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To examine associations among neighbourhood food environments (NFE), household food insecurity (HFI) and child’s weight-related outcomes in a racially/ethnically diverse sample of US-born and immigrant/refugee families.
Design:
This cross-sectional, observational study involving individual and geographic-level data used multilevel models to estimate associations between neighbourhood food environment and child outcomes. Interactions between HFI and NFE were employed to determine whether HFI moderated the association between NFE and child outcomes and whether the associations differed for US-born v. immigrant/refugee groups.
Setting:
The sample resided in 367 census tracts in the Minneapolis/St. Paul, MN metropolitan area, and the data were collected in 2016–2019.
Participants:
The sample was from the Family Matters study of families (n 1296) with children from six racial/ethnic and immigrant/refugee groups (African American, Latino, Hmong, Native American, Somali/Ethiopian and White).
Results:
Living in a neighbourhood with low perceived access to affordable fresh fruits and vegetables was found to be associated with lower food security (P < 0·01), poorer child diet quality (P < 0·01) and reduced availability of a variety of fruits (P < 0·01), vegetables (P < 0·05) and whole grains in the home (P < 0·01). Moreover, residing in a food desert was found to be associated with a higher child BMI percentile if the child’s household was food insecure (P < 0·05). No differences in associations were found for immigrant/refugee groups.
Conclusions:
Poor NFE were associated with worse weight-related outcomes for children; the association with weight was more pronounced among children with HFI. Interventions aiming to improve child weight-related outcomes should consider both NFE and HFI.
This study pilot-tested combining financial incentives to purchase fruits and vegetables with nutrition education focused on cooking to increase the consumption of fruits and vegetables and improve attitudes around healthy eating on a budget among low-income adults. The goal of the pilot study was to examine implementation feasibility and fidelity, acceptability of the intervention components by participants and effectiveness.
Design:
The study design was a pre-post individual-level comparison without a control group. The pilot intervention included two components, a scan card providing free produce up to a weekly maximum dollar amount for use over a 2-month period, and two sessions of tailored nutrition and cooking education. Outcomes included self-reported attitudes about healthy eating and daily fruit and vegetable consumption from one 24-h dietary recall collected before and after the intervention.
Setting:
Greater Minneapolis/St. Paul area in Minnesota.
Participants:
Adults (n 120) were recruited from five community food pantries.
Results:
Findings indicated that the financial incentive component of the intervention was highly feasible and acceptable to participants, but attendance at the nutrition education sessions was moderate. Participants had a statistically significant increase in the consumption of fruit, from an average of 1·00 cup/d to 1·78 cups/d (P < 0·001), but no significant change in vegetable consumption or attitudes with respect to their ability to put together a healthy meal.
Conclusions:
While combining financial incentives with nutrition education appears to be acceptable to low-income adult participants, barriers to attend nutrition education sessions need to be addressed in future research.
To examine level of participation and satisfaction with the Healthy Savings Program (HSP), a programme that provides price discounts on healthier foods.
Design
For Study 1, a survey was distributed to a random sample of adults who were invited to participate in a version of the HSP that provided a discount for the purchase of fresh produce and discounts on other healthier foods. In Study 2, interviews were conducted with a convenience sample of adults invited to participate in a version of the HSP that provided price discounts on specific products only (no fresh produce discount).
Setting
The HSP is provided to all employer-based insurance plan members of a large health plan. Employers can choose to enhance the version of the HSP that their employees receive by paying for a weekly discount on fresh produce.
Subjects
Employees in employer groups that received the enhanced HSP (Study 1) and employees in an employer group (Study 2) that received the standard HSP.
Results
Among survey respondents in Study 1, 69·3 % reported using the HSP card. Most were satisfied with the fresh produce discount and ease of use of the HSP card. Satisfaction was lower for selection of participating stores, amounts of discounts and selection of discounted products. In Study 2, barriers to the use of the HSP card cited included the limited number of participating stores and the limited selection of discounted products.
Conclusions
Satisfaction with some elements of the HSP was high while other elements may need improvement to increase programme use.
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