Sodium, calorie, and sugary drink purchasing patterns in chain restaurants: Findings from NYC.

To understand how consumer purchases in chain restaurants relate to nutrients of public health concern, sodium, calories and sugary drinks purchased for personal consumption were assessed through a customer intercept receipt study at a sample of New York City quick- and full-service chain restaurants (QSR and FSR) in 2015. The percentages of respondents purchasing ≥2,300 mg sodium, ≥2,000 calories, and a sugary drink, respectively, were 14%, 3% and 32% at QSR, and 56%, 23%, and 22% at FSR. Sodium content of purchases averaged 1,260 mg at QSR and 2,897 mg at FSR and calories averaged 770 at QSR and 1,456 at FSR. 71% of QSR sugary drink purchases contained at least 200 calories. Purchasing patterns that are exceptionally high in sodium and calories, and that include sugary drinks, are common in chain restaurants. Because restaurant-sourced foods are a cornerstone of the American diet, fostering conditions that support healthful purchases is essential to reduce preventable disease and advance health.

Sugary Drink Consumption Among NYC Children, Youth, and Adults: Disparities Persist Over Time, 2007-2015.

Sugary drink consumption is associated with many adverse health outcomes, including weight gain, diabetes, and other chronic conditions. These beverages are widely marketed and ubiquitously available. This analysis explores sugary drink consumption across all age groups among New York City (NYC) residents using representative survey data. Three population-based representative surveys of NYC residents of different age groups were analyzed. Adult participants, youth participants, and caregivers of child participants self-reported the number of sugary drinks they consumed per day. Mean sugary drink intake per day was estimated overall and by demographic characteristics, for the 2015 cycle of each survey and the 2007-2015 cycles of the adult survey. T tests were used to determine whether means differed by demographics. Long-term trends in mean sugary drink consumption among adult participants were conducted to examine changes over time overall and by demographic characteristics. In 2015, the mean daily number of sugary drinks consumed was 0.53 (95% CI 0.45, 0.61) among children 0-5 years old, 1.05 (95% CI 0.90, 1.21) among children 6-12 years old, and 1.16 (95% CI 1.09, 1.29) among NYC high school students. Among all NYC adults, sugary drink intake decreased 36% from 1.03 (95% CI 0.99, 1.08) in 2007 to 0.66 (95% CI 0.62, 0.70) drinks per day in 2015, p < 0.01. However, at each age level, there were persistent disparities in sugary drink consumption by sex, race/ethnicity, educational attainment, and poverty level. Decreasing overall rates of sugary drink consumption are promising; however, disparities by socio-demographics are a concern. Reducing sugary drink consumption across all ages is recommended as is minimizing the introduction at an early age. Reduction of sugary drink consumption will require a collaborative, multi-sectoral approach.

Institution-to-institution mentoring to build capacity in 24 local US health departments: best practices and lessons learned.

INTRODUCTION: Institutional mentoring may be a useful capacity-building model to support local health departments facing public health challenges. The New York City Department of Health and Mental Hygiene conducted a qualitative evaluation of an institutional mentoring program designed to increase capacity of health departments seeking to address chronic disease prevention. The mentoring program included 2 program models, a one-to-one model and a collaborative model, developed and implemented for 24 Communities Putting Prevention to Work grantee communities nationwide. METHODS: We conducted semi-structured telephone interviews to assess grantees' perspectives on the effectiveness of the mentoring program in supporting their work. Two interviews were conducted with key informants from each participating community. Three evaluators coded and analyzed data using ATLAS.ti software and using grounded theory to identify emerging themes. RESULTS: We completed 90 interviews with 44 mentees. We identified 7 key program strengths: learning from the New York City health department's experience, adapting resources to local needs, incorporating new approaches and sharing strategies, developing the mentor-mentee relationship, creating momentum for action, establishing regular communication, and encouraging peer interaction. CONCLUSION: Participants overwhelmingly indicated that the mentoring program's key strengths improved their capacity to address chronic disease prevention in their communities. We recommend dissemination of the results achieved, emphasizing the need to adapt the institutional mentoring model to local needs to achieve successful outcomes. We also recommend future research to consider whether a hybrid programmatic model that includes regular one-on-one communication and in-person conferences could be used as a standard framework for institutional mentoring.

Developing built environment programs in local health departments: lessons learned from a nationwide mentoring program.

Local health departments (LHDs) have a key role to play in developing built environment policies and programs to encourage physical activity and combat obesity and related chronic diseases. However, information to guide LHDs' effective engagement in this arena is lacking. During 2011-2012, the New York City Department of Health and Mental Hygiene (DOHMH) facilitated a built environment peer mentoring program for 14 LHDs nationwide. Program objectives included supporting LHDs in their efforts to achieve built environment goals, offering examples from DOHMH's built environment work to guide LHDs, and building a healthy built environment learning network. We share lessons learned that can guide LHDs in developing successful healthy built environment agendas.

Dermatoses associated with mites other than Sarcoptes.

Mites are arthropods of the subclass Acari (Acarina). Although Sarcoptes is the mite most commonly recognized as a cause of human skin disease in the United States, numerous other mite-associated dermatoses have been described, and merit familiarity on the part of physicians treating skin disease. This review discusses several non-scabies mites and their associated diseases, including Demodex, chiggers, Cheyletiella, bird mites, grain itch, oak leaf itch, grocer's itch, tropical rat mite, snake mite, and Psoroptes.

Developing a measure of behavior change in a program to help low-income parents prevent unhealthful weight gain in children.

OBJECTIVE: To develop and test a brief measure of changes in eating, active play, and parenting practices after an intervention to help parents shape children's choices and home environments. DESIGN: Sequential phases of development and testing: expert panel review, cognitive testing interviews, field testing, test-retest study, and assessment of convergence with detailed previously validated instruments. SETTING AND PARTICIPANTS: Expanded Food and Nutrition Education Program (EFNEP), New York State. Low-income parents of 3- to 11-year-old children; Cooperative Extension nutrition and parenting educators. MAIN OUTCOME MEASURES: Questionnaire reliability, validity, respondent comprehension, and feasibility of use in program contexts. ANALYSIS: Qualitative analysis of item comprehension. Correlational analysis of test-retest reliability and convergent validity. RESULTS: A behavior checklist was developed to assess change in parent-reported family eating, physical activity, and parenting practices addressed by an intervention. The checklist was feasible for use in EFNEP and questions were understood as intended. Test-retest reliability was good (r = 0.83) and scores correlated significantly (range, 0.25 to -0.60; P < .05) with detailed measures of dietary habits, parental modeling, physical activity, and home environment. CONCLUSIONS AND IMPLICATIONS: Development and testing in a program context produced a tool community nutritionists can use to evaluate educational interventions aimed at helping parents promote healthful eating and activity.

Maternal mental health and the persistence of food insecurity in poor rural families.

BACKGROUND: Little is known about the causal relationship between and the mechanisms linking depression and food insecurity. Our purpose was to examine these knowledge gaps. METHODS: Chi-squared analysis of longitudinal data from 29 rural upstate New York families followed for three years and qualitative analysis of interviews were used to identify associations and mechanisms. RESULTS: Depressive symptoms (p=.009) and poor mental health (p=.01) in mothers limited the likelihood families would leave food insecurity. This relationship was mediated through limiting the employment of adult family members and operated in three ways: preventing the depressed household member from working, preventing a different household member from working, and limiting access to childcare for depressed children so adults could work. CONCLUSIONS: Poor mental health is associated with keeping families food-insecure by limiting their employment. High-quality, accessible mental health care is needed for poverty-associated food insecurity to be alleviated.