Objective One challenge to healthy nutrition, especially among low-income individuals, is access to and consumption of fresh fruits and vegetables. To address this problem, Veggie Rx, a healthy food incentive programme, was established within a community clinic to increase access to fresh produce for low-income patients diagnosed with obesity, hypertension and/or type 2 diabetes. The current research aimed to evaluate Veggie Rx programme effectiveness. Design A retrospective pre/post design using medical records and programme data was used to evaluate the programme. The study was approved by the University of Albany Institutional Review Board and the Patient Interest Committee of a community clinic. Setting The study was conducted in a low-income, urban neighbourhood in upstate New York. Subjects Medical record data and Veggie Rx programme data were analysed for fifty-four eligible participants. An equal-sized control group of patients who were not programme participants were matched on age, ethnicity and co-morbidity status. Results: A statistically significant difference in mean BMI change (P = 0.02) between the intervention and the control group was calculated. The intervention group had a mean decrease in BMI of 0.74 kg/m2. Conclusions Greater improvement in BMI was found among Veggie Rx programme participants. This information will guide programme changes and inform the field on the effectiveness of healthy food incentive programmes for improving health outcomes for low-income populations.

Background The COVID-19 pandemic profoundly affected food systems including food security. Understanding how the COVID-19 pandemic impacted food security is important to provide support, and identify long-term impacts and needs. Objective The National Food Access and COVID research Team (NFACT) was formed to assess food security over different U.S. study sites throughout the pandemic, using common instruments and measurements. This study present results from 18 study sites across 15 states and nationally over the first year of the COVID-19 pandemic. Methods A validated survey instrument was developed and implemented in whole or part through an online survey of adults across the sites throughout the first year of the pandemic, representing 22 separate surveys. Sampling methods for each study site were convenience, representative, or high-risk targeted. Food security was measured using the USDA six-item module. Food security prevalence was analyzed using analysis of variance by sampling method to statistically significant differences. Results Respondents (n = 27,168) indicate higher prevalence of food insecurity (low or very low food security) since the COVID-19 pandemic, as compared to before the pandemic. In nearly all study sites, there is higher prevalence of food insecurity among Black, Indigenous, and People of Color (BIPOC), households with children, and those with job disruptions. The findings demonstrate lingering food insecurity, with high prevalence over time in sites with repeat cross-sectional surveys. There are no statistically significant differences between convenience and representative surveys, but statistically higher prevalence of food insecurity among high-risk compared to convenience surveys. Conclusions This comprehensive study demonstrates higher prevalence of food insecurity in the first year of the COVID-19 pandemic. These impacts were prevalent for certain demographic groups, and most pronounced for surveys targeting high-risk populations. Results especially document the continued high levels of food insecurity, as well as the variability in estimates due to survey implementation method. Summary Multi-site assessment demonstrates widespread food insecurity during COVID-19, especially on households with children, job loss, and Black, Indigenous, People of Color across multiple survey methods.

Background

Different patterns of food consumption may explain varying determinants of obesity between younger and older students. Regional variations in local associations between the built environment variables and obesity may suggest differences in how healthy food sources are accessed locally.

Background: Senses of Birth (SoB) is a health education intervention in Brazil that aims to reduce unnecessary cesareans in the country by providing information on reproductive rights, benefits and risks of childbirth, and use of intrapartum evidence-based practices (EBP) which are recommended by the World Health Organization (WHO) to improve childbirth outcomes and satisfaction. This study evaluates the impact of the SoB on pregnant women's perceived knowledge about normal birth (NB), cesarean, and use of EBP. Methods: 1287 pregnant women answered a structured survey immediately after their visit to the intervention, between March 2015 and March 2016. To estimate the potential impact of the intervention on women's perceived knowledge, and possible associations between sociodemographic characteristics and perceived knowledge, statistical analyses were performed, including paired T-tests, ANOVA, and logistic and linear regressions. Results: The mean score (MS) of perceived knowledge after the intervention was higher than the MS before experiencing the intervention for all three knowledge domains: Normal Birth (MS Before = 3.71 x MS After = 4.49), Cesarean (MS Before = 3.54 x MS After = 4.26) and EBPs (MS Before = 3.14 x MS After = 4.14). The results suggest that perceived knowledge increased more for low-income women (B = 0.206; p < 0.001 for EBP), women without private health insurance (OR 2.47, 95% CI: 1.49-4.09 for NB), with private prenatal care (OR 2.42, 95% CI: 1.59-3.66 for NB), experiencing their first pregnancy (

Brazil has a cesarean rate of 56% and low use of Intrapartum Evidence-based Practices (IEBP) of 3.4%, reflecting a medically centered and highly interventionist maternal health care model. The Senses of Birth (SoB) is a health education intervention created to promote normal birth, use of EBP, and reduce unnecessary c-sections. This study aimed to understand the use of intrapartum EBP by Brazilian women who participated in the SoB intervention. 555 women answered the questionnaire between 2015 and 2016. Bivariate analysis and ANOVA test were used to identify if social-demographic factors, childbirth information, and perceived knowledge were associated with the use of EBP. A qualitative analysis was performed to explore women’s experiences. Research participants used the following EBP: birth plan (55.2%), companionship during childbirth (81.6%), midwife care (54.2%), freedom of mobility during labor (57.7%), choice of position during delivery (57.2%), and non-pharmacological pain relief methods (74.2%). Doula support was low (26.9%). Being a black woman was associated with not using a birth plan or having doula support. Women who gave birth in private hospitals were more likely not to use the EBP. Barriers to the use of EBP identified by women were an absence of individualized care, non-respect for their choices or provision of EBP by health care providers, inadequate structure and ambiance in hospitals to use EBP, and rigid protocols not centered on women’s needs. The SoB intervention was identified as a potential facilitator. Women who used EBP described a sense of control over their bodies and perceived self-efficacy to advocate for their chosen practices. Women saw the strategies to overcome barriers as a path to become their childbirth protagonist. Health education is essential to increase the use of EBP; however, it should be implemented combined with changes in the maternal care system, promoting woman-centered and evidence-based models.

Background Psychosocial factors are of increasing interest as potential influencers in disease development. This study explores associations between gestational diabetes mellitus (GDM) and maternal depression, adverse childhood experiences (ACEs), and social support, in response to emerging evidence in these areas. Methods An observational, prospective cohort study (AIMS) served as the source of secondary data for this study. Participants included 300 pregnant women aged 18–40 years at an upstate New York prenatal care clinic, who completed a set of self-report questionnaires assessing exposures and stressors both during and prior to their pregnancy. Data were also abstracted from infant and maternal medical records. Results Logistic regression modeling estimated the odds ratios (ORs) of developing GDM in relation to psychosocial factors. There was a significant association between depression and GDM (OR = 2.85, 95% CI: 1.15, 7.06), which persisted in the model adjusted for age and BMI (aOR = 3.19, 95% CI: 1.25, 8.10). No significant associations were found between ACEs or social support with GDM. Conclusions Study findings support an association between maternal depression and GDM development. This study underscores the need for additional research on psychosocial factors and connections to health risks.

Because of the harmful effects of secondhand smoke, communities are organizing to pass clean indoor air policies. With youth being considered one of the most vulnerable populations to this health hazard, it can be strategic to campaigns and beneficial to the youth's development to involve them in efforts to control this toxin. However, youth participation in health campaigns is limited because of barriers inherent in these initiatives. This article presents lessons learned from a qualitative case study on the youth involvement in a successful local clean indoor air campaign. Through the analysis of semistructured interviews with the adult members of the campaign, group interviews and questionnaire completion by the youth members of the campaign, and additional insight made possible by participant observation, recommendations are provided to engage and sustain youth involvement in local public health initiatives.