Explore the vast range of titles available.

To determine whether living in a food swamp (≥4 corner stores within 0·40 km (0·25 miles) of home) or a food desert (generally, no supermarket or access to healthy foods) is associated with consumption of snacks/desserts or fruits/vegetables, and if neighbourhood-level socio-economic status (SES) confounds relationships. Cross-sectional. Assessments included diet (Youth/Adolescent FFQ, skewed dietary variables normalized) and measured height/weight (BMI-for-age percentiles/Z-scores calculated). A geographic information system geocoded home addresses and mapped food deserts/food swamps. Associations examined using multiple linear regression (MLR) models adjusting for age and BMI-for-age Z-score. Baltimore City, MD, USA. Early adolescent girls (6th/7th grade, n 634; mean age 12·1 years; 90·7 % African American; 52·4 % overweight/obese), recruited from twenty-two urban, low-income schools. Girls' consumption of fruit, vegetables and snacks/desserts: 1·2, 1·7 and 3·4 servings/d, respectively. Girls' food environment: 10·4 % food desert only, 19·1 % food swamp only, 16·1 % both food desert/swamp and 54·4 % neither food desert/swamp. Average median neighbourhood-level household income: $US 35 298. In MLR models, girls living in both food deserts/swamps consumed additional servings of snacks/desserts v. girls living in neither (β=0·13, P=0·029; 3·8 v. 3·2 servings/d). Specifically, girls living in food swamps consumed more snacks/desserts than girls who did not (β=0·16, P=0·003; 3·7 v. 3·1 servings/d), with no confounding effect of neighbourhood-level SES. No associations were identified with food deserts or consumption of fruits/vegetables. Early adolescent girls living in food swamps consumed more snacks/desserts than girls not living in food swamps. Dietary interventions should consider the built environment/food access when addressing adolescent dietary behaviours.

The US Department of Agriculture's Summer Food Service Program and Seamless Summer Option (summer nutrition programmes (SNP)) aim to relieve food insecurity for children and teens during summer months. More needs to be known about when and where SNP are available, and how availability varies by community characteristics, particularly in rural areas where food insecurity and reduced food access are more prevalent. The present study examined the geographic availability of SNP and summer meal uptake rates in 2016, using state-wide administrative claims data. Public schools and SNP in California, USA.ParticipantsSchools (n 8842) and SNP (n 4685). Urban counties were more likely than rural counties to have higher summer uptake rates, calculated as the percentage of summer meals served relative to eligible students utilizing school meal programmes during the academic school year, but uptake overall was low at 18·2 % of target populations. Geographic availability analyses showed that 63·9 % of public urban schools had an SNP available within 1·6 km (1 mile), but availability was significantly higher within the proximity of larger, higher-poverty high schools with diverse or majority non-White students, and those with higher school-year breakfast participation rates. Availability of an SNP within 16 km (10 miles) of rural schools averaged 68·1 % but was significantly higher around larger schools, higher-poverty schools and those with diverse or majority non-White students. While many communities have SNP available, much more work is needed to increase the availability of these programmes to reduce summer food insecurity for children, particularly in rural communities.

Background/Objectives: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) improves the health of nutritionally at-risk populations. However, engagement challenges, such as missed appointments and unredeemed food benefits, may limit program efficacy. Barriers to engagement are heightened among American Indian populations, who often experience disproportionately high levels of participation-related challenges. This study assessed whether newly developed health communication theory-based text messages incorporating persuasive language and different message framing (i.e., gain-framed and loss-framed) improved WIC appointment attendance and food benefit redemption rates, above and beyond standard information-based reminders. Methods: The sample included participants served by the Inter Tribal Council of Arizona WIC between the months of September 2022 and February 2023 who (a) had an appointment during the intervention period (n = 7584) or (b) were eligible to receive a reminder text about unused food benefits during the intervention period (n = 2177). A three-phase intervention design was used, with each phase lasting six weeks. During the baseline phase, participants received standard information-based text messages, while during the two intervention phases, participants received newly developed messages using (1) gain-framed and (2) loss-framed persuasive language. Difference-in-difference regression analyses compared whether differences in outcomes (i.e., appointment attendance and monthly food benefit redemption rates) between participants who received reminder messages and those who did not differed over intervention phases. Results: Receipt of both gain-framed and loss-framed theory-based messages was associated with higher appointment attendance, when compared to receipt of standard information-based messages during baseline (p = 0.003 and p = 0.01, respectively). Neither the gain-framed nor loss-framed messages were associated with higher food benefit redemption rates than standard messages. Conclusions: Results indicated that persuasive communication theory-based text reminders may be an effective, low-cost strategy to boost WIC appointment attendance among American Indians.

Health equity is shaped by multiple factors intersecting with service delivery in community-based organizations (CBOs). Providers in under-resourced areas are often the first point of contact for families seeking child development, mental health, and behavioral support. However, system-level barriers hinder service delivery and access. This study explores provider perspectives to identify barriers and inform system-level changes that promote equity in child and family health. Using a narrative qualitative design, in-depth interviews were conducted with 21 health and mental health professionals from child- and family-serving CBOs. Guided by ecological and strengths-based frameworks, interviews examined provider insights on challenges, strengths, and supports affecting service delivery. Key themes emerged across macro (rights-based policies, racism/oppression), community (environmental impacts, social cohesion), organizational (secondary stress, system fragmentation, provider supports), and family levels (basic needs, parenting support, service access). Findings highlight the need for a multilevel approach that prioritizes rights-based policies, strengthens community cohesion, and improves system integration. Enhancing CBO capacity to address these determinants could advance equity-oriented service delivery and mitigate structural barriers that perpetuate health disparities.

Abstract African American caregivers in low-income, urban communities have high rates of food insecurity. Unemployment, education, smoking, stress, and depressive symptoms are associated with household food insecurity. A cumulative risk model suggests that accumulation of risk may compound food insecurity risk, and certain risk factors are more likely to co-occur. This study utilizes two approaches to examine food insecurity risk among African American caregivers with an adolescent daughter—a cumulative risk index to examine accumulation of risk and food insecurity risk; latent class analysis (LCA) to determine if certain risk profiles exist and their relation to food insecurity risk. Caregivers completed surveys including demographic, psychosocial, and behavioral questions (to create a cumulative risk index) and a validated 2-item food insecurity screen. LCA was used to identify risk profiles. Logistic regression was used to examine relations between cumulative risk, risk profiles, and food insecurity risk. Each additional cumulative risk index factor was associated with a 54% increase in odds of risk of food insecurity. LCA identified three subgroups: high stress/depression (class #1), low education/low stress and depression (class #2), and low risk overall (class #3). Odds of food insecurity risk were 4.7 times higher for class #1, and 1.5 times higher for class #2 compared with class #3. This study contributes to understanding of how food insecurity risk relates to cumulative risk and risk profiles. Findings can be used to improve food insecurity risk screening in clinical settings, enhancing intervention/referral for food security risk and mental health among African American caregivers and their households.

Based on the ecological model of active living, the neighborhood environment may relate to individual physical activity (PA) behaviors. The purposes of this study were to (1) generate a replicable neighborhood-level physical activity location availability score (PALAS) from data variables associated with physical activity among adolescents and adults, and apply this score to Baltimore City, Maryland, and (2) determine if relationships exist between PA and PA location availability. Geographic information systems (GISs) were used to create the PALAS. Using linear regression models, we examined relations between objectively measured PA among low-income, urban, predominantly African American adolescent girls (n = 555, 2009–2012 data collection), and the PALAS rating of their neighborhood environment (neighborhood PALAS) and their home neighborhood area (PALAS variables/subcomponents within 0.25 miles of the home). A PALAS map of the study area was created, illustrating neighborhoods varying in availability and variety of PA locations. After adjusting for confounders, a higher neighborhood PALAS (β = 0.10, p = 0.041) and the presence of a recreation center in the home neighborhood area (β = 0.46, p = 0.011) were associated with more minutes per day spent in moderate to vigorous PA. Policy makers and stakeholders should consider increasing access to PA locations as a strategy to promote PA among adolescent girls.

Since 2003 MSW students at an urban university have participated in a problem-based learning maternal and child health (MCH) leadership training program sponsored by the Health Resources and Services Administration. This survey examined overall satisfaction with a leadership training program as well as self-reported leadership competencies in social work practice among 30 scholars. Descriptive statistics indicate overall satisfaction with the leadership program and its individual components. Scholars ranked themselves highest on leadership competencies related to self and others and lowest on competencies related to the broader community. Future leadership programs should focus on methods to improve self-efficacy on policy and research efforts to strengthen social work leadership skills inMCH social work practice.

Findings from a pilot randomized trial of 916 households indicated that outreach text messages were not an effective strategy to increase enrollment in the United States Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) among eligible households in Arizona.

Abstract Background Childhood trauma is a transdiagnostic risk factor for adult psychiatric disorders, including schizophrenia and bipolar-I disorder. Recent meta-analytic and epidemiological studies suggest a 3-fold increase in risk for psychotic symptoms in adulthood, following childhood trauma exposure. However, associations between trauma exposure and schizotypal personality traits, as well as cognitive and social cognitive abilities, have been less well studied in clinical populations spanning the psychotic-mood spectrum. Methods Participants were 79 schizophrenia cases, 84 bipolar disorder cases, and 75 healthy control participants who completed the Childhood Trauma Questionnaire (CTQ), the Schizotypal Personality Questionnaire (SPQ), and a standard battery of cognitive tests (to measure executive functions, working memory, attention, immediate and delayed memory), as well as social cognitive tests of facial emotion processing (the Ekman 60 faces task) and Theory-of-Mind (The Awareness of Social Inference Test; TASIT). The CTQ measures childhood trauma exposure on 5 domains (physical abuse, emotional abuse, sexual abuse, physical neglect, emotional neglect); clinically significant levels of childhood trauma exposure on at least one domain (according to specified thresholds for each domain) were evident in 54 schizophrenia cases, 55 bipolar disorder cases, and 26 healthy individuals. Trauma-exposed and non-exposed groups were compared on schizotypal personality features (referred to as ‘schizotypy’), cognitive and social cognitive abilities. Results In both the clinical groups and healthy controls, trauma-exposed participants reported higher levels of schizotypy, especially suspiciousness, relative to non-exposed individuals; this was revealed in the context of higher overall schizotypy levels in both schizophrenia and bipolar disorder, relative to healthy controls. Similarly, while the schizophrenia group showed lower social cognitive and cognitive performances relative to both the bipolar disorder and healthy control groups, trauma-exposed individuals showed deficits in social cognitive, but not general cognitive abilities, regardless of case versus control status. Discussion These findings suggest that childhood trauma exposure has long-term effects on schizotypy, especially suspiciousness, and complex social cognitive abilities in both healthy and psychotic populations. However, there was no interaction of clinical group with trauma exposure in relation to schizotypal personality dimensions, and the influence of early life trauma on cognitive functions was not distinguishable from the effects of psychotic illness in adulthood. It is possible that traumagenic processes contribute to paranoid ideation and social cognitive disturbances that contribute to psychosis-proneness in the general population, consistent with historical models of schizotypy as latent liability for schizophrenia and related psychotic disorders.