Creating a Healthier Library Youth Food Environment

Appendix

The increased incidence of obesity is a major concern and intervention efforts to thwart this trend in low income minority populations continue. Good nutritional habits and behavioral practices are important for healthy weight management and maintenance. This project was conducted to gain insight the personal and contextual factors, and barriers, impacting food preparation and consumption in rural families'. Focus groups were conducted with 100 low income parents from rural communities to collect cultural perspectives and to identify barriers to healthy eating and food preparation practices. Statements were extracted and categorized from the focus group transcripts. Analysis of the data resulted in themes including general food purchases, preparation practices, and barriers to good nutrition. Food preparation was based primarily on family history and tradition; example ‘fired fish Fridays’, and ‘family member preferences’. Advertising and children in charge were discussed by most of the participants as being significant barriers to healthy eating. Surprisingly, many of the families dining out decisions were determined by daily specials offered at local fast food restaurants with little thought given to the nutritional value of meals.Funding for this project was made possible by 1P20MD0002295 from the National Center on Minority Health and Health Disparities.

Childhood obesity prevalence has increased worldwide and substantially in the 22 countries of the Eastern Mediterranean Region (EMRO). Weight-related interventions are urgently required in these countries to tackle childhood obesity and its related consequences. There has been no review to date of obese children in the Eastern Mediterranean Region. This review discusses the different school-based lifestyle interventions conducted among obese children in the EMRO and assesses the applicability of future programs in Saudi Arabia. A thorough search of the literature was conducted on PubMed. A total of 170 studies were found, and eight of them were included in this review. The included studies were all randomized controlled trials or quasi-experimental. This review article showed that school-based lifestyle interventions may reduce childhood obesity by integrating interactive learning about healthy diet and physical activity within a whole school approach, involving children and their parents, modifying the school environment, and facilitating a workshop on healthy food preparation. To motivate children to change their behavior, it is crucial to meet with parents in person and utilize technology and rewards. School-based lifestyle programs can lower childhood obesity by involving all relevant parties, such as families and schools, and using reliable instruments to track results to establish a healthy community. In order to confirm these findings, more research is required for a longer period of time, more than six months.

Background: Nutrition is the intake of nutrients from food and drinks that support health and cell development. For pregnant women, proper nutrition is crucial for both maternal health and fetal growth. However, their knowledge about pregnancy nutrition needs improvement. This community service activity aims to increase pregnant women's awareness of proper nutrition and introduce nutritious local foods like Kroyam (croquettes made from potato, chicken, carrot, and spinach) and orange juice. Methods : included health counseling on nutrition for pregnant women, accompanied by demonstrations on healthy food preparation. Evaluation was conducted through pre-tests before counseling and post-tests after counseling. This activity was carried out at the Pilang Payung Village Hall, Toroh District, Grobogan Regency, with 18 pregnant women participating. Results: From the counseling session, it was found that 18 pregnant women experienced an increase in the knowledge category, namely 18 respondents (100%). Conclusion: Through the implementation of the "Nutrition Health Education for Pregnant Women and Processing of Kroyam (Croquettes, potatoes, chicken, carrots, spinach) can be concluded that the community's understanding of nutrition is still uneven, so that service activities such as this still need to be carried out continuously to ensure the correctness and accuracy of information regarding efforts to improve nutrition in pregnant women with innovations in processing chicken croquettes and orange juice to reduce KEK

Reviewed by: Nursing with a Message: Public Health Demonstration Projects in New York City by Patricia D’Antonio Dennis Doyle Patricia D’Antonio. Nursing with a Message: Public Health Demonstration Projects in New York City. Critical Issues in Health and Medicine. New Brunswick, N.J.: Rutgers University Press, 2017. xv + 145 pp. $85.00 (978-0-8135-7103-4). Nursing with a Message is a well-researched account of several demonstration projects that took shape in Manhattan’s East Harlem and Belleville-Yorkville health districts between the 1920s and 1940s. Each was intended to prove how public health and clinical care could be coordinated within a community health center. In providing local residents with easy access to a range of services, these demonstration projects relied heavily on public health nurses to enlist, educate, monitor, and collect data on those Italian American, African American, and Puerto Rican clients. Informing these projects was a blended public health model in which disease could be prevented through the promotion of individual health and wellness. Public health reformers and insurers insisted that physicians and allied health professionals ought to abandon a purely therapeutic focus and serve as agents of such preventive care. They advocated that physicians should provide annual medical exams, immunizations, periodic screenings for select diseases, medicalized childbirth, prenatal care, and dental checkups—all services many of us now take for granted as essential elements of comprehensive medical care in the United States. Coordinating with participating physicians and specialists at the health center, the public health nurses of 1922–41’s East Harlem Nursing and Health Demonstration Project facilitated these preventive services. With their professional monopoly over home visits, their adoption of social work’s casework approach, and their status as legitimate data-driven scientific experts, public health nurses were tasked with the difficult job of teaching clients to go to doctors for these preventive services. They also sought to instill them with a sense of personal responsibility for keeping up to date with all of these checkups, screenings, and exams. In addition, the Nursing Project’s public health nurses expanded their base of knowledge to include nutrition as they sought to teach mothers how to stave off disease in their families through healthier food preparation. Yet the public health nurses were [End Page 214] more than messengers. They were agents of cultural change whose work served as a model for the training of public health nurses both in the United States and around the globe. Still, this is much more than a story of how these pilot programs helped produce the U.S. health care system. Where D’Antonio really excels is in the attention she pays to what did not seem to work, did not see widespread adoption, or did not even merit inclusion. Even for such a slim volume, the examples are too numerous to mention them all here. For instance, while I expect that many scholars may be aware that nursing did not require any psychiatric training until after World War II, public health nurses, in adopting social work’s casework method, actually flirted with mental hygiene and preventive psychiatry in the 1920s. As well, project nurses, in zealously facilitating the medicalization of childbirth, missed an opportunity in the 1930s to investigate and prevent a major public health crisis stemming from that very major change: the high maternal mortality rates that accompanied delivery’s initial shift into the hospital. And throughout the book, the author reminds us that the individualized model of health and illness informing these projects pushed public health nursing even further from Lilian Wald’s original social justice vision. The only caveat I have for potential readers of this jam-packed, insightful study is that it does not offer illustrative examples of the nurses’ interactions with the patients they visited. Such evidence would have offered more tangible proof of the author’s assertion that these public health nurses did learn how to communicate their wellness messages while at the same time failing to address the client’s own demands and needs—especially those related to the social determinants of health. The absence of such case studies appears to be a reflection of the sources the author had...

Despite the critical role nutrition plays in T1DM management and growth/development, youth with TIDM consistently have poorer diet qualities compared with their healthy counterparts. While culinary medicine is an area of research that is still in its infancy, initial studies have demonstrated success in improving youth diet quality and dietary and disease management outcomes in individuals with T2DM. Yet despite its great potential to elicit positive behavior change among youth with T1DM, this area of research is under-explored. Therefore, Diabetes Inspired Culinary Education (DICE), a community-based culinary medicine program aiming to improve diet quality and disease management among 6-14 year old youth with T1DM, was developed and assessed for feasibility and potential efficacy in a pilot study. The DICE program included ten, 90-minute lessons delivered weekly at a community teaching kitchen and included: hands-on, age-appropriate culinary education; nutrition and diabetes education delivered through experiential learning; a group family meal prepared by participating youth; and culinary/mealtime goal-setting. Baseline and post-test outcomes were assessed on participating families at the child- (food preparation self-efficacy (SE), involvement, attitude; dietary intake; diabetes management; diabetes quality of life; hgbA1c; BMI), primary caregiver- (dietary intake; diabetes management SE; mealtime SE; BMI) and family-level (family food preparation; mealtime environment). Feasibility was evaluated using participant attendance, retention and a program-specific fidelity tool. Eleven families were recruited and 8 completed (73% retention) the program. On average, 78% of participating families attended weekly lessons. Improvements in primary caregiver SE for healthy mealtime behaviors (p=0.02) and family food preparation (p=0.05) were observed at post-test, inferring potential program efficacy. Disclosure C. R. Mcmanus: None. H. Barkoukis: None. R. Kim: None. J. Nguyen: None.

Background: Eastern Sudan suffered from poverty, drought and climatic changed that increase the burden of food insecurity. Method: This is a cross sectional study conducted in a remote locality in Kassala State (Eastern Sudan), to determine the magnitude and relating factors of household food insecurity. We studied 445 households in 16 villages. We used specially designed structured questionnaire. We used food consumption score (FCS) to measure household food insecurity . Data were analyzed using SPSS version 20.0 statistical package. Frequencies and Chi2 were performed. Multivariable logistic regression was used to develop the final model indicating the predictors of the outcome variable. Results: Food insecurity and vulnerability for food insecurity is found in 181 (38.7%) of household studied. Eating habits and avoidance of certain types of food was found among other contributing factors. The study included 445 households, 181 (38.7%) of them were food insecure or vulnerable to be insecure. A high percentage (67.2%) was reported in Hamishokreib locality. There were significant associations (P Conclusion: According to the study findings, more attention is needed to improve household food security in the study area .Good eating habits can be achieved by designing education programs to improve knowledge, skills, and attitudes related to healthy eating and food preparation and overall, increasing household income through improving the farming methods, and finding the alternative sources of income.

Objectives: This study explored US rural parents’ perceived facilitators, challenges and motivators to healthy eating. Methods: Qualitative and purposive sampling was used to recruit one hundred ( N = 100) parents of children enrolled in the fourth grade to participate in a series of focus group sessions. Eligibility criteria included being the head of the household and having a child enrolled in the fourth grade. Parents were questioned about factors impacting everyday lifestyle practices such as nutrition knowledge and eating habits. Data were analysed using grounded theory and constant comparative method. Results: Twelve focus groups sessions were conducted with parents who self-identified as African American (63%), Hispanic (25%) and Caucasian 2%. The majority (52%) of participants indicated they only had some high school education. Healthy eating among parents was highly dependent on socioeconomic status, time, availability and access to foods. Facilitators to healthy eating were school lunch programmes, nutrition education and family preferences. Findings demonstrate that parents tried to eat meals at home, but many factors (fear of genetically modified foods, money and time) prevented healthy eating and food preparation. Parents who consumed or prepared meals at home did so because of family influence and the fear of being unhealthy. Conclusion and implications: This study provides an in-depth understanding of rural parents’ efforts to promote healthy eating at home regardless of socioeconomic challenges.

Chapter 3 - Culinary Arts Basics: Healthy Cooking Fundamentals: The Culinary Competencies of Healthy Food Selection, Preparation and Food Service

In recent years, several South African Government policies as well as community-focused interventions have been put into effect in an attempt to address household food and nutrition insecurity. This drive is based on the continued challenge of malnutrition, non-communicable diseases, food and nutrition insecurity, as well as hunger within the country. When considering suitable platforms for such health promotion interventions, schools are regarded as suitable environments and unique resources that can promote quality of life, community-wide health and collective well-being through the implementation of school-based interventions. Against this background, we undertook a participatory research project in three purposefully selected primary schools in a resource-constrained community in South Africa, with the purpose of developing and implementing a school-based intervention with Grade 4 to 6 learners to support healthy food and dietary practices in the community. To be more specific, the Wellness in Lifestyle, Intake, Fitness and Environment (Win-LIFE) intervention aimed to facilitate positive change in terms of healthy food choices, production, preparation and consumption within the participating community. The intervention was conceptualised in collaboration with teachers, school principals, governmental officials, university informants and parents of the participating schools, to be facilitated by teachers as part of the national school curriculum in the subjects Life Skills, and Natural Sciences and Technology. The findings of our study indicate that the Win-LIFE intervention was successful in enriching the national school curriculum. As such, we argue in this article that schools can act as sites for social change in vulnerable communities.

This study explored constraints and opportunities in apartment kitchen design for family home cooking and dining. An online audit of 115 two-bedroom apartments in three Melbourne suburbs of Australia was conducted, with images collected from the audit guiding photo-elicitation interviews on the kitchen designs, with architects from firms involved in apartment complex design. Affordance theory provided a conceptual lens to thematically analyse the design process and outcome in relation to architectural practice. Based on previously developed criteria, results from the audit revealed that only 18 (16%) had adequate kitchen design for families with children across five features assessed, with four themes emerging from interviews that identified constraints and facilitators to kitchen design practice: “Limited policy standards”; Architect assumptions align with market-led preferences”; “Built environment and apartment typology constraints”; and “Small scale design opportunities”. Findings provide unique insights into architects’ perspectives on apartment design, deepening understandings of how to support healthy family home food preparation and dining.

Scholars have shown that age, race, and community context are consistent predictors of civilians’ perceptions of police and feelings of safety. Less is known about how young people residing in high-crime disadvantaged neighborhoods perceive police. Using in-depth interviews with 37 youth and adult service providers in Lansing, Michigan, this study examines whether and why young people feel the police increase or decrease their safety within their neighborhood and how these beliefs may differ from those of adults in the community. This study found nearly all of these youth indicated that the police decreased their feelings of safety; however, they did not hold more negative feelings toward the police than adults. Consistent with prior literature, respondents’ feelings were shaped by personal and indirect contact with police, especially adverse incidents.

Convenience Stores and the Marketing of Foods and Beverages Through Product Assortment

Multiple factors can lead to overweight and obesity but unhealthy diets remain one of the key contributors. Diets in turn are influenced by diverse factors. The overall objective of this thesis was to understand the factors influencing dietary behaviours of women and adolescents in low- to middle-income countries, and specifically of adolescents in Ethiopia. Additionally, it aims to explore how these adolescents perceive their food environment and how policies address the different factors of the food environment.
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\nThis study adopted a mixed-method approach and included a wide range of methods. This thesis starts with a global perspective of obesogenic behaviours (Chapter 2) as part of a qualitative evidence synthesis (QES) following a framework synthesis methodology to extract, analyse and synthesise qualitative data from primary research studies. The two studies described in Chapters 3 and 4 focus on specific settings in urban Ethiopia, both in terms of quantitative mapping of the food environment (Chapter 4) as well as qualitative assessment of adolescents’ perceptions, applying the Photovoice method, which is a community-based participatory method (Chapter 3). For Chapter 5, a policy analysis was conducted using the INFORMAS Healthy Food Environment Policy Index (Food-EPI) framework as a basis.
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\nOur findings suggest that the influencing factors of dietary behaviours include individual-, social-, physical- and macro-level factors. Food safety concerns, body ideals, socio-cultural norms, media influence and limited time to prepare healthy food could negatively influence diets and increase exposure to multiple burdens of malnutrition. Perceptions related to the unhealthy diets and bigger body images of wealthy people, combined with healthy food being more difficult to access or afford, are major challenges for people of low socio-economic status to eat healthily. Our findings also suggest that adolescents’ agency to make dietary choices depends not only on their knowledge but on the complexity of their physical and social surroundings and the confidence they have in their future. A nutrition transition is taking place in Ethiopia, with the high presence and advertising of ultra-processed foods and beverages. However, policies are not yet sufficiently in place to coherently address this unhealthy dietary transition in Ethiopia.
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\nThis thesis has identified several entry points for future research and policymaking related to the dietary behaviours of adolescents and their food environments. Future research should aim to engage adolescents as active participants in research using creative participatory methods and to empower adolescents by including them in the design, data collection and analysis. Adolescents should also be part of the programming and policy process as they can be effective agents of change, influencing the diet and health of their family and the community. Comprehensive, multicomponent school programmes are needed to promote healthy school food environments with safe and nutritious meals, inclusive and sustainable food procurement and food and nutrition education throughout the school system, supported by regulations on the foods sold and advertised in and around schools. Future studies on food environments should apply further mixed-method studies for more comprehensive and nuanced assessments of food environments. Specific aspects of the food environment, such as food safety and socio-ecological processes, have been limited in food environment research. Our studies identified multiple influencing factors for dietary behaviours that would need to be addressed using a systems approach. A food systems approach to policymaking would consider potential interlinkages or unintended consequences of policies on different outcomes while identifying appropriate policy actions.

Changing food behaviours amongst Canadian Inuit may contribute to rising chronic disease prevalence, and research is needed to develop nutritional behaviour change programmes. The present study examined patterns of food acquisition and preparation behaviours amongst Inuit adults in Nunavut and associations with psychosocial and socioeconomic factors. Developed from behavioural theories and community workshops, Adult Impact Questionnaires were conducted with adult Inuit (≥19 years) from randomly selected households in three remote communities in Nunavut, Canada, to determine patterns of healthy food knowledge, self-efficacy and intentions, frequencies of healthy and unhealthy food acquisition and healthiness of preparation methods. Associations between these constructs with demographic and socioeconomic factors were analysed using multivariate linear regressions. Amongst 266 participants [mean (SD) age 41.2 (13.6) years; response rates 69-93%], non-nutrient-dense foods were acquired a mean (SD) of 2.9 (2.3) times more frequently than nutrient-dense, and/or low sugar/fat foods. Participants tended to use preparation methods that add fat. Intentions to perform healthy dietary behaviours was inversely correlated with unhealthy food acquisition (β=-0.25, P<0.001), and positively associated with healthy food acquisition (β=0.22, P<0.001) and healthiness of preparation methods (β=0.15, P=0.012). Greater healthy food knowledge and self-efficacy were associated with intentions (β=0.21, P=0.003 and β=0.55, P<0.001, respectively). Self-efficacy was associated with healthier preparation (β=0.14, P=0.025) and less unhealthy food acquisition (β=-0.27, P<0.001), whilst knowledge was associated with acquiring healthy foods (β=0.13, P=0.035). Socioeconomic status was positively associated with healthy preparation and food acquisition behaviours. Interventions to improve diet in Nunavut Inuit should target healthy food intentions, knowledge and self-efficacy. Behaviour change strategies emphasising economic benefits of a healthy diet should be employed to target individuals of low socioeconomic status.