Objectives Greater number and increased frequency of farmers’ markets are an important strategy to improve community-level diet quality by increasing fruit and vegetable availability, yet fall short of addressing health disparities due to a predominantly affluent, white clientele. Introducing Supplemental Nutrition Assistance Program (SNAP) financial incentives at farmers’ markets increases patronage and sales amongst people with economic disadvantage, however SNAP participant incentive program awareness and farmers’ market sales remain low. This study examined whether a digital campaign promoting SNAP incentive programs increases farmers’ market SNAP participation. Methods This study was a parallel RCT, with randomization of zip codes to receive (a) digital promotions or (b) no additional promotions. The study sample included target zip codes (n = 96) near New England farmers’ markets with SNAP incentive programs (n = 23). The intervention was a 13-week campaign, placing digital ads on Facebook and the Fresh EBT app promoting SNAP incentive program savings at farmers’ markets. The study measured farmers’ market SNAP shopping patterns and sales as well as digital campaign delivery and engagement. Data were collected July 1 – September 30, 2020. Results The digital campaign reached 251,966 people, generated 2 million impressions, and resulted in 12,849 clicks. During Summer 2020, zip codes randomized to receive digital promotions had 33.1 SNAP transactions (SE: 6.9) and control zip codes had 18.1 transactions (SE: 4.3), or 82% more transactions associated with promotions (P = 0.068). There were also more new customers from promotion zip codes (10.8 [SE = 2.5] customers) than control zip codes (5.7 [SE = 1.4] customers), or 90% more new customers (P = 0.075). SNAP and incentive sales were higher from promotion zip codes ($1392 [SE: $306]) than control zip codes ($949 [SE: $273]), or 47% greater (P = 0.284), but sales differences were not statistically significant unless controlling for Summer 2019 farmers’ market sales. Conclusions Digital SNAP incentive program promotions can increase farmers’ market SNAP participation, the primary study outcome, leveraging SNAP to expand farmers’ market reach and associated nutrition benefit to historically marginalized populations. Funding Sources USDA Food Insecurity Nutrition Incentives Program.
Objectives: This study aimed to identify features to include in online grocery stores to support healthful food purchasing by those striving to lose weight. Design: A Value Proposition Design Approach was used to gain shopper insights, devise potential online grocery store features, and obtain feedback on these features. Setting: Telephone interviews were conducted to gain insight into shoppers’ needs and perceptions. Results were used by the research team to identify potential online grocery shopping features that may support healthful purchase decisions, and interviews were conducted with a different sample of shoppers to gather feedback on features. Participants: Insight (n=25) and feedback (n=25) interviews were conducted with convenience samples of adults trying to lose weight. Results: Participants were primarily female, white, college educated, and with obesity or overweight. Online grocery features devised by the research team based on findings from the insight interviews included a: 1) shopping cart nutrition rating tool; 2) healthy meal planning tool; 3) interactive healthy eating inspiration aisle; and 4) healthy shopping preference settings option. Findings from the feedback interviews indicated that the healthy meal planning tool, healthy shopping preference settings option and shopping cart nutrition rating tool features were positively rated by most participants. Conclusions: There are multiple features grocers should consider including in their online stores to attract and support customers striving to eat healthy for weight loss.
INTRODUCTION: In 2013, the University of New Mexico Hospital transitioned from a 20IU oxytocin infusion to a “rule of threes” algorithm (3 IU of oxytocin titrated to uterine tone) for prevention of postpartum hemorrhage (PPH) at time of cesarean delivery. This study seeks to identify whether PPH rates have been affected by this change in oxytocin dosing. METHODS: This is a retrospective cohort study comparing PPH rates before and after an institutional shift in oxytocin administration at the time of cesarean delivery. IRB exemption was obtained for this study. Medical records were reviewed for scheduled and unscheduled cesarean section patients before and after the protocol change. 225 patients in each group were randomly selected for the analysis. Our primary outcome was the rate of PPH, determined by estimated blood loss reported by the surgeon. Secondary outcomes included administration of additional uterotonic agents, transfusion, hysterectomy, vasopressor administration, and mortality. RESULTS: There were no significant differences in age, gravidity, parity, prior number of cesarean sections, gestational age, BMI, fetal weight, or induction of labor. Women who received the 20IU oxytocin infusion had a significantly lower rate of PPH (22.2%) compared to “rule of threes” dosing (32.4%, Fishers test P=.0198). CONCLUSION: Our data show an increased rate of PPH with a rule of threes oxytocin dosing at the time of cesarean section compared with infusion dosing of oxytocin. These data indicate that rule of threes dosing may not be applicable to a wider patient population.
INTRODUCTION: Surgical treatments, such as sphincteroplasty or sacral neuromodulation, are available for fecal incontinence (FI). There has been increasing attention on the progress to surgical treatment for overactive bladder, but little is known about the progress towards this therapy for FI. METHODS: This was a retrospective chart review of all new patients presenting to an academic Urogynecology clinic with Wexner Incontinence Scale scores of 11-14 (equivalent to moderately severe FI). Demographics, prior treatments, and how long it took for patients to proceed to definitive treatment were collected. Our prior work described women with severe FI (Wexner score 15–20). With this study we sought to describe women with moderately severe FI and compare moderate to severe FI groups. RESULTS: From January 2014 to July 2017, 158 new patients with a Wexner score of 11-14 were seen in clinic. The mean age was 62.5 +/-12 years. The majority (n=117, 77%) had never had any treatment for FI. The most common treatment plan at the first visit was fiber and dietary modifications (n=59, 38%). Only 3 patients went on to surgical treatment. There were no significant differences between those with moderate versus severe FI in how many ultimate progressed to surgical therapy (3 versus 6) or the number of clinic visits until that decision was made (2 versus 3), all p>.05. CONCLUSION: Very few patients progress to surgical treatment despite at least moderately severe FI. Further work is needed to facilitate timely delivery of definitive care for this patient population.
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