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OBJECTIVES: Few panel studies have investigated how different types of mental health (MH) and socio-emotional wellbeing (SEW) outcomes have changed during the pandemic and if their burden has been equally distributed at the population-level. We aimed to examine temporal changes in these outcomes and their socio-ecological predictors using panel data. STUDY DESIGN: Longitudinal population-based survey with overlapping panels. METHODS: Analyses were carried out using four measurements of data from the Health and Social Survey (April 2020 to April 2021). Participants included Andalusian (Spanish) residents aged 16 years or older who participated in all four measurements (n = 1223). Seven dichotomous MH and SEW outcomes, as well as several socio-ecological predictors informed by a conceptual model, were examined in descriptive and multivariate analyses. RESULTS: Unadjusted odds of regular/bad perceived mental health (vs. excellent/very good/good), low socio-emotional wellbeing (vs. regular), low happiness (vs. regular), and feeling anxious (vs. not feeling anxious) decreased significantly from the first to the second measurement; however, in the fourth, low socio-emotional wellbeing significantly increased while low optimism decreased. Considering varying coefficients, objectively measured COVID-19 status and self-reported severity levels of the infection were statistically significant. Health status, social support, and household financial difficulty predicted higher adjusted odds in most of the seven assessed outcomes. CONCLUSIONS: Significant temporal variations in MH and SEW outcomes, along with their predictors, were observed during the first year of the pandemic. Some of these outcomes worsened as the pandemic progressed, whereas others improved. Findings also suggest that some individuals such as those experiencing poor health, limited social support, and low socioeconomic status are disproportionately impacted.
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COVID-19 , Saúde Mental , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Masculino , Feminino , Adulto , Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Espanha/epidemiologia , Adolescente , Estudos Longitudinais , Adulto Jovem , Idoso , Inquéritos EpidemiológicosRESUMO
BACKGROUND: Behavioral health services (BHS) can help improve and treat mental and emotional health problems. Yet, attitudinal and/or structural barriers often prevent individuals from accessing and benefiting from these services. Positive provider-patient interactions in healthcare, encompassing patient comfort with a primary care provider (PCP), which is often enhanced by shared decision-making, may mitigate the stigma associated with seeing a mental health professional; this may improve BHS utilization among patients who need these services. However, few studies have examined how patient comfort with a PCP, often through shared decision-making, may influence patients' BHS utilization in the real world. This study sought to address this gap in practice. METHOD: Multivariable regression analyses, using weighted data from an internet panel survey of Los Angeles County adults (n = 749), were carried out to examine the associations between patient comfort with a PCP and three measures of BHS utilization. Subsequent analyses were conducted to explore the extent to which shared decision-making moderated these associations. RESULTS: Participants who reported an intermediate or high comfort level with a provider had higher odds of reporting that they were likely to see (aOR = 2.10 and 3.84, respectively) and get advice (aOR = 2.75 and 4.76, respectively) from a mental health professional compared to participants who reported a low comfort level. Although shared decision-making influenced participants' likelihood of seeing and getting advice from a mental health professional, it was not a statistically significant moderator in these associations. CONCLUSION: Building stronger relationships with patients may improve BHS utilization, a provider practice that is likely underutilized.
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Purpose and Objectives: Although considered a promising model of practice, integrating healthy nutrition standards and practices into a large county government's contracting process with food vendors has not been widely described in empirical literature. We conducted an implementation evaluation project to address this gap. Intervention Approach: County of Los Angeles food vendors provide food or meals annually to more than 100,000 employees and millions of clients and visitors. In 2011, the County of Los Angeles Board of Supervisors adopted a policy to integrate healthy nutrition standards and practices into its requests for proposals (RFPs) and contracting process with food vendors. The policy required all contracts awarded to adhere to these new standards. Evaluation Methods: In 2011, the Los Angeles County Department of Public Health (DPH) began reviewing RFPs for food services for county departments that procured, served, or sold food. From 2011 through 2021, DPH applied a 4-pronged formative-evaluative approach to help county departments implement the Board of Supervisors policy and ensure that nutritional requirements were appropriately integrated into all RFPs for new and renewing contracts with food vendors. We focused our evaluation on understanding the process and tracking the progress of this policy intervention. Our evaluation included 13 key informant interviews, a 2-part survey, reviews of contract data, and synthesis of lessons learned. Results: Based on reviews and subsequent actions taken on more than 20 RFPs, DPH successfully assisted 7 county departments to incorporate healthy nutrition standards and practices into their food vendor contracts. Implementation of the food policy encountered several challenges, including staffing and training constraints and a limited infrastructure. An iterative approach to program improvement facilitated the process. Implications for Public Health: Although the model for integrating healthy nutrition standards and practices into a government contracting process is promising, more work is needed to make it less resource-intensive and to increase user buy-in.
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Dieta Saudável , Serviços de Alimentação , Humanos , Governo Local , Política Nutricional , Inquéritos e QuestionáriosRESUMO
This study examined the relationships between varying levels of depressive symptoms and key dietary indicators of chronic disease risk, sugar-sweetened beverage (SSB) and fruit and vegetable (F + V) consumption, among a racially/ethnically diverse urban population in Los Angeles County (LAC). Analyses were carried out using data from a 2012 cross-sectional health survey of 1401 low-income public health center clients. Participants with a high level of depressive symptoms consumed 30% more SSBs (IRR = 1.30, 95% CI = 1.08, 1.55) than participants with a lower level of these symptoms. Other predictors of higher SSB consumption included being African American/Black (IRR = 1.65, 95% CI = 1.32, 2.05), male (IRR = 1.20, 95% CI = 1.06, 1.35), U.S. born (IRR = 1.32, 95% CI = 1.11, 1.57), and using tobacco (IRR = 1.26, 95% CI = 1.11, 1.43). Similar associations with F + V consumption were not found. Findings suggest that depressive symptoms may influence certain health behaviors in certain groups under certain situations. Policy and practice implications are discussed within this context.
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Bebidas , Depressão , Estudos Transversais , Depressão/epidemiologia , Dieta , Comportamentos Relacionados com a Saúde , Humanos , Estilo de Vida , Masculino , População UrbanaRESUMO
In the 2017 strawberry season, several transplant losses reaching 50% were observed in Zamora, Michoacán Valley, Mexico, due to a new fungal disease associated with root rot, crown rot, and leaf spot. In this year the disease appeared consistently and increased in the following seasons, becoming a concern among strawberry growers. Thus, the aim of this research was to determine the etiology of the disease and to determine the in vitro effect of fungicides on mycelial growth of the pathogen. Fungal isolates were obtained from symptomatic strawberry plants of the cultivars 'Albion' and 'Festival' and were processed to obtain monoconidial isolates. Detailed morphological analysis was conducted. Concatenated phylogenetic reconstruction was conducted by amplifying and sequencing the translation elongation factor 1 α, ß-tubulin partial gene, and the internal transcribed spacer region of rDNA. Pathogenicity tests involving inoculation of leaves and crowns reproduced the same symptoms as those observed in the field, fulfilling Koch's postulates. Morphology and phylogenetic reconstruction indicated that the causal agent of the described symptoms was Neopestalotiopsis rosae, marking the first report anywhere in the world of this species infecting strawberry. N. rosae was sensitive to cyprodinil + fludioxonil, captan, iprodione, difenoconazole, and prochloraz.
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Fragaria , Micoses , DNA Fúngico , Humanos , México , Filogenia , Doenças das PlantasRESUMO
INTRODUCTION: Despite numerous federal investments, chronic disease continues to disproportionately affect certain communities across the United States. Understanding the regional distribution (including any overlaps) of factors that extend beyond built and food environments, especially factors that may adversely affect chronic disease-related behaviors, is important. This case study of Los Angeles County's geospatial landscape sought to address these gaps in research and practice. METHODS: We examined the distributions and geographic overlaps between economic hardship, psychological distress, soda consumption, and availability of publicly funded mental health facilities in 8 Service Planning Areas in Los Angeles County. We categorized the geospatial presence of each variable as low, intermediate, or high. We imported all data, collected during 2014-2018, into ArcGIS Pro version 2.3.3 to create 5 bivariate choropleth maps. RESULTS: Levels of economic hardship were not equally distributed across communities; the county was characterized by intermediate levels of soda consumption and psychological distress. Most areas had low or intermediate availability of publicly funded mental health facilities. We also found some discordance between psychological distress and availability of publicly funded mental health facilities, and between economic hardship and availability of these facilities. CONCLUSION: The need exists to address disparities in economic hardship and to increase access to publicly funded mental health supports and providers in Los Angeles County. The information collected in this case study has policy implications for health, public health, and mental health services planning at the local level.
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Doença Crônica/epidemiologia , Transtornos Mentais/epidemiologia , Estresse Fisiológico , California/epidemiologia , Acessibilidade aos Serviços de Saúde , Humanos , Fatores SocioeconômicosRESUMO
The recognition of the role of the environment in contributing to the obesity epidemic has led to increasing efforts to address obesity through environmental or place-based approaches in the past decade. This has challenged the use of the quasi-experimental design for evaluating community interventions. The objective of this study is to describe the development of an index of dose of exposure to community interventions that impact early childhood obesity. The goal is to provide an alternative means for evaluating the impact of multiple intervention strategies that target the same community at the same time. Two workgroups developed domains, constructs and protocols for estimating a "community intervention dose index" (CIDI). Information used to develop the protocol came from multiple sources including databases and reports of major funding organizations on obesity-related interventions implemented in Los Angeles County from 2005 to 2015, key informant interviews, and published literature. The workgroups identified five domains relevant to the consideration of dose of exposure to interventions: physical resources, social resources, context, capacity development, and programs and policies; developed a system for classifying programs and policies into macro- and micro-level intervention strategies; and sought ratings of strategy effectiveness from a panel of 13 experts using the Delphi technique, to develop an algorithm for calculating CIDI that considers intervention strength, reach and fidelity. This CIDI can be estimated for each community and used to evaluate the impact of multiple programs that use a myriad of intervention strategies for addressing a defined health outcome.
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Redes Comunitárias , Intervenção Médica Precoce/métodos , Obesidade Infantil/epidemiologia , Algoritmos , Pré-Escolar , Bases de Dados Factuais , Técnica Delphi , Conhecimentos, Atitudes e Prática em Saúde , Política de Saúde , Humanos , Los Angeles/epidemiologiaRESUMO
CONTEXT: Healthy vending machine policies are viewed as a promising strategy for combating the growing obesity epidemic in the United States. Few studies have evaluated the short- and intermediate-term outcomes of healthy vending policies, especially for interventions that require 100% healthy products to be stocked. OBJECTIVE: To evaluate the potential impact of a 100% healthy vending machine nutrition policy. DESIGN: The vendor's quarterly revenue, product sales records, and nutritional information data from 359 unique vending machines were used to conduct a baseline and follow-up policy analysis. SETTING: County of Los Angeles facilities, 2013-2015. PARTICIPANTS: Vending machines in facilities located across Los Angeles County. INTERVENTION: A healthy vending machine policy executed in 2013 that required 100% of all products sold in contracted machines meet specified nutrition standards. OUTCOME MEASURES: Policy adherence; average number of calories, sugar, and sodium in food products sold; revenue change. RESULTS: Policy adherence increased for snacks and beverages sold by the vending machines by 89% and 98%, respectively. Average snack and beverage revenues decreased by 37% and 34%, respectively, during the sampled period. CONCLUSIONS: Although a 100% healthy vending policy represents a promising strategy for encouraging purchases of healthier foods, steps should be taken to counteract potential revenue changes when planning its implementation.
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Distribuidores Automáticos de Alimentos/economia , Distribuidores Automáticos de Alimentos/normas , Qualidade dos Alimentos , Política Nutricional/tendências , Bebidas/classificação , Bebidas/estatística & dados numéricos , Distribuidores Automáticos de Alimentos/estatística & dados numéricos , Promoção da Saúde/métodos , Humanos , Los Angeles , Política Nutricional/economia , Lanches/classificaçãoRESUMO
OBJECTIVE: The Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are two of the more well-known food assistance programmes in the USA. The current study describes food consumption patterns of children aged 1-5 years living in households dually enrolled in these two programmes v. households enrolled only in WIC. DESIGN: Food consumption and SNAP participation were assessed using data from the 2014 Survey of Los Angeles County (LAC) WIC Participants and the Follow-Up Survey of the same households that were also SNAP beneficiaries. Telephone interviews were conducted with WIC parents regarding each child's (i.e. beneficiary's) food consumption patterns. Follow-up interviews were conducted with those who reported receiving SNAP. Multivariable regression analyses were performed to assess the relationships between food and beverage consumption and dual v. single food assistance programme participation. SETTING: LAC, California. SUBJECTS: Children of WIC-enrolled households in LAC during 2014 (n 3248). This included a sub-sample of dual WIC- and SNAP-enrolled households (n 1295). Survey participants were the beneficiaries' parents. RESULTS: Children from dually enrolled households consumed 1·03 (P<0·05) and 1·04 (P<0·01) more servings of fruits and vegetables daily respectively, 1·07 more sugar-sweetened beverages daily (P<0·001) and ate sweets/sweetened foods 1·04 more times daily (P<0·001) than children from households participating only in WIC. CONCLUSIONS: Results suggest that SNAP+WIC enrolment is associated with increased consumption of both healthy foods and foods containing minimal nutritional value. Complementary nutrition education efforts across the two programmes may help beneficiaries maximize healthful food purchases with SNAP dollars.
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Bebidas , Dieta , Assistência Alimentar/classificação , Avaliação Nutricional , Pré-Escolar , Comportamento do Consumidor , Estudos Transversais , Características da Família , Feminino , Frutas , Educação em Saúde , Humanos , Lactente , Los Angeles , Masculino , Inquéritos Nutricionais , Adoçantes Calóricos/administração & dosagem , Valor Nutritivo , Fatores Socioeconômicos , VerdurasRESUMO
INTRODUCTION: In 2010, the Los Angeles County Department of Public Health launched a local sodium-reduction initiative to address the rising prevalence of high blood pressure (hypertension) and related cardiovascular conditions in the population. To inform this effort, we evaluated self-reported knowledge and health behaviors related to sodium intake among Los Angeles County residents. METHODS: We administered 3 cross-sectional Internet panel surveys on knowledge about dietary sodium to a sample of Los Angeles County adults, at intervals from December 2014 through August 2016. Multinomial and logistic regression models were constructed to describe associations between sodium knowledge and self-reported health behaviors. RESULTS: A total of 7,067 panel subjects clicked into the online survey, and 2,862 completed the survey (adjusted response rate = 40.5%). Only 102 respondents (3.6%) were able to accurately report the recommended milligrams of sodium that an average adult should consume daily (1,500 mg to 2300 mg). Knowing about daily sodium intake recommendations was associated with increased odds of using Nutrition Facts labels to make food purchase decisions (adjusted odds ratio [AOR], 3.48; 95% confidence interval [CI], 1.59-7.60) and with decreased odds of taking measures to prevent hypertension (AOR, 0.38; 95% CI, 0.19-0.74). CONCLUSIONS: Los Angeles County residents had a limited knowledge of recommended daily sodium intake. Efforts to increase understanding of these recommendations may encourage wider engagement in healthy behaviors. Health agencies should integrate sodium reduction messages in their diet and nutrition educational efforts.
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Preferências Alimentares , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Sódio na Dieta , Adolescente , Adulto , Idoso , California , Coleta de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
OBJECTIVE: This study sought to assess promotional activities undertaken to raise public awareness of the Choose Health LA Restaurants program in Los Angeles County, an environmental change strategy that recognizes restaurants for offering reduced-size and healthier menu options. DESIGN: We used multiple methods to assess public awareness of and reactions to the promotional activities, including an assessment of the reach of core promotional activities, a content analysis of earned media, and an Internet panel survey. SETTING: The study was conducted in Los Angeles County, home to more than 10 million residents. PARTICIPANTS: An online survey firm recruited participants for an Internet panel survey; to facilitate generalization of results to the county's population, statistical weights were applied to analyses of the survey data. INTERVENTION: Promotional activities to raise awareness of the program included community engagement, in-store promotion, and a media campaign. MAIN OUTCOME MEASURES: Outcomes included media impressions, the number of people who reported seeing the Choose Health LA Restaurants logo, and a description of the themes present in earned media. RESULTS: Collectively, paid media outlets reported 335 587 229 total impressions. The Internet panel survey showed that 12% of people reported seeing the program logo. Common themes in earned media included the Choose Health LA Restaurants program aims to provide restaurant patrons with more choices, represents a new opportunity for restaurants and public health to work together, will benefit participating restaurants, and will positively impact health. CONCLUSIONS: Promotional activities for the Choose Health LA Restaurants program achieved modest reach and positive reactions from media outlets and consumers. The program strategy and lessons learned can help inform present and future efforts to combine environmental and individually focused strategies that target key influences of consumer food selection.
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Conscientização , Promoção da Saúde/organização & administração , Meios de Comunicação de Massa/estatística & dados numéricos , Planejamento de Cardápio/métodos , Restaurantes/organização & administração , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Participação da Comunidade/métodos , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Los Angeles , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Adulto JovemRESUMO
CONTEXT: Few studies have described the range and health impacts of obesity prevention strategies in local communities supported by the Communities Putting Prevention to Work program. OBJECTIVE: To address this gap, we reviewed implemented strategies in Los Angeles County (LAC) for 3 program focus areas: physical activity-promotion, health marketing, and creation of healthy food environments. Local context and results from an impact simulation are presented. DESIGN: Information on population reach and program milestones was synthesized to describe historical and programmatic progress of the obesity prevention efforts during 2010-2012. To forecast health impacts, the Prevention Impacts Simulation Model (PRISM) was used to simulate population health outcomes, including projected changes in obesity burden and health behaviors 30 years into the future. SETTING: LAC with more than 9.8 million residents. PARTICIPANTS: Low-income adults and youth who were the intended audiences of the Communities Putting Prevention to Work program in LAC. INTERVENTION: Implemented strategies for the 3 focus areas. MAIN OUTCOME MEASURES: Documentation of program reach and PRISM forecasting of obesity rates and health impacts. RESULTS: Implemented strategies in LAC ranged from best practices in healthy food procurement (estimated reach: 600 000 students, 300 000 meals per day) to completed shared-use agreements (10+ agreements across 5 school districts) to a series of strategically designed health marketing campaigns on healthy eating (>515 million impressions). On the basis of PRISM simulations, these highlighted program activities have the potential to reduce by 2040 the number of youth (-29 870) and adults (-94 136) with obesity, youth (-112 453) and adults (-855 855) below recommended levels of physical activity, and youth (-14 544) and adults (-28 835) who consumed excess junk food, as compared with baseline (2010-2011). CONCLUSIONS: Program context and PRISM-simulated health impacts showed modest but promising results in LAC, which may lead to further population health improvements in the future. Downstream health and behavioral surveillance data are needed to confirm these estimates.
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Avaliação do Impacto na Saúde/normas , Obesidade/prevenção & controle , Avaliação de Programas e Projetos de Saúde/métodos , Adolescente , Criança , Dieta Saudável/métodos , Avaliação do Impacto na Saúde/métodos , Avaliação do Impacto na Saúde/estatística & dados numéricos , Promoção da Saúde/normas , Promoção da Saúde/estatística & dados numéricos , Humanos , Los Angeles , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Pesquisa Qualitativa , Serviços de Saúde Escolar/estatística & dados numéricos , Estudantes/estatística & dados numéricosRESUMO
Follicle growth culminates in ovulation, which allows for the expulsion of fertilizable oocytes and the formation of corpora lutea. Bisphenol A (BPA) is present in many consumer products, and it has been suggested that BPA impairs ovulation; however, the underlying mechanisms are unknown. Therefore, this study first evaluated whether BPA alters ovulation by affecting folliculogenesis, the number of corpora lutea or eggs shed to the oviduct, ovarian gonadotropin responsiveness, hormone levels, and estrous cyclicity. Because it has been suggested (but not directly confirmed) that BPA exerts toxic effects on the fertilization ability of oocytes, a second aim was to evaluate whether BPA impacts the oocyte fertilization rate using an in vitro fertilization assay and mating. The possible effects on early zygote development were also examined. Young adult female C57BL/6J mice (39 days old) were orally dosed with corn oil (vehicle) or 50 µg/kgbw/day BPA for a period encompassing the first three reproductive cycles (12-15 days). BPA exposure did not alter any parameters related to ovulation. Moreover, BPA exposure reduced the percentage of fertilized oocytes after either in vitro fertilization or mating, but it did not alter the zygotic stages. The data indicate that exposure to the reference dose of BPA does not impact ovulation but that it does influence the oocyte quality in terms of its fertilization ability.
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Compostos Benzidrílicos/efeitos adversos , Fertilização/efeitos dos fármacos , Oócitos/efeitos dos fármacos , Ovulação/efeitos dos fármacos , Fenóis/efeitos adversos , Animais , Ciclo Estral/efeitos dos fármacos , Feminino , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Folículo Ovariano/efeitos dos fármacos , Zigoto/efeitos dos fármacosRESUMO
OBJECTIVE: To examine behavioural intention to reduce soda consumption after exposure to the Choose Health LA 'Sugar Pack' campaign in Los Angeles County, California, USA. DESIGN: A cross-sectional street-intercept survey was conducted to assess knowledge, attitudes, health behaviours and behavioural intentions after exposure to the 'Sugar Pack' campaign. A multivariable regression analysis was performed to examine the relationships between the amount of soda consumed and self-reported intention to reduce consumption of non-diet soda among adults who saw the campaign. SETTING: Three pre-selected Los Angeles County Metro bus shelters and/or rail stops with the highest number of 'Sugar Pack' campaign advertisement placements. SUBJECTS: Riders of the region's Metro buses and railways who were the intended audience of the campaign advertisements. RESULTS: The overall survey response rate was 56 % (resulting n 1041). Almost 60 % of respondents were exposed to the advertisements (619/1041). The multivariable logistic regression analysis suggested that the odds of reporting intention to reduce soda consumption among moderate consumers (1-6 sodas/week) were 1·95 times greater than among heavy consumers (≥1 soda/d), after controlling for clustering and covariates. Respondents with less than a high-school education and who perceived sugary beverage consumption as harmful also had higher odds; in contrast, respondents aged ≥65 years had lower odds. CONCLUSIONS: Results suggest that future campaigns should be tailored differently for moderate v. heavy consumers of soda. Similar tailoring strategies are likely needed for younger groups, for those with less educational attainment and for those who do not perceive consumption of soda as harmful.
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Bebidas Gaseificadas , Sacarose Alimentar/administração & dosagem , Ingestão de Energia , Comportamento Alimentar , Comportamentos Relacionados com a Saúde , Marketing Social , Adolescente , Adulto , Idoso , Bebidas Gaseificadas/efeitos adversos , Estudos Transversais , Sacarose Alimentar/efeitos adversos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Modelos Logísticos , Los Angeles , Masculino , Pessoa de Meia-Idade , Obesidade/etiologia , Autorrelato , Adulto JovemRESUMO
Recent federal initiatives have used estimates of population reach as a proxy metric for intervention impact, in part to inform resource allocation and programmatic decisions about competing priorities in the community. However, in spite of its utility, population reach as a singular metric of intervention impact may be insufficient for guiding multifaceted program decisions. A more comprehensive, validated approach to measure or forecast dose may complement reach estimates to inform decision makers about optimal ways to use limited resources.
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Obesidade/prevenção & controle , Saúde Pública/métodos , Alocação de Recursos/métodos , Centers for Disease Control and Prevention, U.S. , Dieta , Exercício Físico , Humanos , Los Angeles , Desenvolvimento de Programas , Fatores Socioeconômicos , Estados UnidosRESUMO
OBJECTIVE: We sought to characterize student receptivity to new menu offerings in the Los Angeles Unified School District by measuring the levels of fruit and vegetable waste after implementation of changes to the school lunch menu in fall 2011. METHODS: We measured waste at four randomly selected middle schools in the school district, using two sources: a) food prepared and left over after service (production waste); and b) food that was selected but not eaten by students (plate waste). RESULTS: 10.2% of fruit and 28.7% of vegetable items prepared at the four schools were left over after service. Plate waste data, collected from 2228 students, suggest that many of them did not select fruit (31.5%) or vegetable (39.6%) items. Among students who did, many threw fruit and vegetable items away without eating a single bite. CONCLUSIONS: Our findings suggest that fruit and vegetable waste was substantial and that additional work may be needed to increase student selection and consumption of fruit and vegetable offerings. Complementary interventions to increase the appeal of fruit and vegetable options may be needed to encourage student receptivity to these healthier items in the school meal program.
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Comportamento Alimentar , Frutas , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Verduras , Atitude Frente a Saúde , Criança , Etnicidade/estatística & dados numéricos , Comportamento Alimentar/psicologia , Feminino , Preferências Alimentares , Serviços de Alimentação , Humanos , Modelos Logísticos , Los Angeles , Masculino , Planejamento de Cardápio , Política Nutricional , Obesidade/prevenção & controle , Instituições Acadêmicas , Estados Unidos , United States Department of AgricultureRESUMO
We described the prevalence of overweight and obesity among low-income women in rural West Virginia (WV) and urban Los Angeles County (LA County). Both communities participated in the national Communities Putting Prevention to Work program during 2010-2012. In each community, we completed health assessments on adult women recruited from public-sector clinics serving low-income populations. All participants answered survey questions regarding socio-demographics and diets. In both jurisdictions, we assessed obesity using objectively measured height and weight (calculated BMI). As part of each community case study, we performed multivariable regression analyses to describe the relationships between overweight and obesity and selected covariates (e.g., dietary behaviors). Overweight and obesity were prevalent among low-income women from WV (73%, combined) and LA County (67%, combined). In both communities, race and ethnicity appeared to predict the two conditions; however, the associations were not robust. In LA County, for example, African American and Hispanic women were 1.4 times (95% CI=1.12, 1.81) more likely than white women to be overweight and obese. Collectively, these subpopulation health data served as an important guide for further planning of obesity prevention efforts in both communities. These efforts became a part of the subsequent Community Transformation Grants portfolio.
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Sobrepeso/epidemiologia , Adolescente , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Idoso , Índice de Massa Corporal , Estudos Transversais , Feminino , Promoção da Saúde , Hispânico ou Latino/estatística & dados numéricos , Humanos , Los Angeles/epidemiologia , Pessoa de Meia-Idade , Inquéritos Nutricionais , Obesidade/epidemiologia , Pobreza , Prevalência , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , West Virginia/epidemiologia , População Branca/estatística & dados numéricos , Saúde da Mulher , Adulto JovemRESUMO
As part of a comprehensive approach to combating the obesity epidemic, the Los Angeles County Department of Public Health launched the "Sugar Pack" health marketing campaign in fall 2011. Carried out in three stages, the campaign sought to educate and motivate the public to reduce excess calorie intake from sugar-sweetened beverage consumption. The primary Sugar Pack creative concepts provided consumers with information about the number of sugar packs contained in sugary drinks. Data from formative market research as well as lessons from previous campaigns in other U.S. jurisdictions informed the development of the materials. These materials were disseminated through a multipronged platform that included paid outdoor media on transit and billboards and messaging using social media (i.e., Twitter, Facebook, YouTube, and sendable e-cards). Initial findings from a postcampaign assessment indicate that the Sugar Pack campaign reached broadly into targeted communities, resulting in more than 515 million impressions. Lessons learned from the campaign suggest that employing health marketing to engage the public can lead to increased knowledge, favorable recognition of health messages, and self-reported intention to reduce sugar-sweetened beverage consumption, potentially complementing other obesity prevention strategies in the field.
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Bebidas Gaseificadas , Sacarose Alimentar/administração & dosagem , Promoção da Saúde/métodos , Adolescente , Adulto , Idoso , Feminino , Grupos Focais , Humanos , Los Angeles , Masculino , Meios de Comunicação de Massa , Pessoa de Meia-Idade , Obesidade/prevenção & controle , Inquéritos e Questionários , Adulto JovemRESUMO
Ultraprocessed foods (UPF) consumption is associated with excess adiposity in adults, but this linkage remains unclear among children and adolescents. The present systematic review sought to address this research gap. Publications up to November 2023 were retrieved from PubMed, Web of Science, and Scopus databases. Outcomes included overweight/obesity anthropometric and body composition indicators; the exposure was UPF consumption based on the NOVA classification system. The review included 23 studies (i.e., 8 cohort and 15 cross-sectional); approximately half were carried out in Brazil. Inconclusive and heterogeneous evidence exists as few cohort studies found positive/mixed associations between UPF consumption and excess adiposity in pediatric populations, whereas most cross-sectional studies reported null associations. Such inconsistencies may be attributed to underlying methodological issues, especially heterogeneity in the outcomes assessed and UPF consumption operationalization and/or categorization. Future studies should adopt longitudinal designs with sufficiently extended follow-up periods, account for relevant confounding factors, employ validated and standardized measurement tools to assess dietary exposure, ensure consistent operationalization of variables, and encompass diverse geographic contexts. Ultimately, strengthening the quality of existing research evidence may better inform current and forthcoming policy and practice interventions aimed at mitigating the increasing prevalence of overweight/obesity in childhood and across the life course.
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Adiposidade , Obesidade Infantil , Humanos , Criança , Adolescente , Obesidade Infantil/epidemiologia , Obesidade Infantil/etiologia , Fast Foods/efeitos adversos , Manipulação de Alimentos , Dieta/efeitos adversosRESUMO
This field report describes the accessibility and perceived effectiveness of a free acupuncture program among a group of predominantly low-income Hispanic/Latino adults. Surveys, developed based on the Levesque Conceptual Framework of Access to Health Care, were administered to clients. Baseline (n = 245) and 6-week follow-up (n = 79) surveys were analyzed to document early program findings. A majority of clients were Hispanic/Latino (72.7%) and female (73.1%). Most reported their original pain complaint was treated very well/well (98.7%). Clients reported an average 1.2 points pain level decrease (scale 1-10) at follow-up (p < 0.0001). Early program results suggest this acupuncture program was accessible and well received by low-income Hispanics/Latinos.