Social Network Intervention Reduces Added Sugar Intake Among Baltimore Public Housing Residents: A Feasibility Study.

Public housing residents have high intake of added sugars, which is associated with sugar-sweetened beverage (SSB) consumption in their social networks. In this feasibility study, we designed and tested a network-oriented intervention to decrease added sugar intake by encouraging reduced SSB consumption. We conducted a 6-month single-arm trial testing a small-group curriculum (9 sessions) that combined behavior change strategies to reduce added sugar intake by promoting SSB reduction with a peer outreach approach. We recruited and trained public housing residents to be "Peer Educators," who then communicated information and made changes to reduce SSB with their network members. We calculated the median number of group sessions attended and determined the percentage of individuals satisfied with the program. We estimated added sugar intake using a 5-factor dietary screener and compared baseline and 6-month median values using Wilcoxon signed rank tests. We recruited 17 residents and 17 of their network members (n = 34). Mean age was 45.7 years, 79.4% were women, and 97.1% were African American. Median number of sessions attended was 9 (interquartile range: 4-9), and 88.2% were very satisfied with the program. Overall, baseline median added sugar intake was 38.0 tsp/day, which significantly declined to 17.2 tsp/day at 6 months (P < .001). Residents and network members achieved similar results at 6 months (17.4 vs 16.9 tsp/day, respectively). In conclusion, our results demonstrate that a social network intervention aimed at reducing SSB consumption is feasible and can produce significant decreases in adult added sugar intake, which warrants further investigation in a randomized controlled trial.

Association of personal vehicle access with lifestyle habits and food insecurity among public housing residents.

Transportation type may play a role in the ease with which a person can access healthy food and recreation facilities. Our objective was to determine the relationship between access to a personal vehicle and diet, food insecurity, and physical activity among public housing residents, which are typically low-income, urban populations. We conducted a cross-sectional survey of randomly selected households within two public housing communities in Baltimore, MD (2014-2015). Our independent variable was whether or not the resident had access to a personal vehicle. Our dependent variables were 'high' fruit & vegetable intake (≥6.7 servings/day), 'high' added sugar intake (≥39.9 tsp/day), food insecurity, and being physically active. We used Poisson regression with robust error variance to estimate relative risk ratios adjusted for demographics and perceived environmental factors. Our sample included 265 adults (response rate of 48%) with mean age of 45 years, 86% women, and 96% African-American. Only 42% had access to a vehicle. No significant associations existed between personal vehicle access with diet or physical activity outcomes. Access to a personal vehicle was associated with significantly lower risk of food insecurity (RR 0.76, 95%CI 0.63-0.92, p < 0.01). We found a significant association between personal vehicle access and lower risk of food insecurity; however, there were no associations with diet or exercise. Based on these results, future research might explore how transportation access influences and might possibly reduce food insecurity.