Comparison of Imputation Strategies for Incomplete Longitudinal Data in Life-Course Epidemiology.

Incomplete longitudinal data are common in life-course epidemiology and may induce bias leading to incorrect inference. Multiple imputation (MI) is increasingly preferred for handling missing data, but few studies explore MI-method performance and feasibility in real-data settings. We compared 3 MI methods using real data under 9 missing-data scenarios, representing combinations of 10%, 20%, and 30% missingness and missing completely at random, at random, and not at random. Using data from Health and Retirement Study (HRS) participants, we introduced record-level missingness to a sample of participants with complete data on depressive symptoms (1998-2008), mortality (2008-2018), and relevant covariates. We then imputed missing data using 3 MI methods (normal linear regression, predictive mean matching, variable-tailored specification), and fitted Cox proportional hazards models to estimate effects of 4 operationalizations of longitudinal depressive symptoms on mortality. We compared bias in hazard ratios, root mean square error, and computation time for each method. Bias was similar across MI methods, and results were consistent across operationalizations of the longitudinal exposure variable. However, our results suggest that predictive mean matching may be an appealing strategy for imputing life-course exposure data, given consistently low root mean square error, competitive computation times, and few implementation challenges.

Randomized Comparative Effectiveness Trial of 2 Federally Recommended Strategies to Reduce Excess Body Fat in Overweight, Low-Income Patients: MyPlate.gov vs Calorie Counting.

PURPOSE: Since 2011, US authorities have supported the following 2 approaches to healthier body fat composition: the Centers for Disease Control and Prevention National Diabetes Prevention Program's calorie counting (CC) approach and the US Department of Agriculture's MyPlate (adherence to federal nutrition guidelines). The purpose of this study was to compare the effect of CC vs MyPlate approaches on satiety/satiation and on achieving healthier body fat composition among primary care patients. METHODS: We conducted a randomized controlled trial comparing the CC and MyPlate approaches from 2015 to 2017. The adult participants were overweight, of low income, and were mostly Latine (n = 261). For both approaches, community health workers conducted 2 home education visits, 2 group education sessions, and 7 telephone coaching calls over a period of 6 months. Satiation and satiety were the primary patient-centered outcome measures. Waist circumference and body weight were the primary anthropometric measures. Measures were assessed at baseline, 6 months, and 12 months. RESULTS: Satiation and satiety scores increased for both groups. Waist circumference was significantly decreased in both groups. MyPlate, but not CC, resulted in lower systolic blood pressure at 6 months but not at 12 months. Participants for both MyPlate and CC reported greater quality of life and emotional well-being and high satisfaction with their assigned weight-loss program. The most acculturated participants showed the greatest decreases in waist circumference. CONCLUSIONS: A MyPlate-based intervention might be a practical alternative to the more traditional CC approach to promoting satiety and facilitating decreases in central adiposity among low-income, mostly Latine primary care patients.

Improving Care Linkage for Racial-Ethnic Minority Youths Receiving Emergency Department Treatment for Suicidality: SAFETY-A.

OBJECTIVE: This study evaluated the effects of Safe Alternatives for Teens and Youths-Acute (SAFETY-A), a brief strengths-based, cognitive-behavioral family intervention, on racial-ethnic minority youths receiving emergency department (ED) treatment for suicidal episodes. METHODS: Participants were 105 racial-ethnic minority youths enrolled in a randomized controlled trial evaluating SAFETY-A versus enhanced usual care for youths receiving ED treatment for suicidal episodes. Analyses examined group effects on care linkage after discharge and adequate treatment dose. A sample of 55 White youths was included for comparison. RESULTS: Racial-ethnic minority youths who received SAFETY-A had higher treatment linkage rates than those receiving usual care. Adequate treatment dose rates did not differ by group. CONCLUSIONS: Racial-ethnic minority youths receiving SAFETY-A had higher treatment linkage rates after discharge than those receiving usual care. SAFETY-A is a promising approach to enhance care continuity and mental health equity for racial-ethnic minority youths at risk for suicide.

Assessing Alternative Imputation Strategies for Infrequently Missing Items on Multi-item Scales.

Health-science researchers often measure psychological constructs using multi-item scales and encounter missing items on some participants. Multiple imputation (MI) has emerged as an alternative to ad-hoc methods (e.g., mean substitution) for handling incomplete data on multi-item scales, appealingly reflecting available information while accounting for uncertainty due to missing values in a unified inferential framework. However, MI can be implemented in a variety of ways. When the number of variables to impute gets large, some strategies yield unstable estimates of quantities of interest while others are not technically feasible to implement. These considerations raise pragmatic questions about the extent to which ad-hoc procedures would yield statistical properties that are competitive with theoretically motivated methods. Drawing on an HIV study where depression and anxiety symptoms are measured with multi-item scales, this empirical investigation contrasts ad-hoc methods for handling missing items with various MI implementations that differ as to whether imputation is at the item-level or scale-level and how auxiliary variables are incorporated. While the findings are consistent with previous reports favoring item-level imputation when feasible to implement, we found only subtle differences in statistical properties across procedures, suggesting that weaknesses of ad-hoc procedures may be muted when missing data percentages are modest.

Male-Female Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: A State-by-State Analysis.

Males are at higher risk relative to females of severe outcomes following COVID-19 infection. Focusing on COVID-19-attributable mortality in the United States (U.S.), we quantify and contrast years of potential life lost (YPLL) attributable to COVID-19 by sex based on data from the U.S. National Center for Health Statistics as of 31 March 2021, specifically by contrasting male and female percentages of total YPLL with their respective percent population shares and calculating age-adjusted male-to-female YPLL rate ratios both nationally and for each of the 50 states and the District of Columbia. Using YPLL before age 75 to anchor comparisons between males and females and a novel Monte Carlo simulation procedure to perform estimation and uncertainty quantification, our results reveal a near-universal pattern across states of higher COVID-19-attributable YPLL among males compared to females. Furthermore, the disproportionately high COVID-19 mortality burden among males is generally more pronounced when measuring mortality in terms of YPLL compared to age-irrespective death counts, reflecting dual phenomena of males dying from COVID-19 at higher rates and at systematically younger ages relative to females. The U.S. COVID-19 epidemic also offers lessons underscoring the importance of a public health environment that recognizes sex-specific needs as well as different patterns in risk factors, health behaviors, and responses to interventions between men and women. Public health strategies incorporating focused efforts to increase COVID-19 vaccinations among men are particularly urged.

Racial and Ethnic Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: An Analysis of 45 States and the District of Columbia.

The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios-anchoring comparisons to non-Hispanic Whites-in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.

Intimate Partner Violence and Food Insecurity Predict Early Behavior Problems Among South African Children over 5-years Post-Birth.

Households experiencing intimate partner violence (IPV) and food insecurity are at high risk of lifelong physical and behavioral difficulties. Longitudinal data from a perinatal home-visiting cluster-randomized controlled intervention trial in South Africa townships were used to examine the relationships between household settings and mothers' histories of risk and children's behavior problems at 3 and 5 years of age. IPV, food insecurity, maternal depressed mood, and geriatric pregnancy (at age of 35 or older) were consistently associated with children's internalizing and externalizing behavior problems. Aggressive behavior was more prevalent among 3- and 5-year olds boys, and was associated with maternal alcohol use. The effects of these factors on child behavior were more prominent than maternal HIV status. There is a continuing need to reduce IPV and household food insecurity, as well as supporting older, depressed, alcohol using mothers in order to address children's behavioral needs.

Comparative effectiveness trial comparing MyPlate to calorie counting for mostly low-income Latino primary care patients of a federally qualified community health center: study design, baseline characteristics.

BACKGROUND: Primary care-based behavior change obesity treatment has long featured the Calorie restriction (CC), portion control approach. By contrast, the MyPlate-based obesity treatment approach encourages eating more high-satiety/high-satiation foods and requires no calorie-counting. This report describes study methods of a comparative effectiveness trial of CC versus MyPlate. It also describes baseline findings involving demographic characteristics and their associations with primary outcome measures and covariates, including satiety/satiation, dietary quality and acculturation. METHODS: A comparative effectiveness trial was designed to compare the CC approach (n = 130) versus a MyPlate-based approach (n = 131) to treating patient overweight. Intervenors were trained community health workers. The 11 intervention sessions included two in-home health education sessions, two group education sessions, and seven telephone coaching sessions. Questionnaire and anthropometric assessments occurred at baseline, 6- and 12 months; food frequency questionnaires were administered at baseline and 12 months. Participants were overweight adult primary care patients of a federally qualified health center in Long Beach, California. Two measures of satiety/satiation and one measure of post-meal hunger comprised the primary outcome measures. Secondary outcomes included weight, waist circumference, blood pressure, dietary quality, sugary beverage intake, water intake, fruit and vegetable fiber intake, mental health and health-related quality of life. Covariates included age, gender, nativity status (U.S.-born, not U.S.-born), race/ethnicity, education, and acculturation. ANALYSIS: Baseline characteristics were compared using chi square tests. Associations between covariates and outcome measures were evaluated using multiple regression and logistic regression. RESULTS: Two thousand eighty-six adult patients were screened, yielding 261 enrollees who were 86% Latino, 8% African American, 4% White and 2% Other. Women predominated (95%). Mean age was 42 years. Most (82%) were foreign-born; 74% chose the Spanish language option. Mean BMI was 33.3 kg/m2; mean weight was 82 kg; mean waist circumference was 102 cm. Mean blood pressure was 122/77 mm. Study arms on key baseline measures did not differ except on dietary quality and sugary beverage intake. Nativity status was significantly associated with dietary quality. CONCLUSIONS: The two treatment arms were well-balanced demographically at baseline. Nativity status is inversely related to dietary quality. TRIAL REGISTRATION: NCT02514889 , posted on 8/4/2015.

Benefits of Treatment Completion Over Premature Termination: Findings from the National Child Traumatic Stress Network.

Objective: To evaluate potential differences in therapeutic outcomes between youths who completed a full course of treatment as planned compared to youths who terminated treatment prematurely. Method: Using longitudinal data from the National Child Traumatic Stress Network (NCTSN) Core Data Set, the present study examined demographic characteristics, trauma history, scores on standardized measures, and ratings of functional impairment and behavior problems in a large clinical sample of children and adolescents exposed to trauma who received treatment at NCTSN centers across the United States. Baseline and follow-up data were used to compare treatment completers (n= 3,108) and noncompleters (n = 4,029). Results: Both treatment completers and noncompleters received benefits from treatment by NCTSN mental health providers in that both groups showed significant decreases in mean scores from baseline to follow-up on all standardized measures. However, compared to noncompleters, treatment completers showed three types of significantly greater benefit at follow-up. These included: (a) greater rates of decline (i.e., steeper slopes) on all outcome measures; (b) greater reductions in the odds of falling within the clinical range on standardized measures; and (c) greater reductions in the odds of exhibiting functional impairment and behavior problems at follow-up. In contrast, compared to treatment completers, noncompleters reported significantly higher rates of lifetime exposure to community violence, psychological maltreatment, physical abuse, neglect, sexual abuse, and sexual assault. Conclusion: These findings underscore the value of incorporating engagement and retention strategies in treatments for traumatized youths to maximize therapeutic benefit and raise the standard of care.

Maintaining Internal Validity in Community Partnered Participatory Research: Experience from the Community Partners in Care Study.

Objective: With internal validity being a central goal of designed experiments, we seek to elucidate how community partnered participatory research (CPPR) impacts the internal validity of public health comparative-effectiveness research. Methods: Community Partners in Care (CPIC), a study comparing a community-coalition intervention to direct technical assistance for disseminating depression care to vulnerable populations, is used to illustrate design choices developed with attention to core CPPR principles. The study-design process is reviewed retrospectively and evaluated based on the resulting covariate balance across intervention arms and on broader peer-review assessments. Contributions of the CPIC Council and the study's design committee are highlighted. Results: CPPR principles contributed to building consensus around the use of randomization, creating a sampling frame, specifying geographic boundaries delimiting the scope of the investigation, grouping similar programs into pairs or other small blocks of units, collaboratively choosing random-number-generator seeds to determine randomized intervention assignments, and addressing logistical constraints in field operations. Study protocols yielded samples that were well-balanced on background characteristics across intervention arms. CPIC has been recognized for scientific merit, has drawn attention from policymakers, and has fueled ongoing research collaborations. Conclusions: Creative and collaborative fulfillment of CPPR principles reinforced the internal validity of CPIC, strengthening the study's scientific rigor by engaging complementary areas of knowledge and expertise among members of the investigative team.

Methamphetamine use and oral health-related quality of life.

PURPOSE: Methamphetamine (MA) is associated with adverse health effects, including the rampant tooth decay condition called "Meth Mouth." However, the impact of MA use on oral health-related quality of life (OHRQOL) is unknown. This study assessed the relationship between MA use and self-reported OHRQOL. METHODS: This cross-sectional study uses information from 545 MA-using participants recruited from Los Angeles County, California. Dental examinations were performed by three calibrated dentists using National Health and Nutrition Examination Survey (NHANES) protocols. Data on socio-demographic, behavioral, and drug-use history were recorded using questionnaires. Participants were categorized as 'light' or 'moderate/heavy' users based on reported frequency of MA use in the past 30 days. Route of MA administration was categorized as 'smoking' or 'other.' Self-reported OHRQOL was based on the Oral Health Impact Profile scale. RESULTS: Majority of the participants were male (80.9%). Median age was 45.0 years (IQR-13.0). Median number of days of MA use was 10.0 (IQR-12.0). Smoking was the preferred route of MA use (70.2%). Root caries in ≥ 3 teeth were reported in 78% of MA users. More than half of the participants reported having painful aching in mouth, avoidance of particular food items, feeling embarrassed, and discomfort while eating in the last 12 months. In unadjusted logistic models, moderate/heavy MA users were more likely to report an affected sense of taste [OR = 1.58, 95% CI (1.10-2.27)] and avoidance of particular foods [OR = 1.45, 95% CI (1.02-2.01)] than light users. Among individuals preferring other MA administration routes, moderate/heavy MA users were 3.09 times as likely to report an affected sense of taste than light users [OR = 3.09, 95% CI (1.52-6.27)]. CONCLUSION: Oral health and OHRQOL appear to be worse among Methamphetamine users than in the US general population.

Periodontal status of current methamphetamine users.

BACKGROUND: Methamphetamine (MA) use is associated with extensive dental caries. The purpose of this study was to determine the prevalence and severity of periodontal disease in a convenience sample of MA users. METHODS: In this cross-sectional survey, MA users were recruited with a combination of snowball sampling and street outreach techniques. Three dentists, trained and calibrated to the oral assessments used in the National Health and Nutrition Survey, measured and recorded the participants' attachment loss, probing depth, and gingival recession. Concomitant interviews elicited psychological, substance use, medication, and dietary habits associated with MA use. RESULTS: Periodontal assessments were completed on 546 adults. More than 69% were cigarette smokers, and more than 55% were medium to high MA users. Classifying prevalence by means of the Centers for Disease Control and Prevention and the American Academy of Periodontology definitions, cigarette smokers and medium to high MA users had a high prevalence of periodontal disease. The defining features of the participants were being 30 years and older (average, 42.2 years) and having severe and moderate periodontitis. CONCLUSION: This is the first study to the authors' knowledge to systematically examine periodontal disease in a large population of current MA users. MA users in a Los Angeles urban setting had a high prevalence and severity of destructive periodontal disease. The frequency of MA use had a minimal impact on the severity of periodontal disease. PRACTICAL IMPLICATIONS: An MA user can be at high risk of developing periodontal disease. Knowing that behavioral factors, such as smoking and consuming sugary beverages, are more important than MA use will assist the clinician in managing the treatment of MA users.

Multiple imputation with non-additively related variables: Joint-modeling and approximations.

This paper investigates multiple imputation methods for regression models with interacting continuous and binary predictors when continuous variable may be missing. Usual implementations for parametric multiple imputation assume a multivariate normal structure for the variables, which is not satisfied for a binary variable nor its interaction with a continuous variable. To accommodate interactions, missing covariates are multiply imputed from conditional distribution in a manner consistent with the joint model. Alternative imputation methods under multivariate normal assumptions are also considered as candidate approximations and evaluated in a simulation study. The results suggest that the joint modeling procedure performs generally well across a wide range of scenarios and so do the approximation methods that incorporate interactions in the model appropriately by stratification. It is critical to include interactions in the imputation model as failure to do so may result in low coverage and bias. We apply the joint modeling approach and approximation methods in the study of childhood trauma with gender × trauma interaction.

Long-Term Effects of Pre-Placement Risk Factors on Children's Psychological Symptoms and Parenting Stress Among Families Adopting Children From Foster Care.

This exploratory longitudinal study examined behavioral outcomes and parenting stress among families with children adopted from foster care, taking into account environmental and biological risk factors. Child internalizing and externalizing problems and parenting stress were assessed in 82 adopted children and their families at 2 months post-placement, 12 months post-placement, and then yearly until 5 years post-placement. A history of abuse/neglect predicted significantly higher externalizing and internalizing problems at a borderline level of statistical significance. In the initial stages after placement, externalizing problems were significantly higher among children who were 4 years or older at placement versus those who were younger than 4, although differences were no longer significant 5 years post-placement. Statistical trends in parenting stress reflected reduced stress in the first 12 months followed by a plateau for parents who adopted older children and greater stress for parents who adopted younger children. Familiar limitations for observational cohort data apply. Nonetheless, the availability of longitudinal follow-up on a sizable sample of children adopted from foster care adds insight to the psychological dynamics for adoptive families and suggests that families of children adopted from the foster care system may have unique needs for ongoing support around behavioral issues.

Comparative Effectiveness of Two Models of Depression Services Quality Improvement in Health and Community Sectors.

OBJECTIVE: The effectiveness of community coalition building and program technical assistance was compared in implementation of collaborative care for depression among health care and community sector clients. METHODS: In under-resourced communities, within 93 programs randomly assigned to coalition building (Community Engagement and Planning) or program technical assistance (Resources for Services) models, 1,018 clients completed surveys at baseline and at six, 12, or 36 months. Regression analysis was used to estimate intervention effects and intervention-by-sector interaction effects on depression, mental health-related quality of life, and community-prioritized outcomes and on services use. RESULTS: For outcomes, there were few significant intervention-by-sector interactions, and stratified findings suggested benefits of coalition building in both sectors. For services use, at 36 months, increases were found for coalition building in primary care visits, self-help visits, and appropriate treatment for community clients and in community-based services use for health care clients. CONCLUSIONS: Relative to program technical assistance, community coalition building benefited clients across sectors and shifted long-term utilization across sectors.

A Community-Partnered, Participatory, Cluster-Randomized Study of Depression Care Quality Improvement: Three-Year Outcomes.

OBJECTIVE: Community Partners in Care, a community-partnered, cluster-randomized trial with depressed clients from 93 Los Angeles health and community programs, examined the added value of a community coalition approach (Community Engagement and Planning [CEP]) versus individual program technical assistance (Resources for Services [RS]) for implementing depression quality improvement in underserved communities. CEP was more effective than RS in improving mental health-related quality of life, reducing behavioral health hospitalizations, and shifting services toward community-based programs at six months. At 12 months, continued evidence of improvement was found. This study examined three-year outcomes. METHODS: Among 1,004 participants with depression who were eligible for three-year follow-up, 600 participants from 89 programs completed surveys. Multiple regression analyses estimated intervention effects on poor mental health-related quality of life and depression, physical health-related quality of life, behavioral health hospital nights, and use of services. RESULTS: At three years, no differences were found in the effects of CEP versus RS on depression or mental health-related quality of life, but CEP had modest effects in improving physical health-related quality of life and reducing behavioral health hospital nights, and CEP participants had more social- and community-sector depression visits and greater use of mood stabilizers. Sensitivity analyses with longitudinal modeling reproduced these findings but found no significant differences between groups in change from baseline to three years. CONCLUSIONS: At three years, CEP and RS did not have differential effects on primary mental health outcomes, but CEP participants had modest improvements in physical health and fewer behavioral health hospital nights.

A corner store intervention to improve access to fruits and vegetables in two Latino communities.

OBJECTIVE: Investments have been made to alter the food environment of neighbourhoods that have a disproportionate number of unhealthy food venues. Corner store conversions are one strategy to increase access to fruits and vegetables (F&V). Although the literature shows modest success, the effectiveness of these interventions remains equivocal. The present paper reports on the evaluation of Proyecto MercadoFRESCO, a corner store conversion intervention in two Latino communities. DESIGN: A repeated cross-sectional design was employed. Data were stratified by intervention arm and bivariate tests assessed changes over time. Logistic and multiple regression models with intervention arm, time and the interaction of intervention and time were conducted. Supplementary analyses account for clustering of patrons within stores and staggering of store conversions. SETTING: Three stores were converted and five stores served as comparisons in East Los Angeles and Boyle Heights, California, USA. SUBJECTS: Store patrons were interviewed before (n550) and after (n407) the intervention. RESULTS: Relative to patrons of comparison stores, patrons of intervention stores demonstrated more favourable perceptions of corner stores and increased purchasing of F&V during that store visit. Changes were not detected in store patronage, percentage of weekly dollars spent on food for F&V or daily consumption of F&V. CONCLUSIONS: Consistent with some extant food environment literature, findings demonstrate limited effects. Investments should be made in multilevel, comprehensive interventions that target a variety retail food outlets rather than focusing on corner stores exclusively. Complementary policies limiting the availability, affordability and marketing of energy-dense, nutrient-poor foods should also be pursued.

Mechanisms underlying methamphetamine-related dental disease.

BACKGROUND: The authors clarified the causal mechanisms underlying the high prevalence of dental disease encountered in people who habitually use methamphetamine (meth). METHODS: Using a stratified sampling approach, the authors conducted comprehensive oral examinations and psychosocial assessments for 571 study participants who used meth. Three calibrated dentists, who used National Health and Nutrition Examination Survey (NHANES) protocols, characterized the study participants' dental disease. The authors also collected data related to study participants' history of meth use and other attributes linked to dental disease. RESULTS: Study participants who used meth manifested higher rates of xerostomia and caries experience compared with NHANES control participants. Participants who used meth had a higher level of daily consumption of sugary beverages compared with NHANES control participants. Smoking meth did not increase caries experience over other modes of intake. Dental hygiene was a significant determinant of dental health outcomes. CONCLUSIONS: Mode of intake and frequency of meth use have a minimal impact on dental health outcomes. Behaviors, such as sugary beverage consumption and poor oral hygiene, better explain dental health outcomes. PRACTICAL IMPLICATIONS: Having a better understanding of the causal mechanisms of "meth mouth" sets the stage for clinicians to provide more personalized interventions and management of dental disease in people who use meth.

The association between self-rated eating habits and dietary behavior in two Latino neighborhoods: Findings from Proyecto MercadoFRESCO.

OBJECTIVE: Latinos are the largest racial and ethnic minority group in the United States and bear a disproportionate burden of obesity related chronic disease. Despite national efforts to improve dietary habits and prevent obesity among Latinos, obesity rates remain high. The objective of this study is to explore the relationship between self-rated dietary quality and dietary behavior among Latinos and how this may vary by socio-demographics to help inform future public health efforts aiming to improve eating habits and obesity rates. DESIGN: Cross-sectional study using a series of chi-square tests, the non-parametric Wilcoxon-Mann-Whitney test and logistic regression to explore self-rated eating habits. SETTING: Two urban, low-income, predominantly Latino neighborhoods in Los Angeles County. SUBJECTS: 1000 adults who self-identified as their household's primary food purchaser and preparer were interviewed from 2012 to 2013. Households were randomly selected based on their proximity to corner stores participating in a project to improve the food environment. RESULTS: Most respondents (59%) report "good" eating habits. Significant associations between "good" eating habits and overall health, fruit and vegetable consumption were observed (p < 0.001). Despite these promising findings, we also find high levels of regular soda and energy-dense food consumption. CONCLUSION: This study revealed a general understanding that healthy dietary habits are associated with fruit and vegetable consumption among Latinos in two urban neighborhoods. However, there is a need for more targeted health promotion and nutrition education efforts on the risks associated with soda and energy-dense food consumption to help improve dietary habits and obesity levels in low-income Latino communities.