scholarly journals Breastfeeding Duration in a Low-Income Sample Is Associated With Child Diet Quality at Age Three

2020 ◽  
pp. 089033442090302 ◽  
Author(s):  
Nancy S. Weinfield ◽  
Christine Borger ◽  
Alice Ann Gola
Keyword(s):  
At Risk ◽  
Diet Quality ◽  
Low Income ◽  
Child Outcomes ◽  
Feeding Practices ◽  
Breastfeeding Duration ◽  
National Study ◽  
Food Groups ◽  
Populations At Risk ◽  
Child Age

Background: Little research has focused on breastfeeding and diet quality, particularly in low-income populations at risk for shorter breastfeeding duration and poorer diet quality. Research Aim: The aim of this study was to examine the association between breastfeeding duration and later diet quality in a low-income population. Methods: For this longitudinal prospective cohort study we conducted a secondary analysis of data from the Infant and Toddler Feeding Practices Study-2, a national study of infant feeding practices and child outcomes. Study infants were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children by 2.5 months of age and followed until 36 months ( N = 1,223). We examined the association between breastfeeding duration until 13 months of age, and child diet quality derived from a 24-hour dietary recall with a usual intake adjustment at child age 36 months. Multiple regression analyses were used to examine the association of breastfeeding duration with overall diet quality, as measured by the Heathy Eating Index 2015, and with consumption of specific food groups. Results: Longer breastfeeding duration during infancy was associated with better diet quality at child age 36 months after controlling for key socio-demographic variables. In follow-up analyses, the origin of the association was narrowed to greater consumption of mature/dried beans and peas. Conclusions: Longer breastfeeding duration in infancy was associated with better diet quality at 36 months, in a population at risk for shorter breastfeeding duration and poorer diet quality. Breastfeeding was particularly associated with children’s consumption of mature/dried beans and peas. Clinical Trial Registration: This study is registered at clinicaltrials.gov as Feeding My Baby—A National WIC Study, NCT02031978

scholarly journals Characterization of Infant Feeding Practices and Related-Family Characteristics in the French Nationwide ELFE Birth Cohort

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 33
Author(s):  
Aurore Camier ◽  
Claire Chabanet ◽  
Camille Davisse-Paturet ◽  
Elea Ksiazek ◽  
Sandrine Lioret ◽  
...  
Keyword(s):  
Infant Feeding ◽  
Low Income ◽  
Principal Component ◽  
Feeding Practices ◽  
Education Level ◽  
Family Characteristics ◽  
Complementary Food ◽  
Breastfeeding Duration ◽  
Infant Feeding Practices ◽  
Food Groups

Family characteristics such as education level or income are related to infant feeding practices. This study aimed to characterize infant feeding practices and investigate their associations with family characteristics. Analyses were performed with data from a French nationwide cohort, Etude Longitudinale Française depuis l’Enfance (ELFE). Feeding practices were characterized by two methods, a principal component analysis and a hierarchical ascendant classification (n = 8922). This characterization was conducted in three steps: considering firstly only introduction of main food groups, then also food pieces and finally adding the type of complementary food. The associations between family characteristics and the infant feeding patterns or clusters were tested by linear or multinomial regressions (n = 7556). Besides breastfeeding duration and age of first introduction of complementary foods, it appeared also important to consider specific food groups such as sweetened beverages and cow’s milk, and the introduction of food pieces, to describe feeding practices. Recommended feeding practices (longer breastfeeding, complementary food in the right period) were related to higher maternal age and education level, so was migration status, the presence of older children, low income or the mothers’ attendance to pre-birth preparation classes. The interrelations between feeding practices and family characteristics must be considered when examining the influence of feeding practices on child’s health.

scholarly journals Testing a Web-Based Interactive Comic Tool to Decrease Obesity Risk Among Minority Preadolescents: Protocol for a Pilot Randomized Control Trial (Preprint)

2018 ◽  
Author(s):  
May May Leung ◽  
Katrina F Mateo ◽  
Sandra Verdaguer ◽  
Katarzyna Wyka
Keyword(s):  
At Risk ◽  
Childhood Obesity ◽  
Low Income ◽  
Feeding Practices ◽  
Dietary Behaviors ◽  
Controlled Study ◽  
Obesity Risk ◽  
Web Based ◽  
Randomized Controlled ◽  
Potential Impact

BACKGROUND Childhood obesity is a public health crisis, particularly in low-income, minority populations in the United States. Innovative and technology-enhanced interventions may be an engaging approach to reach at-risk youth and their parents to improve dietary behaviors and feeding practices. However, such tools are limited, especially ones that are theory-based; co-developed with user-centered approaches; tailored to low-income, minority preadolescents; and include parent-focused content. OBJECTIVE The objectives of this study include assessing the feasibility and acceptability and exploring the potential impact of the Intervention INC (Interactive Nutrition Comics for urban, minority preadolescents) Web-based tool, which is focused on decreasing childhood obesity risk in black/African American and Latino children aged 9 to 12 years. METHODS Intervention INC is underpinned by the narrative transportation theory, social cognitive theory, and health belief model, and it was co-developed by children and parents from the intended population. The child component consists of a 6-chapter interactive nutrition comic optimized for use on tablet devices, a goal-setting and self-assessment feature, and weekly text/email messages and reminders. The parental component consists of 6 Web-based newsletters, access to the child comic, and weekly text/email messages and reminders. The tool was evaluated using a pilot, single-blind, 2-group randomized controlled study design. Child-parent dyads were randomized to either the experimental or comparison group and assigned to a targeted behavior (increase fruit/vegetable or water intake) based on initial screening questions. Data were collected at 4 time points: baseline (T1), intervention midpoint (T2), intervention endpoint (T3), and 3 months postintervention (T4). Primary measures comprise usage, usability, and feasibility of the Web-based tool. Secondary measures comprise dietary knowledge, preferences, and intake and anthropometric measures (for child) and feeding practices and home food environment (for parent). RESULTS Study enrollment was completed in November 2017. A total of 89 child-parent dyads were randomized to either the experimental (n=44) or comparison (n=45) group. Data analysis is currently being conducted. CONCLUSIONS This study aims to implement and assess an innovative approach to deliver health messages and resources to at-risk minority preadolescents and their parents. If found to be acceptable, engaging, feasible, and a potential approach to improve dietary behaviors, a full-fledged randomized controlled trial will be conducted to assess its efficacy and potential impact. CLINICALTRIAL ClinicalTrials.gov NCT03165474; https://clinicaltrials.gov/ct2/show/NCT03165474 (Archived by WebCite at http://www.webcitation.org/73122IjgP) INTERNATIONAL REGISTERED REPOR RR1-10.2196/10682

scholarly journals PrEP Uptake and Emergent HIV infections in Southern Arizona: Is There A Disconnect?

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S438-S439 ◽  
Author(s):  
Anca Georgescu ◽  
Cesar Egurrola ◽  
Spencer Schaff ◽  
Julia Fisher ◽  
Shannon Smith ◽  
...  
Keyword(s):  
At Risk ◽  
African American ◽  
American Indian ◽  
Low Income ◽  
Border Region ◽  
Hiv Care ◽  
Minority Population ◽  
Newly Diagnosed ◽  
Populations At Risk ◽  
Significant Difference

Abstract Background Despite expansion of antiretroviral therapy in recent years and growing evidence for PrEP (pre exposure prophylaxis) efficacy, HIV incidence has continued to rise while PrEP uptake has remained low, particularly in populations at risk. Our goal is to compare these populations and further identify discrepancies in populations at risk in Southern Arizona. Methods We retroactively reviewed health records for patients evaluated at Banner University Medical Center Tucson outpatient clinics between January 2014 and September 2016, either with a new HIV diagnosis or prescribed tenofovir/emtricitabine for PrEP. Results We identified 147 patients with new HIV diagnoses and 65 patients evaluated for PrEp. 63% of the newly diagnosed HIV were of Hispanic, African American or American Indian descend (46%, 14% and 3% respectively) while the majority of PrEP patients were White (58%) with a statistically significant difference between the groups (P = 0.006). There was no significant difference between the age groups [28 (19%) of the HIV and 13 (20%) of the PrEP were 18–24] or gender (88% of people accessing HIV care were men, vs. 91% men seen for PrEP). Insurance information at the time of presentation was available for 145 HIV and 64 PrEP patients with statistically significant differences between the groups. 31(21%) newly diagnosed HIV had no insurance and 71 (49%) had a Medicaid plan while 45 (70%) of PrEP patients has a private insurance plan (P < 0.001). None of the people accessing PrEP reported iv drug use as a risk factor compared with 16 (11%) of the newly diagnosed (P = 0.003). Retention in care at 3 months was similar (76% of HIV and 75% of PrEP). The predominant risk categories were MSM with multiple partners and/or condomless anal sex for both groups. Conclusion To our knowledge this is the first study evaluating HIV and PrEP health care disparities in a border region of the Southwestern US, which is home to a large Hispanic minority population. Our findings suggest that low income minority populations, such as Hispanic, African American and American Indian in this region continue to have a higher risk for HIV acquisition and highlights the ongoing need to expand research on how these populations perceive their risk for HIV and navigate complex systems, such as health insurance, when seeking clinical services for PreP. Disclosures All authors: No reported disclosures.

Food Skills Education and Low-Income Adults’ Healthy Food Choices

2021 ◽  
pp. 0272684X2110049
Author(s):  
Jennifer A. Pooler ◽  
Mithuna Srinivasan ◽  
Karen Wong ◽  
Jonathan L. Blitstein
Keyword(s):  
Diet Quality ◽  
Low Income ◽  
Comparison Group ◽  
Food Choices ◽  
Healthy Food ◽  
Food Groups ◽  
Low Income Families ◽  
Skills Education ◽  
Item Scale

Background The Cooking Matters food skills education program equips low-income families with the skills and knowledge to shop for and cook healthy meals within budget and time constraints. Aims To explore whether participation in Cooking Matters is associated with healthier food choices using a 6-item scale, comprised of a variety of food categories. Methods Cooking Matters participants (n = 332) and a comparison group (n = 336) completed surveys at baseline, 3-, and 6-month follow-up. Results Cooking Matters participants experienced greater improvements in healthy choices overall (p < 0.0001) and for each of the six underlying items at 3 month follow-up. Improvements were sustained at 6-month follow-up overall and for all categories, except low-fat milk (p = 0.1168). Discussion Participation in Cooking Matters was associated with improvements in overall healthy food choices across a variety of food groups and maintained at 6-month follow-up. Enabling healthy food choices is an important step toward improved diet quality.

scholarly journals How Well Do Parents Assess Their Children's Diet? (OR03-06-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Jessica Eliason ◽  
Robin DeWeese ◽  
Francesco Acciai ◽  
Sonia Vega-Lopez ◽  
Punam Ohri-Vachaspati
Keyword(s):  
Diet Quality ◽  
Low Income ◽  
Critical Role ◽  
Secondary Analysis ◽  
Robert Wood Johnson Foundation ◽  
Parental Perception ◽  
Food Groups ◽  
Cross Sectional ◽  
Mean Frequency ◽  
Parental Assessment

Abstract Objectives Parents play a critical role in their children's diets, yet there is lack of research in the US quantitatively examining parental assessment of their child's diet. We examined the association between parent assessment of their child's overall diet and the child's diet quality, as measured by frequency of consumption of key food groups. Methods We conducted secondary analysis using data from two cross-sectional surveys of households’ w/parent and a random chosen child (2009-2010 and 2014) conducted in four low-income New Jersey cities. Well-established survey questions assessed parental perception of their child's diet and frequency of consumption of fruits (F), vegetables (V), sugar sweetened beverages (SSB) and unhealthy snacks. Diet quality scores were calculated for each child, with higher scores reflective of healthier diets (max score = 40). We examined concordance using parental assessment and quartiles of diet quality scores. The analytical sample included 2274 children. Results Mean age for children was 10 years, almost half (48%) were non-Hispanic black and 40% were Hispanic. Overall, 52% of parents strongly agreed, 33% somewhat agreed, 10% somewhat disagreed, and 4% strongly disagreed that their child eats a healthy diet. The mean diet quality score for the sample was 22.9 ± 7.2. Among children in the lowest diet quality quartile, mean frequency of consumption for F&V was 2.2 times/day and for SSB was 2 times/day. Among children in the highest diet quality quartile, mean frequency of consumption for F&V was 4 times/day and for SSB was 0.3 times/day. More than 40% of the children with parents who strongly agreed that their child ate healthy were scored in the lower two diet quality quartiles. Almost 77–90% of the children with parents who somewhat or strongly disagreed that their child ate healthy were scored in the lower two diet quality quartiles. Additional results from multivariate analysis and by child and household characteristics including nutrition program participation will be presented. Conclusions Interventions aimed at improving children's diet can benefit from taking parental perception into consideration. Funding Sources Robert Wood Johnson Foundation, National Institutes of Child Health and Human Development.

scholarly journals Pneumococcal Immunization Strategies for High-Risk Pediatric Populations Worldwide: One Size Does Not Fit All

Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1390
Author(s):  
Theano Lagousi ◽  
Ioanna Papadatou ◽  
Petros Strempas ◽  
Elena Chatzikalil ◽  
Vana Spoulou
Keyword(s):  
At Risk ◽  
High Risk ◽  
Low Income ◽  
Pneumococcal Disease ◽  
Added Value ◽  
Low Income Countries ◽  
Populations At Risk ◽  
Wide Range ◽  
Pediatric Populations ◽  
High Risk Children

Despite the significant reduction in pneumococcal disease due to pneumococcal vaccines, protection of vulnerable high-risk individuals, especially pediatric populations, remains a great challenge. In an effort to maximize the protection of high-risk children against pneumococcal disease, a combined schedule that includes both conjugate and polysaccharide vaccines is recommended by several countries in the developed world. On the other hand, middle- and low-income countries do not have in place established policies for pneumococcal immunization of children at risk. Pneumococcal conjugate vaccines, despite their benefits, have several limitations, mainly associated with serotype replacement and the wide range of serotype coverage worldwide. In addition, PPV23-impaired immunogenicity and the hyporesponsiveness effect among populations at risk have been well-documented. Therefore, the added value of continuing to include PPV23 in vaccination schedules for high-risk individuals in the years to come remains to be determined by monitoring whether the replacing/remaining serotypes causing IPD are covered by PPV23 to determine whether its benefits outweigh its limitations. In this review, we aim to describe serotype distribution and vaccine efficacy data on pneumococcal disease in the pre- and post-PCV implementation era among high-risk children in both developed and developing countries, assessing the optimization of current recommendations for their vaccination against pneumococcal disease.

scholarly journals Dietary Intakes, Sources, and Determinants of Total and Free Sugar Consumption Among Lebanese Children and Adolescents: Findings from a National Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1421-1421
Author(s):  
Lamis Jomaa ◽  
Samer Hamamji ◽  
Samer Kharroubi ◽  
Marwa Diab El Harake ◽  
Lara Nasreddine
Keyword(s):  
Children And Adolescents ◽  
Energy Intake ◽  
Low Income ◽  
Fruit Juice ◽  
World Health ◽  
National Study ◽  
Free Sugar ◽  
National Council ◽  
Dietary Intakes ◽  
Food Groups

Abstract Objectives To determine the intake levels and main sources of total sugars (TS) and free sugars (FS) among Lebanese children and adolescents and to investigate the determinants of high FS consumption. Methods In a national cross-sectional survey, data on socio-demographic, anthropometric, and lifestyle characteristics of Lebanese children and adolescents (5–18 years-old) were collected (n = 1133). Dietary intake (24-hr recall) was analyzed using Nutri Pro software to determine average daily energy intake in kilocalories (kcal/d), TS and FS in grams (g/d) and as % of total energy intake (% kcal/d). FS content of foods was defined as 100% of added sugars for non-fruit juice sources and 100% of TS for fruit juice and drinks. Independent t -tests were used to compare mean daily intakes of TS and FS by sex and age groups. Logistic regressions were conducted to explore determinants of high FS intake (&gt;10% kcal/d), as per the World Health Organization recommendations. Results Children and adolescents consumed, on average, 1899.9 ± 25.2 kcal/d of which 17 ± 0.2% kcal/d from TS and 16 ± 0.2% kcal/d from FS. Percentage of children and adolescents having high FS consumption was 62%. Main contributors to TS and FS were sweetened beverages, biscuits/chocolates, and syrups, jams and honey. Per consumer basis, intakes of FS from all food groups were significantly higher in older boys and girls than younger ones, except for candies, ice cream and fresh fruit juices. Multiple logistic regression showed children with higher paternal educational level and highest household monthly income had significantly lower odds of high FS intake (OR = 0.79, 95% CI: 0.64, 0.96 and OR = 0.70, 95% CI: 0.58, 0.83, respectively). Children meeting physical activity recommendations had higher odds of high FS compared to their counterparts (OR = 1.12, 95% CI: 1.003, 1.23). Conclusions High proportion of Lebanese children and adolescents exceeded upper limits for FS intake. Findings highlight the need for developing culture-specific interventions aimed at reducing the intake of TS and FS among adolescents, particularly those from low-income families, to curb rising obesity rates. Funding Sources This project was funded by the Lebanese National Council for Scientific Research and the University Research Board at the American University of Beirut.

Using Telehealth to Address Disparities: A Scoping Review of Early Patient-Centered Outcomes Research Experience (Preprint)

2021 ◽  
Author(s):  
James E. Bailey ◽  
Cathy Gurgol ◽  
Eric Pan ◽  
Shirilyn Njie ◽  
Susan Emmett ◽  
...  
Keyword(s):  
At Risk ◽  
Health Disparities ◽  
Best Practices ◽  
Scoping Review ◽  
Low Income ◽  
Outcomes Research ◽  
Comparative Effectiveness ◽  
Barriers And Facilitators ◽  
Patient Centered ◽  
Populations At Risk

BACKGROUND Increasingly, health systems and providers across America are employing telehealth technologies to better serve medically underserved low-income, minority, and rural populations at highest risk for health disparities. The Patient Centered Outcomes Research Institute (PCORI) has invested $386 million in comparative effectiveness research in telehealth, yet little is known about the key early lessons garnered from this research regarding best practices in using telehealth to address disparities. OBJECTIVE This paper describes preliminary lessons from this body of research using study findings and case studies drawn from these seminal patient-centered outcomes research (PCOR) initiatives. The primary purpose is to identify common barriers and facilitators to implementing telehealth technologies in populations at risk for disparities. METHODS A systematic scoping review of telehealth studies addressing disparities was performed, guided by the Arksey and O’Malley Scoping Review Framework, focused on PCORI’s active portfolio of telehealth studies and key PCOR identified by investigators of these studies. We drew on this broad literature using illustrative examples from early PCOR experience and published literature to assess barriers and facilitators to implementing telehealth in populations at risk for disparities, using the active implementation framework to extract data. Major themes regarding how telehealth interventions can overcome barriers to telehealth adoption and implementation were identified through review of both the extracted data and illustrative examples using an iterative Delphi process to achieve consensus among the PCORI investigators participating in the study. RESULTS PCORI has funded 89 comparative effectiveness studies in telehealth, of which 41 were identified and assessed use of telehealth to improve outcomes for populations at risk for health disparities as part of this scoping review. These 41 studies employed various overlapping modalities including: mobile devices (n=29), web-based interventions (n=30), real-time video (n=15), remote patient monitoring (n=8), and store-and-forward (asynchronous electronic transmission) interventions (n=5). The studies targeted one or more of PCORI’s priority populations, which include racial and ethnic minorities, people living in rural areas, people with low-income or low socioeconomic status, people with low-health literacy, and people with disabilities. Major themes identified across these studies included the importance of patient-centered design, cultural tailoring of telehealth solutions, delivering telehealth through trusted intermediaries, partnering with payers to expand telehealth reimbursement, and ensuring confidential sharing of private information. CONCLUSIONS Early PCOR evidence suggests that the most effective health system- and provider-level telehealth implementation solutions to address disparities employ patient-centered and culturally tailored telehealth solutions whose development is actively guided by patients themselves to meet the needs of specific communities and populations. Further, this evidence shows that best practices in telehealth implementation include delivering telehealth through trusted intermediaries, close partnership with payers to facilitate reimbursement and sustainability, and safeguards to ensure patient-guided confidential sharing of personal health information.

scholarly journals Association of Ready-to-Eat Cereal Consumption with Nutrient and Food Group Intake and Diet Quality by Income Status Among Children, NHANES 2013–2016

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1489-1489
Author(s):  
Jessica Smith ◽  
Vipra Vanage ◽  
Neha Jain ◽  
Norton Holschuh ◽  
Yong Zhu
Keyword(s):  
Diet Quality ◽  
Low Income ◽  
Income Group ◽  
Food Group ◽  
Whole Grains ◽  
High Income ◽  
High Income Group ◽  
Food Groups ◽  
Health And Nutrition ◽  
Income Status

Abstract Objectives Ready-to-eat (RTE) cereal is an important source of nutrients and whole grains in the diet of children and is associated with higher diet quality. Socioeconomic status is also strongly associated with nutrient intake and diet quality in the US. The objective of this study was to characterize the association between RTE cereal consumption and nutrient and food group intake and diet quality in US children ages 2 to 18 years stratified by their household income status. Methods Children age 2 to 18 years (N = 5658) in two cycles (2013–2014 and 2015–2016) of the National Health and Nutrition Examination Survey, a US nationally representative cross-sectional study, were categorized as RTE cereal eaters or non-eaters based on one day 24-hour dietary recall. Children were further stratified by their household income status according to the poverty-to-income ratio (PIR), as low-income (PIR ≤ 1.85), mid-income (PIR &gt; 1.85 to &lt;3.50) or high-income (PIR ≥ 3.50). Nutrient intakes, food group intake, and diet quality were compared between RTE cereal eaters and non-eaters in each income category using t-tests. Results More children in the low-income group were RTE cereal eaters (52%) compared to children in the mid-income (24%) and high-income (23%) groups. RTE cereal eaters, compared to non-eaters, in the low-income group had higher intakes of calcium (23% higher), vitamin D (85%), potassium (9%), fiber (12%), iron (71%), magnesium (11%), vitamin A (66%), and vitamin C (21%) (P &lt; 0.05 for all). Conversely, only intakes of vitamin D (59% higher), iron (56%) and vitamin A (39%) were significantly higher in RTE cereal eaters than non-eaters from the high-income group (P &lt; 0.05 for all). Cereal eaters also had higher intake of several key food groups including total dairy, fluid milk, and whole grains in all groups (P &lt; 0.05 for all). Lastly, diet quality was significantly higher among RTE cereal eaters, compared to non-eaters, in the low- and mid-income groups (P &lt; 0.05 for both) but not the high-income group. Conclusions RTE cereal is a popular, affordable food that provides under-consumed nutrients and food groups and is associated with increased diet quality particularly among low-income children. Funding Sources This study was funded by the Bell Institute of Health and Nutrition, General Mills, Inc.

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