Background Collecting data on daily habits across a population of individuals is challenging. Mobile-based circadian ecological momentary assessment (cEMA) is a powerful frame for observing the impact of daily living on long-term health. Objective In this paper, we (1) describe the design, testing, and rationale for specifications of a mobile-based cEMA app to collect timing of eating and sleeping data and (2) compare cEMA and survey data collected as part of a 6-month observational cohort study. The ultimate goal of this paper is to summarize our experience and lessons learned with the Daily24 mobile app and to highlight the pros and cons of this data collection modality. Methods Design specifications for the Daily24 app were drafted by the study team based on the research questions and target audience for the cohort study. The associated backend was optimized to provide real-time data to the study team for participant monitoring and engagement. An external 8-member advisory board was consulted throughout the development process, and additional test users recruited as part of a qualitative study provided feedback through in-depth interviews. Results After ≥4 days of at-home use, 37 qualitative study participants provided feedback on the app. The app generally received positive feedback from test users for being fast and easy to use. Test users identified several bugs and areas where modifications were necessary to in-app text and instructions and also provided feedback on the engagement strategy. Data collected through the mobile app captured more variability in eating windows than data collected through a one-time survey, though at a significant cost. Conclusions Researchers should consider the potential uses of a mobile app beyond the initial data collection when deciding whether the time and monetary expenditure are advisable for their situation and goals.
Transportation type may play a role in the ease with which a person can access healthy food and recreation facilities. Our objective was to determine the relationship between access to a personal vehicle and diet, food insecurity, and physical activity among public housing residents, which are typically low-income, urban populations. We conducted a cross-sectional survey of randomly selected households within two public housing communities in Baltimore, MD (2014–2015). Our independent variable was whether or not the resident had access to a personal vehicle. Our dependent variables were ‘high’ fruit & vegetable intake (≥6.7 servings/day), ‘high’ added sugar intake (≥39.9 tsp/day), food insecurity, and being physically active. We used Poisson regression with robust error variance to estimate relative risk ratios adjusted for demographics and perceived environmental factors. Our sample included 265 adults (response rate of 48%) with mean age of 45 years, 86% women, and 96% African-American. Only 42% had access to a vehicle. No significant associations existed between personal vehicle access with diet or physical activity outcomes. Access to a personal vehicle was associated with significantly lower risk of food insecurity (RR 0.76, 95%CI 0.63–0.92, p < 0.01). We found a significant association between personal vehicle access and lower risk of food insecurity; however, there were no associations with diet or exercise. Based on these results, future research might explore how transportation access influences and might possibly reduce food insecurity.
Public housing residents have high intake of added sugars, which is associated with sugar-sweetened beverage (SSB) consumption in their social networks. In this feasibility study, we designed and tested a network-oriented intervention to decrease added sugar intake by encouraging reduced SSB consumption. We conducted a 6-month single-arm trial testing a small-group curriculum (9 sessions) that combined behavior change strategies to reduce added sugar intake by promoting SSB reduction with a peer outreach approach. We recruited and trained public housing residents to be “Peer Educators,” who then communicated information and made changes to reduce SSB with their network members. We calculated the median number of group sessions attended and determined the percentage of individuals satisfied with the program. We estimated added sugar intake using a 5-factor dietary screener and compared baseline and 6-month median values using Wilcoxon signed rank tests. We recruited 17 residents and 17 of their network members (n = 34). Mean age was 45.7 years, 79.4% were women, and 97.1% were African American. Median number of sessions attended was 9 (interquartile range: 4-9), and 88.2% were very satisfied with the program. Overall, baseline median added sugar intake was 38.0 tsp/day, which significantly declined to 17.2 tsp/day at 6 months ( P < .001). Residents and network members achieved similar results at 6 months (17.4 vs 16.9 tsp/day, respectively). In conclusion, our results demonstrate that a social network intervention aimed at reducing SSB consumption is feasible and can produce significant decreases in adult added sugar intake, which warrants further investigation in a randomized controlled trial.
El propósito de este trabajo es explorar las características que tienen las familias potosinas en cuanto a su cultura parental; es decir, explorar sus pautas de crianza, los diferentes vínculos de apego que se construyen y los patrones de éxito que se promueven para relacionarlos con sus características biográficas. El estudio se efectuó en la zona conurbada de San Luis Potosí (México), con la participación de 1008 familias de diferentes niveles culturales y se utilizó un instrumento de corte mediacional con 12 reactivos de carácter atribucional, que contempló la exploración de 4 modelos parentales. Los resultados arrojaron una preferencia de los padres por pautas de crianza negociadoras o rígidas, vínculos de apego cálidos o cercanos y patrones de éxito orientadores, encontrándose en menor medida las pautas de crianza indulgentes, los vínculos de apego elementales y los patrones de éxito promotores y emancipadores.
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