Food Insecurity Is Under-reported in Surveys That Ask About the Past Year.

INTRODUCTION: Food insecurity affects 1 in 10 Americans in a typical year; recent U.S. Department of Agriculture data show that this food insecurity rate was stable from 2019 to 2021. However, data from Los Angeles County and other U.S. regions show that food insecurity spiked during the early months of the COVID-19 pandemic. One reason for this discrepancy may be that food insecurity measures assess experiences over different time frames. This study investigated the discrepancies in food insecurity rates by comparing past-week and past-year food insecurity measures and explored the role of recall bias. METHODS: Data were obtained from a representative survey panel of Los Angeles adults (N=1,135). Participants were surveyed about past-week food insecurity 11 times throughout 2021 and once about past-year food insecurity in December 2021. Data were analyzed in 2022. RESULTS: Of the participants who reported past-week food insecurity at any time in 2021, only two thirds also reported past-year food insecurity in December 2021, suggesting that one third of participants under-reported past-year food insecurity. Logistic regression models indicated that 3 characteristics were significantly associated with under-reporting of past-year food insecurity: having reported past-week food insecurity at fewer survey waves, not reporting recent past-week food insecurity, and having a relatively high household income. CONCLUSIONS: These results suggest substantial under-reporting of past-year food insecurity, related to recall bias and social factors. Measuring food insecurity at multiple points throughout the year may help to improve the accuracy of reporting and public health surveillance of this issue.

Community-Based Public Health Vaccination Campaign (VaccinateLA) in Los Angeles' Black and Latino Communities: Protocol for a Participatory Study.

BACKGROUND: The COVID-19 pandemic has significantly affected Los Angeles County and disproportionately impacted Black and Latino populations who experienced disparities in rates of infection, hospitalizations, morbidity, and mortality. The University of Southern California (USC), USC Keck School of Medicine, Southern California Clinical and Translational Science Institute, USC Mann School of Pharmacy and Pharmaceutical Sciences, Annenberg School for Journalism and Communication, and Children's Hospital Los Angeles will launch a collaborative public health campaign called VaccinateLA. OBJECTIVE: VaccinateLA will implement a community-based, community-partnered public health campaign that (1) delivers culturally tailored information about COVID-19 and available vaccines; and (2) addresses misinformation and disinformation, which serves as a barrier to vaccine uptake. The campaign will be targeted to communities in Los Angeles with the highest rates of COVID-19 infection and the lowest vaccination rates. Using these criteria, the campaign will be targeted to neighborhoods located in 34 zip codes in the Eastside and South Los Angeles. The primary aim of VaccinateLA will be to design and deliver an evidence-based multimedia public health campaign tailored for Black and Latino populations. A secondary aim will be to train and deploy community vaccine navigators to deliver COVID-19 education, help individuals overcome barriers to getting vaccinated (eg, transportation and challenges registering), and assist with delivering vaccinations in our targeted communities. METHODS: We will use a community-based, participatory research approach to shape VaccinateLA's public health campaign to address community members' attitudes and concerns in developing campaign content. We will conduct focus groups, establish a community advisory board, and engage local leaders and stakeholders to develop and implement a broad array of educational, multimedia, and field-based activities. RESULTS: As of February 2023, target communities have been identified. The activities will be initiated and evaluated over the course of this year-long initiative, and dissemination will occur following the completion of the project. CONCLUSIONS: Engaging the community is vital to developing culturally tailored public health messages that will resonate with intended audiences. VaccinateLA will serve as a model for how an academic institution can quickly mobilize to address a pressing public health crisis, particularly in underrepresented and underresourced communities. Our work has important implications for future public health campaigns. By leveraging community partnerships and deploying community health workers or promotores into the community, we hope to demonstrate that urban universities can successfully partner with local communities to develop and deliver a range of culturally tailored educational, multimedia, and field-based activities, which in turn may change the course of an urgent public health crisis, such as the COVID-19 pandemic. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/40161.

Perceptions of social circle vaccine acceptance and COVID-19 vaccine initiation among postpriority vaccine eligible adults.

OBJECTIVES: COVID-19 vaccines in the United States were made available to the general public aged 16 years and older in April 2021, but uptake in the months following was variable. We aimed to investigate this variability as a function of interpersonal factors, namely perceived social circle vaccine acceptance and proximity to illness, controlling for intrapersonal factors more often associated with vaccine behavior. METHOD: Data come from the Understanding Coronavirus in America tracking survey (February 2021-July 2021). We estimated the probability of vaccination among those who were unvaccinated as of April 14, 2021 (N = 2,199), the day before the announcement of general public eligibility. Stratified modeling by race accounted for subgroup differences. RESULTS: People who perceived social circle vaccine acceptance (Hazard Ratio [HR] = 1.37, p < .001), higher risk of infection (HR = 1.20, p < .001), greater trust in the vaccine (HR = 1.42, p < .001), and lower risk of vaccine side effects (HR = 0.77, p < .001) were more likely to get vaccinated. Perceptions of social circle vaccine acceptance were associated with vaccine initiation for all racial subgroups except Black respondents, for whom concerns about vaccine side effects were central. CONCLUSIONS: Perceived social circle vaccine acceptance was associated with time to the first dose of the COVID-19 vaccine. With public uncertainty about this new vaccine, people may have relied on perceptions of peers' vaccination intentions when deciding on their own vaccination. We discuss strategies for promoting vaccine uptake by intervening on perceptions of social norms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Self-reported dietary changes among Los Angeles County adults during the COVID-19 pandemic.

Poor diets are historically the leading cause of morbidity and mortality in the United States (U.S.), causing over 44,000 deaths each month. Dietary patterns have likely changed during the COVID-19 pandemic due to major shifts and crises in social, economic, and food systems. This study examines self-reported dietary changes in Los Angeles (L.A.) County during COVID-19, and identifies factors associated with making healthy and unhealthy changes. Data are from the Understanding Coronavirus in America Study, an internet panel of adults representative of L.A. County households (N = 1080). Multinomial logistic regression was used to test if self-reported change in diet healthiness assessed in July 2020 was associated with socio-ecological factors known to be associated with diet, assessed between April-July 2020. More than half of L.A. County residents reported making changes to their diet: 28.3% reported eating healthier food since the beginning of the pandemic, while 24.8% reported eating less healthy food. Individuals who were significantly more likely to report healthy changes were Non-Hispanic Black or Hispanic/Latino (vs. Non-Hispanic White), had received unemployment insurance, or had larger social networks. Individuals who were significantly more likely to report unhealthy changes were younger, of mixed race, had children in their household, had transportation barriers, or had obesity. Individuals who were significantly more likely to report both healthy and unhealthy changes were Asian, had experienced food insecurity, or had challenges getting food due to store closures. The pandemic may be exacerbating diet-related disease risk in some groups, such as communities of color, and among individuals with obesity and those facing transportation barriers.

An integrated risk and epidemiological model to estimate risk-stratified COVID-19 outcomes for Los Angeles County: March 1, 2020-March 1, 2021.

The objective of this study was to use available data on the prevalence of COVID-19 risk factors in subpopulations and epidemic dynamics at the population level to estimate probabilities of severe illness and the case and infection fatality rates (CFR and IFR) stratified across subgroups representing all combinations of the risk factors age, comorbidities, obesity, and smoking status. We focus on the first year of the epidemic in Los Angeles County (LAC) (March 1, 2020-March 1, 2021), spanning three epidemic waves. A relative risk modeling approach was developed to estimate conditional effects from available marginal data. A dynamic stochastic epidemic model was developed to produce time-varying population estimates of epidemic parameters including the transmission and infection observation rate. The epidemic and risk models were integrated to produce estimates of subpopulation-stratified probabilities of disease progression and CFR and IFR for LAC. The probabilities of disease progression and CFR and IFR were found to vary as extensively between age groups as within age categories combined with the presence of absence of other risk factors, suggesting that it is inappropriate to summarize epidemiological parameters for age categories alone, let alone the entire population. The fine-grained subpopulation-stratified estimates of COVID-19 outcomes produced in this study are useful in understanding disparities in the effect of the epidemic on different groups in LAC, and can inform analyses of targeted subpopulation-level policy interventions.