Using spatial analysis to examine best placement of electronic benefit transfer services at farmers' markets in Honolulu County, Hawaii, USA.

OBJECTIVE: Farmers' market interventions are a popular strategy for addressing chronic disease disparities in low-income neighbourhoods. With limited resources, strategic targeting of interventions is critical. The present study used spatial analysis to identify where market interventions have the greatest impact on healthy food access within a geographic region. DESIGN: All farmers' markets in a mixed urban/rural county were mapped and those that accepted Supplemental Nutrition Assistance Program (SNAP) electronic benefit transfer (EBT) cards identified. Households were grouped into small neighbourhoods and mapped. The area of 'reasonable access' around each market (walking distance (0·8 km; 0·5mile) in urban areas, driving distance (15 min) in rural areas) was calculated using spatial analysis. The percentage of county low-income households within a market's access area, and the percentage of county SNAP-participating households within an EBT-accepting market's access area, were calculated. The ten neighbourhoods with the most low-income households and with the most SNAP-participating households were then identified, their access areas calculated and mapped, and those lacking access identified. County-level gains resulting from improving market accessibility in these areas were calculated. SUBJECTS: None. SETTING: Honolulu County, Hawaii, USA. RESULTS: Only 44 % of SNAP-participating households had EBT-market access. Six of the ten highest SNAP-participant neighbourhoods lacked access. Improving access for these neighbourhoods increased county-level access by 23 %. Market access for low-income households was 74 %. Adding markets to these low-income neighbourhoods without market access increased county-level access by 4 %. CONCLUSIONS: Geographic identification of market access demographics, and strategic targeting of EBT interventions, could improve regional access to healthy foods.

From Reef to Table: Social and Ecological Factors Affecting Coral Reef Fisheries, Artisanal Seafood Supply Chains, and Seafood Security.

Ocean and coastal ecosystems provide critical fisheries, coastal protection, and cultural benefits to communities worldwide, but these services are diminishing due to local and global threats. In response, place-based strategies involve communities and resource users in management have proliferated. Here, we present a transferable community-based approach to assess the social and ecological factors affecting resource sustainability and food security in a small-scale, coral reef fishery. Our results show that this small-scale fishery provides large-scale benefits to communities, including 7,353 ± 1547 kg yr(-1) (mean ± SE) of seafood per year, equating to >30,000 meals with an economic value of $78,432. The vast majority of the catch is used for subsistence, contributing to community food security: 58% is kept, 33.5% is given away, and 8.5% is sold. Our spatial analysis assesses the geographic distribution of community beneficiaries from the fishery (the "food shed" for the fishery), and we document that 20% of seafood procured from the fishery is used for sociocultural events that are important for social cohesion. This approach provides a method for assessing social, economic, and cultural values provided by small-scale food systems, as well as important contributions to food security, with significant implications for conservation and management. This interdisciplinary effort aims to demonstrate a transferable participatory research approach useful for resource-dependent communities as they cope with socioeconomic, cultural, and environmental change.

An assessment of community capacity to prevent adolescent alcohol consumption.

To effectively address the issue of youth alcohol use, communities need to have sufficient infrastructure and capacity in place to operate effective prevention programs. This study evaluates community capacity in the state of Hawai'i, using the Capacity Assessment Survey administered to stakeholders in the youth alcohol prevention system. Capacity is quantified with gap scores, which measure the discrepancy between an agency's performance of an attribute and the attribute's relative importance. Six assessment areas, termed capacity domains, are defined. Results are given for each county and the state overall. Based on these results, communities need to prioritize capacity-building efforts specifically in the domains of effectiveness, funding/resource availability, and sustainability. Organization, workforce skills/knowledge, and cultural competency were categorized as relative strengths in comparison, but gap scores are nevertheless significantly greater than 0 ("ideal"; p < .001), indicating these areas need improvement as well. Suggestions for improvement in each capacity domain are given. This assessment is the first step in a five-step planning process to implement youth alcohol prevention programs in communities in Hawai'i.

Trends in alcohol use among Hawai'i adolescents.

It is important to review trends in youth alcohol use over time in order to effectively tailor prevention programs to address those trends. This article reviews data on alcohol use behaviors from the Centers for Disease Control and Prevention's Youth Risk Behavior Survey in Hawai'i from 1993 to 2007. Five alcohol use indicators were examined and stratified by grade level, from 9th grade through 12th grade. Significant drops in nearly all indicators are seen among 9th through 11th graders, but not among 12th graders. This suggests that Hawaii youth are responding well to anti-alcohol messaging as young teens, but a different approach may be needed to target older teens.

The impact of parent-child discussions and parent restrictions on adolescent alcohol consumption.

The impact of parent influence on adolescent drinking behavior has been extensively researched, but remains unclear. This assessment used data from a survey administered in after school programs in Maui County to further examine parents' role in preventing underage drinking. Two factors were explored for their impacts on drinking behavior: parent-child discussions and perceived parent sanctioning of alcohol use. Separate analysis was conducted for all respondents and for those who are drinkers. Youth ages 12-17 (n = 572; 46.7% female; 25.2% alcohol drinkers; 16.4% binge drinkers( participated in the study. No significant differences for the reported number of days of drinking (chi-square = 1.38, p > 0.05) and the number of days of binge drinking (chi-square = 0.31, p > 0.05) between those that did and did not have parent-child communications was found. A significant difference was found, however, for the number of drinking days (chi-square = 38.6, p < 0.05) and the number of binge drinking days (chi-square = 39.4, p < 0.05), f or "all respondents" between those who perceived parent restriction and those who did not. These findings suggest that parent-child communication may be most influential when characterized in such a way as to include well-defined restrictions against alcohol use.