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Food pantries are responsible for the direct distribution of food to low-income households. While food pantries may be concerned about the nutritional quality of the food they are serving, they may have limited resources to adopt and implement nutrition policies to support efforts to promote high nutritional quality of the food served. Guided by the RE-AIM (Reach, Effectiveness or Efficacy, Adoption, Implementation, Maintenance) framework, this qualitative study explored the degree of implementation of nutrition policies at food pantries, as well as the barriers to implementation in those pantries that had not adopted a nutrition policy. Semistructured interviews were conducted with 10 food pantry directors: seven pantries with a formal nutrition policy and three with an informal nutrition policy. Using a thematic analysis method, results demonstrated themes from the interviews with policy-adopting pantries to be barriers, enforcement, delivery of the policy, unexpected consequences, and fidelity to the policy. A targeted intervention that builds on this research and focuses on building the capacity of food pantries to develop, adopt, and implement nutrition policies as well as helping to increase fidelity to the policy would be beneficial to continue to improve the food donated and distributed at food pantries. By supporting food pantries in the development, adoption, and implementation of nutrition policies, researchers can play an important role in improving the quality of food in the emergency food network. [ABSTRACT FROM AUTHOR]

The migration of federal assistance services to online platforms during the COVID-19 pandemic sparked interest in digital nutrition education for individuals participating in the Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) programs. With federal government investing in the modernization of the nutrition education components of both programs, there is a need to identify science-backed electronic health (e-health) dietary interventions to improve health outcomes in this population. Therefore, the objective of this systematic literature review was to summarize the effectiveness, acceptability, and feasibility of e-health dietary interventions among individuals participating in WIC or SNAP. Keyword searches were performed in Google Scholar, PubMed, and Science Direct. The search included peer-reviewed literature from 2014 to 2023 and a few articles offering context about interventions used long-term by the nutrition assistance programs. PRISMA guidelines were followed to conduct this systematic literature review, which resulted in 36 articles eligible for extraction. The studies evaluated e-health (52.8%), short message service/text messaging (27.8%), and smartphone application interventions (19.4%) delivered to WIC or SNAP participants. The interventions identified aimed to modify food choice, eating behavior, and dietary intake among SNAP participants, SNAP-eligible adults, and WIC participants. Most interventions were developed using content delivery and health behavior theoretical frameworks (77.8%) and evidence-based nutritional recommendations (59.3%). Review findings show a high level of acceptability and feasibility for e-health and mobile health dietary interventions among WIC and SNAP participants but varying levels of effectiveness. Level of engagement, dosage, retention, and adherence were strong predictors of positive dietary behavior change regardless of the mode of intervention delivery. Future studies need to prioritize health equity by recruiting samples representative of food nutrition assistance participants and addressing digital health literacy as a potential barrier to intervention effectiveness, as none of the present studies measured literacy among participants. [ABSTRACT FROM AUTHOR]

Nighttime eating has been associated with obesity, inflammation, and poor nutritional intake, yet correlates of this behavior are understudied in pediatric populations and among adolescents in particular. The current study examines modifiable factors related to nighttime eating, including sleep parameters and regulatory abilities-as well as the interplay between these constructs-in adolescents. A total of 223 adolescents (Mage = 15.32 years, 52.9 % female, 15.7 % classified as overweight, 21.1 % had obesity) wore ActiGraph devices to measure sleep and were instructed to complete three 24-h dietary recall measures over a two-week period. Participants also completed self-report measures of executive function. Greater variability in sleep duration was consistently associated with higher average calorie, sugar, and fat consumption after 8, 9, and 10 PM. The main effect of global executive function on all nighttime eating measures was nonsignificant, and executive function did not moderate relationships between sleep parameters and nighttime eating measures. Since adolescents' eating habits may set the stage for lifelong dietary practices, efforts to ensure consistent sleep duration may reduce risk for nighttime eating in this nutritionally vulnerable population. [ABSTRACT FROM AUTHOR]

Few comprehensive measures exist to assess contributors to childhood obesity within the home, specifically among low-income populations. The current study describes the modification and psychometric testing of the Comprehensive Home Environment Survey (CHES), an inclusive measure of the home food, physical activity, and media environment related to childhood obesity. The items were tested for content relevance by an expert panel and piloted in the priority population. The CHES was administered to low-income parents of children 5 to 17 years (N = 150), including a subsample of parents a second time and additional caregivers to establish test–retest and interrater reliabilities. Children older than 9 years (n = 95), as well as parents (N = 150) completed concurrent assessments of diet and physical activity behaviors (predictive validity). Analyses and item trimming resulted in 18 subscales and a total score, which displayed adequate internal consistency (α = .74-.92) and high test–retest reliability (r ≥ .73, ps < .01) and interrater reliability (r ≥ .42, ps < .01). The CHES score and a validated screener for the home environment were correlated (r = .37, p < .01; concurrent validity). CHES subscales were significantly correlated with behavioral measures (r = −.20-.55, p < .05; predictive validity). The CHES shows promise as a valid/reliable assessment of the home environment related to childhood obesity, including healthy diet and physical activity. [ABSTRACT FROM PUBLISHER]

Abstract: Background: Fruit and vegetable (F/V) intake assessment tools that are valid, reliable, brief, and easy to administer and code are vital to the field of public health nutrition. Objective: To evaluate three short F/V intake screeners (ie, a 2-item serving tool, a 2-item cup tool, and a 16-item F/V intake screener) among adults using multiple 24-hour dietary recalls (24-hour recalls) as the reference instrument and evaluate test–retest reliability of the screeners across a 2- to 3-week time period. Design: Validity and reliability study. Participants/setting: Two hundred forty-four adults for the validity study and 335 adults for test–retest reliability. Statistical analyses performed: Median values for F/V intakes were calculated for the screeners and 24-hour recalls. The Wilcoxon signed rank test was used to compare screeners with the 24-hour recalls. Deattenuated Pearson correlations were reported for validity and intraclass correlation coefficient used for reliability. Results: The estimated median daily servings/cups of F/V for the 2-item serving screener was lower, for the 2-item cup screener was equivalent for men but higher for women, and for the 16-item F/V intake screener were about the same when compared with 24-hour recall values. The deattenuated correlations comparing the 24-hour recalls with the screeners were positive but weak for the 2-item serving screener, and were positive and moderate in strength for the 2-item cup and 16-item F/V intake screeners. The test–retest intraclass correlation coefficients were all positive and fairly strong for all of the screeners. Conclusions: Although dietary screeners offer a more cost-effective, less burdensome way to obtain gross estimates to rank individuals with regard to F/V intake, these methods are not recommended for assessing precise intake levels. [Copyright &y& Elsevier]

ObjectiveDue to a proliferation of measures for different components of the home environment related to childhood obesity, the purpose of the present systematic review was to examine these tools and the degree to which they can validly and reliably assess the home environment.DesignRelevant manuscripts published between 1998 and 2010 were obtained through electronic database searches and manual searches of reference lists. Manuscripts were included if the researchers reported on a measure of the home environment related to child eating and physical activity (PA) and childhood obesity and reported on at least one psychometric property.ResultsOf the forty papers reviewed, 48 % discussed some aspect of parenting specific to food. Fifty-per cent of the manuscripts measured food availability/accessibility, 18 % measured PA availability/accessibility, 20 % measured media availability/accessibility, 30 % focused on feeding style, 23 % focused on parenting related to PA and 20 % focused on parenting related to screen time.ConclusionsMany researchers chose to design new measures for their studies but often the items employed were brief and there was a lack of transparency in the psychometric properties. Many of the current measures of the home food and PA environment focus on one or two constructs; more comprehensive measures as well as short screeners guided by theoretical models are necessary to capture influences in the home on food and PA behaviours of children. Finally, the current measures of the home environment do not necessarily translate to specific sub-populations. Recommendations were made for future validation of measures in terms of appropriate psychometric testing. [ABSTRACT FROM PUBLISHER]

Interventions that cultivate sustainable food systems to promote health, prevent obesity, and improve food security have the potential for many large-scale and long-lasting benefits including improvements in social, environmental, health, and economic outcomes. We briefly summarize findings from previous research examining associations between obesity and food insecurity and discuss the need for greater synergy between food insecurity initiatives and national obesity prevention public health goals in the United States. The common ground between these two nutrition-related public health issues is explored, and the transformation needed in research and advocacy communities around the shared goal of improving population health through individual, environmental, and policy level changes to promote healthy sustainable food systems is discussed. We propose an ecological framework to simultaneously consider food insecurity and obesity that identifies levers for change to promote sustainable food systems to improve food security and prevent obesity. [ABSTRACT FROM AUTHOR]

BACKGROUND: Competitive foods are often available in school vending machines. Providing youth with access to school vending machines, and thus competitive foods, is of concern, considering the continued high prevalence of childhood obesity: competitive foods tend to be energy dense and nutrient poor and can contribute to increased energy intake in children and adolescents. METHODS: To evaluate the relationship between school vending machine purchasing behavior and school vending machine access and individual-level dietary characteristics, we used population-level YouthStyles 2005 survey data to compare nutrition-related policy and behavioral characteristics by the number of weekly vending machine purchases made by public school children and adolescents (N = 869). Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were computed using age- and race/ethnicity-adjusted logistic regression models that were weighted on age and sex of child, annual household income, head of household age, and race/ethnicity of the adult in study. Data were collected in 2005 and analyzed in 2008. RESULTS: Compared to participants who did not purchase from a vending machine, participants who purchased ≥3 days/week were more likely to (1) have unrestricted access to a school vending machine (OR = 1.71; 95% CI = 1.13–2.59); (2) consume regular soda and chocolate candy ≥1 time/day (OR = 3.21; 95% CI = 1.87–5.51 and OR = 2.71; 95% CI = 1.34–5.46, respectively); and (3) purchase pizza or fried foods from a school cafeteria ≥1 day/week (OR = 5.05; 95% CI = 3.10–8.22). CONCLUSIONS: Future studies are needed to establish the contribution that the school-nutrition environment makes on overall youth dietary intake behavior, paying special attention to health disparities between whites and nonwhites. [ABSTRACT FROM AUTHOR]

Background: Adequate fruit and vegetable intake has been found to promote health and reduce the risk of several cancers and chronic diseases. Understanding the psychological determinants of fruit and vegetable intake is needed to design effective intervention programs. Methods: Papers published in English from 1994 to 2006 that described the relationship between psychosocial predictors and fruit and vegetable intake in adults were reviewed. Studies and their constructs were independently rated based on the direction of significant effects, quality of execution, design suitability, and frequency. Methodology from the Guide to Community Preventive Services was used to systematically review and synthesize findings. Results: Twenty-five psychosocial constructs spanning 35 studies were reviewed (14 prospective and 21 cross-sectional/descriptive studies). Strong evidence was found for self-efficacy, social support, and knowledge as predictors of adult fruit and vegetable intake. Weaker evidence was found for variables including barriers, intentions, attitudes/beliefs, stages of change, and autonomous motivation. Conclusions: The findings underscore the need to design future behavioral interventions that use strong experimental designs with efficacious constructs and to conduct formal mediation analyses to determine the strength of these potential predictors of fruit and vegetable intake. [Copyright &y& Elsevier]

The purpose of this article is to describe the baseline design elements and sample characteristics of the Behavior Change Consortium (BCC) Dietary Measurement studies for each of the 7 sites that comprised the BCC Nutrition Working Group (NWG). This article summarizes the project designs, including descriptions of diverse study populations, primary assessment methods, and study outcomes. Common measures used across sites included the National Cancer Institute (NCI) Fruit and Vegetable Screener, NCI Percentage Energy from Fat Screener, 24-h dietary recalls, and a single- or 2-item fruit and vegetable measure. Data on sociodemographic characteristics, body weight and height, smoking status, and serum carotenoids were also collected. Study design information such as assessment time points, as well as baseline sample characteristics, is also described. This paper provides the overall framework and descriptive information and serves as the reference for the BCC NWG special supplement. [ABSTRACT FROM AUTHOR]

Four of the 10 leading causes of death can be attributed to poor dietary behaviors. Nutrition professionals continue to stuggle with the most effective ways to deliver nutrition messages that will result in changes in dietary behavior. On July 14-15, 2005, the National Cancer Institute and the Division of Nutrition Research Coordination, both of the National Institutes of Health, hosted a meeting to explore the state of the science concerning this issue. This paper provides an introduction to that meeting and the articles that resulted from it. [ABSTRACT FROM AUTHOR]

Background: Developing effective interventions for the 24% to 28% of U.S. adults who are sedentary requires a better understanding of the factors related to sedentary lifestyles as well as the communication channels to reach various subgroups. This study identified key sociodemographic and health communication characteristics of various subgroups with high rates of inactivity using signal detection methodology.Methods: The sample from the nationally representative Health Information National Trends Survey 2003 (n=6369) was randomly split into two samples. Exploratory analyses (conducted 2004 and 2005) were employed on the first sample to identify various subgroups, and the stability of inactivity rates in those subgroups was examined in the second sample.Results: Eight subgroups with varying levels of inactivity were identified. Three subgroups had inactivity levels of 40% or higher, while the lowest subgroup had a level of less than 15%. The highest inactivity subgroup consisted of individuals with at least some college education who were in fair/poor health and who watched 4 or more hours of television per day. The second-highest inactivity subgroup was composed of those without a college education who tended not to use or attend to many communication channels. The third highest inactive subgroup consisted of those without a college education who read the newspaper and were obese. Levels of inactivity in the second independent sample subgroups were not significantly different from those found in the exploratory sample.Conclusions: This study identified empirically based, physically inactive subgroups that differed on sociodemographic and health communication characteristics. This information should be useful in creating future evidence-based, targeted, and tailored intervention strategies. [ABSTRACT FROM AUTHOR]

Background. Nutrition interventions targeted to individuals are unlikely to significantly shift US dietary patterns as a whole. Environmental and policy interventions are more promising for shifting these patterns. We review interventions that influenced the environment through food availability, access, pricing, or information at the point-of-purchase in worksites, universities, grocery stores, and restaurants.Methods. Thirty-eight nutrition environmental intervention studies in adult populations, published between 1970 and June 2003, were reviewed and evaluated on quality of intervention design, methods, and description (e.g., sample size, randomization). No policy interventions that met inclusion criteria were found.Results. Many interventions were not thoroughly evaluated or lacked important evaluation information. Direct comparison of studies across settings was not possible, but available data suggest that worksite and university interventions have the most potential for success. Interventions in grocery stores appear to be the least effective. The dual concerns of health and taste of foods promoted were rarely considered. Sustainability of environmental change was never addressed.Conclusions. Interventions in “limited access” sites (i.e., where few other choices were available) had the greatest effect on food choices. Research is needed using consistent methods, better assessment tools, and longer durations; targeting diverse populations; and examining sustainability. Future interventions should influence access and availability, policies, and macroenvironments. [Copyright &y& Elsevier]

Background. Grocery stores and community settings are important and promising venues for environmental, policy, and pricing initiatives to increase fruit and vegetable intake. This article examines supermarket-based and community environmental, policy, and pricing strategies for increasing intake of fruits and vegetables and identifies promising strategies, research needs, and innovative opportunities for the future.Methods. The strategies, examples, and research reported here were identified through an extensive search of published journal articles, reports, and inquiries to leaders in the field. Recommendations were expanded with input from participants in the CDC/ACS-sponsored Fruit and Vegetable, Environment Policy and Pricing Workshop held in September of 2002.Results. Four key types of grocery-store-based interventions include point-of-purchase (POP) information; reduced prices and coupons; increased availability, variety, and convenience; and promotion and advertising. There is strong support for the feasibility of these approaches and modest evidence of their efficacy in influencing eating behavior. Church-based programs, child care center policies, and multisectoral community approaches show promise.Conclusions. Both descriptive and intervention research are needed to develop and evaluate more effective environmental strategies to increase F&V intake in grocery stores and communities. Innovative strategies, partnerships, grass roots action involving economic development for low-income communities, and sustainability are important considerations. [Copyright &y& Elsevier]

Discusses a study which examined the validity and reliability of a modified picture-sort food frequency questionnaire administered to low-income, overweight, African-American adolescent girls. Materials and methods; Results; Discussion; Applications. INSET: Surgical treatment for obesity.

Provides information on a study on the validity and reliability of qualitative dietary fat index questionnaires. Methods; Results; Discussion.

Summary: Background: Executive control and temperament have been associated with pediatric obesity. However, interactions between these constructs in relation to future weight outcomes have not been investigated. Objective: This longitudinal study examined early childhood executive control, early temperament (negative affectivity and surgency), and their interactions as predictors of adolescent BMI trajectories. Methods: At age 5.25, children (N = 229) completed executive control tasks, and parents completed the Child Behavior Questionnaire to assess temperament. BMI was calculated annually between ages 14–17. Results: Greater early negative affectivity predicted more positive BMI growth. Although early childhood executive control was not associated with BMI growth, greater negative affectivity predicted greater BMI escalation at average and below average executive control abilities. Conclusions: For children without robust executive control abilities early in development, negative affectivity may be a risk factor for accelerated adolescent BMI growth. Targeted assessment of early risk factors may be useful for childhood obesity prevention efforts. [ABSTRACT FROM AUTHOR]

Presents a nutrition and physical activity intervention designed for inner-city, overweight African American adolescent females. Goal of enhancing efficacy and outcome expectations for losing weight, eating healthier and decreasing sedentariness; Increase in fruit and vegetable intake; Decrease of fat and fast-food intake.

Background: Food insecurity is common in the United States, especially in Rhode Island, where it affects up to 33% of residents. Food insecurity is associated with adverse health outcomes and disproportionally affects people from minoritized backgrounds. Produce prescription programs, in which healthcare providers write "prescriptions" for free or reduced cost vegetables, have been used to address food insecurity and diet-related chronic disease. Although there is growing evidence for the effectiveness of produce prescription programs in improving food security and diet quality, there have been few efforts to use implementation science methods to improve the adoption of these programs. Methods: This two-phase pilot study will examine determinants and preliminary implementation and effectiveness outcomes for an existing produce prescription program. The existing program is funded by an Accountable Care Organization in Rhode Island and delivered in primary care practices. For the first phase, we conducted a formative evaluation, guided by the Consolidated Framework for Implementation Research 2.0, to assess barriers, facilitators, and existing implementation strategies for the produce prescription program. Responses from the formative evaluation were analyzed using a rapid qualitative analytic approach to yield a summary of existing barriers and facilitators. In the second phase, we presented our formative evaluation findings to a community advisory board consisting of primary care staff, Accountable Care Organization staff, and staff who source and deliver the vegetables. The community advisory board used this information to identify and refine a set of implementation strategies to support the adoption of the program via an implementation blueprint. Guided by the implementation blueprint, we will conduct a single-arm pilot study to assess implementation antecedents (i.e., feasibility, acceptability, appropriateness, implementation climate, implementation readiness), implementation outcomes (i.e., adoption), and preliminary program effectiveness (i.e., food and nutrition security). The first phase is complete, and the second phase is ongoing. Discussion: This study will advance the existing literature on produce prescription programs by formally assessing implementation determinants and developing a tailored set of implementation strategies to address identified barriers. Results from this study will inform a future fully powered hybrid type 3 study that will use the tailored implementation strategies and assess implementation and effectiveness outcomes for a produce prescription program. Trial registration: Clinical trials: NCT05941403, Registered June 9, 2023. [ABSTRACT FROM AUTHOR]

There is a critical need for research examining how neural vulnerabilities associated with obesity, including lower executive control, interact with family factors to impact weight trajectories across adolescence. Utilizing a longitudinal design, the present study investigated caregivers' emotion socialization practices as a moderator of the association between preschool executive control and adolescent body mass index (BMI) trajectories. Participants were 229 youth (Mage = 5.24, SD = 0.03; 47.2% assigned female at birth; 73.8% White, 3.9% Black, 0.4% Asian American, 21.8% multiracial; 12.7% Hispanic) enrolled in a longitudinal study. At preschool-age, participants completed performance-based executive control tasks, and their caregivers reported on their typical emotion-related socialization behaviors (i.e., supportive and nonsupportive responses to children's negative emotions). Participants returned for annual laboratory visits at ages 14 through 17, during which their height and weight were measured to calculate BMI. Although neither preschool executive control nor caregiver emotion-related socialization behaviors were directly associated with BMI growth in adolescence, supportive responses moderated the association between executive control and BMI trajectories. The expected negative association between lower preschool executive control and greater BMI growth was present at below average levels of supportive responses, suggesting that external regulation afforded by supportive responses might reduce risk for adolescent overweight and obesity among children with lower internal self-regulatory resources during preschool. Findings highlight the importance of efforts to bolster executive control early in development and targeted interventions to promote effective caregiver emotion socialization (i.e., more supportive responses) for youth with lower internal self-regulatory abilities to mitigate risk for overweight and obesity and promote health across childhood and adolescence. [ABSTRACT FROM AUTHOR]

Background: Nutrition incentive (NI) programs help low-income households better afford fruits and vegetables (FVs) by providing incentives to spend on FVs (e.g., spend $10 to receive an additional $10 for FVs). NI programs are heterogeneous in programmatic implementation and operate in food retail outlets, including brick-and-mortar and farm-direct sites. Objective: This study aimed to explore NI program implementation factors and the amount of incentives redeemed. Methods: A total of 28 NI projects across the United States including 487 brick-and-mortar and 1078 farm-direct sites reported data between 2020 and 2021. Descriptive statistics and linear regression analyses (outcome: incentives redeemed) were applied. Results: Traditional brick-and-mortar stores had 0.48 times the incentives redeemed compared with small brick-and-mortar stores. At brick-and-mortar sites, automatic discounts had 3.47 times the incentives redeemed compared with physical discounts; and auxiliary services and marketing led to greater redemption. Farm-direct sites using multilingual and direct promotional marketing had greater incentives redeemed. Conclusions: To our knowledge, this is the first national study to focus on NI program implementation across sites nationwide. Factors identified can help inform future programming and research. [ABSTRACT FROM AUTHOR]

The authors comments on the results of a study that looked at the result of short-term food deprivation and the resultant food choices. They argue that the findings may be applied to food-insecure populations as well as to medically or voluntarily fasting populations. They also suggest that the study may encourage further research using a more diverse study population which could have greater implications for the study factors relating to food insecurity and obesity.

The advertising and marketing of energy-dense, nutrient-poor (EDNP) food and drink has been cited as one contributor to unhealthy eating behaviors in adolescents. The present study examines perceptions about and trust in food advertising and their association with consumption of EDNP foods and drinks among adolescents in the United States. Data (n = 1,384) come from the U.S. National Cancer Institute's Family Life, Activity, Sun, Health, and Eating Survey. One way ANOVAs were conducted to assess differences between population subgroups in advertising perceptions. Bivariate and multivariable linear regression models were used to examine the associations between perceptions toward and trust in food advertising and consumption of EDNP foods and drinks, controlling for sociodemographic factors. Results show that there are significant differences between racial/ethnic groups on advertising perceptions (F = 16.32, p = < .0001). As positive perceptions toward food advertising increase among adolescents, there is an associated increase in daily frequency of consumption of EDNP foods and drinks (β = 0.10, p < .01). Similarly, the more adolescents agreed that they trusted food advertising, the higher the reported daily frequency of EDNP food and drink consumption (β = 0.08, p = .01). Targeting perceptions about food advertising may be a worthy intervention strategy to reduce the impact of food marketing and the consumption of heavily advertised EDNP foods and drinks among adolescents. [ABSTRACT FROM AUTHOR]

Background: In recent reviews of available measures, no existing measures assessed all four pillars of food security and most only assessed one or two pillars–predominantly the access pillar. The purpose of this study was to preliminarily develop novel measures of availability, utilization, and stability that are complementary to the USDA's household food security survey measure (HFSSM). Methods: A formative phase included an expert advisory group, literature scans, and interviews with individuals experiencing food insecurity. From April-June 2021, the new measures were piloted in five states (California, Florida, Maryland, North Carolina, and Washington). The cross-sectional pilot survey included the new measures (perceived limited availability, utilization barriers, and food insecurity stability), scales and items for validation (e.g., food security, and self-reported dietary and health outcomes), and demographic questions. Exploratory factor analysis was used to assess dimensionality, internal consistency was assessed using Kuder-Richardson formula 21 (KR21), and convergent and discriminant validity were assessed using Spearman's correlation coefficients. Also, a brief screener version was created for the utilization barriers measure that may be necessary for certain applications (e.g., clinical intake screening to inform referrals to assistance programs). Results: The analytic samples (perceived limited availability (n = 334); utilization barriers (n = 428); food insecurity stability (n = 445)) were around 45 years old on average, most households had children, over two-thirds were food insecure, over three-fourths were women, and the samples were racially/ethnically diverse. All items loaded highly and unambiguously to a factor (factor loadings range 0.525–0.903). Food insecurity stability showed a four-factor structure, utilization barriers showed a two-factor structure, and perceived limited availability showed a two-factor structure. KR21 metrics ranged from 0.72 to 0.84. Higher scores for the new measures were generally associated with increased food insecurity (rhos = 0.248–0.497), except for one of the food insecurity stability scores. Also, several of the measures were associated with statistically significantly worse health and dietary outcomes. Conclusions: The findings support the reliability and construct validity of these new measures within a largely low-income and food insecure sample of households in the United States. Following further testing, such as Confirmatory Factor Analysis in future samples, these measures may be used in various applications to promote a more comprehensive understanding of the food insecurity experience. Such work can help inform novel intervention approaches to address food insecurity more fully. [ABSTRACT FROM AUTHOR]

Background Child temperament styles characterized by increased emotionality or pleasure seeking may increase risk for less healthful eating patterns, while strong executive control (EC) may be protective. The interaction of these characteristics with longitudinal outcomes has not yet been examined. Purpose The aim of this study was to examine the association of preschool temperament and EC, as well as their interaction with adolescent eating. Methods Preschoolers (N = 313) were recruited into a longitudinal study, with behavioral measurement of EC at age 5.25 years, temperament assessed multiple times across preschool, and eating outcomes assessed in adolescence (mean age = 15.34 years). Results Separate latent moderated structural equation models demonstrated that weaker EC was associated with eating less healthful foods, including high sugar foods, sugar-sweetened beverages (SSBs), and convenience foods (p <.05). In the moderation models, negative affectivity temperament was correlated with eating less healthful foods, high sugar foods, and SSBs (p <.05). Children lower in surgency/extraversion temperament were more likely to drink SSBs. There was an interaction between temperament and EC, such that children high in negative affectivity with weaker EC were particularly more likely to consume less healthful foods, high sugar foods, and SSBs (p <.05). There was no interaction of surgency with EC and food consumption. Conclusions Child characteristics measured early in development were associated with later adolescent eating behaviors. Adequate EC could be necessary to counteract the drive toward eating associated with temperaments high in negative affectivity. [ABSTRACT FROM AUTHOR]

We examined nine features in grocery stores shoppers reported motivated them to purchase more healthful foods in the past month. Features were compiled from common supermarket practices for each of the 4 Ps of marketing: pricing, placement, promotion, and product. We examined percentages of the features overall and by shopping frequency using Chi square tests from a 2014 cross sectional web-based health attitudes and behaviors survey, ConsumerStyles. The survey was fielded from June to July in 2014. Participants were part of a market research consumer panel that were randomly recruited by probability-based sampling using address-based sampling methods to achieve a sample representative of the U.S. population. Data from 4242 adults ages 18 and older were analyzed. About 44 % of respondents indicated at least one feature motivated them to purchase more healthful foods. Top choices included in-store coupons or specials (20.1 %), availability of convenient, ready-to-eat more healthful foods (18.8 %), product labels or advertising on packages (15.2 %), and labels or signs on shelves that highlighted more healthful options (14.6 %). Frequent shoppers reported being motivated to purchase more healthful foods by in-store tastings/recipe demonstrations and coupons/specials more often than infrequent shoppers. Enhancing the visibility and appeal of more healthful food items in grocery stores may help improve dietary choices in some populations but additional research is needed to identify the most effective strategies for interventions. [ABSTRACT FROM AUTHOR]

Objective Scant evidence exists pertaining to objectively measured sedentary time and dietary quality among adults. Therefore, we examined the relationships between sedentary time, physical activity, and dietary quality. Methods Cross-sectional analyses of a 4,910 US adults from two cycles (2003–2006) of the National Health and Nutrition Examination Survey. The primary independent variables were sedentary time and physical activity (continuous and categorical), while the outcomes were overall dietary quality (Healthy Eating Index (HEI) 2010), fruit and vegetable scores, and empty caloric intake (kcal). Results Multivariable analyses revealed that a 1 min increase in daily sedentary behavior was associated with a 0.2 kcal decrease in empty calories (− 0.18, 95% CI = − 0.34, − 0.03); however, sedentary time was not significantly related to overall dietary quality (HEI) and fruit and vegetable intake. In comparison, a 1 min increase in daily moderate-to-vigorous intensity physical activity was related to a 0.1 higher HEI score (0.08, 95% CI = 0.04, 0.11), a 0.01 higher fruit score (0.01, 95% CI = 0.01, 0.02), and conversely a 1.3 kcal decrease in empty calories (− 1.35, 95% CI = − 2.01, − 0.69). In addition, meeting physical activity guidelines was associated with a 2.8 point higher HEI score (2.82, 95% CI = 1.40, 4.25), a 0.5 point higher fruit score (0.51, 95% CI = 0.31–0.71), and 37.4 fewer empty calories (− 37.43, 95% CI = − 64.86, − 9.10). Conclusions Physical activity is significantly related to better overall dietary quality, while sedentary behavior is not. Findings suggest the need to promote physical activity and encourage adherence to dietary guidelines jointly, whereas sedentary behavior and overall dietary quality might need to be targeted independently. [ABSTRACT FROM AUTHOR]

Nutritionally inadequate dietary intake is a leading contributor to chronic cardiometabolic diseases. Differences in dietary quality contribute to socioeconomic and racial and ethnic health disparities. Food insecurity, a household-level social or economic condition of limited access to sufficient food, is a common cause of inadequate dietary intake. Although US food assistance policies and programs are designed to improve food security, there is growing consensus that they should have a broader focus on nutrition security. In this policy statement, we define nutrition security as an individual or household condition of having equitable and stable availability, access, affordability, and utilization of foods and beverages that promote well-being and prevent and treat disease. Despite existing policies and programs, significant gaps remain for achieving equity in nutrition security across the life span. We provide recommendations for expanding and improving current food assistance policies and programs to achieve nutrition security. These recommendations are guided by several overarching principles: emphasizing nutritional quality, improving reach, ensuring optimal utilization, improving coordination across programs, ensuring stability of access to programs across the life course, and ensuring equity and dignity for access and utilization. We suggest a critical next step will be to develop and implement national measures of nutrition security that can be added to the current US food security measures. Achieving equity in nutrition security will require coordinated and sustained efforts at the federal, state, and local levels. Future advocacy, innovation, and research will be needed to expand existing food assistance policies and programs and to develop and implement new policies and programs that will improve cardiovascular health and reduce disparities in chronic disease. [ABSTRACT FROM AUTHOR]

There are socioeconomic and racial/ethnic health disparities that warrant policy change to advance health equity. The purpose of this qualitative study was to elucidate primary activities and/or tangible characteristics that indicate that a policy advocacy campaign has an embedded health equity focus. Researchers interviewed policy advocacy experts (n = 13) and campaign leaders (n = 9), transcribed audio recordings of interviews, and conducted a thematic analysis to examine health-equity-related processes within policy campaigns. Based on experiences of policy advocacy experts and campaign leaders, mostly within the Voices for Healthy Kids initiative, several objective aspects and activities were identified that indicate that a policy campaign, and the coalition that conducts the campaign, has an embedded health equity focus. It should be stressed that these activities are not intended to represent the extent of all campaign activities, only the subset of activities and aspects of a campaign that indicate a health equity orientation. Broadly, aspects identified were related to what had the campaign done to engage with the community, who in the community was providing input about direction of the campaign, and how had that community input been used. Authentic Community engagement was seen as the foundation of a campaign's health equity focus. A model synthesizing these findings is included in the results. A major strength of this study is that factors associated with health equity in campaign functioning are not typically assessed. These findings support identification of associated constructs to inform measurement development, and can help guide organizations, campaigns, and researchers working to advance health equity. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine the association of timing of introduction and frequency of fruit and vegetable intake during infancy with frequency of fruit and vegetable intake at age 6 years in a cohort of US children. METHODS: We analyzed data on fruit and vegetable intake during late infancy, age of fruit and vegetable introduction, and frequency of fruit and vegetable intake at 6 years from the Infant Feeding Practices Study II and the Year 6 Follow-Up (Y6FU) Study. We determined the percent of 6-year-old children consuming fruits and vegetables less than once per day and examined associations with infant fruit and vegetable intake using logistic regression modeling, controlling for multiple covariates (n = 1078). RESULTS: Based on maternal report, 31.9% of 6-year-old children consumed fruit less than once daily and 19.0% consumed vegetables less than once daily. In adjusted analyses, children who consumed fruits and vegetables less than once daily during late infancy had increased odds of eating fruits and vegetables less than once daily at age 6 years (fruit, adjusted odds ratio: 2.48; vegetables, adjusted odds ratio: 2.40). Age of introduction of fruits and vegetables was not associated with intake at age 6 years. CONCLUSIONS: Our study suggests that infrequent intake of fruits and vegetables during late infancy is associated with infrequent intake of these foods at 6 years of age. These findings highlight the importance of infant feeding guidance that encourages intake of fruits and vegetables and the need to examine barriers to fruit and vegetable intake during infancy. [ABSTRACT FROM AUTHOR]

The recent revisions of the National School Lunch Program (NSLP) requirements are designed to align with the 2010 Dietary Guidelines for Americans. The introduction and implementation of the new NSLP has been received with positive and negative reactions from school food professionals, students, parents, and teachers. To promote student health, this is an important time for policy makers, practitioners, and researchers to implement and evaluate strategies to support the new NSLP guidelines. The purpose of this viewpoint was to outline the new NSLP guidelines and discuss challenges and opportunities for implementation, strategies for practice, and future research questions. [ABSTRACT FROM AUTHOR]

Background The coronavirus 2019 (COVID-19) pandemic has complicated rigorous evaluation of public health nutrition programs. The USDA Gus Schumacher Nutrition Incentive Program (USDA GusNIP) funds nutrition incentive programs to improve fruit and vegetable purchasing and intake by incentivizing Supplemental Nutrition Assistance Program (SNAP) participants at the point of sale. GusNIP grantees are required to collect survey data (e.g. fruit and vegetable intake and food insecurity status) on a subset of participants. However, due to COVID-19, most GusNIP grantees faced formidable barriers to data collection. The Hunger Task Force Mobile Market (HTFMM), a Wisconsin-based 2019 GusNIP grantee, used particularly innovative methods to successfully collect these data (n > 500 surveys). Objectives The aim was to explore HTFMM's successful participant-level data-collection evaluation during COVID-19. Methods A single case study methodological approach framed this study. The case is the HTFMM in Milwaukee, WI, USA. Participants included HTFMM leadership (n  = 3), evaluators (n  = 2), staff (n  = 3), volunteers (n  = 3), and customers (n  = 10). These teleconference interviews were recorded and transcribed verbatim. Transcripts were coded using thematic qualitative analysis methods with 2 independent coders. Results Four salient themes emerged: 1) there were multiple key players with unique roles and responsibilities who contributed to personalized, proactive, and time-intensive, telephone-based proctored survey collection methods; 2) the importance of resources dedicated to comprehensive evaluation; 3) longstanding relationships rooted in trust and community-based service are key to successful program delivery, engagement, and evaluation; and 4) the COVID-19 data-collection protocol also serves to mitigate nonpandemic challenges to in-person survey collection. Conclusions These findings provide guidance on how alternative methods for data collection during COVID-19 can be used and applied to other situations that may affect the ability to collect participant-level data. These findings contribute to a growing body of literature as to best practices and approaches to collecting participant-level data to evaluate public health nutrition programs. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To compare total fruit and vegetable intake in cup equivalents and its individual components among Hispanic subgroups in California. Methods: Data are from the adult portion of the 2005 California Health Interview Survey. Hispanic/Latino subjects (n=7,954) were grouped into six subcategories (Mexican, Central American, Caribbean, Spanish American, South American, and >1 group). Total fruit and vegetable intake in cup equivalents was estimated from frequency responses about seven food categories. Both t test and χ2 test were used to assess differences in sociodemographic characteristics across Hispanic subgroups. Multivariate linear regressions using SUDAAN software (Survey Data Analysis, version 9.0.1, 2005, Research Triangle Institute, Research Triangle Park, NC) were conducted to obtain means of total fruit and vegetable intake in cup equivalents and its components by Hispanic subgroups controlling for confounders. Results: Hispanic subgroups did not differ in their intake of total fruit and vegetable intake in cup equivalents (mean 3.4 c and 2.9 c for men and women, respectively). Small but significant differences (P<0.01) were found across Hispanic subgroups in individual fruit and vegetable components (green salad [women only], cooked dried beans and nonfried white potatoes) after adjusting for potential sociodemographic and acculturation confounders. Conclusions: Fruit and vegetable intake by Hispanic respondents did not meet the national recommendation, although their reported intake is higher compared to other race/ethnicity groups. The public health message remains the same: Increase fruit and vegetable intake. Examination of intake for subgroups of Hispanics may enhance the utility of dietary information for surveillance, program and message design, and intervention and evaluation. [Copyright &y& Elsevier]

The National Institutes of Health Division of Nutrition Research Coordination, the National Cancer Institute, the National Health Lung and Blood Institute, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institute of Diabetes, Digestive and Kidney Diseases convened a scientific workshop entitled "Decision Making in Eating Behavior: Integrating Perspectives from the Individual, Family, and Environment” in April 2008 The purpose of this paper is to provide a synthesis of the workshop. The common themes that ran throughout the conference were as follows: (1) Initiating behavior differs conceptually from sustaining behaviors; (2) The intersection of biology, genetics, and environment (physical, political, economic, and social) is where eating behavior occurs; (3) Marketing and advertising influence eating behavior influence; and (4) sometimes, seemingly unrelated policies influence eating behavior. Additional research is needed. [ABSTRACT FROM AUTHOR]

Objectives. We examined the relationship between acculturation and sun safety among US Latinos. Methods. We used linear regression models to analyze data from 496 Latino respondents to the 2005 Health Information National Trends Survey. Using sunscreen, seeking shade, and wearing protective clothing were the primary outcomes and were assessed by frequency scales. Acculturation was assessed with a composite index. Results. In bivariate models, acculturation was negatively associated with use of shade and protective clothing and positively associated with sunscreen use (all, P<.004). In adjusted models, acculturation was negatively associated with seeking shade and wearing protective clothing across gender and region of residence (all, P<.05). Conclusions. Our results demonstrated both adverse and beneficial effects of acculturation on Latinos' risk behaviors relating to skin cancer. Education about sun safety is needed for all Latinos and should be tailored to different levels of acculturation. Initiatives for Latinos who are not yet acculturated could focus on reinforcing existing sun-safe behaviors and presenting new ones, such as use of sunscreen; initiatives for highly acculturated Latinos might require more resources because the objective is behavior modification. (Am J Public Health. 2009;99:734-741. doi:10.2105/AJPH.2007.122796) [ABSTRACT FROM AUTHOR]

Background: There are few effective sun-safety education programs for use in secondary schools. Project aims were to create a sun-safety curriculum for grades 6 to 8, and to test whether exposure to the curriculum would increase children's sun-protection behavior.Design: A pair-matched, group-randomized, pre--post test, controlled trial was performed with middle schools as the unit of randomization. Teachers implemented the six-unit sun-safety curriculum in 2001-2003, and analyses were performed in 2003-2004.Setting/participants: A total of 2038 children from 30 middle schools in Colorado, New Mexico, and Arizona.Main Outcome Measures: Self-reported sun-protection behavior using frequency ratings and diary.Results: Compared to control schools, children receiving the curriculum reported more frequent sun protection (p=0.0035), and a greater proportion wore long-sleeved shirts during recess (p<0.0001) and applied sunscreen (p<0.0001). Exposure to the curriculum improved knowledge (p<0.0001), decreased perceived barriers to using sunscreen (p=0.0046), enhanced self-efficacy expectations (p=0.0577) about sun safety, and reduced favorable attitudes toward sun tanning (p=0.0026 to <0.0001). In intent-to-treat analyses, the treatment effect was eliminated only under the most conservative assumptions about dropouts.Conclusions: Educational approaches to sun safety in middle school may be effective for improving children's sun safety. Potential trial limitations include measuring short-term outcomes, focusing on young adolescents, using active parental consent, and testing in the American Southwest. [ABSTRACT FROM AUTHOR]

Americans’ consumption of fruits and vegetables has increased slightly over the last 10 years, but most people still do not meet the Dietary Guidelines recommendation to consume 5 to 9 servings per day. New and innovative strategies are needed if we are to significantly increase the mean population intake of fruits and vegetables. To help formulate such strategies as well as to evaluate evidence and identify research gaps, the American Cancer Society and the Centers for Disease Control and Prevention convened the Fruit and Vegetable Environment, Policy, and Pricing Workshop, which brought together experts in how environmental change, policy, and pricing affect fruit and vegetable consumption. The papers in this supplement consist of a review of environmental interventions to improve nutrition and papers covering pricing and consumer value and how fruit and vegetable consumption can be promoted at worksites, restaurants, grocery stores and other community settings, and schools. Conclusions from the workshop were that existing intervention strategies need to be evaluated, promising example programs need to be disseminated, and new innovative interventions and programs need to be created and evaluated. [Copyright &y& Elsevier]

Context: Despite gains in the tobacco control movement, tobacco products remain a threat, with specific populations at greater risk. Objective: The purpose of this paper is to examine the role that leaders in the tobacco control movement have played in progress achieved to date and identify recommendations for the future using a health equity framework. Design: Qualitative key informant interviews were conducted with representatives from four key tobacco control organizations and their partners. Setting: Interviews were conducted on-site at tobacco control organization offices or by telephone. Participants: Key informant interviews (N=87) were conducted in the July-December of 2017. Main outcome measures: Interviewees describe their work in providing technical assistance to leading public health and policy efforts in tobacco control. Interviews were transcribed verbatim and coded for meaning units. This analysis was conducted November 2017-January 2018. This study was determined exempt from review by the University of Nebraska Medical Center Institutional Review Board. Results: Three overarching themes emerged from our analysis: (1) maintaining tobacco control as a public health issue, (2) the importance of health equity in tobacco control work, and (3) planning for the next generation of tobacco control advocates. Certain populations remain untouched by broad public health approaches to reduce tobacco use. Conclusions: Tailored, focused, and comprehensive approaches to across specific communities are needed. Adopting a health equity lens across public health priority areas (e.g., obesity, opioids, and tobacco control) could reduce prevalence among vulnerable groups for multiple conditions. [ABSTRACT FROM AUTHOR]

Food is Medicine (FIM) programs to improve the accessibility of fruits and vegetables (FVs) or other healthy foods among patients with low income and diet-related chronic diseases are promising to improve food and nutrition security in the United States (US). However, FIM programs are relatively new and implementation guidance for healthcare settings using an implementation science lens is lacking. We used a narrative review to describe the evidence base on barriers and facilitators to FIM program integration in US healthcare settings following the Exploration, Preparation, Implementation, and Sustainment (EPIS) Framework. Evidence surrounding the EPIS Inner Context was a focus, including constructs Leadership, Organizational Characteristics, Quality and Fidelity Monitoring and Support, Organizational Staffing Processes, and Individual Characteristics. Peer-reviewed and grey literature about barriers and facilitators to FIM programs were of interest, defined as programs that screen and refer eligible patients with diet-related chronic disease experiencing food insecurity to healthy, unprepared foods. Thirty-one sources were included in the narrative review, including 22 peer-reviewed articles, four reports, four toolkits, and one thesis. Twenty-eight sources (90%) described EPIS Inner Context facilitators and 26 sources (84%) described FIM program barriers. The most common barriers and facilitators to FIM programs were regarding Quality and Fidelity Monitoring and Support (e.g., use of electronic medical records for tracking and evaluation, strategies to support implementation) and Organizational Staffing Processes (e.g., clear delineation of staff roles and capacity); although, barriers and facilitators to FIM programs were identified among all EPIS Inner Context constructs. We synthesized barriers and facilitators to create an EPIS-informed implementation checklist for healthcare settings for use among healthcare organizations/providers, partner organizations, and technical assistance personnel. We discuss future directions to align FIM efforts with implementation science terminology and theories, models, and frameworks to improve the implementation evidence base and support FIM researchers and practitioners. [ABSTRACT FROM AUTHOR]

Purpose: During a pandemic, persons might experience worry because of threats (real or perceived), or as part of stress-related reactions. We aimed to provide insight into Americans' worry about food during COVID-19. Design, Subjects, Measures: Online survey data from June 2020 (n = 4,053 U.S. adults; 62.7% response rate) was used to assess 2 outcomes: worry about food availability (FA); food safety (FS). Adults with missing information about FA and FS were excluded from analysis (final n = 3,652). Analysis: We used descriptive statistics and multivariable logistic regression to examine characteristics associated with the outcomes and estimate adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) for associations between sociodemographic variables and outcomes. Results: 58.3% of respondents reported worry about FA; 57.5% about FS, with higher odds of worry for FA and FS (versus referents) in lower income households (FA: aOR = 1.76 95%CI [1.30, 2.39]; FS: 1.84[1.35, 2.51]); unemployed (1.54[1.05, 2.28]; 1.90[1.26,2.81]); non-Hispanic Black (1.55[1.14,2.12]); 2.25[1.65,3.07]); Hispanic (1.39[1.06,1.82]; 1.94[1.46,2.56]). Conclusion: Findings highlight the importance of strategies to reduce consumer worry about FA and FS and negative food behaviors, and the need for continued access to hunger safety net programs, which could have positive effects on nutrition security. [ABSTRACT FROM AUTHOR]

The USDA Supplemental Nutrition Assistance Program (SNAP) provides food and financial assistance to food-insecure individuals and families. In the midst of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, SNAP benefits evolved. Policy changes and federal legislation expanded SNAP eligibility, raised benefit levels, and introduced program waivers that enabled online ordering to reduce participants' exposure to community-acquired SARS-CoV-2. Although rapid expansion of SNAP benefits in the online space represents significant progress for federal food assistance, changes also introduced unforeseen partiality in how benefits and services were accessed and utilized, as illustrated by 2 populations and regions in the early months of the SARS-CoV-2 pandemic: low-income older adults in rural Alabama and low-income Hispanic adults in urban California. Opportunities exist to build on the recent progress in SNAP, while also ensuring continued inclusiveness of eligible persons. Efforts should be informed by evidence that supports equitable access to federal food assistance. [ABSTRACT FROM AUTHOR]

Diet-related chronic disease remains a public health concern, and low intake of fruits and vegetables disproportionately affects low-income populations. Healthy food incentive (HFI) projects can help close the nutrition gap among low-income populations by increasing purchasing power and access to fruits and vegetables. This study aimed to qualitatively explore lessons learned and best practices from Food Insecurity Nutrition Incentive Grant Program (FINI) grantees across the United States. Thirty semistructured interviews were conducted with FINI grantees and stakeholders in 2018, eliciting best practices and promising findings, policy implications, and knowledge gaps and opportunities to pursue that inform program refinement and sustainability. Telephone and in-person interviews were conducted with FINI grant recipients from 2015 to 2016, specifically, recipients of FINI-funded multiyear community-based projects and large-scale projects. Our results highlighted (1) range of projects and scope, (2) program promotion and awareness, (3) community-based partnerships, (4) technical assistance and peer interactions, (5) measurement and evaluation, (6) program challenges, and (7) future directions and recommendations. Grantees reported a "trifecta of benefits" that affects low-income consumers, farmers, and food retailers. Our findings contribute to understanding how to implement HFI programs in a variety of settings and highlight the variations that can exist between programs, as well as the need for increased technical assistance and synergy between programs (communities of practice). Overall, these findings can help to inform implementation and practice of healthy food incentive programs and the Farm Bill and other policy discussions. [ABSTRACT FROM AUTHOR]

Purpose: To examine associations of adolescent sugar-sweetened beverage (SSB) intake with parent SSB intake and parent and adolescent attitudes about limiting SSB and junk food (SSB/JF) intake.Design: Quantitative, cross-sectional study.Setting: The 2014 Family Life, Activity, Sun, Health, and Eating study.Sample: Parent-adolescent dyads (N = 1555).Measures: The outcome was adolescent SSB intake. Exposure variables were parent SSB intake, sociodemographics, and parent and adolescent attitudes about SSB/JF intake (responses: agree, neither, or disagree).Analysis: Multinomial logistic regressions estimated adjusted odds ratios (aOR) and 95% confidence intervals (CIs).Results: Half (49.5%) of adolescents and 33.7% of parents consumed SSB ≥1 time/day. Parent daily SSB intake was associated with adolescent daily SSB intake (aOR = 8.9; CI = 4.6-17.3) [referent: no consumption]. Adolescents who disagreed on having confidence to limit SSB/JF intake had higher odds of daily SSB intake (aOR = 3.5; CI = 1.8-6.8), as did those who disagreed they felt bad about themselves if they did not limit SSB/JF intake (aOR = 1.9; CI=1.1-3.3), compared to adolescents who agreed with these attitudes. No parental attitudes were significant.Conclusion: Higher odds of daily SSB intake among adolescents was associated with parent SSB intake and adolescent attitudes about confidence in, and feeling bad about, limiting SSB/JF intake. Parent attitudes were not associated with daily adolescent SSB intake. Efforts to reduce adolescent SSB intake could consider strategies geared toward improving adolescent attitudes and dietary behaviors and parental SSB intake. [ABSTRACT FROM AUTHOR]

Objective: To describe low-income parents' and caregivers' perceptions of the Cooking Matters Mobile Application (CM App) meal planning and preparation features.Design: Explanatory mixed-methods design where data were gathered via online surveys based on the Theory of Planned Behaviour and the Theory of Reasoned Action, followed by telephone interviews.Setting: CM App, a mobile phone-based resource geared towards low-income parents and caregivers of young children (pregnancy/infant to age 5 years) for meal planning and preparation, with features based on skills taught in the Cooking Matters course: recipes, shopping list and meal planning.Participants: Low-income parents and caregivers (survey participants, n 461; interview participants, n 20) who had downloaded the CM App to their smartphone and agreed to participate in the current evaluation.Results: Attitudes and self-efficacy related to CM App's subject matter and functions (meal planning; recipe use; creating and using a shopping list) were measured via surveys and interviews. Mean (sd) responses were positive towards 'meal planning' and 'shopping and cooking' (4·17 (0·63) and 3·49 (0·86) on a 5-point Likert scale, respectively). Interviewees described meal planning and preparation behaviours as intrinsic, based on habit, and influenced by family preference and food costs. Early adopters of the CM App may already be engaged in and/or are motivated to engage in the targeted health behaviours.Conclusions: Users may benefit most from incorporating into their routines new ways to prepare easy, cost-efficient, healthy meals at home that their families will enjoy. [ABSTRACT FROM AUTHOR]