scholarly journals Voluntary Kids’ Meal Beverage Standards: Are They Sufficient to Ensure Healthier Restaurant Practices and Consumer Choices?

2020 ◽  
Vol 17 (15) ◽  
pp. 5275
Author(s):  
Phoebe Harpainter ◽  
Sridharshi C. Hewawitharana ◽  
Danielle L. Lee ◽  
Anna C. Martin ◽  
Wendi Gosliner ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Low Income ◽  
Small Sample ◽  
Multilevel Logistic Regression ◽  
Implementation Support ◽  
Voluntary Standards ◽  
Data Collector ◽  
Consumer Choices ◽  
Quick Service ◽  
Optimal Implementation

Many quick-service restaurants (QSRs) instituted voluntary kids’ meal default beverage standards (standards) between 2013 to 2017. Little is known about impacts of standards on QSR drive-through practices and on customer choices. This study assessed differences in restaurant practices including kids’ meal beverages shown on menu boards, offered by cashiers, and selected by customers in QSRs with and without voluntary standards. Observations (n = 111) and customer surveys (n = 84) were conducted in 2018 at QSRs with standards (n = 70) and without (n = 41) in low-income California, U.S. neighborhoods. Kids’ meal beverages on menu boards (n = 149) and offered by cashiers (n = 185) at QSRs with and without standards were analyzed using multilevel logistic regression. Significantly more menu boards at QSRs with standards (n = 103) vs. without (n = 46) featured only milk, water or unsweetened juice (65.1% vs. 4.4%; p < 0.001). Most cashiers at QSRs with standards and QSRs without (53.1%, 62.5%) asked what drink the data collector wanted rather than first offering default beverages. A small sample of customer interviews found that customers at QSRs with standards most commonly ordered juice (37.0%); at QSRs without standards, soda (45.5%). Although menu boards showed healthier kids’ meal beverages at QSRs with standards than without, cashier behavior was inconsistent. Results suggest additional measures (legislation, implementation support, enforcement) may be needed to ensure optimal implementation.

scholarly journals Restaurant kids’ meal beverage offerings before and after implementation of healthy default beverage policy statewide in California compared to citywide in Wilmington, Delaware

2021 ◽  
pp. 1-23
Author(s):  
Lorrene D. Ritchie ◽  
Laura Lessard ◽  
Phoebe Harpainter ◽  
Marisa M. Tsai ◽  
Gail Woodward-Lopez ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Policy Implementation ◽  
Low Income ◽  
Multilevel Logistic Regression ◽  
Sugar Sweetened Beverages ◽  
Additional Information ◽  
Sweetened Beverages ◽  
Before And After ◽  
Manager Perceptions ◽  
Quick Service

Abstract Objective: In 2019, California and Wilmington, Delaware implemented policies requiring healthier default beverages with restaurant kids’ meals. This study assessed restaurant beverage offerings and manager perceptions. Design: Pre-post menu observations were conducted in California and Wilmington. Observations of cashiers/servers during orders were conducted pre-post implementation in California and post-implementation in Wilmington. Changes in California were compared using multilevel logistic regression and paired t-tests. Post-implementation, managers were interviewed. Setting: Inside and drive-through ordering venues in a sample of quick-service restaurants in low-income California communities and all restaurants in Wilmington subject to the policy, the month before and 7-12 months after policy implementation. Participants: Restaurant observations (California n=110; Wilmington n=14); managers (California n=75; Wilmington n=15). Results: Pre-implementation, the most common kids’ meal beverages on California menus were unflavored milk and water (78.8%, 52.0%); in Wilmington, juice, milk, and sugar-sweetened beverages were most common (81.8%, 66.7%, 46.2%). Post-implementation, menus including only policy-consistent beverages significantly increased in California (9.7% to 66.1%, p<0.0001), but remained constant in Wilmington (30.8%). During orders, cashiers/servers offering only policy-consistent beverages significantly decreased post-implementation in California (5.0% to 1.0%, p=0.002). Few managers (California 29.3%; Wilmington 0%) reported policy knowledge, although most expressed support. Most managers wanted additional information for customers and staff. Conclusions: While the proportion of menus offering only policy-consistent kids’ meal default beverages increased in California, offerings did not change in Wilmington. In both jurisdictions managers lacked policy knowledge and few cashiers/servers offered only policy-consistent beverages. Additional efforts are needed to strengthen implementation of kids’ meal beverage policies.

Abstract 17309: Scope and Determinants of Nonfinancial Barriers to Healthcare Access in Individuals With Atherosclerotic Cardiovascular Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Isaac Acquah ◽  
Javier Valero-Elizondo ◽  
Miguel Cainzos Achirica ◽  
Rahul Singh ◽  
Karan Shah ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Logistic Regression ◽  
Low Income ◽  
Barriers To Care ◽  
Multinomial Logistic Regression ◽  
The Elderly ◽  
Atherosclerotic Cardiovascular Disease ◽  
The Us ◽  
Barriers To Healthcare ◽  
Relative Prevalence

Introduction: Barriers to healthcare - financial and nonfinancial - may result in unmet health needs and adverse outcomes. Despite this, the nonfinancial barriers to care among adults with atherosclerotic cardiovascular disease (ASCVD) is poorly defined in the US. We aimed to explore the scope and determinants of nonfinancial barriers to care among individuals with ASCVD. Methods: We analyzed data from the 2013-17 National Health Interview Survey (NHIS). We included adults with self-reported ASCVD (heart attack, angina, and/or stroke). Nine key variables in the NHIS that represent nonfinancial barriers to healthcare were assessed as absent/present, and participants were classified as having 0-1, 2, or ≥3 barriers. Multinomial logistic regression (using 0-1 nonfinancial barriers as reference) was used to evaluate the relationship between various sociodemographic factors, and an increasing number of nonfinancial barriers. Results: Of all the 15,758 adults with ASCVD (8.1% annually in the US; representing 19.6 million), 23.4% reported having at least one nonfinancial barrier to care while 4.9% reported 3 nonfinancial barriers. In a multivariable multinomial logistic regression, after stratifying by age, individuals from low-income families had an almost 2-fold relative prevalence of 3 nonfinancial barriers ( Figure) . In the elderly, however, lack of insurance was the strongest predictor (relative prevalence ratio of 6.51 [95% confidence interval; 2.25, 18.87]) of having ≥3 barriers. Conclusion: Among adults with ASCVD, the relative prevalence of ≥3 nonfinancial barriers was low (4.9%) with low-income being the only modifiable predictor of reporting ≥3 nonfinancial barriers and lack of insurance being the strongest predictor in the elderly. Addressing financial barriers to healthcare may help alleviate these nonfinancial barriers.

scholarly journals Subjective Social Status Is Associated with Dysregulated Eating Behaviors and Greater Body Mass Index in an Urban Predominantly Black and Low-Income Sample

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3893
Author(s):  
Monika M. Stojek ◽  
Paulina Wardawy ◽  
Charles F. Gillespie ◽  
Jennifer S. Stevens ◽  
Abigail Powers ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Social Status ◽  
Body Mass ◽  
Low Income ◽  
Emotional Eating ◽  
Eating Behaviors ◽  
Small Sample Size ◽  
Food Addiction ◽  
Subjective Social Status ◽  
Small Sample

Background: Higher subjective social status (SSS) or a person’s perception of their social standing is related to better health outcomes, but few studies examined SSS in relation to obesity. Emotional eating and food addiction have been linked to obesity. Some studies indicated that manipulating SSS may lead to altered food intake, but the relationship between SSS and dysregulated eating, such as emotional eating and food addiction (FA), has not been examined. The goal of this study was to examine the associations between SSS in the community and the larger society, dysregulated eating (emotional eating and FA), and body mass index (BMI) in a majority racial minority sample. Methods: The participants (N = 89; 93% Black, 86% women, and 56% with obesity; 72% income lower than USD 2000), recruited from a publicly funded hospital in Atlanta, GA, completed the MacArthur Scale, Dutch Eating Behaviors Questionnaire, Yale Food Addiction Scale, Beck Depression Inventory, PTSD Symptom Checklist, and demographics questionnaire. Results: Twenty-two percent of the sample met the criteria for FA; those with FA had significantly higher BMI than those without (p = 0.018). In the hierarchical linear regression, the SSS community (but not in society) predicted higher severity of emotional eating (β = 0.26, p = 0.029) and FA (β = 0.30, p = 0.029), and higher BMI (β = 0.28, p = 0.046), independent from depression and PTSD symptoms. Conclusions: The findings indicate that, among Black individuals with predominantly low income in the U.S., perceived role in their community is associated with eating patterns and body mass. Given the small sample size, the results should be interpreted with caution.

Implementation of Postpartum Depression Screening for Women Participating in the WIC Program

2021 ◽  
pp. 107839032110478
Author(s):  
Kelli Giron ◽  
Shelly Noe ◽  
Lori Saiki ◽  
Elizabeth Kuchler ◽  
Satyapriya Rao
Keyword(s):  
Postpartum Depression ◽  
Sample Size ◽  
Low Income ◽  
Small Sample Size ◽  
Depression Scale ◽  
Small Sample ◽  
National Average ◽  
High Risk Population ◽  
Community Resources ◽  
Wic Program

Introduction: The national average for the occurrence of postpartum depression (PPD) is 11.5%. Women enrolled in the Women, Infants, and Children (WIC) program are at an elevated risk for PPD symptoms due to risk factors such as a low income, unemployment, low education level, and younger maternal age. Objective: To implement screening for PPD symptoms using the Edinburgh Postnatal Depression Scale (EPDS) (1987) for women participating in the local WIC program with an infant <12 months old and compare results of positive screenings to the national average. The second goal was to provide community resources to those women with a positive score. Methods: Of 72 women screened, 69 scores were used in the comparison of the positive scores to the national Centers for Disease Control and Prevention average of 11.5%. Women were offered community resources after completion of the EPDS. Results: There were 13 positive scores out of the sample size of 69. The percentage of positive scores obtained from these data were 18.84% for the WIC population, which is higher than the national average of 11.5%. This was significant with p = .0494. One limitation of this project was a small sample size. Conclusion: It would be beneficial for the WIC program to screen women for PPD symptoms in this high-risk population, so that recommendations for follow-up care could be made and quality of life could be increased.

Household means of transportation and place of child delivery in Nigeria

2020 ◽  
Author(s):  
Lukman Bola Solanke ◽  
Omolayo Bukola Oluwatope ◽  
Yinusa Rasheed Adebayo ◽  
Olaoye James Oyeleye ◽  
Benjamin Bukky Ilesanmi ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Pregnant Women ◽  
Logistic Regression Model ◽  
Institutional Delivery ◽  
Multilevel Logistic Regression ◽  
Place Of Delivery ◽  
Pooled Data ◽  
Support Programme ◽  
Mode Of Transport ◽  
Multilevel Logistic Regression Model

Abstract Background The means of transportation available to pregnant women in households may serve either as a driver or deterrent of institutional delivery. However, how household means of transportation associates with place of delivery has been less explored in Nigeria. Methods This study was based on pooled data of 2008-2013 Nigeria Demographic and Health Survey. The study analysed a weighted sample size of 6,540 women. The multilevel logistic regression model was applied using STATA 14. Results The study revealed 37% institutional delivery among women in Nigeria. Women whose household mode of transport were cars were twice more likely to have institutional delivery compared to women who had no viable household means of transportation (AOR=2.044, p<0.01; CI=1.781-2.345). Women who live in communities with high proportions of households with no means of transportation were 12.8% less likely to have institutional delivery (AOR=0.872, p=0.01; CI: 0.788-0.967). Women who live in communities with high proportions of household who owned motorcycle compared to those in communities with low proportion were 31.9% more likely to have institutional delivery (AOR=1.319, p<0.05; CI: 1.071-1.625). Women who live in communities with high proportions of households who owned cars compared to those in communities with low proportion were more than three times more likely to have institutional delivery (AOR=3.146, p<0.01; CI: 2.621-3.777).Conclusion Means of transportation significantly explains choice of place of child delivery in urban Nigeria. A public-private transport support programme to reduce transportation burden among pregnant women is imperative in the country.

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