School-based nutrition programs are associated with reduced child food insecurity over time among Mexican-origin mother-child dyads in Texas Border Colonias.

In 2011, an estimated 50.2 million adults and children lived in US households with food insecurity, a condition associated with adverse health effects across the life span. Relying solely on parent proxy may underreport the true prevalence of child food insecurity. The present study sought to understand mothers' and children's (aged 6-11 y) perspectives and experiences of child food insecurity and its seasonal volatility, including the effects of school-based and summertime nutrition programs. Forty-eight Mexican-origin mother-child dyads completed standardized, Spanish-language food-security instruments during 2 in-home visits between July 2010 and March 2011. Multilevel longitudinal logistic regression measured change in food security while accounting for correlation in repeated measurements by using a nested structure. Cohen's κ statistic assessed dyadic discordance in child food insecurity. School-based nutrition programs reduced the odds of child food insecurity by 74% [OR = 0.26 (P < 0.01)], showcasing the programs' impact on the condition. Single head of household was associated with increased odds of child food insecurity [OR = 4.63 (P = 0.03)]. Fair dyadic agreement of child food insecurity was observed [κ = 0.21 (P = 0.02)]. Obtaining accurate prevalence rates and understanding differences of intrahousehold food insecurity necessitate measurement at multiple occasions throughout the year while considering children's perceptions and experiences of food insecurity in addition to parental reports.

Children's reporting of food insecurity in predominately food insecure households in Texas border colonias.

BACKGROUND: Food insecurity is associated with detrimental physical, psychological, behavioral, social, and educational functioning in children and adults. Greater than one-quarter of all Hispanic households in the U.S. are food insecure. Hispanic families in the U.S. comprise 30% of households with food insecurity at the child level, the most severe form of the condition. METHODS: Food security discordance was evaluated among 50 Mexican-origin children ages 6-11 and their mothers living in Texas border colonias from March to June 2010. Mothers and children were interviewed separately using promotora-researcher administered Spanish versions of the Household Food Security Survey Module and the Food Security Survey Module for Youth. Cohen's kappa statistic (κ) was used to analyze dyadic agreement of food security constructs and level of food security. RESULTS: Eighty percent of mothers reported household food insecurity while 64% of children identified food insecurity at the child level. There was slight inter-rater agreement in food security status (κ = 0.13, p = 0.15). Poor agreement was observed on the child hunger construct (κ = -0.06, p = 0.66) with fair agreement in children not eating for a full day (κ = 0.26, p < 0.01) and relying on low-cost foods (κ = 0.23, p = 0.05). CONCLUSIONS: Mother and child-reported household and child-level food insecurity among this sample of limited-resource Mexican-origin colonias residents far surpass national estimates. While the level of dyadic agreement was poor, discordance may be attributable to parental buffering, social desirability in responses, and/or the age of children included in the present analysis. Future research should continue to explore how food security is understood from the perspectives and experiences of children and adolescents.

Convenience stores are the key food environment influence on nutrients available from household food supplies in Texas Border Colonias.

BACKGROUND: Few studies have focused on the relationship between the retail food environment and household food supplies. This study examines spatial access to retail food stores, food shopping habits, and nutrients available in household food supplies among 50 Mexican-origin families residing in Texas border colonias. METHODS: The design was cross-sectional; data were collected in the home March to June 2010 by promotora-researchers. Ground-truthed methods enumerated traditional (supercenters, supermarkets, grocery stores), convenience (convenience stores and food marts), and non-traditional (dollar stores, discount stores) retail food stores. Spatial access was computed using the network distance from each participant's residence to each food store. Data included survey data and two household food inventories (HFI) of the presence and amount of food items in the home. The Spanish language interviewer-administered survey included demographics, transportation access, food purchasing, food and nutrition assistance program participation, and the 18-item Core Food Security Module. Nutrition Data Systems for Research (NDS-R) was used to calculate HFI nutrients. Adult equivalent adjustment constants (AE), based on age and gender calorie needs, were calculated based on the age- and gender composition of each household and used to adjust HFI nutrients for household composition. Data were analyzed using bivariate analysis and linear regression models to determine the association of independent variables with the availability of each AE-adjusted nutrient. RESULTS: Regression models showed that households in which the child independently purchased food from a convenience store at least once a week had foods and beverages with increased amounts of total energy, total fat, and saturated fat. A greater distance to the nearest convenience store was associated with reduced amounts of total energy, vitamin D, total sugar, added sugar, total fat, and saturated fat. Participation in the National School Lunch Program (NSLP) was associated with lower household levels of total energy, calcium, vitamin C, sodium, vitamin D, and saturated fat. Spatial access and utilization of supermarkets and dollar stores were not associated with nutrient availability. CONCLUSIONS: Although household members frequently purchased food items from supermarkets or dollar stores, it was spatial access to and frequent utilization of convenience food stores that influenced the amount of nutrients present in Texas border colonia households. These findings also suggest that households which participate in NSLP have reduced AE-adjusted nutrients available in the home. The next step will target changes within convenience stores to improve in-store marketing of foods and beverages to children and adults.

Understanding contextual barriers, supports, and opportunities for physical activity among Mexican-origin children in Texas border colonias: a descriptive study.

BACKGROUND: The increasing numbers of colonias along the U.S.-Mexico border are characterized by disproportionately poor families of Mexican-origin, limited access to resources and health services, and heightened risk for obesity and diabetes. Despite consistent evidence supporting physical activity (PA) in prevention of chronic diseases, many individuals of Mexican-origin, including children, fail to meet PA recommendations. Environmental influences on PA, founded in ecological and social cognitive perspectives, have not been examined among children living in colonias. The purpose of this study was to identify and better understand (1) household and neighborhood environmental PA resources/supports, (2) perceived barriers to engaging in PA, and (3) PA offerings, locations, and transportation characteristics for Mexican-origin children living in colonias. METHODS: Data for this study were collected by promotora-researchers (indigenous community health workers trained in research methods) using face-to-face interviews conducted in Spanish. The sample consists of 94 mother-child dyads from Texas border colonias in Hidalgo County. Interviews included questionnaire items addressing PA barriers, household and neighborhood environmental support assessments conducted with each dyad, and open-ended questions that were coded to identify availability and locations of PA opportunities and transportation options. Descriptive statistics were calculated and differences between genders, birth countries, and BMI categories of children were determined using chi-square tests. RESULTS: All children were of Mexican-origin. The most frequently reported barriers were unleashed dogs in the street, heat, bad weather, traffic, no streetlights, and no place like a park to exercise. Prominent locations for current PA included schools, home, and parks. Common PA options for children were exercise equipment, running, playing, and sports. Environmental assessments identified exercise equipment (bicycles/tricycles, balls, etc.…), paved/good streets, yard/patio space, and social norms as the most frequent household or neighborhood resources within these colonias. Differences in PA barriers, options, and environmental resources for genders, birth countries, and BMI categories were detected. CONCLUSIONS: This study suggests that PA environmental resources, barriers, and opportunities for colonias children are similar to previous studies and distinctively unique. As expected, built resources in these communities are limited and barriers exist; however, knowledge of PA opportunities and available PA resources within colonias households and neighborhoods offers insight to help guide future research, policy, and PA initiatives.

Child hunger and the protective effects of Supplemental Nutrition Assistance Program (SNAP) and alternative food sources among Mexican-origin families in Texas border colonias.

BACKGROUND: Nutritional health is essential for children's growth and development. Many Mexican-origin children who reside in limited-resource colonias along the Texas-Mexico border are at increased risk for poor nutrition as a result of household food insecurity. However, little is known about the prevalence of child hunger or its associated factors among children of Mexican immigrants. This study determines the prevalence of child hunger and identifies protective and risk factors associated with it in two Texas border areas. METHODS: This study uses 2009 Colonia Household and Community Food Resource Assessment (C-HCFRA) data from 470 mothers who were randomly recruited by promotora-researchers. Participants from colonias near two small towns in two South Texas counties participated in an in-home community and household assessment. Interviewer-administered surveys collected data in Spanish on sociodemographics, federal food assistance program participation, and food security status. Frequencies and bivariate correlations were examined while a random-effects logistic regression model with backward elimination was used to determine correlates of childhood hunger. RESULTS: Hunger among children was reported in 51% (n = 239) of households in this C-HCFRA sample. Bivariate analyses revealed that hunger status was associated with select maternal characteristics, such as lower educational attainment and Mexican nativity, and household characteristics, including household composition, reliance on friend or neighbor for transportation, food purchase at dollar stores and from neighbors, and participation in school-based nutrition programs. A smaller percentage of households with child hunger participated in school-based nutrition programs (51%) or used alternative food sources, while 131 households were unable to give their child or children a balanced meal during the school year and 145 households during summer months. In the random effects model (RE = small town), increased household composition, full-time unemployment, and participation in the National School Lunch Program were significantly associated with increased odds for child hunger, while participation in Supplemental Nutrition Assistance Program (SNAP) and purchasing food from a neighbor were significantly associated with decreased odds for child hunger. CONCLUSIONS: This study not only emphasizes the alarming rates of child hunger among this sample of Mexican-origin families, but also identifies economic and family factors that increased the odds for child hunger as well as community strategies that reduced the odds. It is unsettling that so many children did not participate in school-based nutrition programs, and that many who participated in federal nutrition assistance programs remained hungry. This study underscores the importance of identifying the presence of child hunger among low-income Mexican-origin children in Texas border colonias and increasing access to nutrition-related resources. Hunger-associated health inequities at younger ages among colonia residents are likely to persist across the life span and into old age.

Survey of instructors teaching about antimicrobial resistance in the veterinary professional curriculum in the United States.

The objective of this study was to ascertain current teaching methods for antimicrobial resistance (AMR) in veterinary professional curricula and to find out what veterinary instructors consider to be prioritized subtopics related to AMR. The sampling frame was instructors in veterinary professional programs at US colleges of veterinary medicine who provide instruction about antibiotics or AMR in the disciplines of microbiology, pharmacology, public health, epidemiology, internal medicine, surgery, or related subjects. Identified instructors were invited to participate in an online survey of current teaching methods related to subtopics of AMR. From 1,207 invitations, 306 completed surveys were available for analysis (25% response rate) with the largest number of respondents stating their contact hours about antibiotics occur in the discipline of "medicine-food animal." The median contact time suggested for AMR in the core veterinary curriculum was 3-5 hours, and for antibiotics in general, 16-20 hours. Subtopics of AMR were prioritized based on respondents' indication that they use or would use various teaching tools. The most common teaching tool for all topics was projected text (i.e., slides or PowerPoint slides) and the least common were video clips, non-course Web sites, online modules, and laboratory experiments. Recommendations for identifying the priorities of AMR content coverage and learning outcomes are made.

Empowerment of promotoras as promotora-researchers in the Comidas Saludables & Gente Sana en las Colonias del Sur de Tejas (Healthy Food and Healthy People in South Texas Colonias) program.

Promotoras are trusted members of underserved, at-risk Hispanic communities experiencing social and health inequities. As promotora-researchers, promotoras have the unique ability and opportunity not only to provide outreach and education but also to be actively engaged in conducting research in their communities and serve as a cultural bridge between the community and researchers. In this article, we present a case study of personal and collective empowerment of six promotora-researchers who participated in seven community-based participatory research projects. Data sources included debriefing interviews with the promotora-researchers, milestone tracking and documentation completed during and after each study, and observations by the principal investigator and project managers regarding the role of the promotora-researchers in these studies. We qualitatively analyzed the data to identify the processes and decisions that were developed and implemented in a series of projects, which resulted in promotora-researcher empowerment. We found that active engagement empowered promotora-researchers personally and collectively in all phases of the research study. Common elements that contributed to the empowerment of promotora-researchers were valuing promotora-researchers' input, enabling promotora-researchers to acquire and utilize new skills, and allowing promotora-researchers to serve as both researchers and traditional promotoras. Together, these elements enabled them to more fully participate in research projects, while allowing them to identify and address needs within their own communities.

Cultural repertoires and food-related household technology within colonia households under conditions of material hardship.

UNLABELLED: BSTRACT: INTRODUCTION: Mexican-origin women in the U.S. living in colonias (new-destination Mexican-immigrant communities) along the Texas-Mexico border suffer from a high incidence of food insecurity and diet-related chronic disease. Understanding environmental factors that influence food-related behaviors among this population will be important to improving the well-being of colonia households. This article focuses on cultural repertoires that enable food choice and the everyday uses of technology in food-related practice by Mexican-immigrant women in colonia households under conditions of material hardship. Findings are presented within a conceptual framework informed by concepts drawn from sociological accounts of technology, food choice, culture, and material hardship. METHODS: Field notes were provided by teams of promotora-researchers (indigenous community health workers) and public-health professionals trained as participant observers. They conducted observations on three separate occasions (two half-days during the week and one weekend day) within eight family residences located in colonias near the towns of Alton and San Carlos, Texas. English observations were coded inductively and early observations stressed the importance of technology and material hardship in food-related behavior. These observations were further explored and coded using the qualitative data package Atlas.ti. RESULTS: Technology included kitchen implements used in standard and adapted configurations and household infrastructure. Residents employed tools across a range of food-related activities identified as forms of food acquisition, storage, preparation, serving, feeding and eating, cleaning, and waste processing. Material hardships included the quality, quantity, acceptability, and uncertainty dimensions of food insecurity, and insufficient consumption of housing, clothing and medical care. Cultural repertoires for coping with material hardship included reliance on inexpensive staple foods and dishes, and conventional and innovative technological practices. These repertoires expressed the creative agency of women colonia residents. Food-related practices were constrained by climate, animal and insect pests, women's gender roles, limitations in neighborhood and household infrastructure, and economic and material resources. CONCLUSIONS: This research points to the importance of socioeconomic and structural factors such as gender roles, economic poverty and material hardship as constraints on food choice and food-related behavior. In turn, it emphasizes the innovative practices employed by women residents of colonias to prepare meals under these constraints.

Children's very low food security is associated with increased dietary intakes in energy, fat, and added sugar among Mexican-origin children (6-11 y) in Texas border Colonias.

BACKGROUND: Food insecurity among Mexican-origin and Hispanic households is a critical nutritional health issue of national importance. At the same time, nutrition-related health conditions, such as obesity and type 2 diabetes, are increasing in Mexican-origin youth. Risk factors for obesity and type 2 diabetes are more common in Mexican-origin children and include increased intakes of energy-dense and nutrient-poor foods. This study assessed the relationship between children's experience of food insecurity and nutrient intake from food and beverages among Mexican-origin children (age 6-11 y) who resided in Texas border colonias. METHODS: Baseline data from 50 Mexican-origin children were collected in the home by trained promotora-researchers. All survey (demographics and nine-item child food security measure) and 24-hour dietary recall data were collected in Spanish. Dietary data were collected in person on three occasions using a multiple-pass approach; nutrient intakes were calculated with NDS-R software. Separate multiple regression models were individually fitted for total energy, protein, dietary fiber, calcium, vitamin D, potassium, sodium, Vitamin C, and percentage of calories from fat and added sugars. RESULTS: Thirty-two children (64%) reported low or very low food security. Few children met the recommendations for calcium, dietary fiber, and sodium; and none for potassium or vitamin D. Weekend intake was lower than weekday for calcium, vitamin D, potassium, and vitamin C; and higher for percent of calories from fat. Three-day average dietary intakes of total calories, protein, and percent of calories from added sugars increased with declining food security status. Very low food security was associated with greater intakes of total energy, calcium, and percentage of calories from fat and added sugar. CONCLUSIONS: This paper not only emphasizes the alarming rates of food insecurity for this Hispanic subgroup, but describes the associations for food insecurity and diet among this sample of Mexican-origin children. Child-reported food insecurity situations could serve as a screen for nutrition problems in children. Further, the National School Lunch and School Breakfast Programs, which play a major beneficial role in children's weekday intakes, may not be enough to keep pace with the nutritional needs of low and very low food secure Mexican-origin children.

Mobile and home-based vendors' contributions to the retail food environment in rural South Texas Mexican-origin settlements.

A growing concern with high rates of obesity and overweight among immigrant minority populations in the US has focused attention on the availability and accessibility to healthy foods in such communities. Small-scale vending in rural, impoverished and underserved areas, however, is generally overlooked; yet, this type of informal activity and source for food is particularly important in such environs, or "food desserts," where traditional forms of work and mainstream food outlets are limited or even absent. This exploratory study investigates two types of small-scale food vending that take place in rural colonias, or Mexican-origin settlements along the South Texas border with Mexico: mobile and home-based. Using a convenience sample of 23 vendors who live and work in Texas colonias, this study identifies the characteristics associated with mobile and home-based food vendors and their businesses and its contributions to the rural food environment. Findings reveal that mobile and home-based vending provides a variety of food and beverage options to colonia residents, and suggests that home-based vendors contribute a greater assortment of food options, including some healthier food items, than mobile food vendors, which offer and sell a limited range of products. Findings may contribute to the development of innovative policy solutions and interventions aimed at increasing healthy food options or reducing health disparities in immigrant communities.

Association of household and community characteristics with adult and child food insecurity among Mexican-origin households in colonias along the Texas-Mexico border.

BACKGROUND: Food insecurity is a critical problem in the United States and throughout the world. There is little published data that provides insights regarding the extent and severity of food insecurity among the hard-to-reach Mexican-origin families who reside in the growing colonias along the Texas border with Mexico. Considering that culture, economics, and elements of the environment may increase the risk for food insecurity and adverse health outcomes, the purpose of this study was to examine the relation between household and community characteristics and food insecurity. METHODS: The study used data from the 2009 Colonia Household and Community Food Resource Assessment (C-HCFRA). The data included 610 face-to-face interviews conducted in Spanish by promotoras (indigenous community health workers) in forty-four randomly-identified colonias near the towns of Progreso and La Feria in Hidalgo and Cameron counties along the Texas border with Mexico. C-HCFRA included demographic characteristics, health characteristics, food access and mobility, food cost, federal and community food and nutrition assistance programs, perceived quality of the food environment, food security, eating behaviors, and alternative food sources. RESULTS: 78% of participants experienced food insecurity at the level of household, adult, or child. The most severe - child food insecurity was reported by 49% of all households and 61.8% of households with children. Increasing levels of food insecurity was associated with being born in Mexico, increasing household composition, decreasing household income, and employment. Participation in federal food assistance programs was associated with reduced severity of food insecurity. Greater distance to their food store and perceived quality of the community food environment increased the odds for food insecurity. CONCLUSIONS: The Mexican-origin population is rapidly expanding; record numbers of individuals and families are experiencing food insecurity; and for those living in rural or underserved areas such as the colonias, the worst forms of food insecurity are an ongoing reality. The rates of households with adult and child food insecurity in this border area are alarming and among the highest reported. Clearly, systematic and sustained action on federal, state, and community levels is needed to reduce household, adult, and child food insecurity that integrates cultural tailoring of interventions and programs to address food and management skills, multi-sector partnerships and networks, expansion of food and nutrition assistance programs, and enhanced research efforts.

Nativity is associated with sugar-sweetened beverage and fast-food meal consumption among Mexican-origin women in Texas border colonias.

BACKGROUND: Trends of increasing obesity are especially pronounced among Mexican-origin women. There is little understanding of dietary patterns among U.S.- and Mexico-born Mexican-origin individuals residing in new-destination immigrant communities in the United States, especially behaviors related to obesity, such as consumption of sugar-sweetened beverages (SSB) and fast-food meals (FFM). METHODS: The study used survey data of 599 adult Mexican-origin women from the 610 women who completed the 2009 Colonia Household and Community Food Resource Assessment (C-HCFRA), which was completed in person by trained promotora-researchers in 44 colonias near the Texas border towns of Progreso and La Feria. Data included demographic characteristics (age, education, nativity or country of birth, household income, household composition, and employment status), access to transportation, self-reported height and weight, food and nutrition assistance program participation, and consumption of SSB and FFM. Descriptive statistics were calculated by nativity (U.S.-born vs. Mexico-born); multivariable linear regression models were estimated for correlates of consumption of SSB and FFM. RESULTS: There are three major findings related to nativity. First, U.S.-born women consumed more SSB and FFM than Mexican-born counterparts in the same areas of colonias. Second, in the combined sample and controlling for other population characteristics, being born in Mexico was independently associated with FFM (fewer FFM), but not with SSB. Third, in analyses stratified by nativity, FFM and SSB were associated with each other among both nativity groups. Among Mexico-born women only, age, presence of a child, or being a lone parent was significantly associated with SSB; full-time employment, being a lone parent, and SSB consumption were each independently associated with increased frequency of FFM. CONCLUSIONS: Our analyses revealed differences in prevalence and correlates of SSB and FFM based on country of birth. Nativity, as a proxy for acculturation, may indicate the extent that immigrants have adopted behaviors from their new environment. However, nativity could also indicate limited accessibility to resources such as food/nutrition assistance programs, transportation, and proper documentation. Additionally, future research should focus on expanding our understanding of the meaning of nativity among individuals who share common contextual factors, but may have different life course experiences and resources needed to transition into a new place. Additional measures should be considered such as educational and occupational background, migration history, documentation status, and dietary acculturation, which may better explain heterogeneity within Hispanic subgroups.

Focusing on fast food restaurants alone underestimates the relationship between neighborhood deprivation and exposure to fast food in a large rural area.

BACKGROUND: Individuals and families are relying more on food prepared outside the home as a source for at-home and away-from-home consumption. Restricting the estimation of fast-food access to fast-food restaurants alone may underestimate potential spatial access to fast food. METHODS: The study used data from the 2006 Brazos Valley Food Environment Project (BVFEP) and the 2000 U.S. Census Summary File 3 for six rural counties in the Texas Brazos Valley region. BVFEP ground-truthed data included identification and geocoding of all fast-food restaurants, convenience stores, supermarkets, and grocery stores in study area and on-site assessment of the availability and variety of fast-food lunch/dinner entrées and side dishes. Network distance was calculated from the population-weighted centroid of each census block group to all retail locations that marketed fast food (n = 205 fast-food opportunities). RESULTS: Spatial access to fast-food opportunities (FFO) was significantly better than to traditional fast-food restaurants (FFR). The median distance to the nearest FFO was 2.7 miles, compared with 4.5 miles to the nearest FFR. Residents of high deprivation neighborhoods had better spatial access to a variety of healthier fast-food entrée and side dish options than residents of low deprivation neighborhoods. CONCLUSIONS: Our analyses revealed that identifying fast-food restaurants as the sole source of fast-food entrées and side dishes underestimated neighborhood exposure to fast food, in terms of both neighborhood proximity and coverage. Potential interventions must consider all retail opportunities for fast food, and not just traditional FFR.

Association between proximity to and coverage of traditional fast-food restaurants and non-traditional fast-food outlets and fast-food consumption among rural adults.

OBJECTIVE: The objective of this study is to examine the relationship between residential exposure to fast-food entrées, using two measures of potential spatial access: proximity (distance to the nearest location) and coverage (number of different locations), and weekly consumption of fast-food meals. METHODS: Traditional fast-food restaurants and non-traditional fast-food outlets, such as convenience stores, supermarkets, and grocery stores, from the 2006 Brazos Valley Food Environment Project were linked with individual participants (n = 1409) who completed the nutrition module in the 2006 Brazos Valley Community Health Assessment. RESULTS: Increased age, poverty, increased distance to the nearest fast food, and increased number of different traditional fast-food restaurants, non-traditional fast-food outlets, or fast-food opportunities were associated with less frequent weekly consumption of fast-food meals. The interaction of gender and proximity (distance) or coverage (number) indicated that the association of proximity to or coverage of fast-food locations on fast-food consumption was greater among women and opposite of independent effects. CONCLUSIONS: Results provide impetus for identifying and understanding the complex relationship between access to all fast-food opportunities, rather than to traditional fast-food restaurants alone, and fast-food consumption. The results indicate the importance of further examining the complex interaction of gender and distance in rural areas and particularly in fast-food consumption. Furthermore, this study emphasizes the need for health promotion and policy efforts to consider all sources of fast-food as part of promoting healthful food choices.

It's all about the children: a participant-driven photo-elicitation study of Mexican-origin mothers' food choices.

BACKGROUND: There is a desperate need to address diet-related chronic diseases in Mexican-origin women, particularly for those in border region colonias (Mexican settlements) and other new destination communities in rural and non-rural areas of the U.S. Understanding the food choices of mothers, who lead food and health activities in their families, provides one way to improve health outcomes in Mexican-origin women and their children. This study used a visual method, participant-driven photo-elicitation, and grounded theory in a contextual study of food choices from the perspectives of Mexican-origin mothers. METHODS: Teams of trained promotoras (female community health workers from the area) collected all data in Spanish. Ten Mexican-origin mothers living in colonias in Hidalgo County, TX completed a creative photography assignment and an in-depth interview using their photographs as visual prompts and examples. English transcripts were coded inductively by hand, and initial observations emphasized the salience of mothers' food practices in their routine care-giving. This was explored further by coding transcripts in the qualitative data analysis software Atlas.ti. RESULTS: An inductive conceptual framework was created to provide context for understanding mothers' daily practices and their food practices in particular. Three themes emerged from the data: 1) a mother's primary orientation was toward her children; 2) leveraging resources to provide the best for her children; and 3) a mother's daily food practices kept her children happy, healthy, and well-fed. Results offer insight into the intricate meanings embedded in Mexican-origin mothers' routine food choices. CONCLUSIONS: This paper provides a new perspective for understanding food choice through the eyes of mothers living in the colonias of South Texas -- one that emphasizes the importance of children in their routine food practices and the resilience of the mothers themselves. Additional research is needed to better understand mothers' perspectives and food practices with larger samples of women and among other socioeconomic groups.

It's who I am and what we eat. Mothers' food-related identities in family food choice.

This study aimed to understand mothers' everyday food choices using one type of visual method-participant-driven photo-elicitation (PDPE). The sample consisted of 12 low/moderate income mothers (26-53 years) living in Bryan/College Station, Texas. Each mother completed a photography activity, where she created photographs of her food experience, and an in-depth interview using the mother's photographs. Interview transcripts were analyzed using a grounded theory approach and coded using qualitative data analysis software ATLAS.ti. Mothers emphasized their identities related to food and eating as they described food-related decisions and activities. These identities influenced a mother's food choices for herself and those she made for her children. Analysis revealed that mothers with a more defined health identity made healthier choices for themselves and similar food choices for their children. In addition, they exhibited behaviors that positively influenced their children's food choices. Mothers who struggled to see themselves as healthy indulged with more junk food and indicated feelings of anxiety and guilt; these mothers' food choices were more disconnected from their children's. These findings underscore the importance of understanding how identities related to food and eating can influence food choices. Encouraging mothers to develop and maintain health identities may be one way to improve food and eating habits in families.

Relationship of household food insecurity to health-related quality of life in a large sample of rural and urban women.

The authors examined the associations of household food insecurity and other characteristics with fair-to-poor general health, poor physical health, and frequent mental distress among 1,367 rural and urban women in Texas. The 2006 Brazos Valley Community Health Assessment provided data on demographic characteristics, economic risk factors, health-related quality of life, household food insecurity, and geographic residence. Multivariable logistic regression models were estimated for the three health-related quality of life measures: fair-to-poor health, poor physical health, and frequent mental distress, adjusting for confounding variables. Having less than 12 years of education, not being employed full-time, and being household food insecure were independently significantly associated with increased odds for all health-related quality of life outcomes. Rural residence and being nonwhite were associated with fair-to-poor general health, but not physical or mental health. Results from the separate urban and rural models indicated that household food insecurity was associated with fair-to-poor general health among rural women, not among urban women. Poverty and being nonwhite were also associated with increased odds of reporting fair-to-poor general health, but were significant only among urban women. These results emphasize the need for health promotion and policy efforts to consider household food access and availability as part of promoting healthful food choices and good physical and mental health among women, especially rural women.

Neighborhood deprivation, vehicle ownership, and potential spatial access to a variety of fruits and vegetables in a large rural area in Texas.

OBJECTIVE: There has been limited study of all types of food stores, such as traditional (supercenters, supermarkets, and grocery stores), convenience stores, and non-traditional (dollar stores, mass merchandisers, and pharmacies) as potential opportunities for purchase of fresh and processed (canned and frozen) fruits and vegetables, especially in small-town or rural areas. METHODS: Data from the Brazos Valley Food Environment Project (BVFEP) are combined with 2000 U.S. Census data for 101 Census block groups (CBG) to examine neighborhood access to fruits and vegetables. BVFEP data included identification and geocoding of all food stores (n = 185) in six rural counties in Texas, using ground-truthed methods and on-site assessment of the availability and variety of fresh and processed fruits and vegetables in all food stores. Access from the population-weighted centroid of each CBG was measured using proximity (minimum network distance) and coverage (number of shopping opportunities) for a good selection of fresh and processed fruits and vegetables. Neighborhood inequalities (deprivation and vehicle ownership) and spatial access for fruits and vegetables were examined using Wilcoxon matched-pairs signed-rank test and multivariate regression models. RESULTS: The variety of fruits or vegetables was greater at supermarkets compared with grocery stores. Among non-traditional and convenience food stores, the largest variety was found at dollar stores. On average, rural neighborhoods were 9.9 miles to the nearest supermarket, 6.7 miles and 7.4 miles to the nearest food store with a good variety of fresh fruits and vegetables, respectively, and 4.7 miles and 4.5 miles to a good variety of fresh and processed fruits or vegetables. High deprivation or low vehicle ownership neighborhoods had better spatial access to a good variety of fruits and vegetables, both in the distance to the nearest source and in the number of shopping opportunities. CONCLUSION: Supermarkets and grocery stores are no longer the only shopping opportunities for fruits or vegetables. The inclusion of data on availability of fresh or processed fruits or vegetables in the measurements provides robust meaning to the concept of potential access in this large rural area.

"I'm the Momma": using photo-elicitation to understand matrilineal influence on family food choice.

BACKGROUND: Many complex and subtle aspects relating to mothers and food choice are not well understood. Mothers play a primary role in their children's food choices, but research has not specifically examined how matrilineal family members who do not reside in the same household, such as a mother's mother, aunt, or grandmother, influence the current family's food choices. METHODS: Seven participants were recruited from the Household Food Inventory (HFI) Study in the Bryan/College Station, Texas. All participants completed an in-depth interview, photographed food-related activities, and discussed photographs in a follow-up in-depth interview. Interviews were transcribed verbatim from audio recordings. Transcripts were analyzed using several qualitative approaches including grounded theory to identify themes and subthemes. RESULTS: Participants discussed the following themes relating to the influence of their mother or other female relation (Mom) on their families' food choices: Relationship with Mom, Just like Mom, 'Kinda' like Mom, Different than Mom, and Mom's Influence on Children's Food Choices. Overall, participants used the photographs to illustrate how they were similar or different to their mothers, or other female family member, as well as how their mothers either supported or undermined control over their children's food choices. The "Mom effect" or matrilineal influence of mothers, aunts, and grandmothers on a mother's food choices was omnipresent, even though Mom was no longer living with the participants. CONCLUSIONS: We found a matrilineal influence to have a residual and persistent influence on a family's food choices. This finding may be helpful for understanding the contextual elements of food choice and explaining why it is sometimes difficult to change mothers' food habits.

Food access and perceptions of the community and household food environment as correlates of fruit and vegetable intake among rural seniors.

BACKGROUND: Although the importance of fruit and vegetable consumption to health has been well established, few studies have focused on access to fruits and vegetables in rural areas; even fewer examined the relationship between food access and fruit and vegetable consumption among seniors. METHODS: To examine the spatial challenges to good nutrition faced by seniors who reside in rural areas and how spatial access influences fruit and vegetable intake. A cross-sectional analysis using data from the 2006 Brazos Valley Health Assessment (mailsurvey) for 582 rural seniors (60-90 years), who were recruited by random digit dialing; food store data from the 2006-2007 Brazos Valley Food Environment Project that used ground-truthed methods to identify, geocode, and inventory fruit and vegetables in all food stores. RESULTS: Few of the BVHA seniors consumed the recommended intakes of fruits or vegetables; women consumed more servings of fruit (1.49 +/- 0.05 vs. 1.29 +/- 0.07, p = 0.02), similar servings of vegetables (2.18 +/- 0.04 vs. 2.09 +/- 0.07, p = 0.28), and more combined fruit and vegetables (3.67 +/- 0.08 vs. 3.38 +/- 0.12, p = 0.04) than men. The median distances to fresh fruit and vegetables were 5.5 miles and 6.4 miles, respectively. When canned and frozen fruit and vegetables were included in the measurement of overall fruit or vegetables, the median distance for a good selection of fruit or vegetables decreased to 3.4 miles for overall fruit and 3.2 miles for overall vegetables. Almost 14% reported that food supplies did not last and there was not enough money to buy more. Our analyses revealed that objective and perceived measures of food store access--increased distance to the nearest supermarket, food store with a good variety of fresh and processed fruit, or food store with a good variety of fresh and processed vegetables--were associated with decreased daily consumption of fruit, vegetables, and combined fruit and vegetables, after controlling for the influence of individual characteristics and perceptions of community and home food resources. CONCLUSIONS: Findings suggest that interventions designed to increase fruit and vegetable consumption among rural seniors should consider strategies to ameliorate differential access to healthy food due to food store distance.