IntroductionFarmers market programs may increase access to more healthful foods and reduce the high prevalence of obesity in low-income communities. The objective of this study was to examine outcomes of the Fresh Fund farmers market program serving low-income neighborhoods in San Diego, California.MethodsThrough its Farmers Market Fresh Fund Incentive Program, the County of San Diego Health and Human Services Agency offered monetary incentives to government nutrition assistance recipients to purchase fresh produce at 5 farmers markets. Participants enrolled at participating markets from June 1, 2010, through December 31, 2011; they completed baseline and follow-up surveys of daily consumption and weekly spending on fruits and vegetables. We examined enrollment, participation, participant health perceptions, and vendor revenue.ResultsDuring the study period, 7,298 eligible participants enrolled in Fresh Fund; most (82%) had previously never been to a farmers market. Among 252 participants with matched surveys at baseline and 12-month follow-up, the proportion who reported their diet to be “healthy” or “very healthy” increased from 4% to 63% (P < .001); nearly all (93%) stated that Fresh Fund was “important” or “very important” in their decision to shop at the farmers market. Vendors reported that 48% of all market revenue they received was received through the Fresh Fund program. At 2 markets, revenue from June 1, 2011, through January 31, 2012, increased by 74% and 68% compared with revenue from June 1, 2010, through January 31, 2011.ConclusionParticipants in the Fresh Fund program self-reported increases in daily consumption and weekly spending on fruits and vegetables, and vendors at participating farmers markets also increased their revenue.

No abstract

This paper describes the variation in use of soup

A tracking score for determining growth faltering in children was developed and tested. A graphical method was developed for classifying by visual inspection whether or not a given child had faltered in growth. This method was used to classify all children in a sample of Guatemalan children as to faltering in both weight and length between 9 and 24 months of age; 80 of 345 children had faltered in weight, and 44 of 336 children had faltered in length. The accuracies for determining this faltering of seven versions of the tracking score and that of three other commonly used scores were assessed and compared using ROC curves, the areas under the curves, and two other ways. The other scores tested were the increment score, the residual score, and a growth-curve parameter score. The accuracies of the scores were overall lower for weight than for length. For both weight and length, the growth-curve parameter score had the lowest accuracy, and the tracking score that used an intermediate number of measurements (four in the interval of interest and three in the previous interval) had the highest accuracy. The tracking score has a number of features that make it attractive as an indicator of faltering. It is easy to calculate and interpret, preserves magnitude and direction, incorporates several growth measurements into a single indicator of faltering, gives equal weight to the information in all the measurements used, allows for missing measurements, and can be generalized to include other aspects of growth.

No abstract

IntroductionAttitudes and behaviors are salient factors in most of the current public health issues. Most studies measure attitudes and behaviors using a set ofitems included in a single closed-form questionnaire. Inasmuch as attitudes and behaviors toward the same act are examined, the wording of the items and the response formats should be nearly identical to each other.1-13 Feldman and Lynchl4 implied that a response to a question is likely to be retrieved as a basis for a subsequent response if they are presented consecutively in one questionnaire. Using similarly worded items to measure attitudes and behaviors compounds the problem. In the present paper we address the question of whether attitudes and behaviors can be measured accurately with a single questionnaire. MethodsWe randomly divided a sample of 900 general practitioners into two groups. One group (A) received a questionnaire in which both their attitudes and behaviors were assessed. The other group (B) received a questionnaire measuring behaviors; on receipt of that completed questionnaire, we mailed them a second one which pertained to their attitudes.The response rate for group A was 64.3 percent. The response rate for group B was 73.2 percent. Ninety-two percent of the physicians in group B who answered the first questionnaire also completed the second questionnaire.Twenty-one attitudinal items based on a series of questions (see Appendix) and 21 similarly worded behavioral items were presented to physicians on a sixpoint rating scale. They measured practices that physicians considered appropriate to perform (attitudes) and those which they claimed to perform (behaviors) in three clinical situations:* the extent of information that a physician should provide to chronically ill patients about their illness; * the extent to which a physician should promote non-smoking behavior to patients that consult for reasons other than smoking problems; * the extent to which a physician should discuss weight with an obese patient consulting for reasons other than obesity.The items measuring attitudes and behaviors were worded in the same manner.14 Systematic biases in measuring attitudes and behaviors were assessed by comparing the correlation coefficients between attitudes and behaviors in the two groups of physicians.The correlation coefficients were transformed into z-scores, using the Fisher Transformation, to test for the differencel1 between the association of attitudes and behaviors in the two groups of respondents. A total of 21 tests were performed for each of the comparisons between two groups. A P-plot procedure was used16 to estimate the number N of true null hypotheses. The estimate of N was then used to obtain an overall a-level which was less conservative than the usual Bonferonni level. The value of N was 6 in this study, thus the significant level was set at .05/6 = .008. ResmltsEight correlations between attitudes and behaviors were different in the two groups at the 0.008 level (Table 1). Pearson's correlation coefficients between attitu...

No abstract

No abstract