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Digital and Community-Based Interventions to Address Determinants of Food-Related Behaviors to Reduce Obesity and Chronic Disease

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Digital Health".

Deadline for manuscript submissions: closed (30 September 2022) | Viewed by 30047

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Special Issue Editors

Dr. Jylana L. Sheats

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Guest Editor

Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
Interests: health behavior change; digital health; eating behavior; physical activity behavior; social determinants; health disparities
Special Issues, Collections and Topics in MDPI journals

Dr. Elvin Thomaseo Burton

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Guest Editor

Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38103, USA
Interests: health disparities; community health; mental health; pediatric obesity; behavioral intervention
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Determinants of food-related behaviors from the individual to the policy level have major implications for health outcomes, such as obesity and related chronic diseases, over the life course. Food- and health-related disparities are prevalent among racial/ethnic minority, low-income and other vulnerable populations. The COVID-19 pandemic has exacerbated the issue and serves as an important call to action. Thus, we invite scholars, researchers, and practitioners to submit innovative research on digital and/or community-based research to address determinants of food-related behaviors (e.g., choice, purchase, preparation, consumption, eating patterns, nutrient intake).

Given the multidisciplinary nature of the theme, manuscripts from the fields of nutrition, behavior science, public health, psychology, and sociology, among others will be considered as long as the research aligns with the theme of the Special Issue.

We look forward to receiving your contributions.

Types of Submissions:

Original Research
Systematic Reviews
Research briefs
Short Communications

Dr. Jylana L. Sheats
Dr. Elvin Thomaseo Burton
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

determinants of health
food-related behaviors
obesity
chronic disease

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Published Papers (9 papers)

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Research

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15 pages, 358 KiB

Open AccessArticle

Our Voice NOLA: Leveraging a Community Engaged Citizen Science Method to Contextualize the New Orleans Food Environment

by Hasheemah Afaneh, Praveena K. Fernes, Emma C. Lewis, Abby C. King, Ann Banchoff and Jylana L. Sheats

Int. J. Environ. Res. Public Health 2022, 19(22), 14790; https://doi.org/10.3390/ijerph192214790 - 10 Nov 2022

Cited by 2 | Viewed by 2641

Abstract

Objective: We employed the Our Voice citizen scientist method using a mobile application (app) to identify and contextualize neighborhood-level features influencing food access and wellbeing in New Orleans, Louisiana. Design: A three-phase, multi-method study comprised of: (1) a researcher-assisted tag-a-long neighborhood walk (referred to as a ‘journey’) with the Discovery Tool (DT) app to document neighborhood-level features via geo-coded photos and audio-recorded narratives; (2) a post-journey interview to enable citizen scientists to share their lived experiences; and (3) a community meeting with citizen scientists and local stakeholders. Setting: Various neighborhoods in New Orleans, Louisiana, USA. Participants: Citizen Scientists (i.e., residents) aged 18 years and older. Main Outcome Measure(s): Features that influence food access and health behaviors. Analysis: Descriptive statistics and a thematic content analysis were conducted to assess survey and app data. Results: Citizen scientists (N = 14) captured 178 photos and 184 audio narratives. Eight major themes were identified: safety; walkability; aesthetics; amenities; food; health services; neighborhood changes; and infrastructure/city planning. The post-journey interview provided insights around the abovementioned themes. The community meeting demonstrated the willingness of citizen scientists and stakeholders to convene and discuss issues and relevant solutions. Conclusions and Implications: Findings demonstrate the ability of technology and citizen science to help better understand the complexities of New Orleans’ past, present and distinct culture—and implications for food access and wellbeing in the context of trauma in an urban ecosystem. Full article

(This article belongs to the Special Issue Digital and Community-Based Interventions to Address Determinants of Food-Related Behaviors to Reduce Obesity and Chronic Disease)

18 pages, 2634 KiB

Open AccessArticle

A Pilot Study to Examine the Feasibility and Acceptability of a Virtual Adaptation of an In-Person Adolescent Diabetes Prevention Program

by Sumaiya Islam, Cordelia Elaiho, Guedy Arniella, Sheydgi Rivera and Nita Vangeepuram

Int. J. Environ. Res. Public Health 2022, 19(19), 12286; https://doi.org/10.3390/ijerph191912286 - 27 Sep 2022

Cited by 2 | Viewed by 2012

Abstract

Background: Rates of prediabetes and type 2 diabetes are alarmingly high among racial/ethnic minority youth. The current study examines the virtual adaptation of an in-person peer-led youth diabetes prevention program. Methods: The initial phase involved the study team adapting workshop sessions from an in-person to a virtual format (Zoom). We conducted a 2-h feasibility pilot in December 2020 and implemented the full 12 session pilot program from June to September 2021 with 14 prediabetic adolescents recruited from our hospital-based general pediatric clinic. Weekly sessions were led by trained peer educators and focused on promoting healthy eating and physical activity using behavioral techniques (e.g., goal setting, brainstorming, and problem solving). Results: The virtual adaptation of our program was shown to be feasible and acceptable among our pilot participants. We were able to deliver the same workshop content and behavioral skills development as the in-person workshop using a variety of Zoom features. Conclusions: Our peer-led youth diabetes prevention program was successfully adapted and implemented in a virtual format and was well accepted by at-risk youth. Future research is needed to examine the impact of virtual youth lifestyle interventions on behavioral and clinical outcomes such as weight and diabetes risk. Full article

(This article belongs to the Special Issue Digital and Community-Based Interventions to Address Determinants of Food-Related Behaviors to Reduce Obesity and Chronic Disease)

11 pages, 568 KiB

Open AccessArticle

Feasibility of Using Facebook to Engage SNAP-Ed Eligible Parents and Provide Education on Eating Well on a Budget

by Kristen Lawton, Lindsey Hess, Heather McCarthy, Michele Marini, Katie McNitt and Jennifer S. Savage

Int. J. Environ. Res. Public Health 2022, 19(3), 1457; https://doi.org/10.3390/ijerph19031457 - 27 Jan 2022

Cited by 3 | Viewed by 2759

Abstract

This study examined the use of Facebook to provide education on food resource management and healthy eating on a budget to parents of preschool aged children participating in Head Start. A convenience sample of 25 parents participated in a Facebook group based on Sesame Street’s Food for Thought: Eating Well on a Budget curriculum over a 3-week period. Parent engagement was assessed by examining views, likes, and comments on posts. Qualitative data were used to assess knowledge, attitudes, and barriers experienced related to healthy eating on a budget. The results suggest that parents were engaged throughout the intervention, as evidenced by views, likes, and comments on Facebook posts, as well as by study retention (90%). Interactions with the intervention materials varied by post content, with discussion questions having the highest level of interaction. Facebook was found to be a feasible platform for delivering the intervention, and the Facebook-adapted version of the Sesame Street curriculum was shown to engage Head Start parents living in rural areas. Further research should explore the use of social media platforms for delivering nutrition education interventions to rural populations that are otherwise difficult to reach. Full article

(This article belongs to the Special Issue Digital and Community-Based Interventions to Address Determinants of Food-Related Behaviors to Reduce Obesity and Chronic Disease)

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17 pages, 1015 KiB

Open AccessArticle

Online Pilot Grocery Intervention among Rural and Urban Residents Aimed to Improve Purchasing Habits

by Alison Gustafson, Rachel Gillespie, Emily DeWitt, Brittany Cox, Brynnan Dunaway, Lindsey Haynes-Maslow, Elizabeth Anderson Steeves and Angela C. B. Trude

Int. J. Environ. Res. Public Health 2022, 19(2), 871; https://doi.org/10.3390/ijerph19020871 - 13 Jan 2022

Cited by 13 | Viewed by 5516

Abstract

Online grocery shopping has the potential to improve access to food, particularly among low-income households located in urban food deserts and rural communities. The primary aim of this pilot intervention was to test whether a three-armed online grocery trial improved fruit and vegetable (F&V) purchases. Rural and urban adults across seven counties in Kentucky, Maryland, and North Carolina were recruited to participate in an 8-week intervention in fall 2021. A total of 184 adults were enrolled into the following groups: (1) brick-and-mortar “BM” (control participants only received reminders to submit weekly grocery shopping receipts); (2) online-only with no support “O” (participants received weekly reminders to grocery shop online and to submit itemized receipts); and (3) online shopping with intervention nudges “O+I” (participants received nudges three times per week to grocery shop online, meal ideas, recipes, Facebook group support, and weekly reminders to shop online and to submit itemized receipts). On average, reported food spending on F/V by the O+I participants was USD 6.84 more compared to the BM arm. Online shopping with behavioral nudges and nutrition information shows great promise for helping customers in diverse locations to navigate the increasing presence of online grocery shopping platforms and to improve F&V purchases. Full article

(This article belongs to the Special Issue Digital and Community-Based Interventions to Address Determinants of Food-Related Behaviors to Reduce Obesity and Chronic Disease)

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15 pages, 482 KiB

Open AccessArticle

Healthy Food Environments in Food Pantries: Lessons Learned from a Sodium Reduction Intervention

by Emilee L. Quinn, Kate Ortiz, Laura Titzer, Barb Houston-Shimizu and Jessica Jones-Smith

Int. J. Environ. Res. Public Health 2021, 18(24), 13206; https://doi.org/10.3390/ijerph182413206 - 15 Dec 2021

Cited by 5 | Viewed by 2325

Abstract

In the United States, food pantries increasingly serve as regular food sources for low income households experiencing high rates of chronic disease, including hypertension. Sodium consumption is a modifiable risk factor for hypertension, so pantry customers would benefit from access to low-sodium foods. Pantry customers often experience difficulty acquiring healthy foods, however; little is known about pantry foods’ sodium content specifically. This study assesses the sodium content of pantry foods and lessons learned from an adaptable intervention to support pantries in adopting policies and environmental changes to make healthy, lower-sodium foods appealing and accessible. We conducted sodium assessments of food at 13 food pantries, tracked implementation of intervention strategies, and interviewed 10 pantry directors. More than half of food items in 11 categories met sodium standards for foods to be chosen “often”. Pantry directors reported valuing the intervention approach and implemented six of nine behavioral economics strategies, especially those targeting the visibility and convenience of foods, along with layout changes and expanded customer choice. One pantry adopted an agency-specific nutrition policy and 12 adopted a coalition-level policy. Results can inform intervention efforts to make available healthy options appealing and easy to select while also improving the customer experience in food pantries. Full article

(This article belongs to the Special Issue Digital and Community-Based Interventions to Address Determinants of Food-Related Behaviors to Reduce Obesity and Chronic Disease)

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Review

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20 pages, 1373 KiB

Open AccessReview

Moving Food Assistance into the Digital Age: A Scoping Review

by Nina M. Martin, Daniel J. Barnett, Lisa Poirier, Samantha M. Sundermeir, Melissa M. Reznar and Joel Gittelsohn

Int. J. Environ. Res. Public Health 2022, 19(3), 1328; https://doi.org/10.3390/ijerph19031328 - 25 Jan 2022

Cited by 13 | Viewed by 5121

Abstract

One of the most basic needs globally, food assistance refers to the multitude of programs, both governmental and non-governmental, to improve food access and consumption by food-insecure individuals and families. Despite the importance of digital and mobile Health (mHealth) strategies in food insecurity contexts, little is known about their specific use in food assistance programs. Therefore, the purpose of this study was to address that gap by conducting a scoping review of the literature. Keywords were defined within the concepts of food assistance and digital technology. The search included relevant peer-reviewed and grey literature from 2011 to 2021. Excluded articles related to agriculture and non-digital strategies. PRISMA guidelines were followed to perform a partnered, two-round scoping literature review. The final synthesis included 39 studies of which most (84.6%) were from the last five years and United States-based (93.2%). The top three types of articles or studies included text and opinion, qualitative research, and website, application, or model development (17.9%). The top three types of digital tools were websites (56.4%), smartphone applications (20.5%), and chatbots (5.1%). Nineteen digital features were identified as desirable. Most tools included just one or two features. The most popular feature to include was online shopping (n = 14), followed by inventory management, and client tracking. Digital tools for individual food assistance represent an opportunity for equitable and stable access to programs that can enhance or replace in-person services. While this review identified 39 tools, all are in early development and/or implementation stages. Review findings highlight an overall lack of these tools, an absence of user-centered design in their development, and a critical need for research on their effectiveness globally. Further analysis and testing of current digital tool usage and interventions examining the health and food security impacts of such tools should be explored in future studies, including in the context of pandemics, where digital tools allow for help from a distance. Full article

(This article belongs to the Special Issue Digital and Community-Based Interventions to Address Determinants of Food-Related Behaviors to Reduce Obesity and Chronic Disease)

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Other

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12 pages, 323 KiB

Open AccessHypothesis

Usability and Satisfaction Outcomes from a Pilot Open Trial Examining Remote Patient Monitoring to Treat Pediatric Obesity during the COVID-19 Pandemic

by Crystal S. Lim, Cameronne A. Dodd, Laura E. Rutledge, Shanda W. Sandridge, Krista B. King, Darryl J. Jefferson and Tanya Tucker

Int. J. Environ. Res. Public Health 2023, 20(3), 2373; https://doi.org/10.3390/ijerph20032373 - 29 Jan 2023

Cited by 1 | Viewed by 1689

Abstract

Background: Pediatric obesity is common and a significant burden. Supplementing pediatric obesity treatment with technology is needed. This manuscript examines the usability and satisfaction, as well as explores initial effectiveness, of a remote patient monitoring system (RPMS) designed for youth presenting for pediatric weight management treatment. Methods: 47 youth, 10 to 17 years old, with obesity and a caregiver participated. For three months, families received treatment via the RPMS. Usability and satisfaction outcomes were examined. Exploratory analyses were conducted to examine initial effectiveness from baseline and post-treatment (month 3) assessments. Results: More than 80% of patients used the RPMS, and overall, patients completed 27 out of 90 daily sessions (30%). Youth and caregivers reported high satisfaction. Non-parametric tests revealed no significant improvements for youth or caregiver weight status after the RPMS treatment. Significant improvements in other outcomes examined were limited. Conclusions: Families were satisfied with the RPMS, but use of the system was limited. Initial effectiveness was not able to be determined due to the amount of missing data, which was impacted by the COVID-19 pandemic. Modifications of the RPMS and future evaluation of usability and effectiveness are warranted to determine utility in supplementing pediatric obesity clinical treatment. Full article

(This article belongs to the Special Issue Digital and Community-Based Interventions to Address Determinants of Food-Related Behaviors to Reduce Obesity and Chronic Disease)

16 pages, 772 KiB

Open AccessConcept Paper

The “Our Voice” Method: Participatory Action Citizen Science Research to Advance Behavioral Health and Health Equity Outcomes

by Maja Pedersen, Grace E. R. Wood, Praveena K. Fernes, Lisa Goldman Rosas, Ann Banchoff and Abby C. King

Int. J. Environ. Res. Public Health 2022, 19(22), 14773; https://doi.org/10.3390/ijerph192214773 - 10 Nov 2022

Cited by 10 | Viewed by 3188

Abstract

Citizen science research that more fully engages the community can systematically involve people from under-resourced groups to create practical health-enhancing improvements across physical, social and food environments. Exemplary health equity-focused outcomes include key health behaviors (e.g., healthy eating or physical activity) and community-level changes (e.g., public transit to food shops) that are central to health promotion while being demonstrably impacted by local environmental contexts. Yet, few examples of this approach are readily available for application within complex, community-based settings. In this paper, we present the Our Voice (OV) four-step method to demonstrate an integrated participatory citizen science approach and its usability for action-focused researchers and community health practitioners. In addition, we present a summary of the major research, processes, and community outcomes, with examples drawn from nutrition and healthy food access areas, among others. Finally, we explore the hallmark features of the OV method that effectively engage citizen scientists, empowering action and fostering solution-building across social and environmental structures impacting community health. Expanding research that marries participatory research philosophies with innovative citizen science methods, supported by systematic data collection, visualization, and delivery technologies, in turn provides a powerful toolkit for tackling local to global health equity challenges. Full article

(This article belongs to the Special Issue Digital and Community-Based Interventions to Address Determinants of Food-Related Behaviors to Reduce Obesity and Chronic Disease)

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17 pages, 3440 KiB

Open AccessProtocol

The Baltimore Urban Food Distribution (BUD) App: Study Protocol to Assess the Feasibility of a Food Systems Intervention

by Joel Gittelsohn, Emma C. Lewis, Nina M. Martin, Siyao Zhu, Lisa Poirier, Ellen J. I. Van Dongen, Alexandra Ross, Samantha M. Sundermeir, Alain B. Labrique, Melissa M. Reznar, Takeru Igusa and Antonio J. Trujillo

Int. J. Environ. Res. Public Health 2022, 19(15), 9138; https://doi.org/10.3390/ijerph19159138 - 26 Jul 2022

Cited by 8 | Viewed by 3113

Abstract

Low-income urban communities in the United States commonly lack ready access to healthy foods. This is due in part to a food distribution system that favors the provision of high-fat, high-sugar, high-sodium processed foods to small retail food stores, and impedes their healthier alternatives, such as fresh produce. The Baltimore Urban food Distribution (BUD) study is a multilevel, multicomponent systems intervention that aims to improve healthy food access in low-income neighborhoods of Baltimore, Maryland. The primary intervention is the BUD application (app), which uses the power of collective purchasing and delivery to affordably move foods from local producers and wholesalers to the city’s many corner stores. We will implement the BUD app in a sample of 38 corner stores, randomized to intervention and comparison. Extensive evaluation will be conducted at each level of the intervention to assess overall feasibility and effectiveness via mixed methods, including app usage data, and process and impact measures on suppliers, corner stores, and consumers. BUD represents one of the first attempts to implement an intervention that engages multiple levels of a local food system. We anticipate that the app will provide a financially viable alternative for Baltimore corner stores to increase their stocking and sales of healthier foods, subsequently increasing healthy food access and improving diet-related health outcomes for under-resourced consumers. The design of the intervention and the evaluation plan of the BUD project are documented here, including future steps for scale-up. Trial registration #: NCT05010018. Full article

(This article belongs to the Special Issue Digital and Community-Based Interventions to Address Determinants of Food-Related Behaviors to Reduce Obesity and Chronic Disease)

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