AJPM focus最新文献

{"title":"A Pilot Study Assessing Common Medication Organizers for Child-Resistant Features","authors":"Lilai Teum PharmD ,&nbsp;Fallon Gokhman PharmD ,&nbsp;Sophia Park PharmD ,&nbsp;Daniel S. Budnitz MD, MPH ,&nbsp;Joseph W. Aquilina MD ,&nbsp;Edwin K. Kuffner MD","doi":"10.1016/j.focus.2024.100232","DOIUrl":"10.1016/j.focus.2024.100232","url":null,"abstract":"<div><h3>Introduction</h3><p>Prescription and most over-the-counter medicines are required to have child-resistant packaging and/or labeled with instructions “Keep out of reach of children.” Although medication organizers are not required to have such design features or instructions, these could help prevent unsupervised ingestions by children. Commonly purchased medication organizers were evaluated for child-resistant design features and instructions for safe use to prevent unsupervised ingestions.</p></div><div><h3>Methods</h3><p>The 29 best-selling medication organizers on Amazon.com were identified, and product identifiers, design characteristics, and safety characteristics were recorded using a standardized instrument.</p></div><div><h3>Results</h3><p>Of the 29 medication organizers, none claimed to be child resistant. Only 31% provided a specific warning that the organizer was not child resistant on the packaging; only 41% communicated “Keep out of reach of children.” Most organizers (59%) provided neither a warning that the organizer was not child resistant nor instructions to store out of reach of children. The majority of organizers (79%) shared the following characteristics: plastic construction, rectangular shape, nonelectronic flip-top opening mechanisms, and 7-day usage.</p></div><div><h3>Conclusions</h3><p>Opportunities exist for manufacturers of medication organizers to improve child-resistant product design, provide information to help prevent unsupervised ingestions (directions to keep the device out of the reach of children), and help to reduce unsupervised ingestions.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 4","pages":"Article 100232"},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000506/pdfft?md5=062b44bd2fe016387bcd9ad06eea2b1e&pid=1-s2.0-S2773065424000506-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141031402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influences of Outdoor Experiences During Childhood on Time Spent in Nature as an Adult","authors":"Debra K. Kellstedt DrPH ,&nbsp;Courtney S. Suess PhD ,&nbsp;Jay E. Maddock PhD","doi":"10.1016/j.focus.2024.100235","DOIUrl":"10.1016/j.focus.2024.100235","url":null,"abstract":"<div><h3>Introduction</h3><p>Time spent in nature provides myriad physical and mental health benefits for both adults and children. Despite these benefits, most people spend too little time in nature to realize the maximal effect. Different types of childhood experiences may have differential influence on adult time in nature. This study assessed the influences of different kinds of childhood outdoor experiences on time spent in nature as an adult. The first aim was to utilize 20 childhood nature experience items to construct summative scales. The second aim was to examine the influence of each scale and other factors on adult time in nature.</p></div><div><h3>Methods</h3><p>A 2-factor scale measuring wild and domesticated childhood nature experiences was developed using principal and confirmatory factor analyses. An online study of 2,109 American adults was conducted. Multiple linear regression examined the influences of the 2 childhood nature experiences scales, attitude and self-efficacy scales, and sex and age covariates on adult time spent in nature.</p></div><div><h3>Results</h3><p>Significant predictors of adult time in nature were wild childhood nature experiences (β=0.279, <em>p</em>&lt;0.001), positive attitudes about nature (β=0.12, <em>p</em>&lt;0.05), negative attitudes about nature (β= −0.23, <em>p</em>&lt;0.001), and self-efficacy (β=0.71, <em>p</em>&lt;0.001).</p></div><div><h3>Conclusions</h3><p>Wild childhood nature experiences (e.g., camping, hiking, and fishing) that include skill building, that are immersive and engaging, and that involve opportunity for social interaction may translate better into adult nature activities. Programs that introduce and support wild experiences may increase lifelong time spent in nature.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 4","pages":"Article 100235"},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000531/pdfft?md5=ecc32e989d95c190c5eb73439293fc82&pid=1-s2.0-S2773065424000531-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141028342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for Unhealthy Alcohol Use Among Patients With Multiple Chronic Conditions in Primary Care","authors":"Michelle S. Rockwell PhD, RD ,&nbsp;Adam J. Funk BS ,&nbsp;Alison N. Huffstetler MD ,&nbsp;Gabriela Villalobos MSW ,&nbsp;Jacqueline B. Britz MD, MSPH ,&nbsp;Benjamin Webel BA ,&nbsp;Alicia Richards MS ,&nbsp;John W. Epling MD, MSEd ,&nbsp;Roy T. Sabo PhD ,&nbsp;Alex H. Krist MD, MPH","doi":"10.1016/j.focus.2024.100233","DOIUrl":"10.1016/j.focus.2024.100233","url":null,"abstract":"<div><h3>Introduction</h3><p>Unhealthy alcohol use increases the risk for and exacerbation of chronic health conditions. As such, screening, prevention, and management of unhealthy alcohol use is especially critical to improving health outcomes for patients with multiple chronic health conditions. It is unclear to what extent multiple chronic condition status is a barrier to screening for unhealthy alcohol use in the primary care setting. The authors hypothesized that patients with multiple chronic conditions would be at lower odds of being screened for unhealthy alcohol use than patients without multiple chronic conditions.</p></div><div><h3>Methods</h3><p>The authors performed a secondary analysis of electronic health record data for patients from 67 primary care practices in Virginia (2020–2023). Using the Center for Medicare and Medicaid Services’ chronic disease framework, they classified patients by multiple chronic condition status: no multiple chronic conditions, physical multiple chronic conditions, mental health multiple chronic conditions, and physical and mental health multiple chronic conditions. They used multiple logistic regressions with an added practice-level random effect to analyze the relationship between multiple chronic condition status and the odds of receiving an alcohol-related assessment, of being screened for unhealthy alcohol use with a U.S. Preventive Services Task Force–recommended instrument, and of screening positive for unhealthy alcohol use within the past 2 years.</p></div><div><h3>Results</h3><p>Within a final cohort of <em>n</em>=11,789, a total of 6,796 patients (58%) had multiple chronic conditions (29% physical multiple chronic conditions, 4% mental health multiple chronic conditions, and 25% physical and mental health multiple chronic conditions). In all, 69% of patients were screened for unhealthy alcohol use, whereas 16% were screened with a U.S. Preventive Services Task Force–recommended instrument, and 7% screened positive for unhealthy alcohol use. Patients with physical and mental health multiple chronic conditions had 0.9 times lower odds of receiving any screening for unhealthy alcohol use than those with no multiple chronic conditions (95% CI=0.8, 1.0; <em>p</em>=0.0240), whereas patients with only physical multiple chronic conditions or only mental health multiple chronic conditions had similar odds. There was no difference in the odds of being screened with a U.S. Preventive Services Task Force–recommended instrument on the basis of multiple chronic condition status. Patients with mental health multiple chronic conditions and physical and mental health multiple chronic conditions had 1.8 and 1.5 times greater odds of screening positive for unhealthy alcohol use, respectively (95% CI=1.3, 2.7; <em>p</em>=0.0014 and 95% CI=1.2, 1.8; <em>p</em>=0.0003).</p></div><div><h3>Conclusions</h3><p>Although patients with chronic mental health conditions were more likely to screen positive for unhealthy alc","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 4","pages":"Article 100233"},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000518/pdfft?md5=55ff4a9eb5045455e208787fdbfa7294&pid=1-s2.0-S2773065424000518-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141025057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatherhood and Cardiovascular Health, Disease, and Mortality: Associations From the Multi-Ethnic Study of Atherosclerosis","authors":"John James F. Parker MD, MS ,&nbsp;Craig F. Garfield MD, MAPP ,&nbsp;Clarissa D. Simon PhD, MPH ,&nbsp;Laura A. Colangelo MS ,&nbsp;Michael P. Bancks PhD, MPH ,&nbsp;Norrina B. Allen PhD, MPH","doi":"10.1016/j.focus.2024.100231","DOIUrl":"10.1016/j.focus.2024.100231","url":null,"abstract":"<div><h3>Introduction</h3><p>Emerging literature links fatherhood to men's health but lacks comprehensive assessment of health outcomes, especially among multiethnic populations. This study's objective was to evaluate the associations of fatherhood (age at onset and status) with cardiovascular health scores, incident cardiovascular disease, cardiovascular disease death, and all-cause mortality, examining differences by race/ethnicity.</p></div><div><h3>Methods</h3><p>The study sample included men from Multi-Ethnic Study of Atherosclerosis, prospective cohort study that enrolled adults aged 45–84 years without known cardiovascular disease at baseline. Cardiovascular health was defined using the American Heart Association's Life's Essential 8 scores (0–100), excluding sleep (cardiovascular health score).</p></div><div><h3>Results</h3><p>In this sample of 2,814 men, mean age at cardiovascular health assessment was 62.2 years, 82% were fathers, 24% self-identified as Black, 13% self-identified Chinese, 22% self-identified Hispanic, and 41% self-identified White. Fathers who were aged &lt;20 years and 20–24 years at their oldest child's birth had worse overall cardiovascular health than fathers who were aged &gt;35 years (adjusted mean score of 61.1 vs 64.7 [<em>p</em>=0.01] and 61.0 vs 64.7 [<em>p</em>&lt;0.001], respectively). Fathers had worse overall cardiovascular health (adjusted mean score of 63.2 vs 64.7, <em>p</em>=0.03) and more nicotine exposure (63.1 vs 66.6, <em>p</em>=0.04) than nonfathers. In age-adjusted models, fathers overall (hazard ratio=0.82; 95% CI=0.69, 0.98) and Black fathers (hazard ratio=0.73; 95% CI=0.53, 0.999) had a lower rate of all-cause mortality rate than nonfathers, but these associations were no longer significant in fully adjusted models.</p></div><div><h3>Conclusions</h3><p>Fatherhood is a social determinant of health, and understanding its influence may provide opportunities to improve men's health, particularly among men of color.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 4","pages":"Article 100231"},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277306542400049X/pdfft?md5=2b3aebf4f9995366e514d60025878cd6&pid=1-s2.0-S277306542400049X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141049900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental Caries and Preventive Dental Visits Among Children in the U.S.: The Impact of Race/Ethnicity and Immigration","authors":"Huabin Luo PhD ,&nbsp;Bei Wu PhD ,&nbsp;Yanyan Wu PhD ,&nbsp;Mark E. Moss DDS, PhD","doi":"10.1016/j.focus.2024.100230","DOIUrl":"10.1016/j.focus.2024.100230","url":null,"abstract":"<div><h3>Introduction</h3><p>National data on dental caries and dental service use among immigrant children in U.S. are limited. It is not known whether race/ethnicity would interact with immigration status to increase these disparities. Using a nationally representative sample, this study assessed the interaction effects of immigrant generation status and race/ethnicity on dental caries and dental visits among children in the U.S.</p></div><div><h3>Methods</h3><p>Data were from the 2020 and 2021 National Survey of Children's Health. All data were self-reported by parents/guardians. The 2 outcomes were (1) dental caries (yes/no) in the past 12 months and (2) preventive dental visits (yes/no) in the past 12 months. Racial/ethnic groups included non-Hispanic White, Black, Hispanics, and Asian Americans. The analytical sample included 66,167 children aged 2–17 years, including 1,243 first-generation immigrant children; 11,017 second-generation immigrant children; and 53,907 nonimmigrant children. Study authors ran separate multiple logistic regression models for the 2 outcome variables. All analyses accounted for the survey design of National Survey of Children's Health.</p></div><div><h3>Results</h3><p>First-generation immigrant children were more likely to have dental caries than nonimmigrant children (AOR=1.44). The interaction of race/ethnicity and immigrant generation status was significant (<em>p</em>=0.04) in the preventive dental visits model, indicating increased challenges in getting dental visits among minority immigrant children in comparison with that among non-Hispanic White immigrant children, especially among first-generation immigrant children of Asian Americans (AOR=0.41) and non-Hispanic Black immigrant children (AOR=0.37).</p></div><div><h3>Conclusions</h3><p>First-generation immigrant children were less likely to see a dentist and more likely to have dental caries than nonimmigrants. Moreover, first-generation immigrant children from minority racial/ethnic groups were the least likely to seek dental services. To further reduce disparities in oral health and dental use among children in the U.S., culturally sensitive health promotion is warranted to improve oral health literacy and reduce barriers to dental care for immigrants, especially immigrant children of the minority groups.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 4","pages":"Article 100230"},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000488/pdfft?md5=0fc31555d65ce334d5c028b417aff150&pid=1-s2.0-S2773065424000488-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing Children's Vegetable Consumption: Translating a Review of the Evidence Base to Develop Best Practice Guidelines","authors":"Gilly A. Hendrie PhD ,&nbsp;Kim Anastasiou PhD ,&nbsp;Emily Brindal PhD ,&nbsp;Bonnie Wiggins MMktg ,&nbsp;Danielle L. Baird BNutrDiet (Hons) ,&nbsp;Brittany J. Johnson PhD ,&nbsp;Lucinda K. Bell PhD ,&nbsp;Claire Gardner MNutrDiet ,&nbsp;Jennifer C. Arguelles BNutrDiet ,&nbsp;Amber Kelaart MHSM ,&nbsp;David N. Cox PhD ,&nbsp;Rebecca K. Golley PhD","doi":"10.1016/j.focus.2024.100229","DOIUrl":"10.1016/j.focus.2024.100229","url":null,"abstract":"<div><h3>Introduction</h3><p>Dietary guidelines worldwide emphasize the importance of consuming vegetables as part of a healthy diet. Despite this, translating this information into messages for consumers that change behavior has been difficult. There have been population-level social marketing campaigns as well as several smaller campaigns directed specifically toward children, which have demonstrated small increases in consumption. However, achieving meaningful and sustained increases in children's vegetable consumption remains a challenge. This article describes the process of synthesizing the published literature and translating these findings to inform the development of 7 best practice guidelines to increase children's vegetable intake.</p></div><div><h3>Methods</h3><p>The first step in this process was a systematic review of scientific literature to identify the components of interventions that were associated with successfully increasing vegetable intake. The synthesis of effective intervention components was guided by the Behavior Change Wheel. These scientific findings were translated to guidelines for best practice. This process involved a team of nutrition and behavioral researchers and nutrition practitioners translating the science into actionable advice that could be adopted by a range of stakeholders. The 6 selected stakeholders included long daycare centers, after-hours school care providers, primary schools, industry groups and growers, researchers, and government policy makers. Stakeholders were involved in the development process through surveys and interviews to understand their requirements for resources to support adoption of the best practice guidelines within each setting and within the context of existing practice.</p></div><div><h3>Results</h3><p>The guidelines center on coordination of effort, with a focus on components such as planning, environmental restructuring, barrier reduction, feedback, and monitoring. In consultation with key stakeholders, a range of resources were developed for each setting to support the implementation of best practice, with the aim of achieving meaningful increases in intake. The resources and tools have been made available at http://www.vegkit.com.au.</p></div><div><h3>Conclusions</h3><p>The translation of knowledge into practice is not traditionally included as part of the research process. Therefore, combining the process of reviewing the science and translating the evidence to stakeholder resources to influence practice in 1 research study is novel, and the study could be used to guide future research translation activities within and beyond the field of public health nutrition.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 4","pages":"Article 100229"},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000476/pdfft?md5=880e83b9036ffe1b8af2d138abe51855&pid=1-s2.0-S2773065424000476-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Board and Journal Information","authors":"","doi":"10.1016/S2773-0654(24)00040-3","DOIUrl":"https://doi.org/10.1016/S2773-0654(24)00040-3","url":null,"abstract":"","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 2","pages":"Article 100221"},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000403/pdfft?md5=efc91d8762757ddcc4f6c3fbc80865bf&pid=1-s2.0-S2773065424000403-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140187186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residential Density Is Associated With BMI Trajectories in Children and Adolescents: Findings From the Moving to Health Study","authors":"Paula Maria Lozano MD, MPH ,&nbsp;Jennifer F. Bobb PhD ,&nbsp;Flavia P. Kapos DDS, PhD ,&nbsp;Maricela Cruz PhD ,&nbsp;Stephen J. Mooney PhD ,&nbsp;Philip M. Hurvitz PhD ,&nbsp;Jane Anau BS ,&nbsp;Mary Kay Theis MS ,&nbsp;Andrea Cook PhD ,&nbsp;Anne Vernez Moudon Dr es Sc ,&nbsp;David E. Arterburn MD, MPH ,&nbsp;Adam Drewnowski PhD","doi":"10.1016/j.focus.2024.100225","DOIUrl":"10.1016/j.focus.2024.100225","url":null,"abstract":"<div><h3>Introduction</h3><p>This study investigates the associations between built environment features and 3-year BMI trajectories in children and adolescents.</p></div><div><h3>Methods</h3><p>This retrospective cohort study utilized electronic health records of individuals aged 5–18 years living in King County, Washington, from 2005 to 2017. Built environment features such as residential density; counts of supermarkets, fast-food restaurants, and parks; and park area were measured using SmartMaps at 1,600-meter buffers. Linear mixed-effects models performed in 2022 tested whether built environment variables at baseline were associated with BMI change within age cohorts (5, 9, and 13 years), adjusting for sex, age, race/ethnicity, Medicaid, BMI, and residential property values (SES measure).</p></div><div><h3>Results</h3><p>At 3-year follow-up, higher residential density was associated with lower BMI increase for girls across all age cohorts and for boys in age cohorts of 5 and 13 years but not for the age cohort of 9 years. Presence of fast food was associated with higher BMI increase for boys in the age cohort of 5 years and for girls in the age cohort of 9 years. There were no significant associations between BMI change and counts of parks, and park area was only significantly associated with BMI change among boys in the age cohort of 5 years.</p></div><div><h3>Conclusions</h3><p>Higher residential density was associated with lower BMI increase in children and adolescents. The effect was small but may accumulate over the life course. Built environment factors have limited independent impact on 3-year BMI trajectories in children and adolescents.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100225"},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000440/pdfft?md5=a5a873ee3699fe036fae2e60620f27f8&pid=1-s2.0-S2773065424000440-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140273731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Fast-Food Restaurant Kids’ Meal Beverage Offerings 1 Year After a State-Level Healthy Beverage Default Policy","authors":"Lisa M. Powell PhD ,&nbsp;Aline Vandenbroeck MS ,&nbsp;Julien Leider MA ,&nbsp;Andrea A. Pipito MS ,&nbsp;Alyssa Moran ScD","doi":"10.1016/j.focus.2024.100226","DOIUrl":"10.1016/j.focus.2024.100226","url":null,"abstract":"<div><h3>Introduction</h3><p>Ordering from kids’ menus and children's restaurant consumption is associated with greater purchasing and intake, respectively, of sugar-sweetened beverages. In response, policymakers have enacted strategies to improve the healthfulness of kids’ meal offerings. This study investigated restaurant kids’ meal beverage offerings and compliance with an Illinois healthy beverage default act, effective from January 1, 2022.</p></div><div><h3>Methods</h3><p>Using a pre–post intervention (Illinois)–comparison (Wisconsin) site research design, fast-food restaurant audit data were collected before and 1 year after the Illinois Healthy Beverage Default Act from 6 platforms: restaurant interior and drive-thru menu boards and websites/applications and 3 third-party ordering platforms (DoorDash, Uber Eats, and Grubhub). Analyses included 62–110 restaurants across platforms. Difference-in-differences–weighted logistic regression models with robust SEs, clustered on restaurants, were estimated to assess pre to 1-year postpolicy changes in overall compliance for each audit setting in Illinois relative to that in Wisconsin.</p></div><div><h3>Results</h3><p>This study found no statistically significant (<em>p</em>&lt;0.05) changes in the compliance of kids’ meal beverage default offerings associated with the enactment of the Illinois Healthy Beverage Default Act in Illinois relative to that in Wisconsin at fast-food restaurants. There were some observed differences in results in the restaurants’ physical locations versus online that are worth noting. That is, after the enactment of the Illinois Healthy Beverage Default Act, the results showed greater odds of fast-food restaurants exclusively offering healthy beverage defaults with kids’ meals on restaurant interior (OR=1.83, 95% CI=0.93, 3.58) and drive-thru (OR=2.38, 95% CI=0.95, 5.96) menus, with weak statistical significance (<em>p</em>&lt;0.10). However, the policy was not associated with either meaningful or statistically significant changes in healthy beverage default offerings on restaurant websites or third-party online ordering platforms.</p></div><div><h3>Conclusions</h3><p>This study found limited evidence of changes in kids’ meal beverage offerings attributable to the Illinois Healthy Beverage Default Act. Future investigations of communication channels that support awareness and implementation and the resources required for implementation and enforcement may provide insight that is key to improving compliance.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100226"},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000439/pdfft?md5=382064edaf6581183effb52c4b4481ea&pid=1-s2.0-S2773065424000439-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Culinary Intervention (Cooking Class) for Salt Reduction in Japanese Home Cooking: Strategies and Assessment","authors":"Miyuki Imamoto MS ,&nbsp;Toshihiko Takada MD, PhD ,&nbsp;Sho Sasaki MD, PhD ,&nbsp;Yoshihiro Onishi PhD, MPH","doi":"10.1016/j.focus.2024.100227","DOIUrl":"10.1016/j.focus.2024.100227","url":null,"abstract":"<div><h3>Introduction</h3><p>Culinary interventions (cooking classes) are a potential educational tool for salt reduction in the home diet, but their content has never been reported in detail. This study aimed to develop a cooking class for salt reduction, describe its rationale and structure so that other parties could replicate it, and preliminarily assess its impact on salt intake.</p></div><div><h3>Methods</h3><p>A multidisciplinary research team developed a cooking class package to reduce salt content in the Japanese home diet. The package comprised its developmental policy, teaching methodology, a menu and recipes, and an implementation manual and aimed to allow third parties to replicate and modify the content. The team took the following step-by-step developmental approach. First, traditional home meals were modeled to create strategies contributing to a target of 2 g salt/meal. Then, educational topics were developed through these strategies, and finally, a dietitian produced menus and prepared documents for the class. The impact of the cooking class was assessed in a nonrandomized study of community residents. The outcome was differences in urinary salt excretion before and after the intervention. General linear models were used to account for the possible confounders.</p></div><div><h3>Results</h3><p>The authors assumed 4–7 g salt/meal from analyzing typical Japanese home diets and developed 3 strategies: (1) restricting salt content in the main dish, (2) maintaining good tastes without salty dishes, and (3) balancing nutrition with low-salt dishes. On the basis of these strategies, the authors selected a total of 5 educational topics that participants could learn and apply at home: 1a, a simple and reliable technique to limit salt in a serving; 2a, excluding salty dishes; 2b, staple foods with notable flavor and aroma; 3a, flavoring without salt in side dishes; and 3b, ingredients that should be used intentionally. The team dietitian translated these educational topics into a menu and recipes for hands-on training and prepared a manual for conducting the class. The class developed using this approach was successfully overseen by a dietitian outside the research team. In the validation study, the intervention group (<em>n</em>=52) showed a greater decrease in urinary salt excretion than the control group (<em>n</em>=46), with an adjusted difference of −1.38 g (<em>p</em>=0.001).</p></div><div><h3>Conclusions</h3><p>The authors developed a cooking class package for salt reduction so that third parties could replicate and modify the class. The significant salt reduction noted in this study warrants further studies to apply this cooking class to other populations.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 3","pages":"Article 100227"},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000452/pdfft?md5=e10462abd7e3e014949e35747e0749d4&pid=1-s2.0-S2773065424000452-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140275481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}