Dietary behaviours during COVID-19 among households at risk for food insecurity.

The objective of the present study was to examine associations between variables of COVID-19-related concerns and changes in fruit and vegetable (FV) consumption among a sample of participants from the Brighter Bites program at risk for food insecurity. Cross-sectional data were collected during April-June 2020 using a rapid-response survey to understand social needs, COVID-19-related concerns and diet-related behaviours among families with children participating in Brighter Bites (n 1777) in the 2019-2020 school year at risk for food insecurity, within the surrounding Houston, Dallas, Austin, Texas area; Southwest Florida; Washington, D.C., United States. Of the 1777 respondents, 92 % of households reported being at risk for food insecurity. Among those from food insecure households, the majority were of Hispanic/Mexican-American/Latino (84⋅1 %) ethnic background, predominantly from Houston, Texas (71⋅4 %). During the pandemic, among individuals from food insecure households, 41 % (n 672) reported a decrease in FV intake, 32 % (n 527) reported an increase in FV intake, and 27 % (n 439) reported no change in FV intake. Those who reported concerns about financial stability had a 40 % greater risk of decreased FV intake compared to those not concerned about financial stability (RR 1⋅4; 95 % CI 1⋅0, 2⋅0; P = 0⋅03). The present study adds to this current body of sparse literature on how the initial phase of the pandemic impacted FV consumption behaviours among food insecure households with children. Effective interventions are needed to diminish the negative impact of COVID-19 on the population's health.

Spatial Patterns of COVID-19 Vaccination Coverage by Social Vulnerability Index and Designated COVID-19 Vaccine Sites in Texas.

Equitable access to the COVID-19 vaccine remains a public health priority. This study explores the association between ZIP Code-Tabulation Area level Social Vulnerability Indices (SVI) and COVID-19 vaccine coverage in Texas. A mixed-effects, multivariable, random-intercept negative binomial model was used to explore the association between ZIP Code-Tabulation Area level SVI and COVID-19 vaccination coverage stratified by the availability of a designated vaccine access site. Lower COVID-19 vaccine coverage was observed in ZIP codes with the highest overall SVIs (adjusted mean difference (aMD) = -13, 95% CI, -23.8 to -2.1, p < 0.01), socioeconomic characteristics theme (aMD = -16.6, 95% CI, -27.3 to -5.7, p = 0.01) and housing and transportation theme (aMD = -18.3, 95% CI, -29.6 to -7.1, p < 0.01) compared with the ZIP codes with the lowest SVI scores. The vaccine coverage was lower in ZIP Code-Tabulation Areas with higher median percentages of Hispanics (aMD = -3.3, 95% CI, -6.5 to -0.1, p = 0.04) and Blacks (aMD = -3.7, 95% CI, -6.4 to -1, p = 0.01). SVI negatively impacted COVID-19 vaccine coverage in Texas. Access to vaccine sites did not address disparities related to vaccine coverage among minority populations. These findings are relevant to guide the distribution of COVID-19 vaccines in regions with similar demographic and geospatial characteristics.

Impact of a Virtual Culinary Medicine Curriculum on Biometric Outcomes, Dietary Habits, and Related Psychosocial Factors among Patients with Diabetes Participating in a Food Prescription Program.

Culinary medicine is an evidence-based approach that blends the art of cooking with the science of medicine to inculcate a healthy dietary pattern. Food prescription programs are gaining popularity in the Unites States, as a means to improve access to healthy foods among patient populations. The purpose of this paper is to describe the implementation and preliminary impact of A Prescription for Healthy Living (APHL) culinary medicine curriculum on biometric and diet-related behavioral and psychosocial outcomes among patients with diabetes participating in a clinic-led food prescription (food Rx) program. We used a quasi-experimental design to assess APHL program impact on patient biometric outcome data obtained from electronic health records, including glycosylated hemoglobin (HbA1c), body mass index (BMI), and blood pressure (n = 33 patients in the APHL group, n = 75 patients in the food Rx-only group). Pre-post surveys were administered among those in the APHL group to monitor program impact on psychosocial and behavioral outcomes. Results of the outcome analysis showed significant pre-to-post reduction in HbA1c levels among participants within the APHL group (estimated mean difference = -0.96% (-1.82, -0.10), p = 0.028). Between-group changes showed a greater decrease in HbA1c among those participating in APHL as compared to food Rx-only, albeit these differences were not statistically significant. Participation in APHL demonstrated significant increases in the consumption of fruits and vegetables, fewer participants reported that cooking healthy food is difficult, increased frequency of cooking from scratch, and increased self-efficacy in meal planning and cooking (p < 0.01). In conclusion, the results of our pilot study suggest the potential positive impact of a virtually-implemented culinary medicine approach in improving health outcomes among low-income patients with type 2 diabetes, albeit studies with a larger sample size and a rigorous study design are needed.

Community-Academic Partnerships to Promote Health Literacy and Address Social Needs Among Low-Income Families During COVID-19.

Brighter Bites is a school-based health promotion program that delivers fresh produce and nutrition education to low-income children and their families across 6 locations in the US. This article provides a perspective on how, despite coronavirus disease 2019-related school closures, Brighter Bites pivoted rapidly to collaborate with medical and public health institutions to improve health and food literacy among their families. Through these partnerships, Brighter Bites was able to rapidly provide accurate, evidence-based information related to coronavirus disease 2019 and other social needs, including food, housing, transportation, and access to health care, to help fill a needed gap in vulnerable communities.