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2.

A cross-country analysis of climate shocks and smallholder food insecurity.

Niles, Meredith T; Salerno, Jonathan D
| Idioma(s): Inglés
Future climate changes will affect smallholder farmers in the developing world, posing threats to household food security. Nevertheless, there remains limited comparable evidence across multiple countries and regions regarding the global extent of climate shocks affecting smallholder food security. We examine data from 5,299 household surveys across 15 countries in Latin America, Africa and South Asia to assess the extent of climate shocks and their association with food insecurity, as well as what strategies may help buffer against climate shocks. We find that 71% of households reported experiencing a climate shock in the previous five years. Fifty-four percent reported experiencing food insecurity during one or more months annually. A multilevel statistical model estimated factors correlated with food insecurity as well as factors correlated with food insecurity among households that had experienced a climate shock. Households that reported experiencing a climate shock were 1.73 times more likely to be food insecure. As well, larger and poorer households were associated with higher odds of food insecurity while using pesticides, keeping large livestock, and being more educated are associated with lower odds of food insecurity. Among households that had experienced a climate shock, additional factors are correlated with lower odds of food insecurity when compared to otherwise similar households: use of fertilizers, pesticides, veterinary medicines, large livestock, and household assets. Together, these results demonstrate the extent of existing climate shocks affecting smallholder farmers and how interventions may potentially support adaptation and reduce food insecurity.
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3.

Adequação normativa dos planos estaduais de segurança alimentar e nutricional no Brasil/ Compliance with guidelines by state plans for food and nutritional security in Brazil/ Adecuación normativa de los planes estatales de seguridad alimentaria y nutricional en Brasil

Machado, Mick Lennon; Gabriel, Cristine Garcia; Soar, Claudia; Mamed, Gisele Rockenbach; Machado, Patrícia Maria de Oliveira; Lacerda, Josimari Telino de; Martins, Milena Corrêa; Marcon, Maria Cristina
| Idioma(s): Portugués
Resumo: Com o intuito de analisar a adequação dos Planos Estaduais de Segurança Alimentar e Nutricional (PlanSAN) às normas estabelecidas pela Política Nacional de Segurança Alimentar e Nutricional (PNSAN), foi realizada pesquisa descritiva e documental, com coleta de dados entre agosto a outubro de 2016. O acesso aos planos foi realizado na página de Internet da Câmara Interministerial de Segurança Alimentar e Nutricional (CAISAN) ou dos governos estaduais, com coleta de informações complementares no âmbito dos estados. Todos os estados brasileiros aderiram ao Sistema de Segurança Alimentar e Nutricional (SISAN), entretanto menos da metade (13 estados, 48%) elaborou seus planos, destacando-se alguns aspectos: 5 (38%) dos PlanSAN tinham vigência correspondente ao plano plurianual do estado; 5 (38%) dos PlanSAN descreviam os requisitos orçamentários para execução das metas propostas; e 7 (54%) descreviam mecanismos de monitoramento do plano e apenas 2 (15%) definiam metodologia para monitoramento de segurança alimentar e nutricional. O menor tempo de existência da CAISAN e de adesão parecem estar relacionados com a inexistência de PlanSAN. Ainda que a maioria dos estados com planos atendam algumas normativas estabelecidas pela PNSAN, esses instrumentos tornam-se frágeis e pouco exequíveis quando não possuem vinculação orçamentária para suas metas. Pelo fato de a PNSAN ser estruturalmente intersetorial, a construção dos planos depende de um trabalho coletivo das diversas secretarias de governo. Reforça-se que os itens analisados foram todos normativos, o que implica necessidade do estabelecimento de mecanismos que garantam a sua adequada execução. Abstract: A descriptive and documental study was performed from August to October 2016 to analyze compliance by state plans for food and nutritional security (PlanSAN) with the guidelines set by the Brazilian National Policy for Food and Nutritional Security (PNSAN). The state plans were accessed via the websites of the Inter-Ministerial Chamber for Food and Nutritional Security (CAISAN) or the state governments, plus complementary data collection at the state level. All the states of Brazil joined the National System for Food and Nutritional Security (SISAN), while fewer than half (13 states, 48%) had drafted their plans. Of these, 5 (38%) of the PlanSAN had schedules that coincided with the same state's pluriannual plan, 5 (38%) of the PlanSAN specified the budget requirements for meeting the proposed targets, 7 (54%) specified mechanisms for monitoring the plan, and only 2 (15%) defined methodologies for monitoring food and nutritional security. The recent existence of (and adherence to) the CAISAN appear to be related to the lack of state plans in half the states. Although most of the states that did have plans met some of the guidelines laid out by the PNSAN, these mechanisms become weak and impractical when they lack earmarked budget funds to meet their targets. Since the PNSAN is structurally inter-sectorial, the development of plans requires collective work by various government departments. Importantly, the items analyzed here are all guidelines, which implies the need for mechanisms to monitor their actual implementation. Resumen: Con el propósito de analizar la adecuación de los planes estatales de seguridad alimentaria y nutricional (PlanSAN), a las normas establecidas por la Política Nacional de Seguridad Alimentaria y Nutricional (PNSAN), se realizó una investigación descriptiva y documental, con una recogida de datos entre agosto a octubre de 2016. El acceso a los planes se realizó en el sitio web de la Cámara Interministerial de Seguridad Alimentaria y Nutricional (CAISAN) de los gobiernos estatales, con una recogida de información complementaria en el ámbito de los estados. Todos los estados brasileños se adhirieron al Sistema de Seguridad Alimentaria y Nutricional (SISAN), mientras que menos de la mitad (13 estados, un 48%) elaboró sus planes, destacándose algunos aspectos: 5 (38%) de los PlanSAN tenían una vigencia correspondiente al plan plurianual del estado; 5 (38%) de los PlanSAN describían los requisitos presupuestarios para la ejecución de las metas propuestas; y 7 (54%) describían mecanismos de monitoreo del plan y solamente 2 (15%) definían la metodología para el monitoreo de la seguridad alimentaria y nutricional. El menor tiempo de existencia de la CAISAN y de adhesión parecen estar relacionados con la inexistencia de PlanSAN. A pesar de que la mayoría de los estados con planes atiendan algunas normativas establecidas por la PNSAN, esos instrumentos se convierten en frágiles y poco viables, cuando no poseen una vinculación presupuestaria para sus metas. Debido al hecho de que el PNSAN sea estructuralmente intersectorial, la construcción de los planes depende de un trabajo colectivo de las diversas secretarías de gobierno. Se refuerza que los ítems analizados fueron todos normativos, lo que implica necesidad del estabelecimiento de mecanismos que garanticen su adecuada ejecución.
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4.

Neighborhood disparities in access to healthy foods and their effects on environmental justice.

Hilmers, Angela; Hilmers, David C; Dave, Jayna
| Idioma(s): Inglés
Environmental justice is concerned with an equitable distribution of environmental burdens. These burdens comprise immediate health hazards as well as subtle inequities, such as limited access to healthy foods. We reviewed the literature on neighborhood disparities in access to fast-food outlets and convenience stores. Low-income neighborhoods offered greater access to food sources that promote unhealthy eating. The distribution of fast-food outlets and convenience stores differed by the racial/ethnic characteristics of the neighborhood. Further research is needed to address the limitations of current studies, identify effective policy actions to achieve environmental justice, and evaluate intervention strategies to promote lifelong healthy eating habits, optimum health, and vibrant communities.
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5.

Tackling 'wicked' health promotion problems: a New Zealand case study.

Signal, Louise N; Walton, Mat D; Ni Mhurchu, Cliona; Maddison, Ralph; Bowers, Sharron G; Carter, Kristie N; Gorton, Delvina; Heta, Craig; Lanumata, Tolotea S; McKerchar, Christina W; O'Dea, Des; Pearce, Jamie
| Idioma(s): Inglés
This paper reports on a complex environmental approach to addressing 'wicked' health promotion problems devised to inform policy for enhancing food security and physical activity among Maori, Pacific and low-income people in New Zealand. This multi-phase research utilized literature reviews, focus groups, stakeholder workshops and key informant interviews. Participants included members of affected communities, policy-makers and academics. Results suggest that food security and physical activity 'emerge' from complex systems. Key areas for intervention include availability of money within households; the cost of food; improvements in urban design and culturally specific physical activity programmes. Seventeen prioritized intervention areas were explored in-depth and recommendations for action identified. These include healthy food subsidies, increasing the statutory minimum wage rate and enhancing open space and connectivity in communities. This approach has moved away from seeking individual solutions to complex social problems. In doing so, it has enabled the mapping of the relevant systems and the identification of a range of interventions while taking account of the views of affected communities and the concerns of policy-makers. The complex environmental approach used in this research provides a method to identify how to intervene in complex systems that may be relevant to other 'wicked' health promotion problems.
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6.

A corner store intervention in a low-income urban community is associated with increased availability and sales of some healthy foods.

Song, Hee-Jung; Gittelsohn, Joel; Kim, Miyong; Suratkar, Sonali; Sharma, Sangita; Anliker, Jean
| Idioma(s): Inglés
OBJECTIVE: While corner store-based nutrition interventions have emerged as a potential strategy to increase healthy food availability in low-income communities, few evaluation studies exist. We present the results of a trial in Baltimore City to increase the availability and sales of healthier food options in local stores. DESIGN: Quasi-experimental study. SETTING: Corner stores owned by Korean-Americans and supermarkets located in East and West Baltimore. SUBJECTS: Seven corner stores and two supermarkets in East Baltimore received a 10-month intervention and six corner stores and two supermarkets in West Baltimore served as comparison. RESULTS: During and post-intervention, stocking of healthy foods and weekly reported sales of some promoted foods increased significantly in intervention stores compared with comparison stores. Also, intervention storeowners showed significantly higher self-efficacy for stocking some healthy foods in comparison to West Baltimore storeowners. CONCLUSIONS: Findings of the study demonstrated that increases in the stocking and promotion of healthy foods can result in increased sales. Working in small corner stores may be a feasible means of improving the availability of healthy foods and their sales in a low-income urban community.
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7.

Assessment of a healthy corner store program (FIT Store) in low-income, urban, and ethnically diverse neighborhoods in Michigan.

Paek, Hye-Jin; Oh, Hyun Jung; Jung, Yumi; Thompson, Tracy; Alaimo, Katherine; Risley, John; Mayfield, Kellie
| Idioma(s): Inglés
This study evaluated a community-based and social marketing healthy corner store program (FIT store) to improve the affordability and availability of healthy foods in low-income, urban, and ethnically diverse neighborhoods in Michigan. The Nutrition Environment Measures Survey in Stores data were analyzed for the FIT (N = 4) stores. Two cross-sectional surveys were conducted among the FIT store customers before (N = 401) and after (N = 318) the intervention. Three FIT stores improved their total Nutrition Environment Measures Survey in Stores availability score from before to after the intervention. A significantly higher level of FIT awareness and monthly bean and nut consumption was reported in the postintervention.
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8.

Formative evaluation for a healthy corner store initiative in Pitt County, North Carolina: engaging stakeholders for a healthy corner store initiative, part 2.

Pitts, Stephanie B Jilcott; Bringolf, Karamie R; Lloyd, Cameron L; McGuirt, Jared T; Lawton, Katherine K; Morgan, Jo
| Idioma(s): Inglés
INTRODUCTION: We examined the feasibility of increasing access to healthful food in corner stores to inform a Communities Putting Prevention to Work (CPPW) initiative by engaging stakeholders (corner store owners and customers) in a formative evaluation. METHODS: Qualitative interviews were conducted with corner store owners and managers (n = 11). Customer intercept surveys (n = 179) were also conducted with customers of 9 stores. Corner stores were located in rural food deserts (municipalities without a chain supermarket) and in low-income, urban municipalities in eastern North Carolina. Interviews were transcribed verbatim and double-coded. Qualitative themes related to feasibility of increasing access to healthful foods were extracted. Shopping patterns of rural and urban customers were compared by using t tests. RESULTS: Corner store owners were willing to stock more healthful foods, but they perceived that customer demand for these foods was low. Rural customers reported more frequently shopping at corner stores than urban customers and more frequently stated that the reason they do not eat more fruits and vegetables is that the stores in which they shop do not sell them. Most customers reported they would be very or somewhat likely to purchase fresh produce at a corner store. CONCLUSION: Corner stores may be an important source of food for rural and low-income residents and thus a good place in which to intervene. The results of this formative evaluation were used to plan and evaluate a CPPW healthy corner store initiative.
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9.

Prioritizing health and community food security through the farm bill.

Kaiser, Michelle L
| Idioma(s): Inglés
Food security and health are complex interrelated issues. Individual characteristics exist within the physical and built environments. Title IV of the Food, Conservation, and Energy Act of 2008 is analyzed in terms of how it addresses systemic food insecurity and the opportunities the policy has for improving public health by increasing support for the availability of affordable local produce to low-income households. Structural changes need to occur for programs to be equitable, efficient, and effective. Interdisciplinary leadership within government agencies, school systems, social service agencies, health care agencies, and nonprofit networks is necessary to ensure food security and health for all Americans. Social work and public health practitioners have the opportunity to change the status quo, encourage community-level interventions, advocate for producers and consumers, and encourage more equitable distribution of food to create a healthier low-income population.
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10.

Changes in food and beverage environments after an urban corner store intervention.

Cavanaugh, Erica; Green, Sarah; Mallya, Giridhar; Tierney, Ann; Brensinger, Colleen; Glanz, Karen
| Idioma(s): Inglés
OBJECTIVE: In response to the obesity epidemic, interventions to improve the food environment in corner stores have gained attention. This study evaluated the availability, quality, and price of foods in Philadelphia corner stores before and after a healthy corner store intervention with two levels of intervention intensity ("basic" and "conversion"). METHODS: Observational measures of the food environment were completed in 2011 and again in 2012 in corner stores participating in the intervention, using the Nutrition Environment Measures Survey for Corner Stores (NEMS-CS). Main analyses included the 211 stores evaluated at both time-points. A time-by-treatment interaction analysis was used to evaluate the changes in NEMS-CS scores by intervention level over time. RESULTS: Availability of fresh fruit increased significantly in conversion stores over time. Specifically, there were significant increases in the availability of apples, oranges, grapes, and broccoli in conversion stores over time. Conversion stores showed a trend toward a significantly larger increase in the availability score compared to basic stores over time. CONCLUSION: Interventions aimed at increasing healthy food availability are associated with improvements in the availability of low-fat milk, fruits, and some vegetables, especially when infrastructure changes, such as refrigeration and shelving enhancements, are offered.
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