scholarly journals Facilitators and barriers to preparing and offering whole grains to children diagnosed with prediabetes: qualitative interviews with low-income caregivers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tashara M. Leak ◽  
Navika Gangrade ◽  
June Tester
Keyword(s):  
Pilot Study ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Comparative Method ◽  
Qualitative Interviews ◽  
Clinic Visit ◽  
Whole Grains ◽  
Dietary Recommendations ◽  
Convenience Sample ◽  
Facilitators And Barriers

Abstract Background The prevalence of U.S. youth with prediabetes and type 2 diabetes (T2D) is increasing, with those from racial/ethnic minority and low socioeconomic status (SES) backgrounds at greater risk. Dietary fiber (e.g., whole grains and vegetables) is shown to be inversely associated with T2D risk, yet dietary recommendations are not being met. Caregivers play an important role in home food availability, but low SES neighborhoods are shown to have limited access to fiber-rich foods such as whole grains. The overall aim of this qualitative study was to assess caregiver perceptions about facilitators and barriers to preparing and offering whole grains that they received as part of the 16-week Food Overcoming Our Diabetes Risk (FoodRx) pilot study. Methods A convenience sample of 60 youth (8–17 years) with obesity and prediabetes were recruited from an urban pediatric weight management clinic to participate in the FoodRx pilot study. Caregivers accompanied youth to a baseline clinic visit and completed a survey that asked about individual and household characteristics. Exit interviews were conducted at the follow-up clinic visit with caregivers of all youth who completed the study (n = 48) in order to assess facilitators and barriers experienced when preparing and offering whole grains. Interview transcripts were coded using the constant comparative method and grounded theory approaches. Results Caregivers (n = 48) had a mean age of 43 years and were primarily female (n = 46) and Hispanic (71%). Main facilitators to preparing and offering whole grains in the home were caregivers’ improved knowledge of whole grain health benefits and the development of strategies to encourage their children to consume whole grains (i.e., pairing whole grains with another liked food). A main barrier for caregivers was the lack of resources available to identify and prepare the novel whole grains that they received. Conclusion Findings suggest that caregivers are receptive to incorporating more whole grains into home-prepared meals, but they may need additional nutrition and cooking education to improve their self-efficacy.

scholarly journals The utility of linking National Food Ingredient Databases to National Food Consumption surveys: a pilot study on fibre and sugar

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Sarah Kelly ◽  
Aoibhinn Moore-Heslin ◽  
Mengna Yang ◽  
Maria Buffini ◽  
Laura Kehoe ◽  
...  
Keyword(s):  
Pilot Study ◽  
Food Consumption ◽  
Sugar Content ◽  
Portion Size ◽  
Dietary Recommendations ◽  
Food Ingredient ◽  
Small Pilot Study ◽  
Convenience Sample ◽  
High Fibre ◽  
Safety Considerations

AbstractIntroduction:Current dietary recommendations encourage increased fibre and reduced sugar consumption. In the UK, specific targets and benchmarks have been established for the sugar content of some foods but not for fibre. National Food Consumption Surveys provide comprehensive information of all foods consumed by representative population samples. The Irish national food surveys as completed by the Irish Universities Nutrition Alliance (IUNA) capture dietary data at brand level with all details as gathered on pack entered into a discrete but inter-linked database, the Irish National Food Ingredient Database (INFID). The aim of this study was to profile the carbohydrate quality of a convenience sub-sample of packaged foods as eaten by Irish children during the National Children's Food Survey II (2017/2018) as entered into INFID.Materials and Methods:All on-pack details from 385 available foods in the categories ‘white breads and rolls’; ‘brown breads and rolls’; ‘other breads and scones’; ‘ready to eat breakfast cereals (RTEBC)’; ‘biscuits’; and ‘cakes, buns and pastries’ were entered in to INFID and quality control completed. The carbohydrate profile of the products was assessed with respect to fibre labelling criteria and UK sugar guidelines and targets. SPSS Version 25 was used for all analyses.Results:Although 56% (n210) of all products entered were eligible to make a ‘source of’ or ‘high’ fibre claim, only 20% (n78) made such a claim. Of this, 46% stated ‘high fibre’ and 32% ‘source’, predominately in the ‘brown breads and rolls’ and ‘RTEBC’ groups. When compared to UK Department of Health guidance for ‘low’, ‘medium’ and ‘high’ sugar, 65% of all products examined (n250) were either ‘low’ or ‘medium’ sugar. Comparison of median sugar contents with Public Health England sugar reformulation targets revealed different responses in each category, with all categories other than foods deemed as “morning goods” yet to meet the 2020 target of 20% reduction in sugar content.Discussion:This small pilot study of a convenience sample of foods suggests that for the limited number of foods examined, for some there remains challenges to reduce sugar and increase fibre contents. Strategies such as reformulation, change in portion size, flexibility in labelling and/or a shift in sales portfolios could be considered but only alongside technological and safety considerations. Further research to broaden this analysis and to link nutrient levels as listed on pack with actual consumption patterns could help ensure all recent initiatives including reformulation are recognised.

Moral Identity Among Low–Socioeconomic Status Adolescents: Stressful Events and Family Relationships Considered

2017 ◽  
Vol 33 (4) ◽  
pp. 395-415
Author(s):  
Alexandra N. Davis ◽  
Cara Streit
Keyword(s):  
Low Socioeconomic Status ◽  
Low Income ◽  
Family Relationships ◽  
Conceptual Models ◽  
Moral Identity ◽  
Qualitative Interviews ◽  
The United States ◽  
Family Processes ◽  
Stressful Events ◽  
Low Socioeconomic

The current study aimed to examine themes surrounding the moral identity of adolescents from two low-income communities in the United States using qualitative interviews. Based on previous conceptual models, the authors aimed to examine the co-occurrence of themes of morality, stressors, and family processes. Participants were adolescents from the Northeast and Midwest ( n = 38; mean age = 15.64; 73.7% female; 23.7% Black, 30.6% Latino, and 47.4% White). The results demonstrated that morality was a salient theme among adolescents. In addition, a subset of adolescents discussed stressors and family processes in conjunction with morality. The discussion will focus on the resiliency of youth living in low-income communities.

The Feasibility of an eLearning Nutrition Education Program for Low-Income Individuals

2016 ◽  
Vol 18 (1) ◽  
pp. 150-157 ◽  
Author(s):  
Sarah Stotz ◽  
Jung Sun Lee ◽  
Hui Rong ◽  
Deborah Murray
Keyword(s):  
Nutrition Education ◽  
Low Income ◽  
Education Program ◽  
Comparative Method ◽  
Cost Effective ◽  
Convenience Sample ◽  
Individual Interviews ◽  
Cost Effective Method ◽  
Nutrition Education Program ◽  
Nutrition Educators

Background. Online eLearning may be an innovative, efficient, and cost-effective method of providing nutrition education to a diverse low-income audience. Aims. The intent of this project is to examine perceptions of nutrition educators regarding the feasibility of an eLearning nutrition education program tailored to low-income Georgians. Method. Semistructured individual interviews were conducted, guided by the constructivist theory. The interview guide focused on three themes: accessibility, literacy, and content. A prototype of the program also served as a talking point. Interviews were conducted in two urban Georgian counties in a location chosen by each participant. We recruited a convenience sample of Georgian nutrition educators ( n = 10, 100% female, 50% Black). Interviews were transcribed and analyzed using constant comparative method. Results and Discussion. Motivation is considered the primary barrier to program feasibility. Neither access to the Internet nor literacy are considered significant barriers. Inclusion of skill-based, visual education methods such as cooking videos, recipes, and step-by-step teaching tools was highlighted. Nutrition educators perceived this program would be a feasible form of nutrition education for the priority audience. Conclusions. Findings from this study will inform the user-centered development of the program.

scholarly journals The Role of Adolescents From a Low Socioeconomic Background in Household Food Preparation: A Qualitative Study

2018 ◽  
Vol 20 (6) ◽  
pp. 890-896
Author(s):  
Tashara M. Leak ◽  
Taylor A. Aasand ◽  
Zata Vickers ◽  
Marla Reicks
Keyword(s):  
Low Income ◽  
Comparative Method ◽  
Work And Family ◽  
Food Preparation ◽  
Socioeconomic Background ◽  
Negative Consequences ◽  
Convenience Sample ◽  
Primary Responsibility ◽  
Healthy Family ◽  
As Stress

The purpose of this study was to understand adolescents’ from low-income households perceptions of their involvement in home food preparation, reasons underlying the extent to which they were involved, and positive and negative consequences associated with their involvement. Semistructured interviews were conducted with a convenience sample of 19 adolescents (13-18 years). Audio-recorded interviews were transcribed verbatim. Themes were identified using grounded theory and the constant comparative method. Eight adolescents described cooking as a primary responsibility due to adult work and family schedules, age, gender, and/or cultural expectations. They were typically preparing food for themselves and their family without assistance, and making decisions about what was prepared. They identified positive and negative consequences including enjoyment and satisfaction, as well as stress and less time for other activities. Eleven adolescents mostly assisted the primary food preparer, with little input in deciding what was prepared. They identified benefits such as enjoyment and family interaction. Foods prepared by many adolescents tended to be quick and easy to prepare foods. Future studies should investigate the relationship between adultified cooking responsibilities, diet quality, and health. Also, cooking education for adolescents needs to address how to prepare a healthy family meal on a budget.

scholarly journals Development of a Tool to Identify Poverty in a Family Practice Setting: A Pilot Study

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Vanessa Brcic ◽  
Caroline Eberdt ◽  
Janusz Kaczorowski
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Low Income ◽  
Poverty Line ◽  
Primary Care Providers ◽  
Case Finding ◽  
Care Providers ◽  
Convenience Sample ◽  
Rural Primary Care ◽  
Housing Security

Objective. The goal of this pilot study was to develop and field-test questions for use as a poverty case-finding tool to assist primary care providers in identifying poverty in clinical practice. Methods. 156 questionnaires were completed by a convenience sample of urban and rural primary care patients presenting to four family practices in British Columbia, Canada. Univariate and multivariate logistic regression analyses compared questionnaire responses with low-income cut-off (LICO) levels calculated for each respondent. Results. 35% of respondents were below the “poverty line” (LICO). The question “Do you (ever) have difficulty making ends meet at the end of the month?” was identified as a good predictor of poverty (sensitivity 98%; specificity 60%; OR 32.3, 95% CI 5.4–191.5). Multivariate analysis identified a 3-item case-finding tool including 2 additional questions about food and housing security (sensitivity 64.3%; specificity 94.4%; OR 30.2, 95% CI 10.3–88.1). 85% of below-LICO respondents felt that poverty screening was important and 67% felt comfortable speaking to their family physician about poverty. Conclusions. Asking patients directly about poverty may help identify patients with increased needs in primary care.

scholarly journals Local perceptions of the impact of group interpersonal psychotherapy in rural Uganda

2016 ◽  
Vol 3 ◽  
Author(s):  
R. E. Lewandowski ◽  
P. A. Bolton ◽  
A. Feighery ◽  
J. Bass ◽  
C. Hamba ◽  
...  
Keyword(s):  
Low Income ◽  
School Attendance ◽  
Qualitative Interviews ◽  
Interpersonal Psychotherapy ◽  
Community Members ◽  
Local Perceptions ◽  
Convenience Sample ◽  
Prevalence Of Depression ◽  
Improved Sanitation ◽  
The Impact

Background.This study investigated local perceptions of changes stemming from a long-standing Group Interpersonal Psychotherapy (IPT-G) program for the treatment of depression in rural Uganda. The study was conducted in a low-income, severely HIV/AIDS-affected area where in 2001 the prevalence of depression was estimated at 21% among adults.Method.Data were collected using free-listing and key informant qualitative interviews. A convenience sample of 60 free-list respondents was selected from among IPT-G participants, their families, and other community members from 10 Ugandan villages. Twenty-two key informants and six IPT-G facilitators were also interviewed.Results.Content analysis yielded five primary categories of change in the community related to the IPT-G program: (1) improved school attendance for children; (2) improved productivity; (3) improved sanitation in communities; (4) greater cohesion among community members; and (5) reduced conflict in families. Community members and IPT-G facilitators suggested that as depression remitted, IPT-G participants became more hopeful, motivated and productive.Conclusion.Results suggest that providing treatment for depression in communities with high depression prevalence rates may lead to positive changes in a range of non-mental health outcomes.

scholarly journals Socioeconomic Disparities in Foods/Beverages and Nutrients Consumed by U.S. Adolescents When Snacking: National Health and Nutrition Examination Survey 2005–2018

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2530
Author(s):  
Navika Gangrade ◽  
Janet Figueroa ◽  
Tashara M. Leak
Keyword(s):  
National Health ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
High Income ◽  
Future Research ◽  
Nutrition Examination Survey ◽  
Middle Income ◽  
Low Socioeconomic ◽  
Health And Nutrition ◽  
Income Ratio

Snacking contributes a significant portion of adolescents’ daily energy intake and is associated with poor overall diet and increased body mass index. Adolescents from low socioeconomic status (SES) households have poorer snacking behaviors than their higher-SES counterparts. However, it is unclear if the types of food/beverages and nutrients consumed during snacking differ by SES among adolescents. Therefore, this study examines SES disparities in the aforementioned snacking characteristics by analyzing the data of 7132 adolescents (12–19 years) from the National Health and Nutrition Examination Survey 2005–2018. Results reveal that adolescents from low-income households (poverty-to-income ratio (PIR) ≤ 1.3) have lower odds of consuming the food/beverage categories “Milk and Dairy” (aOR: 0.74; 95% CI: 0.58-0.95; p = 0.007) and “Fruits” (aOR: 0.62, 95% CI: 0.50–0.78; p = 0.001) as snacks and higher odds of consuming “Beverages” (aOR: 1.45; 95% CI: 1.19-1.76; p = 0.001) compared to those from high-income households (PIR > 3.5). Additionally, adolescents from low- and middle-income (PIR > 1.3–3.5) households consume more added sugar (7.98 and 7.78 g vs. 6.66 g; p = 0.012, p = 0.026) and less fiber (0.78 and 0.77 g vs. 0.84 g; p = 0.044, p = 0.019) from snacks compared to their high-income counterparts. Future research is necessary to understand factors that influence snacking among adolescents, and interventions are needed, especially for adolescents from low-SES communities.

scholarly journals Long-term condition management for prisoners: improving the processes between community and prison

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
NMJ Wright ◽  
F Hankins ◽  
P Hearty
Keyword(s):  
Qualitative Interviews ◽  
Electronic Record ◽  
Medicines Management ◽  
Long Term Conditions ◽  
Police Custody ◽  
Barriers To Screening ◽  
High Prevalence ◽  
Facilitators And Barriers ◽  
Ongoing Monitoring

Abstract Background Prisoner populations have a disproportionately high prevalence of risk factors for long-term conditions (LTCs), and movement between community and prisons is a period of potential disruption in the ongoing monitoring and management of LTCs. Method Nineteen qualitative interviews with staff, recruited by purposive sampling for professional background, were conducted to explore facilitators and barriers to screening, monitoring and medicines management for LTCs. Results There is variability in prisoner behaviours regarding bringing community GP-prescribed medication to prison following arrest and detention in police custody, which affects service ability regarding seamless continuation of community prescribing actions. Systems for actively inputting clinical data into existing, nationally agreed, electronic record templates for QOF monitoring are under-developed in prisons and such activity is dependent upon individual “enthusiast(s)”. Conclusion There is a pressing need to embed standardised QOF monitoring systems within an integrated community/prison commissioning framework, supported by connectivity between prison and community primary care records, including all activity related to QOF compliance.

scholarly journals “You run out of hope:” An Exploration of Low-Income Parents’ Experiences with Food Insecurity using Photovoice

2021 ◽  
pp. 1-21
Author(s):  
Payge Lindow ◽  
Irene H. Yen ◽  
Mingyu Xiao ◽  
Cindy W. Leung
Keyword(s):  
Food Insecurity ◽  
San Francisco ◽  
Low Income ◽  
Eating Behaviors ◽  
Comparative Method ◽  
Well Being ◽  
Structured Interviews ◽  
Unhealthy Eating ◽  
Low Income Families ◽  
The Impact

ABSTRACT Objective: Using an adaption of the Photovoice method, this study explored how food insecurity affected parents’ ability to provide food for their family, their strategies for managing household food insecurity, and the impact of food insecurity on their well-being. Design: Parents submitted photos around their families’ experiences with food insecurity. Afterwards, they completed in-depth, semi-structured interviews about their photos. The interviews were transcribed and analyzed for thematic content using the constant comparative method. Setting: San Francisco Bay Area, California, USA. Subjects: 17 parents (14 mothers and 3 fathers) were recruited from a broader qualitative study on understanding the experiences of food insecurity in low-income families. Results: Four themes were identified from the parents’ photos and interviews. First, parents described multiple aspects of their food environment that promoted unhealthy eating behaviors. Second, parents shared strategies they employed to acquire food with limited resources. Third, parents expressed feelings of shame, guilt, and distress resulting from their experience of food insecurity. And finally, parents described treating their children to special foods to cultivate a sense of normalcy. Conclusions: Parents highlighted the external contributors and internal struggles of their experiences of food insecurity. Additional research to understand the experiences of the food-insecure families may help to improve nutrition interventions targeting this structurally vulnerable population.

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