Background: Diarrhea remains a major cause of morbidity and mortality among children in Tanzania. The purpose of this study was to explore associations between diarrheal disease and water, sanitation, and hygiene (WASH) related behaviors and determine care-seeking predictors for diarrheal disease. Methods: Data from 9996 female primary caregivers were collected as part of a larger integrated nutrition program. Logistic regression was used to measure associations between predictor and dependent variables and diarrheal and care-seeking outcomes. Results: Knowledge of the importance of handwashing after assisting a child who has defecated (OR 0.79, CI 0.72–0.87), before preparing food (OR 0.88, CI 0.80–0.97), and before feeding a child (OR 0.89, CI 0.81–0.99) were each associated with not having a child with diarrhea in the past two weeks. Fathers or male caregivers (OR 0.65, CI 0.48–0.89) were less likely to seek medical care for a child with diarrhea. No associations were found between WASH-related knowledge or behavior and seeking medical care for a child with diarrhea. Conclusions: Findings indicate that knowledge of handwashing importance was significant in washing hands after assisting a child who has defecated, before preparing food, and prior to feeding a child. These findings demonstrate the value of parental involvement to lower morbidity and mortality among children.
Background: The purpose of this study was to examine the extent to which a national nutrition communication campaign (NNCC) intervention providing interpersonal communication (IPC) was associated with improved knowledge and behaviors related to feeding practices among mothers with children under two years of age in rural Indonesia. Methods: Data came from a follow-up, cross-sectional survey of 1734 mothers. Key outcomes of interest were minimum meal frequency, minimum dietary diversity and minimum acceptable diet, as defined by the World Health Organization. Associations between exposure to the NNCC intervention and infant and young child feeding (IYCF) knowledge and behaviors were analyzed using adjusted linear and logistic regression, controlling for age, education, and income. Results: A total of 525 mothers reported exposure to IPC interventions (30.3%). Participation in IPC was associated with increased knowledge of feeding practices (p < .0001). Separately, knowledge of feeding practices was related to achieving recommended behavioral practices of minimum meal frequency (p = 0.019), dietary diversity (p = 0.013), adequate diet (p < .001). Conclusion: These findings underscore the value of increasing maternal knowledge of IYCF practices through IPC interventions as a way to improve behavioral practices and address stunting in rural Indonesia.
Objectives: Childhood obesity rates remain high. The youth sports environment is an opportunity to combat obesity. The purpose of this study was to determine the types of beverages/ snacks provided at youth sports and determine associations between energy consumption and expenditure. Methods: This cross-sectional study observed 4 different sports in a youth sports league (N = 189). The System for Observing Fitness Instruction Time (SOFIT) was used to quantify physical activity. Food environmental scans were used to quantify caloric intake. A t-test was conducted to examine differences between energy consumption and expenditure. We conducted a separate analysis for games that did not offer snacks/beverages. Results: The average energy expenditure was 170.3 calories per game; males were more physically active than females. The average caloric content was 213.3 calories for games that did not offer snacks/beverages and average sugar provided was 26.4 grams per game. The majority of sugar came from sugar-sweetened beverages. Conclusions: Calorie intake was higher than expenditure. Children were consuming more sugar in one game than daily recommendations. Youth sports would benefit from an intervention aimed at the food environment.
Objectives: The purpose of this study was to test a small-scale intervention and its ability to decrease total sugar intake and number of calories offered at youth sports games. Methods: This study was a pre/post-test quasi-experimental design. A flier was developed and distributed to parents. The flier aimed to decrease the sugar-sweetened beverages and increase the nutritional quality of food brought to games. Baseline data were collected in 2018 (n = 61). The flier was distributed prior to the start of the league, once during the league, and posted online in 2019. Postintervention data were collected in the intervention group (n = 122) and a comparison group (n = 74). Nutritional information was collected through direct observation. Results: The average amount of total sugar provided per game per child was 25.5 g at baseline when snacks/beverages were provided at games. After the intervention, the average amount of total sugar provided significantly decreased (16.7 g/game/child, p < 0.001). Conclusions: The intervention reduced total sugar offered and the number of sugar-sweetened beverages brought to games. It was low-cost and could be easily implemented by public health practitioners and/or parks and recreation administrators. Further, considerations could be made to implement policies relative to snacks and beverages at youth sports games.
The Navajo Nation, an area home to approximately 173,000 people in the southwest United States, experiences the highest rates of food insecurity in the United States and is classified as a food desert. The present study assessed the accessibility to food outlets (grocery stores, convenience stores, and restaurants) as measured by driving time on the Navajo Nation and in selected surrounding border towns. Food outlets located in neighboring border towns were examined using network analysis tools in ArcGIS Pro to calculate driving distance and examine the potential impact of driving time within the Navajo Nation on accessibility to nutritious foods. There were 14 grocery stores, 21 convenience stores, and 65 restaurants identified in the Navajo Nation using Mergent Intellect, a proprietary database, as compared to border towns which had a total of 542 grocery stores, 762 convenience stores, and 3,329 restaurants equaling a ratio of about 50:1 (grocery, 39:1; convenience, 36:1; restaurants, 51:1) when comparing food outlets nearby versus on the Navajo Nation. This ecological study presents a visual representation of driving time and food accessibility, revealing geographic areas within the Navajo Nation where access to border town food stores is sparse, and food insecurity may be elevated.
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