Using the Power of Culinary Nutrition, Health Literacy, and Partnerships to Prevent and Reverse Chronic Disease in Low-income Communities

2016 ◽  
Vol 116 (9) ◽  
pp. A66 ◽  
Author(s):  
M. Majchrzak ◽  
K. Shannon ◽  
A. Pleasant ◽  
J. Cabe ◽  
E. Rella ◽  
...  
2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
DeAnna Nara ◽  
Linda Thompson ◽  
Allan Johnson ◽  
Oyonumo Ntekim ◽  
Chimene Castor ◽  
...  

Abstract Objectives The aims of this study were to develop and implement a “Food as Medicine” intervention using quantitative methods supported by health literacy and food choice and behavioral models to target chronic diseases under free-living conditions in adults diagnosed with chronic diseases. The hypothesis of this study is that “Food as Medicine” nutrition and lifestyle intervention sessions will result in significant improvements in food choices, as well as shopping and cooking behaviors. Methods The Food as Medicine (FAM) study is a community-based pilot study that measured the effectiveness of a nutrition intervention to improve chronic disease risk factors and outcomes among African Americans with either pre-diabetes, type 2 diabetes mellitus, hypertension, elevated total blood cholesterol levels, obesity or a combination of these disorders. The study enrolled patients who were attending both Howard University Family Medicine and Internal Medicine Practices, and were residents of wards seven or eight in the District of Columbia. Fifty-four participants were enrolled and assigned to five cohorts, which consisted of five group sessions over three months, and focused on improving diet and health literacy through nutritionist-led, culturally-tailored, nutrition education classes that included health literacy, mindfulness exercises, and cooking demonstrations. Results After program completion, FAM participants demonstrated significant improvements in all outcome measures of interest: healthy dietary patterns (P < .001), healthful eating (P = .002), positive changes in dietary choices (P < .001), cooking confidence (P < .001), reduction of cooking barriers (P < .001), and healthy food preparation (P < .001). Participants also increased the number of times in one week that they cooked dinner at home (P < .001). Conclusions This study demonstrated the positive impacts of including health literacy, mindfulness exercises, and cooking demonstrations in a nutrition education program. The outcomes of this study can be used to inform and improve future community intervention studies within the areas of chronic disease in low income and minority populations. Funding Sources Funding for this study was received from the Ardmore Institute of Health.


Author(s):  
Alyshia Gálvez

In the two decades since the North American Free Trade Agreement (NAFTA) went into effect, Mexico has seen an epidemic of diet-related illness. While globalization has been associated with an increase in chronic disease around the world, in Mexico, the speed and scope of the rise has been called a public health emergency. The shift in Mexican foodways is happening at a moment when the country’s ancestral cuisine is now more popular and appreciated around the world than ever. What does it mean for their health and well-being when many Mexicans eat fewer tortillas and more instant noodles, while global elites demand tacos made with handmade corn tortillas? This book examines the transformation of the Mexican food system since NAFTA and how it has made it harder for people to eat as they once did. The book contextualizes NAFTA within Mexico’s approach to economic development since the Revolution, noticing the role envisioned for rural and low-income people in the path to modernization. Examination of anti-poverty and public health policies in Mexico reveal how it has become easier for people to consume processed foods and beverages, even when to do so can be harmful to health. The book critiques Mexico’s strategy for addressing the public health crisis generated by rising rates of chronic disease for blaming the dietary habits of those whose lives have been upended by the economic and political shifts of NAFTA.


2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Sunday Joseph Ayamolowo ◽  
Lydia Feyisayo Akinrinde ◽  
Monisola Omoyeni Oginni ◽  
Love Bukola Ayamolowo

The global incidence of cancer is rising, and low-income and lower-middle-income countries have the worst figures. However, knowledge of cervical cancer prevention and cervical cancer screening practices remains poor in these regions. This study assessed the concept of health literacy as a potential determinant of knowledge of cervical cancer prevention and screening practices among female undergraduates. A descriptive cross-sectional study was conducted among 385 female undergraduates at a university in southwest Nigeria. A validated questionnaire composed of subscales on nine components of health literacy, knowledge of cervical cancer prevention, and cervical cancer screening practices was used for data collection. The majority of the respondents obtained a high score on most of the components of health literacy and 66% had good knowledge of cervical cancer prevention. Only 11% demonstrated good practices of Pap smear testing. Of all the components of health literacy, “feeling understood and supported by healthcare providers” (OR = 0.075; 95% CI [0.036–0.115]; p = 0.015) and “understanding health information well enough to know what to do” (OR = 0.055; 95% CI [0.006–0.104]; p = 0.029) were significantly associated with knowledge of cervical cancer prevention. Out of the major challenges related to cervical cancer screening among undergraduates, the feeling of being at risk (OR = 4.71; p < 0.05) and uncomfortable experiences from past screening (OR = 0.12; p < 0.05) were significantly associated with going for cervical cancer screening. The study concluded that levels of health literacy influenced knowledge of cervical cancer prevention among female undergraduates, but it did not affect their engagement in cervical cancer screening practices.


2021 ◽  
Vol 11 ◽  
pp. 263355652110281
Author(s):  
John S. Moin ◽  
Richard H. Glazier ◽  
Kerry Kuluski ◽  
Alex Kiss ◽  
Ross E.G. Upshur

Background: Multimorbidity, often defined as having two or more chronic conditions is a global phenomenon. This study examined the association between key determinants identified by the chronic disease indicator framework and multimorbidity by rural and urban settings. The prevalence of individual diseases was also investigated by age and sex. Methods: The Canada Community Health Survey and linked health administrative databases were used to examine the association between multimorbidity, sociodemographic, behavioral, and other risk factors in the province of Ontario. A multivariable logistic regression model was used to conduct the main analysis. Results: Analyses were stratified by age (20–64 and 65–95) and area of residence (rural and urban). A total sample of n = 174,938 residents between the ages of 20–95 were examined in the Ontario province, of which 18.2% (n = 31,896) were multimorbid with 2 chronic conditions, and 23.4% (n = 40,883) with 3+ chronic conditions. Females had a higher prevalence of 2 conditions (17.9% versus 14.6%) and 3+ conditions (19.7% vs. 15.6%) relative to males. Out of all examined variables, poor self-perception of health, age, Body Mass Index, and income were most significantly associated with multimorbidity. Smoking was a significant risk factor in urban settings but not rural, while drinking was significant in rural and not urban settings. Income inequality was associated with multimorbidity with greater magnitude in rural areas. Prevalence of multimorbidity and having three or more chronic conditions were highest among low-income populations. Conclusion: Interventions targeting population weight, age/sex specific disease burdens, and additional focus on stable income are encouraged.


2015 ◽  
Vol 23 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Lyndsay A Nelson ◽  
Shelagh A Mulvaney ◽  
Tebeb Gebretsadik ◽  
Yun-Xian Ho ◽  
Kevin B Johnson ◽  
...  

Abstract Objective Mobile health (mHealth) interventions may improve diabetes outcomes, but require engagement. Little is known about what factors impede engagement, so the authors examined the relationship between patient factors and engagement in an mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes (T2DM). Materials and Methods Eighty patients with T2DM participated in a 3-month mHealth intervention called MEssaging for Diabetes that leveraged a mobile communications platform. Participants received daily text messages addressing and assessing medication adherence, and weekly interactive automated calls with adherence feedback and questions for problem solving. Longitudinal repeated measures analyses assessed the relationship between participants’ baseline characteristics and the probability of engaging with texts and calls. Results On average, participants responded to 84.0% of texts and participated in 57.1% of calls. Compared to Whites, non-Whites had a 63% decreased relative odds (adjusted odds ratio [AOR] = 0.37, 95% confidence interval [CI], 0.19-0.73) of participating in calls. In addition, lower health literacy was associated with a decreased odds of participating in calls (AOR = 0.67, 95% CI, 0.46-0.99, P = .04), whereas older age ( Pnonlinear = .01) and more depressive symptoms (AOR = 0.62, 95% CI, 0.38-1.02, P = .059) trended toward a decreased odds of responding to texts. Conclusions Racial/ethnic minorities, older adults, and persons with lower health literacy or more depressive symptoms appeared to be the least engaged in a mHealth intervention. To facilitate equitable intervention impact, future research should identify and address factors interfering with mHealth engagement.


Author(s):  
Azike, Chidimma Anthonia ◽  
Jeremiah Owubokiri Ngowari ◽  
Orudukobipi Tamunonengiye-Ofori

The pandemic of COVID-19 infection has had an untold adverse impact on patients living with chronic disease, across various ethnicity/race, age and gender. Underlying hypertension, cardiovascular disease, diabetes and respiratory illness are key risk factors for the development of severe COVID-19 pneumonia and systematic inflammation. Patients who are immunosuppressed by virtue of their chronic disease, age or a therapy have been identified as susceptible groups. The redirection of healthcare services towards the increasing numbers of COVID-19 patients has compromised the healthcare delivery to patients with chronic illness. Movement restriction measures as approach to curb the spread of the infection have also compromised the metabolic health of many patients who need enhanced physical activity to improve their health. Media publications on COVID-19 infection and restrictions may have also contributed to the poor mental health of some individuals, especially patients with underlying mental conditions or its risk factors. The inadequate or availability of quality health care system across low income and developing regions especially, those with older age groups, has further accelerated the spread and death rate from COVID-19. Future research should be directed towards protecting vulnerable groups from possible waves of COVID-19 as a measure to reduce the negative impact of the pandemic on these individuals.


2018 ◽  
Vol 102 ◽  
pp. 134-138 ◽  
Author(s):  
Iris van der Heide ◽  
Iraj Poureslami ◽  
Wayne Mitic ◽  
Jessica Shum ◽  
Irving Rootman ◽  
...  

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e019192 ◽  
Author(s):  
Sharon Parker ◽  
Amy Prince ◽  
Louise Thomas ◽  
Hyun Song ◽  
Diana Milosevic ◽  
...  

ObjectivesThe objective of this review was to assess the benefit of using electronic, mobile and telehealth tools for vulnerable patients with chronic disease and explore the mechanisms by which these impact patient self-efficacy and self-management.DesignWe searched MEDLINE, all evidence-based medicine, CINAHL, Embase and PsychINFO covering the period 2009 to 2018 for electronic, mobile or telehealth interventions. Quality was assessed according to rigour and relevance. Those studies providing a richer description (‘thick’) were synthesised using a realist matrix.Setting and participantsStudies of any design conducted in community-based primary care involving adults with one or more diagnosed chronic health condition and vulnerability due to demographic, geographic, economic and/or cultural characteristics.ResultsEighteen trials were identified targeting a range of chronic conditions and vulnerabilities. The data provided limited insight into the mechanisms underpinning these interventions, most of which sought to persuade vulnerable patients into believing they could self-manage their conditions through improved symptom monitoring, education and support and goal setting. Patients were relatively passive in the interaction, and the level of patient response attributed to their intrinsic level of motivation. Health literacy, which may be confounded with motivation, was only measured in one study, and eHealth literacy was not assessed.ConclusionsResearch incorporating these tools with vulnerable groups is not comprehensive. Apart from intrinsic motivation, health literacy may also influence the reaction of vulnerable groups to technology. Social persuasion was the main way interventions sought to achieve better self-management. Efforts to engage patients by healthcare providers were lower than expected. Use of social networks or other eHealth mechanisms to link patients and provide opportunities for vicarious experience could be further explored in relation to vulnerable groups. Future research could also assess health and eHealth literacy and differentiate the specific needs for vulnerable groups when implementing health technologies.


Author(s):  
Davis AL ◽  
◽  
Zare H ◽  
Kanwar O ◽  
McCleary R ◽  
...  

Objective: The authors conducted an integrative literature review of recent studies that explored the impact of interventions implemented in the U.S. that focused on improving access to dental care for low-income and vulnerable populations. Methods: The authors conducted an integrative literature review of studies published between 2012-2018 that addressed six oral health policy spheres. 1) Community-based dental access programs; (2) Medicaid reimbursement and expansion; (3) Student loan support; (4) Oral health services in non-traditional settings and dental residency programs; (5) Programs to improve oral health literacy; and (6) Use of dental therapists. Results: The authors included 39 articles for qualitative synthesis. Numerous public health initiatives and programs exist in the US aimed at increasing access to quality oral health care. Medicaid expansion, increased Medicaid fee-for-service reimbursement rates, and state loan repayment programs have demonstrated some success in improving access among underserved populations. A diversified dental workforce, with community dental health workers and mid-level providers like dental therapists, as well as interprofessional training of nurses and primary-care physicians in oral health have also shown positive impacts in advancing health equity. Further studies are needed to understand how oral health literacy programs can affect access and utilization of dental services. Conclusions: Improvements to the oral health care safety net will require a holistic and multifaceted approach in order to reduce oral health disparities. Policy levers should work, not in isolation, but rather in complementary fashion to one another.


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