Impact of an Arts-based Public Health Literacy Program Delivered Online to High School Students during the COVID-19 Pandemic.

The COVID-19 pandemic, coupled with the domestic socio-political unrest of 2020, provides a critical opportunity to reframe how we engage with youth around health and disease risk. The Bigger Picture (TBP), a spoken word, arts-based public health literacy campaign, uses a social justice and racial equity frame to activate youth around social determinants of health, including salient topics such as type 2 diabetes, COVID-19, climate change, and police violence. This quasi-experimental study determined the impact of providing an online adaptation of TBP during the COVID-19 pandemic to urban, low-income, diverse high school students (3 intervention schools assigned to receive TBP-based spoken word program; 3 comparison schools received a non-health focused spoken word program). We used outcomes derived from the Culture of Health framework, including: (1) health-related mind-sets and expectations; (2) sense of belonging; and (3) civic engagement. Students completed pre/post surveys; a subset of adults and youth from all 6 schools completed semi-structured interviews. TBP participation resulted in measurable shifts in students' mind-sets around structural drivers of health and health inequity and increases in plans for future civic engagement. Arts-based programming with an intentional focus on the social ecological model and health equity appears to impact young people, even when delivered online.

Limited implementation of California's Healthy Default Beverage law for children's meals sold online.

OBJECTIVE: To reduce children's sugar-sweetened beverage intake, California's Healthy-By-Default Beverage law (SB1192) mandates only unflavoured dairy/non-dairy milk or water be the default drinks with restaurant children's meals. The objective of this study is to examine consistency with this law for meals sold through online platforms from restaurants in low-income California neighbourhoods. DESIGN: This observational, cross-sectional study examines beverage availability, upcharges (additional cost) and presentation of beverage options consistent with SB1192 (using four increasingly restrictive criteria) within a random sample of quick-service restaurants (QSR) in Supplemental Nutrition Assistance Program Education eligible census tracts selling children's meals online from November 2020 to April 2021. SETTING: Low-income California neighbourhoods (n 226 census tracts). PARTICIPANTS: QSR that sold children's meals online via a restaurant-specific platform, DoorDash, GrubHub and/or UberEats (n 631 observations from 254 QSR). RESULTS: Seventy percent of observations offered water; 63 % offered unflavoured milk. Among all beverages, water was most likely to have an upcharge; among observations offering water (n 445), 41 % had an upcharge (average $0·51). Among observations offering unflavoured milk (n 396), 11 % had an upcharge (average $0·38). No observations upcharged for soda (regular or diet). Implementation consistency with SB1192 ranged from 40·5 % (using the least restrictive criteria) to 5·6 % (most restrictive) of observations. CONCLUSIONS: Based on observations from restaurant websites and three of the most popular online ordering platforms, most California QSR located in low-income neighbourhoods are not offering children's meal beverages consistent with the state's Healthy-By-Default Beverage law. As the popularity of online ordering increases, further work to ensure restaurants offering healthy default beverages with children's meals sold online is necessary.

Evaluating Food Packaging Waste in Schools: A Systematic Literature Review

Public schools in the U.S. generate about 14,500 tons of municipal solid waste daily, and approximately 42% of that is food packaging generated by school foodservice, contributing significantly to the global packaging waste crisis. This literature review summarizes methods used to evaluate food packaging waste in school foodservice. This review has two objectives: first, to understand which methodologies currently exist to evaluate food packaging waste generation and disposal in school foodservice;and second, to describe the creation of and share a practical standardized instrument to evaluate food packaging waste generation and disposal in school foodservice. A systematic review was conducted using the following search terms: solid waste, school, cafeteria and food packaging, waste, and school. The final review included 24 studies conducted in school environments (kindergarten through twelfth grade or college/university), 16 of which took place in the U.S. Food packaging waste evaluations included objective methods of waste audits, models, and secondary data as well as subjective methods of qualitative observations, questionnaires, interviews, and focus groups. Large variation exists in the settings, participants, designs, and methodologies for evaluating school foodservice packaging waste. Lack of standardization was observed even within each methodology (e.g., waste audit). A new instrument is proposed to support comprehensive and replicable data collection, to further the understanding of school foodservice food packaging waste in the U.S., and to reduce environmental harms.

Pandemic-related financial hardship and disparities in sugar-sweetened beverage consumption and purchasing among San Francisco Bay Area residents during COVID-19.

Some reports suggest that the COVID-19 pandemic resulted in shifts to unhealthier diets. These unhealthier diets may include sugar-sweetened beverages (SSBs), which strongly contribute to diabetes and other chronic diseases. Using cross-sectional surveys in the San Francisco Bay Area, California, USA we sought to assess self-reported SSB consumption during the pandemic's shelter-in-place and self-reported changes in SSB purchasing from before to during the pandemic's shelter-in-place, stratifying by indices of pandemic-related financial hardship. Nearly 60% of our diverse sample (N = 943) reported that it was harder to pay for basics (like food and utilities) during shelter-in-place. Among those who found it harder to pay for basics and received financial assistance during shelter-in-place, we found a ten-fold higher frequency of daily SSB consumption compared to those not facing new financial hardship (2.76 [95% CI: 1.78, 3.74] versus 0.30 [95% CI: 0.23, 0.37] times/day). There were no statistically significant increases in reported purchasing of any SSB, but those with new financial hardship during shelter-in-place reported greater purchasing of regular soda relative to those with no new hardship (0.20 on a 3-point scale [95% CI: 0.03, 0.37]). Our findings suggest that new hardship may increase unhealthy behaviors and worsen existing disparities in SSB consumption. Such disparities are a reminder of the urgent need to reduce economic inequity and improve the quality of our emergency food system in order to mitigate the impact of public health crises like the COVID-19 pandemic.

High-Throughput CRISPR-Cas13 SARS-CoV-2 Test.

BACKGROUND: The ability to control the spread of COVID-19 continues to be hampered by a lack of rapid, scalable, and easily deployable diagnostic solutions. METHODS: We developed a diagnostic method based on CRISPR (clustered regularly interspaced short palindromic repeats) that can deliver sensitive, specific, and high-throughput detection of Sudden Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2). The assay utilizes SHERLOCK (Specific High-sensitivity Enzymatic Reporter unLOCKing) for the qualitative detection of SARS-CoV-2 RNA and may be performed directly on a swab or saliva sample without nucleic acid extraction. The assay uses a 384-well format and provides results in <1 hour. RESULTS: Assay performance was evaluated with 105 (55 negative, 50 positive) remnant SARS-CoV-2 specimens previously tested using Food and Drug Administration emergency use authorized assays and retested with a modified version of the Centers for Disease Control and Prevention (CDC) quantitative PCR with reverse transcription (RT-qPCR) assay. When combined with magnetic bead-based extraction, the high-throughput SHERLOCK SARS-CoV-2 assay was 100% concordant (n = 60) with the CDC RT-qPCR. When used with direct sample addition the high-throughput assay was also 100% concordant with the CDC RT-qPCR direct method (n = 45). With direct saliva sample addition, the negative and positive percentage agreements were 100% (15/15, 95% CI: 81.8-100%) and 88% (15/17, 95% CI: 63.6-98.5%), respectively, compared with results from a collaborating clinical laboratory. CONCLUSIONS: This high-throughput assay identifies SARS-CoV-2 from patient samples with or without nucleic acid extraction with high concordance to RT-qPCR methods. This test enables high complexity laboratories to rapidly increase their testing capacities with simple equipment.

Assessing sensitivity and reproducibility of RT-ddPCR and RT-qPCR for the quantification of SARS-CoV-2 in wastewater.

Throughout the COVID-19 global pandemic there has been significant interest and investment in using Wastewater-Based Epidemiology (WBE) for surveillance of viral pathogen presence and infections at the community level. There has been a push for widescale implementation of standardized protocols to quantify viral loads in a range of wastewater systems. To address concerns regarding sensitivity, limits of quantification, and large-scale reproducibility, a comparison of two similar workflows using RT-qPCR and RT-ddPCR was conducted. Sixty raw wastewater influent samples were acquired from nine distinct wastewater treatment plants (WWTP's) served by the Hampton Roads Sanitation District (HRSD, Virginia Beach, Virginia) over a 6-month period beginning March 9th, 2020. Common reagents, controls, master mixes and nucleic acid extracts were shared between two individual processing groups based out of HRSD and the UNC Chapel Hill Institute of Marine Sciences (IMS, Morehead City, North Carolina). Samples were analyzed in parallel using One-Step RT-qPCR and One-Step RT-ddPCR with Nucleocapsid Protein 2 (N2) specific primers and probe. Influent SARS-CoV-2 N2 concentrations steadily increased over time spanning a range from non-detectable to 2.13E + 05 copies/L. Systematic dilution of the extracts indicated that inhibitory components in the wastewater matrices did not significantly impede the detection of a positive N2 signal for either workflow. The RT-ddPCR workflow had a greater analytical sensitivity with a lower Limit of Detection (LOD) at 0.066 copies/µl of template compared to RT-qPCR with a calculated LOD of 12.0 copies/µL of template. Interlaboratory comparisons using non-parametric correlation analysis demonstrated that there was a strong, significant, positive correlation between split extracts when employing RT-ddPCR for analysis with a ρ value of 0.86.

COVID-19 surveillance in Southeastern Virginia using wastewater-based epidemiology.

Wastewater-based epidemiology (WBE) has been used to analyze markers in wastewater treatment plant (WWTP) influent to characterize emerging chemicals, drug use patterns, or disease spread within communities. This approach can be particularly helpful in understanding outbreaks of disease like the novel Coronavirus disease-19 (COVID-19) when combined with clinical datasets. In this study, three RT-ddPCR assays (N1, N2, N3) were used to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in weekly samples from nine WWTPs in southeastern Virginia. In the first several weeks of sampling, SARS-CoV-2 detections were sporadic. Frequency of detections and overall concentrations of RNA within samples increased from mid March into late July. During the twenty-one week study, SARS-CoV-2 concentrations ranged from 101 to 104 copies 100 mL-1 in samples where viral RNA was detected. Fluctuations in population normalized loading rates in several of the WWTP service areas agreed with known outbreaks during the study. Here we propose several ways that data can be presented spatially and temporally to be of greatest use to public health officials. As the COVID-19 pandemic wanes, it is likely that communities will see increased incidence of small, localized outbreaks. In these instances, WBE could be used as a pre-screening tool to better target clinical testing needs in communities with limited resources.