Disparities in preconception health indicators in U.S. women: a cross-sectional analysis of the behavioral risk factor surveillance system 2019.

OBJECTIVES: Optimized preconception care improves birth outcomes and women's health. Yet, little research exists identifying inequities impacting preconception health. This study identifies age, race/ethnicity, education, urbanicity, and income inequities in preconception health. METHODS: We performed a cross-sectional analysis of the Center for Disease Control and Prevention's (CDC) 2019 Behavioral Risk Factor Surveillance System (BRFSS). This study included women aged 18-49 years who (1) reported they were not using any type of contraceptive measure during their last sexual encounter (usage of condoms, birth control, etc.) and (2) reported wanting to become pregnant from the BRFSS Family Planning module. Sociodemographic variables included age, race/ethnicity, education, urbanicity, and annual household income. Preconception health indicators were subdivided into three categories of Physical/Mental Health, Healthcare Access, and Behavioral Health. Chi-squared statistical analysis was utilized to identify sociodemographic inequities in preconception health indicators. RESULTS: Within the Physical/Mental Health category, we found statistically significant differences among depressive disorder, obesity, high blood pressure, and diabetes. In the Healthcare Access category, we found statistically significant differences in health insurance status, having a primary care doctor, and being able to afford a medical visit. Within the Behavioral Health category, we found statistically significant differences in smoking tobacco, consuming alcohol, exercising in the past 30 days, and fruit and vegetable consumption. CONCLUSIONS: Maternal mortality and poor maternal health outcomes are influenced by many factors. Further research efforts to identify contributing factors will improve the implementation of targeted preventative measures in directly affected populations to alleviate the current maternal health crisis.

Mechanism Studies of Madden-Julian Oscillation Coupling Into the Mesosphere/Lower Thermosphere Tides Using SABER, MERRA-2, and SD-WACCMX.

The Madden-Julian Oscillation (MJO), an eastward-moving disturbance near the equator (±30°) that typically recurs every ∼30-90 days in tropical winds and clouds, is the dominant mode of intraseasonal variability in tropical convection and circulation and has been extensively studied due to its importance for medium-range weather forecasting. A previous statistical diagnostic of SABER/TIMED observations and the MJO index showed that the migrating diurnal (DW1) and the important nonmigrating diurnal (DE3) tide modulates on MJO-timescale in the mesosphere/lower thermosphere (MLT) by about 20%-30%, depending on the MJO phase. In this study, we address the physics of the underlying coupling mechanisms using SABER, MERRA-2 reanalysis, and SD-WACCMX. Our emphasis was on the 2008-2010 time period when several strong MJO events occurred. SD-WACCMX and SABER tides show characteristically similar MJO-signal in the MLT region. The tides largely respond to the MJO in the tropospheric tidal forcing and less so to the MJO in tropospheric/stratospheric background winds. We further quantify the MJO response in the MLT region in the SD-WACCMX zonal and meridional momentum forcing by separating the relative contributions of classical (Coriolis force and pressure gradient) and nonclassical forcing (advection and gravity wave drag [GWD]) which transport the MJO-signal into the upper atmosphere. Interestingly, the tidal MJO-response is larger in summer due to larger momentum forcing in the MLT region despite the MJO being most active in winter. We find that tidal advection and GWD forcing in MLT can work together or against each other depending on their phase relationship to the MJO-phases.

The Impact of State Farm to School Procurement Incentives on School Purchasing Decisions.

BACKGROUND: The most recent Farm to School (FTS) Census reported that of the 42% of US schools that participate in FTS, 77% procure food locally. In 2019, Colorado joined many other states in passing legislation that provides per-meal incentives for purchasing local foods. However, little is known about how these incentives impact procurement decisions of school Food Service Directors (FSDs), and purported benefits of FTS cannot accrue without additional local purchases by school FSDs. METHODS: We constructed a unique, primary dataset of fresh fruit and vegetable purchases from 18 months of school invoices in 3 Northern Colorado school districts and parameterized an optimization model that mimics FSD decisions. Subsequently, we simulated how procurement is impacted by local food reimbursements. RESULTS: Assuming 2017 and 2018 purchasing behavior, at $0.05 per meal reimbursement, FSDs would increase fresh fruit and vegetable purchasing by 11-12% in August-October, but by only 0-1% in November-December, likely due to seasonality constraints. CONCLUSIONS: While an increase in FTS procurement was expected, the magnitude of the potential increase when aligned with the Colorado growing season is notable. This work underscores that adequately funded reimbursement-based FTS policies can increase FTS procurement without disrupting normal cost-minimizing purchasing behavior.

Farm to School Activities and Student Outcomes: A Systematic Review.

Farm to school programs (F2SPs) operate in 42% of school districts and are supported in part through federal and state policies as well as philanthropic funding. Although research evaluating the effects of farm to school-related activities on student outcomes is growing, a systematic review of the results and thus a synthesis of implications for future programming have not occurred. The primary objective of this systematic literature review is to summarize and evaluate studies on student outcomes associated with farm to school-related activities up to 1 September, 2017. Four databases spanning 4 research disciplines were used to identify full-text, English-language studies. Twenty-one studies were reviewed: 7 explicitly investigated F2SPs, and 14 evaluated the impact of school-based interventions that were relevant to activities reported in the 2013 and/or 2015 Farm to School Census. All of the F2SP studies (n = 7) and 85.7% of farm to school-related activity studies (n = 12) were multicomponent, and there was a wide variety of implemented intervention components across the reviewed studies. Results from F2SP and farm to school-related activity studies consistently show positive impacts on food and nutrition-related knowledge; most studies also suggest a positive relation between farm to school-related activities and healthy food selection during school meals, nutrition self-efficacy, and willingness to try fruits and vegetables. The impact of farm to school activities on fruit and vegetable consumption and preferences is unclear. The most common F2SP study limitations were study designs that preclude causal inference, outcome measurement with no reported or limited psychometric testing, lack of long-term outcome evaluation, and challenges related to quantifying intervention implementation. These findings underscore the need for more conclusive evidence on the relation between farm to school-related activities and changes in fruit and vegetable consumption.

Development and Psychometric Evaluation of the Child Neglect Questionnaire.

Neglect poses a significant risk for children throughout their development and is often linked with serious consequences that reach into adulthood. The Child Neglect Questionnaire (CNQ) fills existing gaps by incorporating multiple perspectives from both parents and the child, as well as measuring the complex phenomenon of neglect multidimensionally. Furthermore, this measure addresses the need for an instrument specifically developed for late childhood (ages 10-12), as much of the extant evidence and corresponding measures focus on young children and their mothers. A panel of three psychologists, using Cicchetti's model of child neglect as a theoretical guide, began by selecting items from an existing database. Results of exploratory and confirmatory factor analyses and item response theory demonstrated the unidimensionality of physical, emotional, educational, and supervision neglect as well as a second-order construct of child neglect. Analyses controlling for risk status due to father's substance use disorder, socioeconomic status, and child's ethnicity demonstrated that father's and mother's (parental) neglect, particularly in the child's versions, had sound concurrent and predictive validity. Concurrently, at age 10-12, the child's version of both parents' neglect correlated with their parenting behaviors evaluated by other available measures. Prospectively, from 10-12 years of age to 11-13 years of age, parental neglect predicted child's drug use frequency with coexisting psychological dysregulation, psychiatric symptoms, antisocial behavior, non-normative sexual behavior, involvement with deviant peers and leisure activities thus demonstrating sound predictive validity. Also, internal consistency and inter-rater reliability were excellent. The CNQ, particularly the child's version, may thus be useful for detecting children at high risk for parental neglect.

MAPP in the classroom: oxymoron or opportunity?

As Mobilizing for Action through Planning and Partnerships (MAPP) becomes increasingly important for community public health practice, it is critical to examine what learning MAPP entails as well as its barriers and benefits. Competency-based education and training interventions that prepare public health workers to effectively contribute to the implementation of MAPP in their communities face significant obstacles. Current public health education and training programs are poorly positioned to enhance MAPP-related competencies among significant numbers of public health students and workers. Establishing the community as the classroom for learning MAPP and forging links with professional education and lifelong professional development strategies are necessary for MAPP to be successful in promoting healthy communities.