Creating healthy and just bioregions.
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ABSTRACT:
SUBMITTER: Pezzoli K
PROVIDER: S-EPMC5554710 | biostudies-other | 2016 Mar
REPOSITORIES: biostudies-other
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Project description:ObjectivesEffective government policies are essential to increase the healthiness of food environments. The International Network for Food and Obesity/non-communicable diseases (NCDs) Research, Monitoring and Action Support (INFORMAS) has developed a monitoring tool (the Healthy Food Environment Policy Index (Food-EPI)) and process to rate government policies to create healthy food environments against international best practice. The aims of this study were to pilot test the Food-EPI, and revise the tool and process for international implementation.SettingNew Zealand.ParticipantsThirty-nine informed, independent public health experts and non-governmental organisation (NGO) representatives.Primary and secondary outcome measuresEvidence on the extent of government implementation of different policies on food environments and infrastructure support was collected in New Zealand and validated with government officials. Two whole-day workshops were convened of public health experts and NGO representatives who rated performance of their government for seven policy and seven infrastructure support domains against international best practice. In addition, the raters evaluated the level of difficulty of rating, and appropriateness and completeness of the evidence presented for each indicator.ResultsInter-rater reliability was 0.85 (95% CI 0.81 to 0.88; Gwet's AC2) using quadratic weights, and increased to 0.89 (95% CI 0.85 to 0.92) after deletion of the problematic indicators. Based on raters' assessments and comments, major changes to the Food-EPI tool include strengthening the leadership domain, removing the workforce development domain, a stronger focus on equity, and adding community-based programmes and government funding for research on obesity and diet-related NCD prevention, as good practice indicators.ConclusionsThe resulting tool and process will be promoted and offered to countries of varying size and income globally. International benchmarking of the extent of government policy implementation on food environments has the potential to catalyse greater government action to reduce obesity and NCDs, and increase civil society's capacity to advocate for healthy food environments.
| S-EPMC4289721 | biostudies-literature
Project description:The US Army Public Health Center developed the Creating Active Communities and Healthy Environments (CACHE) Toolkit to help military installations evaluate the quality of their built environments relative to healthy eating, physical activity, and tobacco-free living. This study sought to improve its implementation process and assess subsequent Action Plan Guides' utility at 5 military installations. Baseline data included a knowledge, attitudes, and beliefs survey (N = 34); post-Toolkit implementation data included focus groups (N = 2) and interviews (N = 10). Although >80% of participants agreed the built environment affects healthy living, only 44%, 53%, and 35% agreed their installations' built environments promoted healthy eating, physical activity, and tobacco-free living, respectively. Emerging themes comprised "Opportunities to Improve Toolkit and Action Plan Guide Functionality," the "Sociopolitical Landscape Affects Toolkit Implementation," and the "Sociopolitical and Physical Landscapes Affect the Toolkit's Value and Utility." This study provides concrete lessons for the CACHE Toolkit and other public health-based military initiatives.
| S-EPMC6628517 | biostudies-literature
Project description:Recreation and sport settings (RSS) are ideal for health promotion, however, they often promote unhealthy eating. Choice architecture, a strategy to nudge consumers towards healthier options, has not been comprehensively reviewed in RSS and indicators for setting-based multi-level, multi-component healthy eating interventions in RSS are lacking. This scoping review aimed to generate healthy food environment indicators for RSS by reviewing peer-reviewed and grey literature evidence mapped onto an adapted choice architecture framework. One hundred thirty-two documents were included in a systematic search after screening. Data were extracted and coded, first, according to Canada's dietary guideline key messages, and were, second, mapped onto a choice architecture framework with eight nudging strategies (profile, portion, pricing, promotion, picks, priming, place and proximity) plus two multi-level factors (policy and people). We collated data to identify overarching guiding principles. We identified numerous indicators related to foods, water, sugary beverages, food marketing and sponsorship. There were four cross-cutting guiding principles: (i) healthy food and beverages are available, (ii) the pricing and placement of food and beverages favours healthy options, (iii) promotional messages related to food and beverages supports healthy eating and (iv) RSS are committed to supporting healthy eating and healthy food environments. The findings can be used to design nested, multipronged healthy food environment interventions. Future research is needed to test and systematically review the effectiveness of healthy eating interventions to identify the most promising indicators for setting-based health promotion in RSS.
| S-EPMC10500220 | biostudies-literature
Project description:This study developed, validated, and evaluated a framework of factors influencing dietary behaviours in urban African food environments, to inform research prioritisation and intervention development in Africa. A multi-component methodology, drawing on concept mapping, was employed to construct a framework of factors influencing dietary behaviours in urban Africa. The framework adapted a widely used socio-ecological model (developed in a high-income country context) and was developed using a mixed-methods research approach that comprised: i. Evidence synthesis consisting of a systematic review of 39 papers covering 14 African countries; ii. Qualitative interview data collected for adolescents and adults (n = 144) using photovoice in urban Ghana and Kenya; and iii. Consultation with interdisciplinary African experts (n = 71) from 27 countries, who contributed to at least one step of the framework (creation, validation/evaluation, finalisation). The final framework included 103 factors influencing dietary behaviours. Experts identified the factors influencing dietary behaviours across all the four levels of the food environment i.e. the individual, social, physical and macro levels. Nearly half (n = 48) were individual-level factors and just under a quarter (n = 26) were at the macro environmental level. Fewer factors associated with social (n = 15) and physical (14) environments were identified. At the macro level, the factors ranked as most important were food prices, cultural beliefs and seasonality. Factors ranked as important at the social level were household composition, family food habits and dietary practices. The type of food available in the neighbourhood and convenience were seen as important at the physical level, while individual food habits, food preferences and socioeconomic status were ranked highly at the individual level. About half of the factors (n = 54) overlap with those reported in an existing socio-ecological food environment framework developed in a high-income country context. A further 49 factors were identified that were not reported in the selected high-income country framework, underlining the importance of contextualisation. Our conceptual framework offers a useful tool for research to understand dietary transitions in urban African adolescents and adults, as well as identification of factors to intervene when promoting healthy nutritious diets to prevent multiple forms of malnutrition.
| S-EPMC8061920 | biostudies-literature
Project description:BACKGROUND:Evidence-based metrics are needed to inform urban policy to create healthy walkable communities. Most active living research has developed metrics of the environment around residential addresses, ignoring other important walking locations. Therefore, this study examined: metrics for built environment features surrounding local shopping centres, (known in Melbourne, Australia as neighbourhood activity centres (NACs) which are typically anchored by a supermarket); the association between NACs and transport walking; and, policy compliance for supermarket provision. METHODS:In this observational study, cluster analysis was used to categorize 534 NACs in Melbourne, Australia by their built environment features. The NACS were linked to eligible Victorian Integrated Survey of Travel Activity 2009-2010 (VISTA) survey participants (n=19,984). Adjusted multilevel logistic regressions estimated associations between each cluster typology and two outcomes of daily walking: any transport walking; and, any 'neighbourhood' transport walking. Distance between residential dwellings and closest NAC was assessed to evaluate compliance with local planning policy on supermarket locations. RESULTS:Metrics for 19 built environment features were estimated and three NAC clusters associated with walkability were identified. NACs with significantly higher street connectivity (mean:161, SD:20), destination diversity (mean:16, SD:0.4); and net residential density (mean:77, SD:65) were interpreted as being 'highly walkable' when compared with 'low walkable' NACs, which had lower street connectivity (mean:57, SD:15); destination diversity (mean:11, SD:3); and net residential density (mean:10, SD:3). The odds of any daily transport walking was 5.85 times higher (95% CI: 4.22, 8.11), and for any 'neighborhood' transport walking 8.66 (95% CI: 5.89, 12.72) times higher, for residents whose closest NAC was highly walkable compared with those living near low walkable NACs. Only highly walkable NACs met the policy requirement that residents live within 1km of a local supermarket. CONCLUSIONS:Built environment features surrounding NACs must reach certain levels to encourage walking and deliver walkable communities. Research and metrics about the type and quantity of built environment features around both walking trip origins and destinations is needed to inform urban planning policies and urban design guidelines.
| S-EPMC5716232 | biostudies-literature
Project description:Molecular-based approaches are rapidly developing in medicine for the evaluation of physiological and pathological conditions and discovery of new biomarkers in prevention and therapy. Fatty acid diversity and roles in health and disease in humans are topical subjects of lipidomics. In particular, membrane fatty acid-based lipidomics provides molecular data of relevance in the study of human chronic diseases, connecting metabolic, and nutritional aspects to health conditions. In veterinary medicine, membrane lipidomics, and fatty acid profiles have not been developed yet in nutritional approaches to health and in disease conditions. Using a protocol widely tested in human profiling, in the present study erythrocyte membrane lipidome was examined in 68 clinically healthy dogs, with different ages, sex, and sizes. In particular, a cluster composed of 10 fatty acids, present in membrane glycerophospholipids and representative of structural and functional properties of cell membrane, was chosen, and quantitatively analyzed. The interval values and distribution for each fatty acid of the cluster were determined, providing the first panel describing the healthy dog lipidomic membrane profile, with interesting correlation to bodyweight increases. This molecular information can be advantageously developed as benchmark in veterinary medicine for the evaluation of metabolic and nutritional status in healthy and diseased dogs.
| S-EPMC7472600 | biostudies-literature
Project description:Sensing technologies hold enormous potential for early detection of health changes that can dramatically affect the aging experience. In previous work, we developed a health alert system that captures and analyzes in-home sensor data. The purpose of this research was to collect input from older adults and family members on how the health information generated can best be adapted, such that older adults and family members can better self-manage their health. Five 90-minute focus groups were conducted with 23 older adults (mean age = 80 years; 87% female) and five family members (mean age = 64; 100% female). Participants were asked open-ended questions about the sensor technology and methods for interacting with their health information. Participants provided feedback regarding tailoring the technology, such as delegating access to family and health care providers, receiving health messages and alerts, interpreting health messages, and graphic display options. Participants also noted concerns and future likelihood of technology adoption. [Journal of Gerontological Nursing, 46(7), 35-40.].
| S-EPMC7577641 | biostudies-literature
Project description:BackgroundThe CHEERS is a self-administered tool to measure gaps, weaknesses, and strengths of an early childhood education and care (ECEC) centre-based nutrition and physical activity environment. ECEC settings have the potential to profoundly influence early dietary and physical activity behaviours. Content validation of the CHEERS tool has been previously reported. The purpose of this study was to develop reliability and validity evidence for the CHEERS audit tool and the proposed subscales of food served, healthy eating environment, program planning, and physical activity environment in ECEC centre-based programs.MethodsThis cross-sectional study consisted of 2 phases: Phase 1 included inter-, intra-rater and Cronbach's ?. A subset of this sample was invited to participate in a second survey (Trial 2) for intra-rater assessment within 3 weeks of completing the first survey (Trial 1). Phase 2 included concurrent validity assessment between a nutrition expert and the ECEC director using within a one-week period.ResultsOne hundred two directors and 85 educators (total of 187) returned the survey. Of these, there were 75 matched pairs for inter-rater reliability analysis providing a CHEERS ICC score of 0.59 and ICC scores ranging from 0.40 to 0.58 for the subscales. The ICC for intra-rater reliability of the CHEERS score was 0.81 for 40 participants completing the survey a second time and a range of 0.72 to 0.79 for the subscales. The CHEERS tool demonstrated very good internal consistency (??=?0.91) and ? scores ranging from 0.73 to 0.79 for the subscales. In phase 2, concurrent validation was ICC?=?0.65 (n?=?30) CHEERS scores with a range of 0.42 to 0.69 for the subscales.ConclusionsThis study provides evidence of inter-, intra-rater reliability, internal consistency, and concurrent validity of an environmental assessment audit tool to assess the nutrition and physical activity environment of ECEC centre-based programs. The results demonstrate that the self-administered CHEERS instrument is stable overtime and between evaluators at the same ECEC centre. The scores obtained with CHEERS self-administered audit tool are reasonably accurate compared to an expert rater (dietitian) assessment. This study adds additional support to establishing the psychometric soundness of the CHEERS tool.
| S-EPMC6816176 | biostudies-literature
Project description:ObjectiveTo determine and compare the level of implementation of policies for healthy food environments in Thailand with reference to international best practice by state and non-state actors.DesignData on the current level of implementation of food environment policies were assessed independently using the adapted Healthy Food Environment Policy Index (Food-EPI) by two groups of actors. Concrete actions were proposed for Thai Government. A joint meeting between both groups was subsequently held to reach consensus on priority actions.SettingThailand.SubjectsThirty state actors and twenty-seven non-state actors.ResultsLevel of policy implementation varied across different domains and actor groups. State actors rated implementation levels higher than non-state actors. Both state and non-state actors rated level of implementation of monitoring of BMI highest. Level of implementation of policies promoting in-store availability of healthy foods and policies increasing tax on unhealthy foods were rated lowest by state and non-state actors, respectively. Both groups reached consensus on eleven priority actions for implementation, focusing on food provision in public-sector settings, food composition, food promotion, leadership, monitoring and intelligence, and food trade.ConclusionsAlthough the implementation gaps identified and priority actions proposed varied between state and non-state actors, both groups achieved consensus on a comprehensive food policy package to be implemented by the Thai Government to improve the healthiness of food environments. This consensus is a platform for continued policy dialogue towards cross-sectoral policy coherence and effective actions to address the growing burden of non-communicable diseases and obesity in Thailand.
| S-EPMC10261628 | biostudies-literature
Project description:To ensure that health behavior interventions for children living in low socioeconomic position (SEP) neighborhoods are in line with children's wishes and needs, participation of the children in the development, implementation, and evaluation is crucial. In this paper, we show how children living in three low-SEP neighborhoods in the Netherlands can be involved in Participatory Action Research (PAR) by using the photovoice method, and what influences this research process. Observations, informal chats, semi-structured interviews, and focus group discussions with children and professionals were done to evaluate the research process. The photovoice method provided comprehensive information from the children's perspectives. With the help of the community workers, the children identified feasible actions. We found that it is important to constantly discuss the research process with participants, start with a concrete question or problem, and adapt the project to the local context and skills of participants.
| S-EPMC8624284 | biostudies-literature