A Commentary on the Healthy Community Stores Case Study Project: Implications for Retailers, Policy, and Future Research.

In the United States, low-income, underserved rural and urban settings experience poor access to healthy, affordable food. Introducing new food outlets in these locations has shown mixed results for improving healthy food consumption. The Healthy Community Stores Case Study Project (HCSCSP) explored an alternative strategy: supporting mission-driven, locally owned, healthy community food stores to improve healthy food access. The HCSCSP used a multiple case study approach, and conducted a cross-case analysis of seven urban healthy food stores across the United States. The main purpose of this commentary paper is to summarize the main practice strategies for stores as well as future directions for researchers and policy-makers based on results from the prior cross-case analyses. We organize these strategies using key concepts from the Retail Food Environment and Customer Interaction Model. Several key strategies for store success are presented including the use of non-traditional business models, focus on specific retail actors such as store champions and multiple vendor relationships, and a stores' role in the broader community context, as well as the striking challenges faced across store locations. Further exploration of these store strategies and how they are implemented is needed, and may inform policies that can support these types of healthy retail sites and sustain their efforts in improving healthy food access in their communities.

Implementation of vascular surgery teleconsultation during the COVID-19 pandemic: Insights from the outpatient vascular clinics in a tertiary care hospital in Qatar.

BACKGROUND: The COVID-19 pandemic has sparked a surge in the use of virtual communication tools for delivering clinical services for many non-urgent medical needs allowing telehealth or telemedicine, to become an almost inevitable part of the patient care. However, most of patients with vascular disease may require face-to-face interaction and are at risk of worse outcomes if not managed in timely manner. OBJECTIVE: We aimed to describe the utilization of telemedicine services in the outpatient vascular surgery clinics in a tertiary hospital. METHODS: A retrospective analysis of data on all vascular outpatient encounters during 2019 and 2020 was conducted and compared to reflect the pattern of practice prior to and during the COVID-19 pandemic. RESULTS: The study showed that 61% of the total patient encounters in 2020 were reported through teleconsultation. Females were the majority of patients who sought the virtual vascular care. Consultations for the new cases decreased from 29% to 26% whereas, the follow-up cases increased from 71% to 74% in 2020 (p = 0.001). The number of procedures performed in the vascular outpatient clinics decreased by 46% in 2020 when compared to 2019. This decrease in procedures was more evident in the duration from February 2020 to April 2020 in which the procedures decreased by 97%. The proportion of procedures represented 22.6% of the total encounters in 2019 and 10.5% of the encounters during 2020, (p = 0.001). CONCLUSIONS: Teleconsultation, along with supporting practice guidelines, can be used to maximize the efficiency of care in vascular surgery patients during the pandemic and beyond. Adoption of the 'hybrid care' which combines both virtual and in-person services as an ongoing practice requires evidence obtained through audits and studies on patients and healthcare providers levels. It is essential to establish a clear practice that ensures patient's needs.

The Case for a National SNAP Fruit and Vegetable Incentive Program

Supplemental Nutrition Assistance Program (SNAP) enrollment has increased dramatically during the COVID19 economic crisis. Currently, one in three households with children experiences food insecurity, the greatest prevalence in modern times.1 SNAP effectively reduces poverty and improves food insecurity,2 and the current recession has increased many US households' reliance on federal nutrition programs. These new developments have intensified ongoing public debate about the most effective program designs for promoting food security and dietary quality.SNAP fruit and vegetable (FV) incentives aim to improve diet quality for participants by providing matching funds for FVs purchased with electronic benefit transfer (EBT). SNAP incentives encourage healthy eating behaviors by subsidizing FV purchase and consumption. FV incentives have been piloted nationwide, providing important evidence than can inform optimal program design. However, incentives are not uniformly available to all SNAP participants, and there are currently insufficient federal resources appropriated to expand incentives nationwide. We review the scientific evidence base for FV incentives and their correlation with healthy eating behaviors, highlight potential challenges for scaling FV incentive programs, and explain the public health opportunity associated with nationwide expansion of evidencebased FV incentives.

Resistance to Racial Equity in U.S. Federalism and Its Impact on Fragmented Regions

In this commentary, we provide our ground-level observations of how the novel coronavirus disease (COVID-19 or COVID) has exposed weaknesses in our federal system to respond to local communities, particularly Black and Latina/os who live and work in the St. Louis region. Our perspectives come from a virtual town hall hosted by the Community Innovation and Action Center (CIAC) at the University of Missouri, St. Louis on April 18, 2020. Based on these initial public discussions, we use St. Louis as a lens for arguing that government?s attenuated impact is not due to a natural disaster itself, but the inevitable result of race-based policies that had worked against Black peoples over generations. The real failure involves our federalist system?s lack of a commitment to racial equity?when race no longer is used to predict life outcomes, and outcomes for all groups are improved?when designing the federal plan to respond to COVID-19 in local communities.