Nutrition Interventions Addressing Structural Racism: A Scoping Review

2022 ◽  
pp. 1-53
Author(s):  
Matthew Greene ◽  
Bailey Houghtaling ◽  
Claire Sadeghzadeh ◽  
Molly De Marco ◽  
De’Jerra Bryant ◽  
...  
Keyword(s):  
African Americans ◽  
Nutrition Education ◽  
Healthy Eating ◽  
Scoping Review ◽  
Food Environment ◽  
Environmental Changes ◽  
Structural Barriers ◽  
Nutrition Interventions ◽  
Structural Racism ◽  
Policy Systems

Abstract African Americans experience high rates of obesity and food insecurity in part due to structural racism, or overlapping discriminatory systems and practices in housing, education, employment, health care, and other settings. Nutrition education and nutrition-focused policy, systems, and environmental changes may be able to address structural racism in the food environment. This scoping review aimed to summarize the available literature regarding nutrition interventions for African Americans that address structural racism in the food environment and compare them to the “Getting to Equity in Obesity Prevention” framework of suggested interventions. An electronic literature search was conducted with the assistance of a research librarian encompassing 6 databases—MEDLINE, PyscINFO, Agricola, ERIC, SocINDEX, and ProQuest Dissertations & Theses. A total of 30 sources were identified detailing interventions addressing structural barriers to healthy eating. The majority of nutrition interventions addressing structural racism consisted of policy, systems, and/or environmental changes in combination with nutrition education, strategies focused on proximal causes of racial health disparities. Only two articles each targeted the “reduce deterrents” and “improve social and economic resources” aspects of the framework, interventions which may be better suited to addressing structural racism in the food environment. Because African Americans experience high rates of obesity and food insecurity and encounter structural barriers to healthy eating in the food environment, researchers and public health professionals should address this gap in the literature.

scholarly journals The Influence of Gender and Self-Efficacy on Healthy Eating in a Low-Income Urban Population Affected by Structural Changes to the Food Environment

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Brenda Robles ◽  
Lisa V. Smith ◽  
Mirna Ponce ◽  
Jennifer Piron ◽  
Tony Kuo
Keyword(s):  
At Risk ◽  
Los Angeles ◽  
Healthy Eating ◽  
Low Income ◽  
Food Environment ◽  
Self Efficacy ◽  
Risk Groups ◽  
Health Data ◽  
Local Health ◽  
Nutrition Interventions

Although US obesity prevention efforts have begun to implement a variety of system and environmental change strategies to address the underlying socioecological barriers to healthy eating, factors which can impede or facilitate community acceptance of such interventions are often poorly understood. This is due, in part, to the paucity of subpopulation health data that are available to help guide local planning and decision-making. We contribute to this gap in practice by examining area-specific health data for a population targeted by federally funded nutrition interventions in Los Angeles County. Using data from a local health assessment that collected information on sociodemographics, self-reported health behaviors, and objectively measured height, weight, and blood pressure for a subset of low-income adults (n= 720), we compared health risks and predictors of healthy eating across at-risk groups using multivariable modeling analyses. Our main findings indicate being a woman and having high self-efficacy in reading Nutrition Facts labels were strong predictors of healthy eating (P<0.05). These findings suggest that intervening with women may help increase the reach of these nutrition interventions, and that improving self-efficacy in healthy eating through public education and/or by other means can help prime at-risk groups to accept and take advantage of these food environment changes.

scholarly journals Facilitating Healthier Eating at Restaurants: A Multidisciplinary Scoping Review Comparing Strategies, Barriers, Motivators, and Outcomes by Restaurant Type and Initiator

2021 ◽  
Vol 18 (4) ◽  
pp. 1479
Author(s):  
Melissa Fuster ◽  
Margaret A. Handley ◽  
Tamara Alam ◽  
Lee Ann Fullington ◽  
Brian Elbel ◽  
...  
Keyword(s):  
Public Health ◽  
Community Health ◽  
Food Availability ◽  
Healthy Eating ◽  
Scoping Review ◽  
Food Environment ◽  
Business Models ◽  
Important Food ◽  
Promotion Strategies ◽  
Improve Community Health

Restaurants are understudied yet increasingly important food environment institutions for tackling diet-related diseases. This scoping review analyzes research and gray literature (n = 171 records) to assess which healthy eating promotion strategies have been implemented in restaurants and the associated motivations, barriers, and outcomes, compared by restaurant type (corporate/chain vs. independently owned restaurants) and initiator (restaurant-initiated vs. investigator-initiated). We found that the most commonly reported strategy was the increase of generally healthy offerings and the promotion of such offerings. Changes in food availability were more common among corporate restaurants and initiated by restaurants, while environmental facilitators were more commonly initiated by investigators and associated with independently owned restaurants. Aside from those associated with revenue, motivations and barriers for healthy eating promoting strategies varied by restaurant type. While corporate restaurants were also motivated by public health criticism, independently owned restaurants were motivated by interests to improve community health. Revenue concerns were followed by food sourcing issues in corporate restaurants and lack of interest among independently owned restaurants. Among reporting sources, most outcomes were revenue positive. This study shows the need for practice-based evidence and accounting for restaurant business models to tailor interventions and policies for sustained positive changes in these establishments.

scholarly journals School-Based Nutrition Interventions in Children Aged 6 to 18 Years: An Umbrella Review of Systematic Reviews

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4113
Author(s):  
Kate M. O’Brien ◽  
Courtney Barnes ◽  
Serene Yoong ◽  
Elizabeth Campbell ◽  
Rebecca Wyse ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Nutrition Education ◽  
Systematic Reviews ◽  
Food Environment ◽  
Grey Literature ◽  
World Health Organisation ◽  
World Health ◽  
Umbrella Review ◽  
Nutrition Interventions ◽  
School Based

Schools are identified as a key setting to influence children’s and adolescents’ healthy eating. This umbrella review synthesised evidence from systematic reviews of school-based nutrition interventions designed to improve dietary intake outcomes in children aged 6 to 18 years. We undertook a systematic search of six electronic databases and grey literature to identify relevant reviews of randomized controlled trials. The review findings were categorised for synthesis by intervention type according to the World Health Organisation Health Promoting Schools (HPS) framework domains: nutrition education; food environment; all three HPS framework domains; or other (not aligned to HPS framework domain). Thirteen systematic reviews were included. Overall, the findings suggest that school-based nutrition interventions, including nutrition education, food environment, those based on all three domains of the HPS framework, and eHealth interventions, can have a positive effect on some dietary outcomes, including fruit, fruit and vegetables combined, and fat intake. These results should be interpreted with caution, however, as the quality of the reviews was poor. Though these results support continued public health investment in school-based nutrition interventions to improve child dietary intake, the limitations of this umbrella review also highlight the need for a comprehensive and high quality systematic review of primary studies.

scholarly journals Scoping Review of Intervention Strategies for Improving Coverage and Uptake of Maternal Nutrition Services in Southeast Asia

2021 ◽  
Vol 18 (24) ◽  
pp. 13292
Author(s):  
Kauma Kurian ◽  
Theophilus Lakiang ◽  
Rajesh Kumar Sinha ◽  
Nishtha Kathuria ◽  
Priya Krishnan ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Scoping Review ◽  
Maternal Nutrition ◽  
Health Workers ◽  
Protein Energy Malnutrition ◽  
Conditional Cash Transfer ◽  
Cash Transfer ◽  
Micronutrient Deficiencies ◽  
Nutrition Interventions ◽  
Maternal Undernutrition

Maternal undernutrition can lead to protein-energy malnutrition, micronutrient deficiencies, or anemia during pregnancy or after birth. It remains a major problem, despite evidence-based maternal-nutrition interventions happening on ground. We conducted a scoping review to understand different strategies and delivery mechanisms to improve maternal nutrition, as well as how interventions have improved coverage and uptake of services. An electronic search was conducted in PubMed and Google Scholar for published studies reporting on the effectiveness of maternal-nutrition interventions in terms of access or coverage, health outcomes, compliance, and barriers to intervention utilization. The search was limited to studies published within ten years before the initial search date, 8 November 2019; later, it was updated to 17 February 2021. Of 31 studies identified following screening and data extraction, 22 studies were included for narrative synthesis. Twelve studies were reported from India and eleven from Bangladesh, three from Nepal, two from both Pakistan and Thailand (Myanmar), and one from Indonesia. Nutrition education and counselling, home visits, directly observed supplement intake, community mobilization, food, and conditional cash transfer by community health workers were found to be effective. There is a need to incorporate diverse strategies, including various health education approaches, supplementation, as well as strengthening of community participation and the response of the health system in order to achieve impactful maternal nutrition programs.

scholarly journals Eating behavior among persons with type 2 diabetes mellitus in North Ethiopia: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hagos Amare Gebreyesus ◽  
Girmatsion Fisseha Abreha ◽  
Sintayehu Degu Besherae ◽  
Merhawit Atsbha Abera ◽  
Abraha Hailu Weldegerima ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Eating Behavior ◽  
Healthy Eating ◽  
Food Selection ◽  
Cross Sectional Study ◽  
Three Dimensions ◽  
Cross Sectional ◽  
Healthy Eating Behavior ◽  
Meal Planning

Abstract Background Diet is central to the management of type 2 diabetes mellitus (T2DM). Depending on the stage of the disease at which the recommended diet is initiated, optimal adherence can reduce HbA1c by about 1 to 2%. However, evidence on eating behavior is generally scarce including in Ethiopia. The present study aimed to assess the eating behavior of adults with T2DM in North Ethiopia. Methods This cross-sectional study was conducted among 421 adults with T2DM from September to November 2019. Socio-demographic variables were collected using structured questionnaires; an asset-based wealth index was used to determine socioeconomic status. Three dimensions of eating behavior were assessed using Likert-type items: food selection, meal planning and calorie recognition. Raw Likert scores in each dimension were transformed to percent scales to maximum (%SM). Participants’ behavior in each dimension was categorized into healthy and unhealthy taking 66.7% SM score as a cutoff. Overall eating behavior was determined by aggregating ranks scored in the three dimensions. Correlates of overall eating behavior were identified using Chi-square test and multinomial logistic regression with statistical significance set at P-value < 0.05. Result Only 1% of the participants had overall healthy eating behavior. Yet, overall unhealthy eating was apparent in 54.4%. By dimensions, healthy eating behaviors in food selection, meal planning and calorie recognition were seen in 43.5, 7.4 and 2.9% participants, respectively. Factors that were positively associated with having healthy eating behavior in one dimension relative to unhealthy in all were: receiving nutrition education [AOR 1.73; CI 1.09, 2.74], female gender [AOR 1.78; CI 1.03, 3.08] & being in 26–44 age category [AOR 3.7; CI 1.56, 8.85]. But, being in the poor [AOR 0.42; CI 0.16, 1.32] or average [AOR 0.54; CI 0.19, 1.55] socioeconomic strata were negatively associated. However, only receiving nutrition education [AOR 3.65; CI 1.31, 10.18] was significantly associated with having healthy behavior in two eating dimensions over unhealthy in all. Conclusion In North Ethiopia, the overall eating behavior of adults with T2DM is extremely poor. Diverse and integrated approaches including nutrition education during consultation should be implemented to address the gap.

scholarly journals Facilitators and barriers to healthy eating in a worksite cafeteria: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dalia Stern ◽  
Ilian Blanco ◽  
Lucy A. Olmos ◽  
Joel J. Valdivia ◽  
Archana Shrestha ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Mexico City ◽  
Healthy Eating ◽  
Working Hours ◽  
Sales Managers ◽  
Healthy Foods ◽  
Nutrition Interventions ◽  
Group Discussions ◽  
Facilitators And Barriers ◽  
Job Category

Abstract Background Worksite-based nutrition interventions can serve as access points to facilitate healthy eating and translate existing knowledge of cardiometabolic disease prevention. We explored perceptions, facilitators, and barriers for healthy eating in a cafeteria at a large worksite in Mexico City. Methods We conducted an exploratory qualitative study in a large department store in Mexico City with ~ 1500 employees. We conducted eight focus group discussions (FGD) with 63 employees stratified by job category (sales, maintenance, shipping, restaurant, cafeteria, administrative staff, and sales managers). Employees were invited to participate in the FGD if they were at the store at the day and time of the FGD for their job type. FGDs were audio-recorded, transcribed verbatim and analyzed using the thematic method. This process involved the researches´ familiarizing themselves with the data, generating initial codes, searching for themes, reviewing the themes, defining and naming themes, and then interpreting the data. Results Employees defined healthy eating as eating foods that are fresh, diverse, and prepared hygienically. The most commonly reported facilitators of healthy eating at the worksite were availability of affordable healthy food options and employees’ high health awareness. Major barriers to healthy eating included unavailability of healthy foods, unpleasant taste of food, and preference for fatty foods and meat. For lower-wage workers, affordability was a major concern. Other barriers included lack of time to eat work and long working hours. Conclusion A broad range of factors affect healthy eating at the cafeteria, some related to nutrition and some related to the employees type of job. Availability of healthy, hygienic, and tasty food at an affordable price could lead to healthier food choices in the worksite cafeteria. These strategies, along with work schedules that allow sufficient time for healthy eating, may help improve dietary behaviors and health of employees.

School-Based Nutrition Programs for Adolescents in Dodoma, Tanzania: A Situation Analysis

2021 ◽  
pp. 037957212110207
Author(s):  
Colette Rector ◽  
Nadhira Nuraini Afifa ◽  
Varun Gupta ◽  
Abbas Ismail ◽  
Dominic Mosha ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Ad Hoc ◽  
School Administrators ◽  
School Nutrition ◽  
Overweight And Obesity ◽  
School Meals ◽  
Nutrition Interventions ◽  
Double Burden ◽  
School Based ◽  
Sanitation And Hygiene

Background: Tanzania has a double burden of malnutrition, including a high prevalence of undernutrition and an increasing prevalence of overweight and obesity among adolescents. Schools present a valuable opportunity to reach a large section of the country’s adolescent population with nutrition-oriented interventions. Objective: The objective of this study was to assess the current state of adolescent school nutrition interventions in Dodoma, Tanzania, with emphases on 3 potential school-based nutrition interventions, school vegetable gardens, school meals, and education (on nutrition, agriculture, and water, sanitation, and hygiene). Methods: Focus group discussions were conducted with several regional and district-level governmental stakeholders, including health, education, and agricultural officers. Ten public secondary schools were visited, and interviews with school administrators, teachers, students, and parents were conducted. Results: All stakeholders interviewed supported interventions to improve school-based nutrition, including school gardens, school feeding, and nutrition education. All 10 schools visited had some experience providing school meals, but parents’ contributions were essential for the program’s sustainability. Most schools visited had land available for a school garden program, but water availability could be challenging during certain times of the year. The teachers interviewed expressed that the curriculum on nutrition education was highly theoretical and did not allow students to practice the knowledge and skills they learned in the classroom. Conclusions: The current school-based approach to tackling the double burden of adolescent malnutrition in Dodoma is localized and ad hoc. To leverage the potential of schools as a platform for nutrition interventions, integrated and policy-mandated interventions are needed.

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