Objective
In response to recent national efforts to increase the availability of healthy food in small stores, we sought to understand the extent to which small food stores could implement the newly published Healthy Small Store Minimum Stocking Recommendations and reflect on the new US Department of Agriculture Food and Nutrition Service's final rule for stocking of staple foods for Supplemental Nutrition Assistance Program–approved retailers.
Design
We collected qualitative and quantitative data from 57 small stores in four states (Arizona, Delaware, Minnesota, and North Carolina) that accepted Supplemental Nutrition Assistance Program but not Special Supplemental Nutrition Assistance Program for Women, Infants, and Children benefits. Data from semistructured, in-depth interviews with managers/owners were transcribed, coded, and analyzed. We collected quantitative store inventory data onsite and later performed descriptive analyses.
Results
Store interviews revealed a reluctant willingness to stock healthy food and meet new recommendations. No stores met recommended fruit and vegetable stocking, although 79% carried at least one qualifying fruit and 74% carried at least one qualifying vegetable. Few stores met requirements for other food categories (ie, whole grains and low-fat dairy) with the exception of lean proteins, where stores carrying nuts or nut butter were more likely to meet the protein recommendation. Water and 100% juice were widely available and 68% met basic healthy beverage criteria.
Conclusions
In contrast to the inventory observed, most owners believed store stock met basic recommendations. Further, findings indicate that small stores are capable of stocking healthy products; however, technical and infrastructure support, as well as incentives, would facilitate shifts from staple to healthier staple foods. Retailers may need support to understand healthier product criteria and to drive consumer demand for new products.
In response to lack of access to healthy foods, many low-income communities are instituting local healthy corner store programs. Some stores also participate in the United States Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP). This study used two assessment tools to compare the healthfulness of offerings at stores participating in local healthy store programs (upgraded stores), WIC, and/or SNAP to that of similar non-participating stores.
Based on store audits conducted in 315 New Jersey corner stores in 2014, we calculated healthy food availability scores using subsections of the Nutrition Environment Measures Survey for Corner Stores (NEMS-CS-Availability) and a short-form corner store audit tool (SCAT). We used multivariable regression to examine associations between program participation and scores on both instruments.
Adjusting for store and block group characteristics, stores participating in a local healthy store program had significantly higher SCAT scores than did non-participating stores (upgraded: M = 3.18, 95% CI 2.65–3.71; non-upgraded: M = 2.52, 95% CI 2.32–2.73); scores on the NEMS-CS-Availability did not differ (upgraded: M = 12.8, 95% CI 11.6–14.1; non-upgraded: M = 12.5, 95% CI 12.0–13.0). WIC-participating stores had significantly higher scores compared to non-participating stores on both tools. Stores participating in SNAP only (and not in WIC) scored significantly lower on both instruments compared to non-SNAP stores.
WIC-participating and non-SNAP corner stores had higher healthfulness scores on both assessment tools. Upgraded stores had higher healthfulness scores compared to non-upgraded stores on the SCAT.
Women with breast cancer often experience weight gain during and after treatment, significantly increasing risk for recurrence as well as all-cause mortality. Based on a growing body of evidence, meditative movement practices may be effective for weight management. First, we describe the effects of stress on factors associated with weight gain for breast cancer survivors. Then, a model is proposed that utilizes existing evidence to suggest how meditative movement supports behavioral, psychological, and neurohormonal changes that may explain weight loss. Application of the model suggests how a novel "mindful-body-wisdom" approach may work to help reduce weight for this at-risk group.
Programs such as the Healthy Corner Store Initiative have been widely adopted in recent years to increase the availability of healthy foods in small retail food stores. Valid and reliable measures are necessary to evaluate the effectiveness of these programs. The validated instruments currently available for assessments require in-person evaluations, with surveys taking up to 30 minutes per store to complete. This instrument was developed by researchers at Arizona State University to simplify the process of evaluating the effectiveness of healthy store interventions, and to enable community partners and practitioners to conduct their own evaluations of food access. The SCAT was validated against an adapted version of the Nutrition Environment Measures Survey for Corner Stores, and tested for feasibility of use over the telephone. The SCAT was found to discriminate between corner stores in the top 20% of healthfulness scores from those in the lower 80% with 89% accuracy.
In 2015 a panel of experts was convened by Healthy Eating Research, a program of the Robert Wood Johnson Foundation, to establish a set of minimum guidelines small retail food stores could reach to be classified as meeting basic or preferred stocking levels. Work is currently in progress to assess how the SCAT scores correlate with basic and preferred levels.
Aims: to evaluate 1) the PA variation explained by work walkability, 2) the moderating effects of person-level characteristics to the relationship between PA and work walkability, and 3) the differences in the rate of change in PA over time by worksite walkability.
Methods: self-report and accelerometer measured PA at baseline (aim 1, 2); longitudinal accelerometer PA during the initial 56 days of a behavioral intervention (aim 3). Adults were generally healthy and reported part- or full-time employment with a geocodeable address outside the home. Geographic Information Systems (GIS) measured walkability followed established techniques (i.e., residential, intersection, and transit densities, and land-use-mix).
Results: On average, worksite walkability did not show direct relationships with PA (aim 1); yet certain person-level characteristics moderated the relationships: sex, race, and not having young children in the household (aim 2). During 56 days of intervention, the PA rate of change over time showed no evidence of a moderating effect by worksite walkability.
Discussion: Worksite walkability was generally not shown to relate to the overall PA. However, specific subgroups (women, those without young children) appeared more responsive to their worksite neighborhood walkability. Prior literature shows certain demographics respond differently with various BE exposures, and this study adds a potentially novel moderator of interest regarding young children at home. Understanding who benefits from access to walkable BE may inform targeted interventions and policy to improve PA levels and foster health equity.
Investigation one revealed a moderate-to-large effect size for school-based interventions (n=10) increasing CVF (g=0.75; 95%CI [0.40-1.11]). Multi-level interventions (g=.79 [0.34-1.25]) were more effective than interventions focused on the individual (g=0.67 [0.12-1.22]). In investigations two and three children (78.3% Hispanic; mean ± SD age 53.2±4.5 months) completed a mean ± SD 3.7±2.3 PACER laps and 19.0±5.5 CSMP criteria. Individual and family factors associated with PACER laps included child sex (B=-0.96, p=0.03) and age (B=0.17, p<0.01), parents’ promotion of inactivity (B=0.66, p=0.08) and screen time (B=0.65, p=0.05), and parents’ concern for child’s safety during physical activity (B=-0.36, p=0.09). Child age (B=0.47, p<0.01) and parent employment (B=2.29, p=0.07) were associated with CMSP criteria. At the ECEC level, policy environment quality (B=-0.17; p=0.01) was significantly associated with number of PACER laps completed. Outdoor play environment quality (B=0.18; p=0.03), outdoor play equipment total (B=0.32; p<0.01) and screen time environment quality (B=0.60; p=0.02) were significantly associated with CMSP criteria. Researchers, ECEC teachers and policy makers should promote positive environmental changes to preschool-aged children’s family and ECEC environments, as these environments have the potential to improve CVF and GLS more than programs focused on the child alone.
Methods: Participants were recruited from the parent REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. ActicalTM accelerometers provided estimates of PA variables, including moderate-to-vigorous PA (MVPA), high light PA (HLPA), low light PA (LLPA) and sedentary time, for 4-7 consecutive days. Prevalence and incidence of cognitive impairment were defined by the Six-Item Screener. Letter fluency, animal fluency, word list learning and Montreal Cognitive Assessment (orientation and recall) were conducted to assess executive function and memory.
Results: Of the 7,339 participants who provided accelerometer wear data > 4 days (70.1 ± 8.6 yr, 54.2% women, 31.7% African American), 320 participants exhibited impaired cognition. In cross-sectional analysis, participants in the highest MVPA% quartile had 39% lower odds of cognitive impairment than those in the lowest quartile (OR: 0.61, 95% C.I.: 0.39-0.95) after full adjustment. Further analysis shows most quartiles of MVPA% and HLPA% were significantly associated with executive function and memory (P<0.01). During 2.7 ± 0.5 years of follow-up, 3,385 participants were included in the longitudinal analysis, with 157 incident cases of cognitive impairment. After adjustments, participants in the highest MVPA% quartile had 51% lower hazards of cognitive impairment (HR: 0.49, 95% C.I.: 0.28-0.86). Additionally, MVPA% was inversely associated with change in memory z-scores (P<0.01), while the highest quartile of HLPA% was inversely associated with change in executive function and memory z-scores (P<0.01).
Conclusion: Higher levels of objectively measured MVPA% were independently associated with lower prevalence and incidence of cognitive impairment, and better memory and executive function in older adults. Higher levels of HLPA% were also independently associated with better memory and executive function. The amount of MVPA associated with lower risk of cognitive impairment (259 min/week) is >70% higher than the minimal amount of MVPA recommended by PA guidelines.
