American journal of preventive medicine
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Randomized Controlled Trial Multicenter Study
Mailed intervention to promote sun protection of children: a randomized controlled trial.
Sun exposure, especially during childhood, is the most important preventable risk factor for skin cancer, yet few effective interventions to reduce exposure exist. ⋯ The level of behavior change associated with this single-modality intervention is not likely sufficient to reduce skin cancer risk. However, the intervention shows promise for inclusion in longer-term, multicomponent interventions that have sufficient intensity to affect skin cancer incidence.
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Neighborhood attractiveness and safety may encourage physical activity and help individuals maintain a healthy weight. However, these neighborhood characteristics may not be equally relevant to health across all settings and population subgroups. ⋯ Potentially attractive community and natural features were associated with lower BMI among adults in NYC, and there was some evidence of effect modification.
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With nearly 49,000 authorized retailers nationwide, a policy change that added fruits and vegetables (FV) to the U.S. Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages in 2009 had the potential to expand neighborhood FV availability. ⋯ Expansion of WIC foods was associated with small positive externalities on the food environment. Larger subsidies to create more demand and more-substantial stocking requirements for retailers may yield significantly larger improvements and thus warrant further investigation. Approaches targeting rural, low-income, and racial/ethnic minority neighborhoods also may be needed.
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Comparative Study
Restaurant menus: calories, caloric density, and serving size.
The increasing trend toward eating out, rather than at home, along with concerns about the adverse nutritional profile of restaurant foods has prompted the introduction of calorie labeling. However, the calorie content in food from sit-down and fast-food restaurants has not been analyzed. ⋯ Variation in calories per serving was seen when comparing various types of food, types of establishments, and the specific establishments that provided the foods. Compared to caloric density, serving size was shown to be a more important driver of calories per serving in restaurant foods.
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There is growing recognition that policymakers can promote access to healthy, affordable foods within neighborhoods, schools, childcare centers, and workplaces. Despite the disproportionate risk of obesity and type 2 diabetes among American Indian children and adults, comparatively little attention has been focused on the opportunities tribal policymakers have to implement policies or resolutions to promote access to healthy, affordable foods. This paper presents an approach for integrating formative research into an action-oriented strategy of developing and disseminating tribally led environmental and policy strategies to promote access to and consumption of healthy, affordable foods. ⋯ Using community-based participatory research and informed by the Social Cognitive Theory and ecologic frameworks, the American Indian Healthy Eating Project was started in fall 2008 and has evolved through five phases: (1) starting the conversation; (2) conducting multidisciplinary formative research; (3) strengthening partnerships and tailoring policy options; (4) disseminating community-generated ideas; and (5) accelerating action while fostering sustainability. Collectively, these phases helped develop and disseminate Tools for Healthy Tribes-a toolkit used to raise awareness among participating tribal policymakers of their opportunities to improve access to healthy, affordable foods. Formal and informal strategies can engage tribal leaders in the development of culturally appropriate and tribe-specific sustainable strategies to improve such access, as well as empower tribal leaders to leverage their authority toward raising a healthier generation of American Indian children.