Factors associated with fruit and vegetable consumption among Burmese refugees.

OBJECTIVE: The Burmese population is one of the fast-growing refugee populations in the USA. This study investigated behavioural and environmental factors associated with fruit and vegetable (FV) consumption among Burmese refugees. DESIGN: We conducted a cross-sectional interview survey in 2018-2019. The 24-h recall was used to assess dietary behaviour. Multivariable logistic regression models were constructed with meeting the daily FV consumption recommendation (two or more servings of fruits and three or more servings of vegetables) as the outcome variable. We selected socio-economics, nutritional knowledge, food shopping frequency, ethnicity of preferred food store owners, perceived neighbourhood food environment and network distance to preferred food stores as potential explanatory variables. SETTING: Two Upstate New York counties. PARTICIPANTS: Burmese refugees (n 173) aged ≥18 years. RESULTS: Forty-five percentage of respondents met the daily FV consumption recommendation, and nearly all respondents identified ethnic (Burmese, Chinese/pan-Asian, or South Asian/halal) stores as their preferred stores to purchase FV. In the best-fit model, age (OR 1·08, 95 % CI (1·04, 1·12)) and shopping frequency (OR 1·51, 95 % CI (1·01, 2·26)) were positively associated, and network distance to preferred stores in kilometres (OR 0·81, 95 % CI (0·73, 0·90)) was negatively associated with meeting the daily FV consumption recommendation. No significant effect modifications by car ownership, poverty, length of stay in the USA and Supplemental Nutrition Assistance Program participation were detected. CONCLUSIONS: The findings suggested that having Asian ethnic food stores within a short, walkable distance from home and shopping at these stores often can promote healthy dietary behaviour among Burmese refugees.

Commentary: An Equitable Approach to Serving Structurally Marginalized Communities.

As the United States grapples with social injustices, greater attention is being placed on the historical lack of equity practices among health and social service organizations that serve marginalized and predominantly racially minoritized communities. We describe strategies health and social service organizations that partner with community-led organizations must take to ensure actionable equitable changes. The opportunity and promise are upon us to resolve health inequities and promote equity-oriented practices, policies, systems, and social-environmental changes.

Mediating role of self-esteem: Black Caribbean and African American adolescents' initiation of sex.

To determine how self-esteem mediates the relationship between family support and initiation of sex for US-born Black Caribbean compared to African American adolescents. Secondary data analyses were performed on responses from 1170 adolescents from the National Survey of American Life-Adolescents supplement (2003-2004). Weighted descriptive statistics and logistic regression analyses were performed to examine whether initiation of sex on perceived family support is mediated by self-esteem. The study population consists of 360 Black Caribbean and 810 African American adolescents. Sexual initiation prevalence was higher for Black Caribbean adolescents (42.1%) than African American adolescents (36.75%). The adjusted odds ratio for Black Caribbean adolescents' initiation of sex was 0.85 (95% confidence interval [CI]: 0.16-4.51) compared to African American adolescents' 0.59 (95% CI: 0.35-1.00). Self-esteem represented a statistically significant mediation path and might be more important for African American adolescents' sexual health than the Black Caribbean. The unfounded mediating role of self-esteem between perceived family support and Black Caribbean adolescents' sexual initiation suggests possible influences of Black heterogeneity stemming from ethnic identity differences in sexual health decision-making.

Population-Level Nutritional Well-Being: Nutrition Security and Equitability.

Nutrition is essential to sustaining the quality of life and a fundamental right of all people [...].

Association between sociodemographic characteristics and age stopped breastfeeding on early childhood weight status.

INTRODUCTION: Epidemiological studies have suggested that breastfeeding is associated with child weight status. However, the length of breastfeeding in relation to child weight remains poorly understood. Therefore, this study investigated the association between age stopped breastfeeding and child weight status by sociodemographic characteristics. METHODS: This cross-sectional analysis utilized a nationally representative sample of 3248 U.S. children ages 2-6 years from 2009 to 2018, from parents interviewed as part of the National Health and Nutrition Examination Survey. Child body weight and height were measured during physical examination. Information on age stopped breastfeeding and other demographic characteristics were assessed using questionnaires. Multivariable logistic regression models were performed to examine the association between age stopped breastfeeding and child weight status, adjusting for potential confounders. RESULTS: Children breastfed for ≤ 11 months had an increased odds of being overweight and obese with the strongest association observed among those classified as obese (OR=2.12; 95%CI 1.23, 3.64) compared with children breastfed for > 11-24 months. The association between breastfeeding and child weight status was observed by racial/ethnic groups. Non-Hispanic white and Black children breastfed for ≤ 11 months had an associated increased likelihood of being overweight than their counterparts breastfed for > 11-24 months. Among Hispanic children, we observed elevated odds of being obese when breastfed for ≤ 11 months (OR=1.98; 95%CI 1.00, 3.91) than those breastfed for > 11-24 months. CONCLUSION: Child weight status was associated with age stopped breastfeeding, where likelihood of being overweight and obese were greatest among children breastfed for ≤ 11 months.

A mixed-method evaluation of the New York State Eat Well Play Hard Community Projects: Building local capacity for sustainable childhood obesity prevention.

This study used a mixed-method, comparative case study approach to assess the level of capacity built for childhood obesity prevention among seven New York State Eat Well Play Hard-Community Projects (EWPH-CP). Data were collected through a self-reported survey in 2007, semi-structured interviews in 2009, and EWPH-CP program documentation throughout the 2006-2010 funding cycle. Quantitative and qualitative analyses were used along with an integrative framework for assessing local capacity building to characterize the capacity built by the study coalitions. Four coalitions rated membership characteristics as a challenge at the beginning of the funding cycle. Towards the end of the funding cycle, all seven coalitions reported activities that were initially focused on building their membership (i.e., member capacity) or positive working relationships (i.e. relational capacity), before eventually pursuing support and resources (i.e., organizational capacity) for implementing their chosen community-oriented programmatic goals (i.e., programmatic capacity). Five coalitions reported environmental changes aimed at increasing physical activity or fruit and vegetable intake. Technical assistance provided to coalitions was credited with contributing to the achievement of programmatic goals. These results suggest that the coalitions succeeded in building local capacity for increasing age-appropriate physical activity or fruit and vegetables intake in the target communities.