Increasing the Usability of Climate Models through the Use of Consumer-Report-Style Resources for Decision-Making

Consumers of climate model information face difficulty in assessing which models and projections are best for their particular needs. This difficulty stems from the abundance of climate information, as well as the relative inaccessibility or unavailability of information concerning a given model’s quality, trade-offs, and suitability for a particular geographic region or decision-making application. Consumer reports have traditionally provided potential consumers with background knowledge and a review of available products and services to help to make decisions. As a knowledge broker for climate information in the Great Lakes region, the Great Lakes Integrated Sciences and Assessments (GLISA) team has developed a suite of climate model consumer-report-style documents to help climate information consumers make decisions when selecting models and projections for their work. To develop the reports, GLISA reviewed examples of consumer reports from other sectors, relied on the feedback and advice of our ongoing Practitioner Working Group composed of real-world consumers, and incorporated otherwise-unavailable information from model developers. Due to close, continuing partnership with our Practitioner Working Group, the content and the formatting of our climate model consumer reports respond directly to the needs of consumers. Our reports therefore evolve based on needs of the practitioners as well as with the knowledge generated by our research in usability of climate knowledge. We pose that climate model consumer reports, especially when developed in the context of trusted user–knowledge broker relationships, contribute to making climate information more relevant to and usable by practitioners.

Accuracy of Stated Calorie and Sodium Counts of Menu Items at Popular Chain Restaurants

Objectives The objective of this study was to evaluate the accuracy of stated calorie and sodium content of various menu items from 13 fast food/fast casual restaurants. Methods Three samples of four different menu items (52 total menu items) were collected from 13 popular fast food/fast casual restaurant chains (n = 152) in NY, NJ and CT. Each sample was weighed to obtain the serving size in grams. Sodium content was determined and a proximate analysis was performed to estimate total calories. Analytical test data per 100g was calculated based on actual serving size weights. For each menu item, samples were averaged and compared to the restaurant's stated calorie and sodium counts. Results Of the 152 samples analyzed, 15% (n = 23) were 20% or more of the declared calories and 26% (39 of 152) were 20% or more than the declared sodium content. The highest average overage for a menu item was 31% for calories and more than twice the declared amount for sodium. Among the 52 menu items, on average, three were approximately 26 to 31% higher, or about 150 to 200 calories more than declared. Fourteen of the 52 menu items (27%) had average analytical sodium amounts greater than 20% of the declared sodium. This translates to about 150 to 500 mg more sodium than expected. Sodium was less than 20% of the declared sodium for 31 models (60%), with more than half within 100 mg of the declared sodium values. Conclusions Across 52 menu items representing 13 fast food/fast casual chains, the amount of calories provided by restaurants were more consistent with stated amounts as compared to sodium content. If stated calorie or sodium content inaccuracies are widespread, this could hamper the consumer's ability to self-monitor their dietary intake. It also impacts the ability of researchers to accurately estimate the contribution of these nutrients to dining outside the home. Funding Sources Performed as part of my role at Consumer Reports.

Recent estimates of the out-of-pocket expenditure on health care in Australia

Objective The aims of this study were to estimate the average annual out-of-pocket (OOP) expenditure on health care by households in Australia in 2015–16, and to compare this with the estimate for 2009–10. Methods Data from the most recent Household Expenditure Survey (HES) conducted by the Australian Bureau of Statistics were used. Various statistical methods were used to estimate the annual OOP expenditures at the household and national levels. Results The average annual OOP expenditure was A$4290 per household, representing 5.8% of the amount spent on all goods and services. Private health insurance (PHI) premiums, although not a direct expenditure on health care, were 40.6% of the total OOP expenses. Of the remaining 59.4%, nearly half was spent on doctors and other health professionals, and approximately one-third was spent on medicines. Dental treatments and specialist consultations were the most expensive, whereas visits to general practitioners incurred the least OOP expenditure. Households with PHI (58.6%) spent fourfold more on health care than those not insured. Compared with the 2009–10 survey, the biggest increases were in the cost of PHI (50.7%) and copayments to specialists (34.8%) and other health professionals (42.0%). Conclusions OOP expenditure on health care as a proportion of the total household expenditure on all goods and services has increased by more than 25% between 2009–10 and 2015–16. What is known about the topic? Australian households incur OOP expenses for health care in Australia for a wide range of goods and services, such as copayments to doctors and other health professionals beyond the Medicare rebates, the cost of medicines and other pharmaceutical goods not covered entirely by the Pharmaceutical Benefits Scheme and PHI premiums. Although other estimates of OOP expenditure are available in official reports of the Australian Institute of Health and Welfare, they are based on administrative records rather than consumer reports, and cannot be disaggregated by item or the characteristics of households. What does this paper add? This paper provides detailed information on OOP expenditure on health care as reported by a probability sample of households interviewed for the HES conducted by the ABS during 2015–16. These estimates of OOP expenditure, based on consumer reports, add a further dimension to the information available from administrative records only. What are the implications for practitioners? Practitioners should take account of the effect of increasing copayments for their services, especially on patients belonging to the lower socioeconomic categories. Increasing copayments may lead to people foregoing medical care. Health planners and politicians should note the steady upward drift in OOP expenses and factor these into their policies for future funding of health care.

Development and Piloting Testing of an Experimental Tobacco and Nicotine Product Marketplace

Introduction We describe the development and pilot testing of the experimental tobacco and nicotine product marketplace (ETM)—a method for studying tobacco and nicotine product (TNP) choices and use behavior in a standardized way. Aims and Methods The ETM resembles an online store populated with TNPs. Surveillance activities and data from a US representative survey and consumer reports were used to determine the most popular TNPs for inclusion in the ETM. Standardized information and videos demonstrating how to use the TNPs were provided. To test the feasibility of using the ETM, smokers (n = 119) underwent monitoring of usual brand cigarette smoking and other TNP use (Baseline Phase) followed by access to the ETM (ETM Phase) that included their usual brand cigarettes, e-cigarettes, moist snuff, snus, and nicotine replacement therapy. During the ETM Phase, participants were provided points based on their baseline TNP consumption to exchange for TNPs in the ETM. Participants were advised to exchange points for enough TNPs to last until their next visit and to refrain from using TNPs not obtained in the ETM. A subset of the participants (n = 62) completed a survey on their experience with the ETM. Results The majority of the participants stated they were comfortable with navigating the ETM (97%), it was easy to determine product characteristics (89%), and they were satisfied with the products included in the marketplace (85%). Conclusions The ETM was well received by the vast majority of the participants and can be utilized by researchers to investigate a variety of TNP policy and regulatory science research questions. Implications Patterns of TNP use are complex due to greater availability, marketing, and promotion of a diverse array of TNPs. Innovative methods are needed to experimentally study TNP choices and patterns. Through describing the development of the ETM, we provide researchers with a tool that can be readily adapted to studying a variety of phenomena challenging public health.