A mixed-methods impact evaluation of the feasibility of an initiative in small rural stores to improve access to fruit and vegetables

2016 ◽  
Vol 22 (6) ◽  
pp. 545 ◽  
Author(s):  
Claire Palermo ◽  
Breeana Gardiner ◽  
Carena Gee ◽  
Stella Charaktis ◽  
Miranda Blake
Keyword(s):  
Mixed Methods ◽  
Rural Communities ◽  
Impact Evaluation ◽  
Vegetable Intake ◽  
Community Support ◽  
Fruit And Vegetables ◽  
Qualitative And Quantitative ◽  
Sustaining Change ◽  
Post Evaluation ◽  
Improve Access

Retail stores are a promising setting for improving access to nutritious food. This study opportunistically evaluated an initiative that supported stores in small rural Victorian towns to sell fresh fruit and vegetables. It aimed to measure whether the initiative showed a trend towards improved access to fruit and vegetables in these rural communities. A mixed-methods, pre-post evaluation was employed to measure the range and price of 39 fruits and 45 vegetables, together with 15 interviews with stakeholders 2.5 years after the commencement of the initiative. Twenty-one of 35 eligible stores took up the initiative. Analysis of qualitative and quantitative data showed that the initiative improved the availability of and access to fruit and vegetables, and that stores have a role in improving access to fruit and vegetables. The overall range of fruit and vegetables increased over 18 months from a median of 10 varieties (n=10) to 17 varieties (n=15) (P=0.028) and the prices decreased over 12 months in five out of seven stores where data was available. The capacity to influence availability of fruit and vegetables was affected by time, human resources and community support. Sustaining change to fruit and vegetables access is challenging. Using stores for health promotion may be an effective strategy for improving rural populations’ fruit and vegetable intake.

scholarly journals Physical Activity Barriers and Assets in Rural Appalachian Kentucky: A Mixed-Methods Study

2021 ◽  
Vol 18 (14) ◽  
pp. 7646
Author(s):  
Natalie Jones ◽  
Deirdre Dlugonski ◽  
Rachel Gillespie ◽  
Emily DeWitt ◽  
Joann Lianekhammy ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
Rural Communities ◽  
Community Support ◽  
Mixed Methods Study ◽  
Cultural Barriers ◽  
Health Concern ◽  
Socioecological Model ◽  
Appalachian Kentucky ◽  
Rural Appalachia

Obesity is an increasing public health concern in the U.S. and a contributor to chronic illness, with trends revealing a rise in adult obesity and chronic disease rates among the most vulnerable and disadvantaged populations, including those in rural communities. A mixed-methods approach was used to examine perspectives on perceived physical activity barriers, resources, and level of community support. Researchers utilized the socioecological model to examine the multiple domains that support physical activity in rural Appalachia. The present study focuses on baseline data, including a cohort survey to assess physical activity, health status, and barriers to physical activity, and five focus groups with elected community leaders, community residents, members, and key stakeholders to assess perspectives on physical activity barriers and resources within the county. The cohort survey sample (N = 152) reported a median of 6 barriers (range 0–13) to participating in at least 30 min of physical activity daily. The qualitative analysis yielded three overarching themes related to physical activity participation: lack of motivation, physical environment, and cultural barriers. This mixed-methods study revealed the challenges and perceptions among rural residents across the socioecological model when assessing physical inactivity. Findings can be used to tailor future interventions focused on expanding social support, designing infrastructure, and creating policies that promote physical activity.

Analysing capabilities and resources used to incorporate fruit and vegetables into the family diet: findings from an Australian case study

2014 ◽  
Vol 2 (1) ◽  
pp. 13
Author(s):  
Samantha B Meyer
Keyword(s):  
Low Income ◽  
Vegetable Intake ◽  
Vegetable Consumption ◽  
Fruit And Vegetables ◽  
Fruit And Vegetable ◽  
Organizational Skills ◽  
Australian Case ◽  
Low Income Families ◽  
Conducting Research

Research attributes low fruit and vegetable consumption to problems of access, availability and affordability. We conducted, for the first time, a case study with three families designed and analysed using the sustainable Livelihoods Framework. The benefit of such an approach is that we moved away from identified barriers and towards identifying the capabilities and resources low-income families use to incorporate fruit and vegetables into their diets. Mitigating cost and access, we provided families with a box of fresh fruit and vegetables free of charge for up to 10 weeks and observed and recorded how/if the contents were used. Results identify the importance of social networking, organizational skills, knowledge of health benefits, and social structures. This paper demonstrates an effective methodology for understanding the capabilities of, rather than barriers to, low-income families increasing fruit and vegetable intake. Additionally, we provide a ‘how to’ and ‘lessons from the field’ for researchers interested in conducting research of this nature.

scholarly journals Older age, smoking, tooth loss and denture-wearing but neither xerostomia nor salivary gland hypofunction are associated with low intakes of fruit and vegetables in older Danish adults

2021 ◽  
Vol 10 ◽  
Author(s):  
Anne Marie Lynge Pedersen ◽  
Anja Weirsøe Dynesen ◽  
Berit Lilienthal Heitmann
Keyword(s):  
Salivary Gland ◽  
Tooth Loss ◽  
Vegetable Intake ◽  
Community Dwelling ◽  
Older Age ◽  
Fruit And Vegetables ◽  
Fruit And Vegetable ◽  
Flow Rates ◽  
Whole Saliva ◽  
Salivary Gland Hypofunction

Abstract Xerostomia and salivary gland hypofunction are prevalent conditions in older people and may adversely influence the intake of certain foods, notably fruit and vegetables. Here, we aimed to investigate whether xerostomia and salivary gland hypofunction were associated with a lower intake of fruit and vegetables. The study included 621 community-dwelling adults, mean age 75⋅2 ± 6⋅4 years, 58⋅9 % female, who had participated in the Copenhagen City Heart Study follow-up, and undergone interviews regarding food intake (preceding month), oral and general health (xerostomia, taste alterations, diseases, medication, alcohol consumption and smoking), clinical oral examination and measurements of unstimulated and chewing-stimulated whole saliva flow rates. The average total energy intake (8⋅4 ± 2⋅7 MJ) and protein energy percentage (14⋅8 ± 3⋅1 %) were slightly below recommendations. The average fruit (234⋅7 ± 201⋅2 g/d) and vegetables (317⋅3 ± 157⋅4 g/d) intakes were within recommendations. Xerostomia and hyposalivation were more prevalent in women than in men (16⋅4 v. 7⋅1 %, P < 0⋅001 and 40⋅7 v. 27⋅5 %, P < 0⋅001). Multiple linear regression analyses revealed that older age (β −0⋅009, se 0⋅003, P = 0⋅005), smoking (β −0⋅212, se 0⋅060, P = 0⋅0005) and wearing complete dentures/being partially or fully edentulous (β −0⋅141, se 0⋅048, P = 0⋅003), but neither xerostomia nor salivary flow rates were associated with an inadequate fruit and vegetable intake, after adjustment for covariates. Older age, smoking, tooth loss and denture-wearing were stronger determinants of low fruit and vegetable intakes than xerostomia and salivary hypofunction supporting the importance of dietary counselling and maintenance of oral health and an adequate masticatory performance.

scholarly journals A framework for identifying and learning from countries that demonstrated exemplary performance in improving health outcomes and systems

2020 ◽  
Vol 5 (12) ◽  
pp. e002938
Author(s):  
Austin Carter ◽  
Nadia Akseer ◽  
Kevin Ho ◽  
Oliver Rothschild ◽  
Niranjan Bose ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Global Health ◽  
Health Outcomes ◽  
Mixed Methods Research ◽  
Multidisciplinary Teams ◽  
Ongoing Research ◽  
Qualitative And Quantitative ◽  
Success Stories ◽  
Quantitative Analyses ◽  
Comprehensive Framework

This paper introduces a framework for conducting and disseminating mixed methods research on positive outlier countries that successfully improved their health outcomes and systems. We provide guidance on identifying exemplar countries, assembling multidisciplinary teams, collecting and synthesising pre-existing evidence, undertaking qualitative and quantitative analyses, and preparing dissemination products for various target audiences. Through a range of ongoing research studies, we illustrate application of each step of the framework while highlighting key considerations and lessons learnt. We hope uptake of this comprehensive framework by diverse stakeholders will increase the availability and utilisation of rigorous and comparable insights from global health success stories.

Joint displays for qualitative-quantitative synthesis in mixed methods reviews

2021 ◽  
pp. 263208432098437
Author(s):  
Ahtisham Younas ◽  
Shahzad Inayat ◽  
Amara Sundus
Keyword(s):  
Mixed Methods ◽  
Nursing Students ◽  
Quantitative Research ◽  
Practice Research ◽  
Quantitative Evidence ◽  
Qualitative And Quantitative ◽  
Quantitative Synthesis ◽  
Research Findings ◽  
Excellent Method ◽  
Levels Of Integration

Mixed methods reviews offer an excellent approach to synthesizing qualitative and quantitative evidence to generate more robust implications for practice, research, and policymaking. There are limited guidance and practical examples concerning the methods for adequately synthesizing qualitative and quantitative research findings in mixed reviews. This paper aims to illustrate the application and use of joint displays for qualitative and quantitative synthesis in mixed methods reviews. We used joint displays to synthesize and integrate qualitative and quantitative research findings in a segregated mixed methods review about male nursing students' challenges and experiences. In total, 36 qualitative, six quantitative, and one mixed-methods study was appraised and synthesized in the review. First, the qualitative and quantitative findings were analyzed and synthesized separately. The synthesized findings were integrated through tabular and visual joint displays at two levels of integration. At the first level, a statistics theme display was developed to compare the synthesized qualitative and quantitative findings and the number of studies from which the findings were generated. At the second level, the synthesized qualitative and quantitative findings supported by each other were integrated to identify confirmed, discordant, and expanded inferences using generalizing theme display. The use of two displays allowed in a robust and comprehensive synthesis of studies. Joint displays could serve as an excellent method for rigorous and transparent synthesis of qualitative and quantitative findings and the generation of adequate and relevant inferences in mixed methods reviews.

scholarly journals Housing with support for older people: a mixed-methods systematic review protocol

2020 ◽  
Vol 3 ◽  
pp. 64
Author(s):  
Camille Coyle ◽  
Sarah Buggy ◽  
Olivia Cagney ◽  
Louise Farragher ◽  
Caitriona Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Mixed Methods ◽  
Older People ◽  
Grey Literature ◽  
Qualitative And Quantitative ◽  
Ovid Medline ◽  
The Impact ◽  
People’S Perceptions

Background: The implementation of housing with support is rapidly expanding, particularly as life expectancy is increasing throughout the world. This expansion is likely to intensify in the context of coronavirus disease 2019 (COVID-19), which has revealed the risks of relying primarily on nursing homes. This mixed-methods systematic review aims to: 1) explore older people’s perceptions and experiences of housing with support and 2) examine the impact of providing housing with support for older people on their quality of life. Methods: The databases Ovid Medline, Ovid Social Policy & Practice, EBSCO CINAHL, and EBSCO SOCIndex will be searched, and grey literature will also be identified. Quality assessment will be carried out using Joanna Briggs Institute’s Critical Appraisal Checklist for Qualitative Research as well as a tool from the National Institutes of Health for observational cohort studies. This review will employ convergent parallel design; as such, qualitative and quantitative findings will be synthesised separately in the initial stage of analysis. The results from the qualitative and quantitative syntheses will then be integrated in the final stage of the analysis. Conclusion: This systematic review will synthesise the evidence regarding older people’s perceptions and experiences of housing with support and the impact of providing housing with support for older people on their quality of life.

scholarly journals Fruit and vegetable intake in Austrian adults: intake frequency, serving sizes, reasons for and barriers to consumption, and potential for increasing consumption

2009 ◽  
Vol 13 (4) ◽  
pp. 480-487 ◽  
Author(s):  
Manuel Schätzer ◽  
Petra Rust ◽  
Ibrahim Elmadfa
Keyword(s):  
Response Rate ◽  
Vegetable Intake ◽  
Vegetable Consumption ◽  
Postal Questionnaire ◽  
Fruit And Vegetables ◽  
Fruit And Vegetable Intake ◽  
Fruit And Vegetable ◽  
Seasonal Fluctuations ◽  
Four Seasons ◽  
Serving Sizes

AbstractObjectiveTo assess the intake frequency of fruit and vegetables, serving sizes, reasons for and barriers to consumption, and the potential for increasing fruit and vegetable intake.DesignA nationwide postal questionnaire survey was conducted in 2006 over all four seasons. The participants were stratified according to occupation and sex. The response rate for 5130 questionnaires sent out was 52·7 %.SettingAustria.SubjectsAustrian adults, aged 19–64 years.ResultsDaily fruit consumption was reported by 57·1 % of the participants and daily vegetable consumption by 36·2 %. On average, 2·1 (sd 1·9) servings (250 (sd 225) g) of fruit and 1·7 (sd 1·3) servings (198 (sd 159) g) of vegetables were consumed daily. Women ate fruit and vegetables both more frequently and in greater quantities than men. Both intake frequency and the number of fruit and vegetable servings were largely independent of seasonal fluctuations. The primary reason for the consumption of both fruit and vegetables was taste. The greatest barrier to higher intake was the perception that current individual consumption was already sufficient. Price did not constitute a relevant barrier in Austria. At present, the potential for increasing fruit and vegetable intake can be estimated at two servings.ConclusionsAustrian adults still consume less fruit and vegetables than recommended. Strategies to increase intake should pay more attention to the taste instead of the various health aspects.

scholarly journals Mediators and moderators of nutrition intervention effects in remote Indigenous Australia

2018 ◽  
Vol 119 (12) ◽  
pp. 1424-1433 ◽  
Author(s):  
Julie Brimblecombe ◽  
Megan Ferguson ◽  
Federica Barzi ◽  
Clare Brown ◽  
Kylie Ball
Keyword(s):  
Food Security ◽  
Behaviour Change ◽  
Self Efficacy ◽  
Dietary Intervention ◽  
Vegetable Intake ◽  
Soft Drink ◽  
Indigenous Communities ◽  
Fruit And Vegetables ◽  
Dietary Behaviour ◽  
The Impact

AbstractWe conducted a longitudinal dietary intervention study to assess the impact of a store-based intervention on mediators and moderators and consequent dietary behaviour in Indigenous communities in remote Australia. We assessed dietary intake of fruit, vegetable, water and sweetened soft drink, mediators and moderators among 148, eighty-five and seventy-three adult participants (92 % women) at baseline (T1), end of intervention (T2) and at 24 weeks post intervention (T3), respectively. Mediators included perceived affordability and self-efficacy. Moderators were barriers to eat more fruit and vegetables and food security. Mixed-effects models were used to determine changes in mediators and moderators with time and associations between these and each dietary outcome. Perceived vegetable affordability increased from T1 (19 %; 95 % CI 11, 27) to T2 (38 %; 95 % CI 25, 51) (P=0·004) and returned to baseline levels at T3. High self-efficacy to eat more fruit and vegetables and to drink less soft drink decreased from T1 to T3. A reduction in soft drink intake of 27 % (95 % CI −44, −4; P=0·02) was reported at T3 compared with T1; no changes with time were observed for all other outcome measures. Regardless of time, vegetable intake was positively associated with self-efficacy to cook and try new vegetables, no barriers and food security. The dietary intervention went someway to improving perceived affordability of vegetables but was probably not strong enough to overcome other mediators and moderators constraining behaviour change. Meaningful dietary improvement in this context will be difficult to achieve without addressing underlying constraints to behaviour change.

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