The influence of cultural food security on cultural identity and well-being: a qualitative comparison between second-generation American and international students in the United States.

The purpose of this study was to explore the impact of cultural food insecurity on identity and well-being in second-generation American and international university students. Thirty-one semi-structured interviews were conducted from January-April 2020. Audio transcripts were analyzed using continuous and abductive thematic analysis. Students indicated that cultural foodways enhanced their well-being by facilitating their cultural/ethnic identity maintenance, connection, and expression. Conversely, cultural food insecurity diminished student well-being due to reduced cultural anchors, highlighting the importance of cultural food in this population. Universities that reduce cultural foodways barriers may mitigate cultural food insecurity for second-generation American and international university students. (100/100).

The impact that cultural food security has on identity and well-being in the second-generation U.S. American minority college students.

Food contributes to an individual's physical and mental well-being and expresses one's cultural identity through preparation, sharing, and consumption (i.e., foodways). Inadequate access to cultural foods can create cultural stress and affect one's identity and well-being. In particular, second-generation U.S. American student populations may have a higher risk for cultural stress due to being away from family, academic stress, environmental changes, and diminished financial stability to purchase cultural foods. Thus, an exploratory qualitative methodology was used to elicit information about second-generation U.S. Americans' food experiences to identify how cultural foods play a role in individual identity and how individual well-being is influenced by the presence or lack of cultural foods. Sixteen semi-structured interviews were conducted with second-generation American students at the University of Nevada, Reno, who self-identified as a cultural or ethnic minority. A standard thematic analysis was conducted. The authors identified that cultural food security influenced the ability to practice foodways, which tied Second-generation American students to their cultural identities. The absence of foodways led to anxiety and depression among students, amplifying the feelings of identity degradation. Second-generation American students discussed that the ability to practice their foodways improved multiple well-being components and led to feelings of happiness, decreased stress, warmth, better digestion, and a sense of belonging, comfort, and safety. College populations continue to grow and become more diverse, and with the increasing Second-generation American students, it is essential to improve the access and availability of cultural foods to improve their overall well-being. (245/250 words). Supplementary Information: The online version contains supplementary material available at 10.1007/s12571-020-01140-w.

Newspaper content analysis in evaluation of a community-based participatory project to increase physical activity.

This study conducted a newspaper content analysis as part of an evaluation of a community-based participatory research project focused on increasing physical activity through policy and environmental changes, which included activities related to media advocacy and media-based community education. Daily papers (May 2003 to December 2005) from both the intervention and comparison counties were reviewed for topics related to physical activity and an active living environment (e.g. safety, policy, urban design, transportation and recreational resources). A total of 2681 articles from 1764 newspapers were analyzed. The intervention county had a greater proportion of articles on the selected topics. Specifically, the intervention county had a greater proportion of articles in topics related to safety, policy and community initiatives, as well as in sidewalks and recreational facilities; both priority areas for the intervention. Prominence of the articles was assessed using a composite index score. Generally, prominence of the topics analyzed was low. Articles in the sidewalks and recreational facilities topic category in the intervention county had higher prominence scores on average than the comparison county. The study demonstrates that media content analysis can be a valuable component in evaluating community-based interventions.

Correlates of television viewing among African American and Caucasian women.

This study explores the associations between time spent watching television and physical activity, selected eating behaviors, and quality of life variables among 189 African American and Caucasian women aged 18-60 years. Data were collected via a cross-sectional, random-digit-dialed telephone survey. Seventy-two percent and 46% of women reported to "always, often, or sometimes" eating or overeating while watching television, respectively. Significant associations with television time per week included: eating meals or snacks while watching television, number of days per month feeling depressed, number of days per month feeling anxious, self-rated health, and BMI. Results contribute to recent studies finding associations between television viewing, body mass index, and health; and suggest potential points for intervention.

Healthcare Utilization, Unmet Service Needs, and Medication Adherence Among People Living with HIV/AIDS.

BACKGROUND: Comorbidity rates and service needs are high among people living with HIV/AIDS (PLWHA). The effects of service utilization and unmet service needs on antiretroviral therapy (ART) adherence are not well understood. The purpose of this study was to investigate associations among PLWHA's service utilization, unmet service needs, and ART adherence. METHODS: PLWHA (N=162) 18 years or older were recruited from a Nevada statewide needs assessment project in 2016. Participants completed a self-administered questionnaire on paper or online. The independent variables were service utilization and unmet service needs. The outcome variable was ART adherence. Multivariable logistic regression analyses were conducted to examine associations between the amount of utilized services and unmet service needs with ART adherence. RESULTS: Only 12 (7.5%) participants reported they received all the needed services. The ART nonadherence group showed significantly higher unmet medical service needs compared to the ART adherence group (p=0.007). Unmet medical service needs (Adjusted Odds Ratio (AOR) 0.69, CI 0.53-0.90) and unmet support service needs (AOR 0.68, CI 0.48-0.97) were negatively associated with ART adherence. However, utilizing medical services (AOR 1.06, CI 0.87-1.30) and support services (AOR 0.88, CI 0.74-1.04) in the current year were not significantly associated with ART adherence. CONCLUSION: The results of this study indicate that health promotion programming should focus not only on introducing new services at the community level, but also work to optimize the availability and awareness of current services. Furthermore, health promotion programs should focus on filling service coverage gaps and improving the facilitation of services.

Correlates of physical activity among African American and white women.

OBJECTIVE: To compare potential correlates of physical activity between African American and white women. METHODS: A random-digit-dialed telephone survey was conducted in central South Carolina. Bivariate and multivariate analyses focused on women aged 18+ (N = 1176). RESULTS: African American women reported greater maintenance of sidewalks and public parks than did white women, who reported higher physical activity, exercise self-efficacy, access to indoor walking facilities, and knowledge of mapped-out walking routes. Exercise self-efficacy was the only significant correlate of physical activity among both African American and white women. CONCLUSIONS: Self-efficacy was a robust cross-sectional correlate of physical activity in women.

Recruitment strategies and costs for a community-based physical activity program.

A community-based participatory research project using social marketing strategies was implemented to promote physical activity among women aged 35 to 54 who were insufficiently active or completely inactive. A variety of media were used to disseminate messages about how to enroll in Step Up. Step Out! This article describes the effectiveness and cost of the recruitment strategies and lessons learned in recruiting the women. Of the total inquiries (n = 691), 430 women were eligible and enrolled in the program. Based on data from questionnaires, the most effective method of recruiting women into Step Up. Step Out! was word of mouth (36%). Newspaper ads accounted for 29% of the women's responses. The least effective method was billboards. Mass media was not as effective in recruiting women for the program as interpersonal efforts such as word of mouth. Interpersonal efforts are a valuable and possibly underrated recruitment and promotion tool.

A randomised study of the effects of massage therapy compared to guided relaxation on well-being and stress perception among older adults.

OBJECTIVE: The objective was to assess the effects of massage compared to guided relaxation on stress perception and well-being among older adults. DESIGN: A randomised pilot study enrolled adults ages 60 and older to receive 50 min, twice weekly massage therapy or guided relaxation sessions. Questionnaires were administered at pre-test (1 week before the first session) and post-test (after the last session). SETTING: Participants came to the University of South Carolina campus for sessions. Adults aged 60 and older were recruited from community venues and were briefly screened by telephone for contraindications. INTERVENTION: Participants (n=54) received 50 min massage or guided relaxation sessions twice weekly for 4 weeks. The massage included Swedish, neuromuscular, and myofascial techniques. For the relaxation group, an appropriately trained assistant read a script to guide the participant in using visualization and muscle relaxation. MAIN OUTCOME MEASURES: The General Well-being Schedule is an 18-item scale with subscales measuring anxiety, depression, positive well-being, self-control, vitality, and general health. The Perceived Stress Scale is a 14-item scale assessing the degree to which situations in one's life are appraised as stressful during the past month. RESULTS: Significant improvements were found for the anxiety, depression, vitality, general health, and positive well-being subscales of the General Well-being Schedule and for Perceived Stress among the massage participants compared to guided relaxation. CONCLUSIONS: Findings indicate that massage therapy enhances positive well-being and reduces stress perception among community-dwelling older adults.

Availability of weight-loss supplements: Results of an audit of retail outlets in a southeastern city.

The sale of nonprescription weight-loss products accounts for millions of dollars spent by Americans trying to lose weight, yet there is little evidence for effectiveness and there are multiple safety concerns. The purpose of this study was to determine what products, and ingredients within products, were available at retail outlets in a metropolitan area. A purposive sampling strategy identified 73 retail outlets. An audit form was used to collect information from product labels. The audit identified 402 products containing 4,053 separate ingredients. The mean number of ingredients per product was 9.9+/-8.96 (range = 1 to 96). A database search was conducted regarding evidence for effectiveness, safety precautions, and side effects for the 10 ingredients that appeared most often across products. Modest evidence of effectiveness exists for green tea (Camellia sinensis), chromium picolinate, and ma huang (Ephedra major). For the remaining seven (ginger root [Zingiber officinale], guarana [Paullinia cupana], hydroxycitric acid [Garcinia cambogia], white willow [Salix alba], Siberian ginseng [Eleutherococcus senticosus], cayenne [Capsicum annuum], and bitter orange/zhi shi [Citrus aurantium]), inadequate or negative evidence exists. Although precautions and contraindications were found for all 10 ingredients, the strongest concerns in the literature appear for ma huang, bitter orange, and guarana. Our audit revealed numerous weight-loss products available to consumers, yet there is little evidence to support the effectiveness of the top 10 ingredients identified and many potential adverse reactions; therefore, food and nutrition professionals should discuss dietary supplement use with their clients.

Using focus groups in the consumer research phase of a social marketing program to promote moderate-intensity physical activity and walking trail use in Sumter County, South Carolina.

INTRODUCTION: The use of social marketing approaches in public health practice is increasing. Using marketing concepts such as the "four Ps" (product, price, place, and promotion), social marketing borrows from the principles of commercial marketing but promotes beneficial health behaviors. Consumer research is used to segment the population and develop a strategy based on those marketing concepts. In a community-based participatory research study, 17 focus groups were used in consumer research to develop a social marketing program to promote walking and other moderate-intensity physical activities. METHODS: Two phases of focus groups were conducted. Phase 1 groups, which included both men and women, were asked to respond to questions that would guide the development of a social marketing program based on social marketing concepts. Phase 1 also determined the intervention's target audience, which was irregularly active women aged 35 to 54. Phase 2 groups, composed of members of the target audience, were asked to further define the product and discuss specific promotion strategies. RESULTS: Phase 1 participants determined that the program product, or target behavior, should be walking. In addition, they identified price, place, and promotion strategies. Phase 2 participants determined that moderate-intensity physical activity is best promoted using the term exercise and offered suggestions for marketing walking, or exercise, to the target audience. CONCLUSION: There have been few published studies of social marketing campaigns to promote physical activity. In this study, focus groups were key to understanding the target audience in a way that would not have been accomplished with quantitative data alone. The group discussions generated important insights into values and motivations that affect consumers' decisions to adopt a product or behavior. The focus group results guided the development of a social marketing program to promote physical activity in the target audience in Sumter County, South Carolina.

Association of environmental factors to meeting physical activity recommendations in two South Carolina counties.

PURPOSE: The purpose of the study was to examine associations between environment and policy factors and physical activity. DESIGN: A random-digit-dialed, cross-sectional telephone survey was administered. SETTING: The setting was a two-county area of eastern South Carolina. SUBJECTS: Before weighting, the sample included 1936 adults; 36.9% African-American, 63.1% white, and 60.1% women. The age group distribution was 28.8% 55+ years, 39.3% 35-54 years, and 31.9% 18-34 years of age. The response rate was 62.9%. MEASURES: Six physical activity questions (2001 Behavioral Risk Factor Surveillance Survey [BRFSS]) were used to create a dischotomous variable, "meets/does not meet recommendation for moderate or vigorous physical activity." Self-report items assessed knowledge, presence, and use of recreational facilities; presence of environmental and worksite supports; perceived safety; condition of sidewalks; and quality of street lighting. RESULTS: Linear and logistic regression were used to analyze the data. Unadjusted odds for meeting the recommendation were significantly greater for well-maintained sidewalks (OR = 1.90); safe areas for walking/jogging (OR = 1.39); knowledge of routes for bicycling (OR = 1.38) and walking/jogging (OR = 1.32); and worksites with sports teams (OR = 1.53), exercise facilities (OR = 1.33), flexible time for exercise (OR = 1.33), and preventive checkups (OR = 1.26). Among persons who met the recommendation, means were greater for number of known walking/jogging routes (p = .04); number of known bicycling routes (p < .01); number of days per month uses tracks, trails, routes, pathways (p < .01); and number of days per month uses outdoor recreation areas (p < .01). CONCLUSION: The results support an association between level of physical activity and environmental and policy factors in two southeastern counties in South Carolina. Limitations of the study include self-reported data and cross-sectional design.

Factors of fruit and vegetable intake by race, gender, and age among young adolescents.

OBJECTIVE: To explore demographic differences in individual, social, and environmental factors potentially related to fruit and vegetable intake. DESIGN: Self-report questionnaires administered to a convenience sample of middle school students during regular classes. PARTICIPANTS: Black and white adolescents, 11 to 15 years of age (N = 736). VARIABLES MEASURED: Measures included self-efficacy, family dinner frequency, normative beliefs, outcome expectations, modeling, availability, preferences, snack choice, and demographics. ANALYSIS: Chi-square, general linear models, and Poisson and linear regressions as appropriate. RESULTS: Black participants reported greater social influences than did white participants, whereas white adolescents reported greater family environmental influences on fruit and vegetable intake. The oldest adolescents reported lower self-efficacy, peer modeling, family dinner frequency, and fruit and vegetable preferences compared with younger adolescents. White participants and females reported a higher preference for vegetables than did black participants and males. Regression models for self-efficacy and snack choice explained 41% and 34% of the variance, respectively. Preferences for vegetables and parental modeling were the strongest correlates of self-efficacy. Self-efficacy was the strongest correlate of snack choice. CONCLUSIONS AND IMPLICATIONS: Decreases in several factors with age highlight the importance of intervention for this age group. Future research is needed for a better understanding of the formation and modification of self-efficacy and snack choice.

Levels of cigarette and alcohol use related to eating-disorder attitudes.

OBJECTIVE: To examine levels of cigarette and alcohol use relative to body dissatisfaction and drive for thinness in 206 black and white college women. METHOD: Anonymous, paper-and-pencil, self-report questionnaires were administered. RESULTS: Frequency of both cigarette and alcohol use were significantly and linearly related to body dissatisfaction and drive for thinness. Regression analyses indicated that negative-affect reduction motivations for use of these substances were more strongly related to eating-disorder attitudes than were levels of use. CONCLUSIONS: Cigarette and alcohol use, independent of race and other demographic variables, increased along a continuum with eating-disorder attitudes.

Association of body mass index to meeting physical activity recommendations.

OBJECTIVE: To investigate the association between BMI and physical activity based on the CDC-ACSM recommendation and a more demanding standard consistent with the IOM recommendation. METHODS: A random-digit-dialed survey (n=1810) used 2001 BRFSS questions to measure physical activity. RESULTS: Data revealed a monotonic association between BMI and physical activity level. Lower odds of meeting both recommendations were associated with higher BMI. The proportion meeting the CDC-ACSM recommendation was at least 3 times that of persons meeting the IOM-based recommendation. CONCLUSIONS: Meeting either recommendation was associated with BMI; however, a larger proportion of persons were meeting the less demanding CDC-ACSM recommendation.

Measurement properties of psychosocial and environmental measures associated with fruit and vegetable intake among middle school adolescents.

OBJECTIVE: To assess the measurement properties of several scales modified or created to assess factors related to fruit and vegetable intake within a young adolescent population. DESIGN: Cross-sectional with data collected via self-report. SETTING: Data were collected in regularly scheduled classes in the school setting. PARTICIPANTS: African American and Caucasian middle school students (ages 11-15 years). VARIABLES MEASURED: Self-efficacy, modeling, outcome expectations, normative beliefs, parental food management practices, and influences on food choice. ANALYSIS: Pearson correlations, factor analysis, and Cronbach α. RESULTS: Subscales with adequate to good internal consistencies (0.65-0.88) were established. Fruit and vegetable intake was significantly correlated with self-efficacy, parent and peer modeling, family and peer normative beliefs, and social and health outcome expectations. Fruit and vegetable intake was not significantly correlated with permissive eating, food self-preparation, or the 3 subscales measuring influences on food choice (social influence, avoiding weight-gain food, and appeal and access). CONCLUSIONS AND IMPLICATIONS: These measures, most originally developed for children and adults and modified for this study, demonstrated adequate measurement properties for an adolescent sample.

Variables associated with fruit and vegetable intake in adolescents.

OBJECTIVES: To assess individual, social, and family environmental factors related to fruit and vegetable intake among white and black adolescents aged 11-15 years (n=736). METHODS: Self-report questionnaire. RESULTS: Preferences, availability at home, family dinner frequency, snack choice, self-efficacy, modeling, normative beliefs, and social outcome expectations were significant associates of fruit and vegetable intake. Multivariate models indicated that these associations varied by categories of intake. Availability was the most consistent associate whereas fruit preference, availability, family dinner frequency, and self-efficacy were the strongest associates. CONCLUSIONS: Results highlight the important influence of the family environment on fruit and vegetable intake.

Impact of a community-based prevention marketing intervention to promote physical activity among middle-aged women.

A physical activity intervention applied principles of community-based participatory research, the community-based prevention marketing framework, and social cognitive theory. A nonrandomized design included women ages 35 to 54 in the southeastern United States. Women (n = 430 preprogram, n = 217 postprogram) enrolled in a 24-week behavioral intervention and were exposed to a media campaign. They were compared to cross-sectional survey samples at pre- (n = 245) and postprogram (n = 820) from the media exposed county and a no-intervention county (n = 234 pre, n = 822 post). Women in the behavioral intervention had statistically significant positive changes on physical activity minutes, walking, park and trail use, knowledge of mapped routes and exercise partner, and negative change on exercise self-efficacy. Media exposed women had statistically significant pre- to postprogram differences on knowledge of mapped routes. No-intervention women had significant pre- to postprogram differences on physical activity minutes, walking, and knowledge of mapped routes.

The effect of question order on reporting physical activity and walking behavior.

BACKGROUND: Question order might affect self-reported regular physical activity (PA) measured with items from the Behavioral Risk Factor Surveillance System (BRFSS) PA module. METHODS: A telephone survey was conducted using 2 forms (N = 1004, N = 212) with varying PA question order. The standard form presented moderate-PA, vigorous-PA, and walking questions, in that order, whereas the alternate form presented walking questions, followed by moderate-PA, and then vigorous-PA questions. Weighted, adjusted rates of vigorous PA, walking, meeting the Centers for Disease Control and Prevention (CDC) recommendation for moderate or vigorous PA, and moderate PA from each form were compared. RESULTS: Vigorous PA and walking were similar regardless of question order. Meeting the CDC recommendation for moderate or vigorous PA was reported less often with the alternate form among 18- to 34-year-olds. Less moderate PA was reported with the alternate form overall and among 18- to 34-year-olds, women, whites, and those with a high school education or less. CONCLUSION: Estimating PA and walking across sociodemographic strata with differing patterns of PA requires asking moderate-PA and vigorous-PA questions before walking questions. Asking walking questions first might lead to bias, especially for moderate PA. Walking, added to a survey with BRFSS moderate and vigorous PA items, should be placed after moderate and vigorous PA. Walking questions first may cause bias, especially for moderate PA.

Perceived individual, social, and environmental factors for physical activity and walking.

BACKGROUND: Few studies have explored associations of individual, social, and environmental factors with physical activity and walking behavior. METHODS: A random-digit-dial questionnaire, which included selected individual, social, and environmental variables, was administered to 2025 adults, age 18 y and older, in two adjacent counties in a southeastern state. Logistic regressions were conducted adjusting for age, race, sex, education, and employment. RESULTS: In multivariate models, somewhat different variables were associated with physical activity versus regular walking. Self-efficacy (OR = 19.19), having an exercise partner (OR = 1.47), recreation facilities (OR = 1.54), and safety of trails from crime (OR = 0.72) were associated with physical activity level; while self-efficacy (OR = 4.22), known walking routes (OR = 1.54), recreation facilities (OR = 1.57-1.59), and safety of trails from crime (OR = 0.69) were associated with regular walking behavior. CONCLUSIONS: Physical activity and walking behaviors were associated with similar variables in this study.