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.
Periodontal disease (PD) is a well-known risk factor for cardiovascular disease (CVD) but the casual relationship is unclear. American Indians/Alaskan Natives (AI/AN) have high rate of both PD and CVD and a better understanding of how PD might affect heart health would be particularly helpful in this population. In this study, we sequenced the bacterial biofilms of periodontal (gum) pockets and used metagenomic sequencing and vascular health measurements (immune cytokine profiles and vascular flow) to determine the relationship of microbial pathogens and CVD. Twelve subjects were sequenced before and after standard periodontal treatment. Other measures taken before and after treatment included a full dental screening; serum concentration of key immune cytokines from blood samples; lipid profiles from fasting venous blood; and plasma glucose concentrations. The non-invasive Laser Doppler Fluxmetry (LDF) procedure was conducted to measures the microvascular vasodilation. We found highly significant relationships between the total abundance of 4 periodontal pathogens, Porphyromonas gingivalis, Fusobacterium nucleatum, Tannerella forsythia and Treponema denticola, and the inflammatory cytokine interleukin 1 beta (IL-1β) (r=0.63; p=0.009) as well as with vascular flow post sodium nitroprusside (SNP) treatment (r=p=0.006). Two bacterial species that correlated most with IL-1β were F. nucleatum and P. gingivalis. IL-1β has been strongly implicated as a causal factor in atherosclerosis and in periodontal bone loss. To our knowledge, this is the first direct link between abundance of specific periodontal pathogens and cardiovascular disease in humans, and suggests that these pathogens could be used as warning signs for cardiovascular risk.
The NIH-funded Research Centers in Minority Institutions (RCMI) program is currently funding 18 academic institutions to strengthen the research environment and contribution to health disparities research. The purpose of this multiphase mixed-methods study was to establish a uniform evaluation framework for demonstrating the collective success of this research consortium. Methods included discussions of aims and logic models at the RCMI Evaluators’ Workshop, a literature review to inform an evaluation conceptual framework, and a case study survey to obtain evaluation-related information and metrics. Ten RCMIs participated in the workshop and 14 submitted responses to the survey. The resultant RCMI Evaluation Conceptual Model presents a practical ongoing approach to document RCMIs’ impacts on health disparities. Survey results identified 37 common metrics under four primary categories. Evaluation challenges were issues related to limited human resources, data collection, decision-making, defining metrics, cost-sharing, and revenue-generation. There is a need for further collaborative efforts across RCMI sites to engage program leadership and community stakeholders in addressing the identified evaluation challenges and measurement. Program leadership should be engaged to apply the Evaluation Conceptual Framework and common metrics to allow for valid inter-institutional comparisons and consortium-wide evaluations. Stakeholders could ensure evaluation metrics are used to facilitate community impacts.
The purpose of Moores Cancer Center (MCC) CancerDAT is to reduce cancer disparities through the development of an online tool that will facilitate research partnerships, build the capacity of community-based organizations, and encourage community engagement. CancerDAT is a part of the MCC Community Outreach and Engagement Initiative (COE), which aims to decrease the burden of cancer in San Diego County, the MCC catchment area. San Diego is geographically and demographically unique, bordering the Pacific Ocean and Mexico. Across and within neighborhoods, the population varies greatly in socioeconomic status, acculturation, and languages spoken. In order to effectively recruit from, collaborate with, and intervene in communities, cancer researchers and practitioners must understand these unique sociodemographic characteristics and community needs. To achieve this kind of understanding, researchers need access to local data and local organizations and leaders, as well as information about existing efforts to address cancer disparities in a given community. Many organizations in San Diego are devoted to reducing cancer disparities; their efforts, however, are hampered by an inability to fully engage in research and implement evidence-based practices. Local community needs assessments have identified barriers to organizational participation in these activities, including an inability to access relevant and current local data, a lack of knowledge about adopting and adapting interventions for their communities, and a lack of connection to local academics open to collaborative research. The MCC COE, in partnership with their Community Advisory Board, will address these needs by: 1) assessing the catchment area cancer burden across neighborhoods; 2) facilitating transdisciplinary basic, translational, and clinical research; and 3) disseminating evidence-based practices and resources for cancer prevention, screening, and treatment. To facilitate this, the MCC COE collaborated with the UC San Diego Altman Clinical and Translational Research Institute and consortium partner San Diego State University to develop CancerDAT (moores.healthdat.org). This tool will be used by academics and community partners to identify and address cancer disparities across communities. For example, breast cancer mortality rates vary greatly in different San Diego communities: the age-adjusted death rate in the Del Mar region is 6.06/100,000 compared with 49.67/100,000 in the Jamul region. These disparities can be easily visualized and identified by CancerDAT users. CancerDAT is a free, user-friendly, online platform that provides: 1) mapping of neighborhood-level cancer outcomes, demographics, behaviors, and social determinants of health; 2) descriptions of best practices to address cancer disparities; 3) neighborhood programs and resources that address disparities; 4) links to community-engaged academics interested in collaborating; and 5) links to existing relevant local collaboratives. Citation Format: Corinne R. McDaniels-Davidson, Jesse Nodora, Samir Gupta, Sandip P. Patel, Tanya Penn, Maria E. Martinez. University of California Moores Cancer Center CancerDAT: Development of an online tool to reduce cancer disparities by engaging and linking local organizations and researchers [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A041.
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