Availability and Use of Workplace Supports for Health Promotion Among Employees of Small and Large Businesses.

PURPOSE: To explore the availability and utilization of workplace health supports by employees of small and large-sized employers. DESIGN: Cross-sectional, telephone-based interviews collected on 16 workplace health supports for physical activity and diet. SETTING: Participants selected by random-digit-dialing from 4 metropolitan areas of Missouri employees from 2012 to 2013. PARTICIPANTS: Two thousand fifteen working adults. METHODS: We explored the availability and use of supports by employer size (<100 employees vs ≥100 employees), accounting for industry and personal factors. ANALYSIS: We examined distributions and Poisson regression models of availability for supports by employer size and by industry and use of supports by employer size and personal factors. RESULTS: One-fifth of the 1796 employees were employed by small-sized employers. Large employers offered more supports than small (mean: 6 vs 3), but a higher proportion of employees of small-sized employers used supports when available (59% vs 47%). The differences in offered supports between industries were not due to size alone. In regard to the determinants of participation, the personal factors of gender, age, weight, and income were associated with participation in 10 of the supports. Employer size was also associated with participation in 10 supports. No associations were found between personal factors or workplace size and participation for 3 supports. CONCLUSION: A higher proportion of employees working for smaller businesses use available supports than employees of larger businesses. Supports offered by employers should target the needs and interests of the workforce, particularly for the higher risk low-income employees.

How Segregation Makes Us Fat: Food Behaviors and Food Environment as Mediators of the Relationship Between Residential Segregation and Individual Body Mass Index.

OBJECTIVES: Racial residential segregation affects food landscapes that dictate residents' food environments and is associated with obesity risk factors, including individual dietary patterns and behaviors. We examine if food behaviors and environments mediate the association between segregation and body mass index (BMI). METHODS: Non-Hispanic Whites and Blacks living in the St. Louis and Kansas City metro regions from 2012 to 2013 were surveyed on dietary behaviors, food environment, and BMI (n = 1,412). These data were combined with the CDC's modified retail food environment index and 2012 American Community Survey data to calculate racial segregation using various evenness and exposure indices. Multi-level mediation analyses were conducted to determine if dietary behavior and food environment mediate the association between racial residential segregation and individual BMI. RESULTS: The positive association between racial segregation and individual BMI is partially mediated by dietary behaviors and fully mediated by food environments. CONCLUSION: Racial segregation (evenness and exposure) is associated with BMI, mediated by dietary behaviors and food environment. Elements of the food environment, which form the context for dietary behaviors, are potential targets for interventions to reduce obesity in residentially segregated areas.

Objective reports versus subjective perceptions of crime and their relationships to accelerometer-measured physical activity in Hispanic caretaker-child dyads.

Crime and safety are commonly cited barriers to physical activity (PA). We had three objectives, 1) describe the association between objective crime measures and perceptions of crime, 2) analyze the relationships between each type of crime and accelerometer-measured physical activity in caretakers and young children (ages 3-5years), and 3) explore for early gender differences in the relationship between crime and physical activity in young children. Data are from the cross-sectional baseline data of an ongoing randomized controlled trial in Nashville, Tennessee spanning September 2012 through May 2014. Data was analyzed from 480 Hispanic dyads (adult caretaker and 3-5year old child). Objective crime rate was assessed in ArcGIS and perception of crime was measured by caretaker agreement with the statement "The crime rate in my neighborhood makes it unsafe to go on walks." The primary outcome was accelerometer-measured physical activity over seven consecutive days. Objective and perceived crime were significantly positively correlated. Caretaker vigorous PA was significantly related to perceptions of crime; however, its relationship to objective crime was not significant. Child PA was not significantly related to caretaker perceptions of crime. However, interactions suggested that the relationship between crime rate and PA was significantly more negative for girls than for boys. Objective and subjective measures of crime rate are expected to be important correlates of PA, but they appear to have complex relationships that are different for adults than they are for young children, as well as for young girls compared to boys, and research has produced conflicting findings.

The Impact of Worksite Supports for Healthy Eating on Dietary Behaviors.

OBJECTIVE: The purpose of this study was to assess the availability of worksite supports (WSS) for healthy eating and examine associations between existing supports and dietary behaviors. METHODS: A cross-sectional, telephone-based study was conducted with 2013 participants in four metropolitan areas in 2012. Logistic regression was used to examine associations between dietary behaviors and the availability or use of WSS. RESULTS: Those reporting the availability of a cafeteria/snack bar/food services at the worksite were more likely to consume fruits and vegetables more than twice/day, and less likely to consume fast food more than twice/week. CONCLUSIONS: Study results highlight the utility of specific WSS to improve employee dietary behaviors while raising questions about why the presence of healthy foods at the worksite may not translate into employee consumption of such foods.

Spatial analysis of undernutrition of children in léogâne Commune, Haiti.

BACKGROUND: Over a fifth (21.9%) of children under 5 years of age in Haiti suffer from chronic malnutrition, 11.4% are underweight, and 5.1% suffer from acute malnutrition. Léogâne Commune has one of the highest under-five mortality rates in the country. Ordinary least squares regression conducted using data from household surveys to assess the impact of causal factors on child undernutrition may mask important local variations. OBJECTIVE: To characterize the nutrition and health situation of children 6 to 35 months of age in LLogdne Commune, Haiti, using geographically weighted regression. METHODS: In July 2008, the Children's Nutrition Program of Haiti conducted a representative cross-sectional household survey (N = 150) using a modified 33 x 6 alternative sampling design. Household questionnaires were administered to caregivers of children 6 to 35 months of age and anthropometric measurements were collected. Geographically weighted regression was employed to evaluate how undernutrition (weight-forage) and its household determinants vary across the region. Geographically weighted regression and ordinary least squares regression models were compared. RESULTS: The residuals of the ordinary least squares regression model were spatially autocorrelated (Moran's I = 0.08, z = 1.90, p = .058), indicating that undernutrition occurs in pockets rather than being evenly distributed throughout the population. There was no improvement in performance from the ordinary least squares regression model to the geographically weighted regression model. CONCLUSIONS: Despite some limitations, this study illustrates a promising approach for using geospatial data to improve the understanding of how a nutrition situation varies across a region and provide deeper insight into its underlying causes.