scholarly journals Daily Food Insecurity and Its Impact on Diet Quality in Low-Income Adults in Two Seasons: An Ecological Momentary Assessment Study

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 137-137
Author(s):  
Sara Jimenez Rincon ◽  
Nan Dou ◽  
Yujie Liao ◽  
Muzi Na
Keyword(s):  
Food Insecurity ◽  
Diet Quality ◽  
Low Income ◽  
Ecological Momentary Assessment ◽  
Healthy Eating Index ◽  
Assessment Model ◽  
Dairy Consumption ◽  
Phone Calls ◽  
Ecological Momentary ◽  
Momentary Assessment

Abstract Objectives Chronic food insecurity (FI) is common in low-income adults and is associated with a suboptimal diet. The dynamicity of FI in the short term in relation to diet is not well understood. We aim to examine if there are seasonal shifts in the relationship between FI and diet. Methods Low-income adults (with a household income <185% federal poverty line) were recruited in Central Pennsylvania. An ecological momentary assessment model on smartphones was used to collect daily FI and diet data over two three-week long waves: one during a fall month, and one during a winter month. An adapted USDA adult module was used to assess daily FI (“food secure” if module score = 0 or “food insecure” if module score >0). A food record was recorded on smartphones and verified by a trained dietitian via phone calls on Sunday, Monday, and Tuesday. For each subject, daily caloric intake was calculated using the Nutrition Data System for Research software. Daily Healthy Eating Index 2015 (HEI-2015) score and food group intake were calculated. Generalized estimating equation (GEE) models were used to estimate the associations between daily FI and dietary outcomes, accounting for within-person correlation and adjusting for gender, race/ethnicity, employment, and poverty status. Results 22 participants were recruited in fall 2019, 18 were followed up in winter 2020, with a total of 290 person-days (response rate = 80.64%) of data. Higher FI scores in the winter, but not in the fall, were associated with lower HEI-2015 score [b (95%CI)] [−9.06 (−14.15, −3.96)]. Higher FI in winter was associated with decreased intake of total fruit ([−0.24 (−0.44, −0.05)], whole fruit [−0.27 (−0.48, −0.06)], and whole grain [−0.52 (−1.03, −0.01)]. Higher FI in the fall months was associated with increased dairy consumption [0.65 (0.08, 1.22)]. FI was not associated with calorie intake in either season. Conclusions This pilot study found that higher daily FI was associated with lower diet quality in the winter, but not fall, which may be driven by shifts in food accessibility and altered coping strategies across seasons. Funding Sources The National Center for Advancing Translational Sciences, National Institutes of Health (UL1TR002014) and the Broadhurst Career Development Professorship for the Study of Health Promotion and Disease Prevention.

scholarly journals Food Insecurity and Affective Well-Being in Low-Income Adults: An Ecological Momentary Assessment Study Over Two Months

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 165-165
Author(s):  
Muzi Na ◽  
Nan Dou ◽  
Yujie Liao ◽  
Sara Jimenez Rincon ◽  
Lori Francis ◽  
...  
Keyword(s):  
Negative Affect ◽  
Food Insecurity ◽  
Positive Affect ◽  
Low Income ◽  
Ecological Momentary Assessment ◽  
Well Being ◽  
Funding Sources ◽  
Daily Food ◽  
Ecological Momentary ◽  
Momentary Assessment

Abstract Objectives Food insecurity is a dynamic phenomenon within a given month and across seasons. It remains unknown how food insecurity influences low-income adults’ day-to-day affective well-being, which is associated with long-term mental and physical health. In this pilot study, we explored the association between daily food insecurity and affect over a 2-month period (spanning 2 seasons) in a sample of low-income adults in Central Pennsylvania. Methods A total of 22 healthy low-income adults were recruited during the fall months (September, October, or November) in 2019, 18 of whom were also followed in the winter months (February or March) in 2020. Using an ecological momentary assessment framework administered on smart phones over a three-week-long wave (2nd – 4th week) in each survey month, daily food insecurity (once daily), and positive and negative affect (5 times daily) were collected. Time Varying Effect Models were used to estimate the association between levels of daily food insecurity and daily aggregated positive/negative affect as a function of study day, adjusting for gender, race/ethnicity, employment, and poverty status. Results A total of 713 person-days (84.9% of what was possible) of daily-level data was collected. Food insecurity was reported in 42.9% and 36.0% of participants in the fall and winter months, respectively. Greater daily food insecurity was associated with significantly lower positive affect scores in the 3rd week of the fall months (β ranged from −1.40 (95% CI −2.62, −0.18) to −3.17 (95% CI: −5.93, −0.42)) and in the 4th week of the winter months (β ranged from −2.24 (95% CI: −4.08, −0.39) to −2.84 (95% CI: −4.28, −1.40)). No consistent association was identified between daily food insecurity and negative affect. Conclusions Daily food insecurity was associated with lower positive affect in the second half of the months in both fall and winter seasons. Future large observational studies should verify our study findings in order to better identify, target, and intervene in food insecure adults who are at-risk of adverse mental health outcomes. Funding Sources The National Center for Advancing Translational Sciences, National Institutes of Health (UL1TR002014) and the Broadhurst Career Development Professorship for the Study of Health Promotion and Disease Prevention.

scholarly journals An ecological momentary assessment study of physical activity behaviors among mothers of toddlers from low-income households

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katherine L. Campbell ◽  
Yan Wang ◽  
Ann Pulling Kuhn ◽  
Maureen M. Black ◽  
Erin R. Hager
Keyword(s):  
Physical Activity ◽  
Low Income ◽  
Ecological Momentary Assessment ◽  
Normal Weight ◽  
Activity Count ◽  
Group Relations ◽  
Environment Factors ◽  
Group Relation ◽  
Ecological Momentary ◽  
Momentary Assessment

Abstract Background Mothers of young children from low-income communities may be vulnerable to barriers associated with low physical activity. The purpose of this study was to examine associations between home environment factors and maternal physical activity among mothers of toddlers. Methods Mothers of toddlers (n = 200) recruited from low-income communities simultaneously wore an ankle-placed accelerometer and were given a personal digital assistant for ecological momentary assessment. Mothers received randomly prompted questions about their current environment, activity, and social setting several times a day over eight consecutive days. Data were analyzed using linear mixed-effects regression models with random intercepts; within-group and between-group relations between physical activity and environment factors were disaggregated. Results Within-group relations included higher physical activity counts for specific mothers with television off versus on (95% CI = 130.45, 199.17), children absent versus present (95% CI = 82.00, 3.43), engaging with a child versus not (95% CI = 52.66, 127.63), and outside versus inside location (95% CI = 277.74, 392.67). Between-group relations included higher physical activity on average when other adults were absent versus present (95% CI = − 282.63, − 46.95). Recruitment site (urban vs. semi-urban) significantly moderated the within-group relation between being outside versus inside and activity count (β = − 243.12, 95% CI = − 358.74, − 127.47), and showed stronger relations among urban mothers (β = 440.33, 95% CI = 358.41, 522.25), than semi-urban (β = 190.37, 95% CI = 109.64, 271.11). Maternal body weight significantly moderated the within-group relation between being located outside versus inside the home and activity count (β for interaction = − 188.67, 95% CI = − 308.95, − 68.39), with a stronger relation among mothers with normal weight (β = 451.62, 95% CI = 345.51, 557.73), than mothers with overweight/obesity (β = 271.95, 95% CI = 204.26, 339.64). Conclusions This study highlights home environmental factors, including screen time, the presence of others (adults and children), and location (i.e., outside versus inside) that may relate to maternal physical activity behaviors. Understanding factors associated with physical activity could reduce physical activity disparities. Trial registry ClinicalTrials. NCT02615158, April 2006

Methods for Using Ecological Momentary Assessment to Assess Weight-related Behaviors in the Home Environment of Children from Low-Income, Racially/Ethnically Diverse and Immigrant Households (Preprint)

2021 ◽  
Author(s):  
Amanda Trofholz ◽  
Allan Tate ◽  
Mark Janowiec ◽  
Angela Fertig ◽  
Katie Loth ◽  
...  
Keyword(s):  
Native American ◽  
Phase I ◽  
Home Environment ◽  
Low Income ◽  
Ecological Momentary Assessment ◽  
Ethnically Diverse ◽  
Conducting Phase ◽  
The Family ◽  
Ecological Momentary ◽  
Momentary Assessment

BACKGROUND Ecological momentary assessment (EMA) is an innovative tool to capture in-the-moment health behaviors as people go about their regular lives. EMA is an ideal tool to measure weight-related behaviors, such as parent feeding practices, stress, and dietary intake, as these occur on a daily basis and vary across time and context. A recent systematic review recommended standardized reporting of EMA design for studies that address weight-related behaviors. OBJECTIVE This manuscript describes in detail the EMA design of the Family Matters study. METHODS Family Matters is an incremental, two-phased, mixed-methods study conducted with a racially/ethnically diverse and immigrant/refugee sample from largely low-income households designed to examine the risk and protective factors for childhood obesity in the home environment. The Family Matters study intentionally recruited White, Black, Hmong, Latino, Native American, and Somali parents with young children. Parents in Phase I of the study completed eight days of EMA on their smart phones, which included 1) signal-contingent surveys (e.g., asking about the parent’s stress at the time of the survey); 2) event-contingent surveys (e.g., descriptions of the meal the child ate); 3) end-of-day surveys (e.g., overall assessment of the child’s day).cribes in detail the EMA design of the Family Matters study. RESULTS A detailed description of EMA strategies, protocols, and methods used in Phase I of the Family Matters study is provided. Compliance with EMA surveys and participant time spent completing EMA surveys is presented, stratified by race/ethnicity. Additionally, lessons learned while conducting Phase I EMA are shared to document how EMA methods were improved and expanded upon for Phase II. CONCLUSIONS Results from this study provide an important next step in identifying best practices for EMA use in assessing weight-related behaviors in the home environment.

scholarly journals Describing Ecological Momentary Assessment Methods for Collecting Dietary Intake in a Racially/Ethnically Diverse Sample

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 886-886
Author(s):  
Amanda Trofholz ◽  
Jerica !Berge
Keyword(s):  
Physical Activity ◽  
Dietary Intake ◽  
Low Income ◽  
Ecological Momentary Assessment ◽  
Ethnically Diverse ◽  
Feeding Practices ◽  
Parent Feeding Practices ◽  
Ecological Momentary ◽  
Parent Feeding ◽  
Momentary Assessment

Abstract Objectives Ecological momentary assessment (EMA) is an innovative tool being used in the obesity field to capture real-time information about people's health. A recent systematic review regarding the use of EMA to assess dietary intake and physical activity in youth found the need for standardized reporting of EMA measures and methods. This presentation will discuss EMA methods used in the NIH-funded Family Matters study, including survey design, registration/technology, EMA protocols, implementation, and lessons learned for future EMA studies. Methods Family Matters is an incremental, two-phased (Phase I = 150 participants; Phase II = 627 participants), mixed-methods study conducted with a racially/ethnically diverse and immigrant/refugee sample from largely low-income households. Across two phases, the Family Matters research team designed and administered EMA surveys to parents of 5–9 year olds to measure momentary factors of importance to child weight and weight-related behaviors including parent feeding practices, child eating behaviors, meal preparation, and foods served at family meals. Results EMA data allowed for many cutting-edge research questions to be addressed, innovative analyses to be run, and methodological approaches to be advanced. Many diet-related topics were investigated, including 1) the investigation of both within-and across-day relationships between transient and chronic stress and parent feeding practices; 2) parental stress and mood earlier in the day and its association with parent feeding practices later in the day; and 3) family meal characteristics by meal type and day of the week. Additionally, concordance between diet-related EMA measures and objectively collected 24-hour dietary recalls was examined. Family Matters EMA diet-related measures will be presented and related results discussed. Conclusions This presentation will be valuable for researchers interested in using EMA for collecting obesity-related measures, such as dietary intake, physical activity, parent feeding practices, and stress/mood. Funding Sources Research is supported by grant number R01HL126171 from the National Heart, Lung, and Blood Institute (PI: Berge).

scholarly journals Low-Income, Older African Americans’ Engagement in and Perceptions of a Smartphone-Based Ecological Momentary Assessment Study of Physical Activity and Sedentary Behavior

2021 ◽  
Author(s):  
Laurie Kennedy-Malone ◽  
Derek J Hevel ◽  
Kourtney B Sappenfield ◽  
Heidi Scheer ◽  
Christine Zecca ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
African Americans ◽  
Sedentary Behavior ◽  
Low Income ◽  
Ecological Momentary Assessment ◽  
Health Research ◽  
Ecological Momentary ◽  
Study Questionnaire ◽  
Momentary Assessment

Abstract Background and Objectives Smartphone-based ecological momentary assessment (EMA) methods can provide novel insights into modeling and predicting activity-related behaviors, yet many racial and ethnic minority groups report barriers to participating in mobile health research. We aim to (1) report on strategies used to successfully recruit and retain minority older adults in a smartphone-based physical activity and sedentary behavior EMA study and (2) report on participants’ perceptions of study acceptability. Research Design and Methods Researchers partnered with trusted individuals and community organizations serving older adults to facilitate recruitment for an 8-day EMA study of minority older adults’ physical activity and sedentary behavior. Additional strategies such as having experienced, culturally competent team members and available technical support were employed to further recruitment and retention efforts. A post study questionnaire assessed participants’ perceptions of study acceptability. Results In total, 123 minority older adults were recruited; 102 met inclusion criteria, 91 completed the study, and 89 completed the post-study questionnaire. The sample consisted of predominantly low-income African American women with an average age of 70 years. Responses to open-ended questions revealed the most enjoyable aspects of study participation were the ability to learn more about themselves, contribute to science and/or their community, engage in a new activity, and receive financial compensation. Participants reported the least enjoyable aspects of the study included the frequency of EMA questionnaires, apprehension of missing EMA questionnaires, carrying the smartphone, and difficulty wearing the accelerometer. Most participants (97%) expressed interest in being contacted for future studies. Discussion and Implications Low-income, older African Americans reported positive perceptions of a smartphone-based EMA study of physical activity and sedentary behavior. Findings suggest that applying demonstrated strategies to engage this population in technology-based health research can enhance recruitment and retention efforts; however, it is unclear which strategies are most effective in reducing participation barriers.

scholarly journals Factors in the home environment associated with toddler diet: an ecological momentary assessment study

2018 ◽  
Vol 21 (10) ◽  
pp. 1855-1864 ◽  
Author(s):  
Katherine L Campbell ◽  
Aleksandra Babiarz ◽  
Yan Wang ◽  
Nicholas A Tilton ◽  
Maureen M Black ◽  
...  
Keyword(s):  
Home Environment ◽  
Low Income ◽  
Ecological Momentary Assessment ◽  
Vegetable Consumption ◽  
Dietary Recommendations ◽  
Sugar Sweetened Beverage ◽  
Environment Factors ◽  
Dietary Behaviours ◽  
Ecological Momentary ◽  
Momentary Assessment

AbstractObjectiveTo identify home environment factors associated with toddler dietary behaviours using ecological momentary assessment (EMA).DesignHome environment and toddler’s diet were assessed by mothers through EMA (random beeps over ≤8 d and a brief survey). Dietary outcomes were fruit/vegetable consumption, eating episode (‘snack’ v. ‘meal’) and sugar-sweetened beverage (SSB) consumption. Home environment factors included interacting with mother, eating alone/with others, eating in a high chair/chair at the table, watching television and movement/translocation. Multilevel logistic mixed-effects regression models assessed both within- (individual toddlers across time) and between- (toddlers-on-average) subject effects.SubjectsLow-income mother–toddler dyads (n 277).SettingUrban and suburban Maryland, USA.ResultsEMA captured eating/drinking episodes for 249/277 (89·9 %) toddlers (883 eating episodes, 1586 drinking episodes). Toddlers-on-average were more likely (adjusted OR, P value) to eat fruit/vegetables when not moving around (0·43, P=0·043), eat with the television off (0·33, P<0·001) and eat in a high chair/chair (3·38, P<0·001); no within-subject effects were shown. For eating episodes, both toddlers-on-average and individual toddlers were more likely to eat snacks when not in a high chair/chair (0·13, P<0·001 and 0·06, P<0·001, respectively) and when eating alone (0·30, P<0·001 and 0·31, P<0·001, respectively). Also, individual toddlers were more likely to eat snacks when moving around (3·61, P<0·001). Toddlers-on-average were more likely to consume SSB when not in a high chair/chair (0·21, P=0·001), eating alone (0·38, P=0·047) or during a snacking episode (v. a meal: 3·96, P=0·012); no within-subject effects shown.ConclusionsFactors in the home environment are associated with dietary behaviours among toddlers. Understanding the interplay between the home environment and toddler diet can inform future paediatric dietary recommendations.

scholarly journals Associations between parent and child physical activity and eating behaviours in a diverse sample: an ecological momentary assessment study

2020 ◽  
Vol 23 (15) ◽  
pp. 2728-2736
Author(s):  
Rachel Wirthlin ◽  
Jennifer A Linde ◽  
Amanda Trofholz ◽  
Allan Tate ◽  
Katie Loth ◽  
...  
Keyword(s):  
Physical Activity ◽  
Dietary Intake ◽  
Low Income ◽  
Ecological Momentary Assessment ◽  
Vegetable Intake ◽  
Interaction Analysis ◽  
Dietary Quality ◽  
Future Research ◽  
Ecological Momentary ◽  
Momentary Assessment

AbstractObjective:This study is a secondary data analysis that examines the association between parent modelling of dietary intake and physical activity and the same child behaviours among different races/ethnicities using innovative, rigorous and objective measures.Design:Ecological momentary assessment surveys were sent to parents to assess whether their child had seen them exercise or consume food. Dietary recall data and accelerometry were used to determine dietary intake and physical activity behaviours of children.Setting:Participants were randomly selected from primary care clinics, serving low-income and racially/ethnically diverse families in Minnesota, USA.Participants:Participants were families with children aged 5–7 years old who lived with parents 50 % of the time and shared at least one meal together.Results:A 10 percentage point higher prevalence in parent modelling of fruit and vegetable intake was associated with 0·12 higher serving intake of those same foods in children. The prevalence of parent modelling of eating energy dense foods (10 % prevalence units) was associated with 0·09 higher serving intake of sugar-sweetened beverages. Furthermore, accelerometry-measured parent sedentary hours was strongly correlated with child sedentary time (0·37 child sedentary hours per parent sedentary hours). An exploratory interaction analysis did not reveal any statistical evidence that these relationships depended on the child’s race/ethnic background.Conclusions:Interventions that increase parent modelling of healthy eating and minimise modelling of energy dense foods may have favourable effects on child dietary quality. Additionally, future research is needed to clarify the associations of parent modelling of physical activity and children’s physical activity levels.

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