Rebeccah L. Sokol

Measures of the food environment: A systematic review of the field, 2007–2015

Background Many studies have examined the relationship between the food environment and health‐related outcomes, but fewer consider the integrity of measures used to assess the food environment. The present review builds on and makes comparisons with a previous review examining food environment measures and expands the previous review to include a more in depth examination of reliability and validity of measures and study designs employed. Methods We conducted a systematic review of studies measuring the food environment published between 2007 and 2015. We identified these articles through: PubMed, Embase, Web of Science, PsycINFO, and Global Health databases; tables of contents of relevant journals; and the National Cancer Institute’s Measures of the Food Environment website. This search yielded 11,928 citations. We retained and abstracted data from 432 studies. Results The most common methodology used to study the food environment was geographic analysis (65% of articles) and the domination of this methodology has persisted since the last review. Only 25.9% of studies in this review reported the reliability of measures and 28.2% reported validity, but this was an improvement as compared to the earlier review. Very few of the studies reported construct validity. Studies reporting measures of the school or worksite environment have decreased since the previous review. Only 13.9% of the studies used a longitudinal design. Conclusions To strengthen research examining the relationship between the food environment and population health, there is a need for robust and psychometrically‐sound measures and more sophisticated study designs. HighlightsBetween 2007 and 2015, 432 studies have been published that measure the food environment.Geographic analysis dominates food environment measurement; 65% of articles included in this review employ this method.Psychometric testing of food environment measures is sub‐optimal.

Peer Support for the Hardly Reached: A Systematic Review

BACKGROUND Health disparities are aggravated when prevention and care initiatives fail to reach those they are intended to help. Groups can be classified as hardly reached according to a variety of circumstances that fall into 3 domains: individual (e.g., psychological factors), demographic (e.g., socioeconomic status), and cultural-environmental (e.g., social network). Several reports have indicated that peer support is an effective means of reaching hardly reached individuals. However, no review has explored peer support effectiveness in relation to the circumstances associated with being hardly reached or across diverse health problems. OBJECTIVES To conduct a systematic review assessing the reach and effectiveness of peer support among hardly reached individuals, as well as peer support strategies used. SEARCH METHODS Three systematic searches conducted in PubMed identified studies that evaluated peer support programs among hardly reached individuals. In aggregate, the searches covered articles published from 2000 to 2015. SELECTION CRITERIA Eligible interventions provided ongoing support for complex health behaviors, including prioritization of hardly reached populations, assistance in applying behavior change plans, and social-emotional support directed toward disease management or quality of life. Studies were excluded if they addressed temporally isolated behaviors, were limited to protocol group classes, included peer support as the dependent variable, did not include statistical tests of significance, or incorporated comparison conditions that provided appreciable social support. DATA COLLECTION AND ANALYSIS We abstracted data regarding the primary health topic, categorizations of hardly reached groups, program reach, outcomes, and strategies employed. We conducted a 2-sample t test to determine whether reported strategies were related to reach. RESULTS Forty-seven studies met our inclusion criteria, and these studies represented each of the 3 domains of circumstances assessed (individual, demographic, and cultural-environmental). Interventions addressed 8 health areas, most commonly maternal and child health (25.5%), diabetes (17.0%), and other chronic diseases (14.9%). Thirty-six studies (76.6%) assessed program reach, which ranged from 24% to 79% of the study population. Forty-four studies (94%) reported significant changes favoring peer support. Eleven strategies emerged for engaging and retaining hardly reached individuals. Among them, programs that reported a strategy of trust and respect had higher participant retention (82.8%) than did programs not reporting such a strategy (48.1%; P = .003). In 5 of the 6 studies examining moderators of the effects of peer support, peer support benefits were greater among individuals characterized by disadvantage (e.g., low health literacy). CONCLUSIONS Peer support is a broad and robust strategy for reaching groups that health services too often fail to engage. The wide range of audiences and health concerns among which peer support is successful suggests that a basis for its success may be its flexible response to different contexts, including the intended audience, health problems, and setting. PUBLIC HEALTH IMPLICATIONS The general benefits of peer support and findings suggesting that it may be more effective among those at heightened disadvantage indicate that peer support should be considered in programs intended to reach and benefit those too often hardly reached. Because engendering trust and respect was significantly associated with participant retention, programs should emphasize this strategy.

Parenting styles and body mass index: a systematic review of prospective studies among children

Parenting style may be an important determinant of an individuals future weight status. However, reviews that evaluate the relationship between parenting style and weight‐related outcomes have not focused on prospective studies.

Identifying Those Whom Health Promotion Hardly Reaches A Systematic Review

To understand what circumstances lend groups to be recognized as hardly reached by health services and research, we systematically reviewed studies that identified their priority populations as hard to reach. We classified attributes of hardly reached groups into cultural/environmental, individual, and demographic domains. Of the 334 identified studies, 78.74% used attributes that were classified into the cultural/environmental, 74.85% the individual, and 50% the demographic domain to identify those hardly reached. Of all possible combinations of domains, the most common was the use of all three domains (28.74%). Overall, papers were more likely to use attributes to identify their hardly reached population that fell into more than one domain (74.85%) compared to only one domain (25.15%; χ2, p < .0001). Through this review, we identified the attributes of those who have been identified as hardly reached in published research. No single attribute is used to identify those who are hardly reached. This reflects a socioecological perspective, emphasizing that both intrapersonal and external elements may cause interventions to fail to reach those intended. Moreover, the focus not on populations hardly reached but on the attributes of those hardly reached suggests objectives for interventions to reach them better.

Child and family health in the era of prevention: new opportunities and challenges

To maintain positive health outcomes over the life course, prevention efforts should begin early in childhood. Two research domains that significantly impact the trajectory of health over the life course are childhood obesity and early trauma and violence. Prevention strategies addressing multiple levels of influence are being adopted in these fields. Childhood obesity prevention efforts no longer focus solely on individuals, but embrace multiple ecological levels, such as family, school, and community. Similarly, research on early trauma and violence has broadened to consider risk and protective factors across domains of influence. Although we have improved our understanding and prevention of these two issues, gaps remain in research, practice, and policy. The purpose of this review is to relay relevant findings that could enhance prevention strategies. We describe early life and multilevel risk factors relevant to these areas of research. We also provide recommendations for future efforts to better ensure good health for generations to come.

Variability in self-rated health trajectories from adolescence to young adulthood by demographic factors

Self-rated health (SRH) is a robust measure of general health status and an indicator of where and when to target disease prevention efforts-especially in adolescent populations when clinical endpoints are rare. This studys purpose was to model SRH trajectories from ages 13 to 31 and identify whether and when differences between demographic groups emerge. We employed a conditional latent growth model of SRH in December 2016 using a nationally representative sample of 11,512 adolescents from the National Longitudinal Study of Adolescent to Adult Health data collected in 1994-2008. The average SRH trajectory is curvilinear: SRH increases until age 21 and then decreases. This trajectory contains significant between-individual variability in the intercept and linear slope. Males and self-identified non-Hispanic Blacks had higher SRH at age 13 but experienced steeper linear declines than their demographic counterparts. Individuals who grew up in households without two parents and whose parents did not graduate college had consistently lower SRH compared to those living in households with two parents and whose parents graduated college. Self-rated health is not stable over the span of early adolescence to young adulthood; demographic factors account for differences in individual variability around the starting point and overtime changes in SRH. Because these differences are apparent as early as age 13years, prevention efforts targeting demographic-based disparities should occur early in life.

Peer support opportunities across the cancer care continuum: a systematic scoping review of recent peer-reviewed literature

ObjectiveEvidence suggests peer support (PS) is as an effective strategy for enhancing prevention and control of chronic and infectious diseases, including cancer. This systematic scoping review examines the range and variety of interventions on the use of PS across the cancer care continuum.MethodWe used a broad definition of PS to capture a wide-range of interventions and characterize the current status of the field. Literature searches were conducted using PubMed, SCOPUS, and CINAHL to identify relevant articles published from January 2011 to June 2016. We screened the title and abstracts of 2087 articles, followed by full-text screening of 420 articles, resulting in a final sample of 242 articles of which the most recent 100 articles were reviewed (published June 2014 to May 2016).ResultsA number of the recent intervention studies focused on breast cancer (32%, breast cancer only) or multiple cancer sites (23%). Although the interventions spanned all phases of the cancer care continuum, only 2% targeted end-of-life care. Seventy-six percent focused on clinical outcomes (e.g., screening, treatment adherence) and 72% on reducing health disparities. Interventions were primarily phone-based (44%) or delivered in a clinic setting (44%). Only a few studies (22%) described the impact of providing PS on peer supporters.ConclusionPS appears to be a widely used approach to address needs across the cancer care continuum, with many opportunities to expand its reach.

Measuring beverage consumption in US children and adolescents: a systematic review: Measuring beverage consumption in youth

Beverage consumption habits are associated with weight outcomes for children and adolescents. Many studies have examined youths beverage consumption, but little is known about what methods are commonly used to assess youth beverage consumption and whether these strategies are valid and reliable. This study aimed to systematically review articles assessing beverage consumption among children and adolescents. We searched PubMed and Scopus for English‐language articles published between February 2007 and February 2017 that measured and reported on American youths (ages 2–18 years) beverage consumption. Searches yielded 17,165 articles, of which 589 articles describing 615 measures were extracted. We examined the types of assessment methods used, characteristics of these methods (e.g. validity, reliability, and literacy level), characteristics of study samples, and beverages assessed. The most common assessment methods were questionnaires/screeners (used by 65.4% of articles) and recalls (24.4%). About three‐quarters of articles did not address validity (70.5%) or reliability (79.5%) of any measures used. Study populations were diverse: 54.7% of articles included low‐income children, and 90.2% included non‐White children. The most commonly assessed beverage category was sugar‐sweetened beverages. Findings suggest that improved measurement techniques and reporting are both needed to track progress towards a goal of ensuring all youth have healthy beverage consumption.

Psychology, Mental Health, and Quality of Life

This chapter reviews the scope and epidemiology of the problems of mental health worldwide including the epidemiological transition from acute to chronic disease and increased focus on conditions that debilitate, including psychological problems. Chief among these are depression, anxiety disorders, substance use disorders, personality disorders, psychological distress, and serious mental illness including schizophrenia and bipolar disorder. These interact in varied ways with other health challenges, including maternal health and child development, diabetes, cardiovascular disease, cancer, and HIV/AIDS. Understanding these is facilitated by a review of both key life course phases, namely, parental health and child development, adolescent development, and older adulthood, and conceptual issues concerning what we call “mental illness” and how we think about psychological problems and their roles in physical disease. This chapter closes with a description of several noteworthy intervention approaches including peer support, stress management in cancer and HIV, mindfulness approaches, and Assertive Community Treatment (ACT), emphasizing the integrative roles of self-management and problem-solving. Along with inclusion of treatment for mental health problems in general healthcare systems, it is important to recognize important ways in which “mental illness” is not “just like any other illness.” The field is headed toward an integration built on shared themes and approaches, but not an assumption of equivalence.

Peer Support in Prevention, Chronic Disease Management, and Well-Being

Social support is powerful, and epidemiologic reviews show that its absence, social isolation, is as lethal as smoking cigarettes. Thus, harnessing support through peer support programs (community health workers, promotores de salud, lay health advisors, etc.) has been shown to have diverse and reliable benefits. Studies show its feasibility, sustainability, and adoption. Studies also show its effectiveness in reaching those whom health initiatives too often fail to engage, reaching populations, and reducing psychological distress and the avoidable hospital and acute care that so often accompanies it. This chapter reviews the implications for peer support interventions from fundamental knowledge of social support, including research on attachment and social connections, types of social support, especially emotional support, social networks and diversity of connections, and the general importance of contexts in moderating features of peer support and their effects. This chapter also reviews success factors including the importance of proactive contact, dissemination and organizational models for peer support, integration with behavioral health and mental health, dissemination through primary care and digital health, and policy considerations. It closes with discussion of the importance of the continuum of peer support, from informal support among family, friends, or neighbors, to individuals volunteering a few hours a week, to highly trained volunteers such as the Village Health Volunteers of Thailand or clinical staff such as the Lady Health Workers in Pakistan’s primary care system.