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Youth access to tobacco in retail settings remains a pressing public health concern and may vary across retail corporations. This study compares underage sales violation rates in tobacco-selling dollar store corporations—a rapidly growing retail segment where cheaper tobacco prices may appeal to youth—with rates in other major grocery corporations. In 2021, U.S. Food and Drug Administration data (N=64,059 inspections) from January 2015 to March 2020 were used to compare underage tobacco sales in the two major tobacco-selling dollar store corporations, Dollar General and Family Dollar, with sales in major grocery corporations: Albertsons, Delhaize, Kroger, Publix, and Walmart. Generalized linear mixed models controlled for neighborhood characteristics. Post hoc analyses examined whether the corporation with the highest violation rate was more likely to be in neighborhoods with higher proportions of racially minoritized residents, socioeconomic disadvantage, or rural status. Family Dollar failed 12.1% of underage sales inspections. All other corporations had a significantly lower likelihood of selling tobacco to an underage buyer than Family Dollar. This significant association persisted after controlling for neighborhood characteristics. Family Dollar locations were associated with being in neighborhoods with higher proportions of racially minoritized residents and greater socioeconomic disadvantage. Regulating corporate behavior is necessary to reduce underage access to tobacco in dollar stores and address place-based inequities in youth tobacco access. Increasing the use of U.S. Food and Drug Administration no-tobacco-sale orders and Assurances of Voluntary Compliance, which provide a mechanism for state attorneys general to engage with tobacco retailers regarding enforcement of minimum legal sales age laws, may help to reduce youth tobacco access in retail settings. [ABSTRACT FROM AUTHOR]

Objectives A skilled workforce is essential to advancing maternal and child health (MCH) in a rapidly changing public health system. Little is known about the MCH workforce's existing capacity to maximize opportunities afforded by ongoing change. We assessed MCH workforce capacity in three areas: Systems Integration, Evidence-Based Decision-Making, and Change Management/Adaptive Leadership. We then examined associations between workforce capacity and modifiable workforce development strategies/resources. Methods Data are from the Public Health Workforce Interests and Needs Survey (PH WINS). The present study was limited to employees working in MCH programs (weighted N = 3062). Workforce capacity was operationalized as self-reported awareness of public health trends and proficiency to perform related skills in the three areas. Survey-weighted generalized estimating equations were used to fit logistic regression models accounting for employee clustering within states. Results While awareness of public health trends was low, the majority of employees (> 70% in each area) reported proficiency to perform skills related to these trends. Capacity was lowest in Systems Integration. Employee engagement in academic partnerships and higher state contributions to MCH program budgets were the strategies/resources most consistently associated with higher capacity. Workplace support was the strongest correlate of capacity in Change Management/Adaptive Leadership. Conclusions for Practice Although employees lacked familiarity with specific public health trends, they were proficient in skills needed to engage in related work. Still, areas for improvement remain. Results provide a baseline against which future training efforts can be evaluated. Academic partnerships and MCH program funding may be useful to prioritize in the context of health transformation. [ABSTRACT FROM AUTHOR]

Objective: To examine whether psychosocial health mediates the association between food insecurity and grade point average (GPA) among college and university students.Design: Data for the present study are from a longitudinal cohort study. Structural equation modelling (SEM) was used to test the proposed mediation hypothesis. Food insecurity was measured using the US Department of Agriculture's Six-Item Short Form. Psychosocial health was operationalized as a latent factor with three indicators: depression, anxiety and hope. Validated scales were used to measure each indicator. GPA was self-reported.Setting: Seven colleges and universities in Georgia, USA.ParticipantsStudents aged 18-25 years were recruited via email and surveyed every four months over a two-year period (analytic n 2377).Results: Approximately 29 % of students were food insecure. In the final SEM, food insecurity was associated (standardized β, se) with poorer psychosocial health (0·22, 0·03, P<0·0001) and poorer psychosocial health was associated with a lower GPA (-0·21, 0·03, P<0·0001). The indirect effect of food security status on GPA, as mediated by psychosocial health, was significant (-0·05, 0·01, P<0·0001) and accounted for 73 % of the total effect. After accounting for psychosocial health, the direct effect of food security status on GPA was not significant (-0·02, 0·02, P=0·43).Conclusions: Psychosocial health may be an important mechanism through which food insecurity affects academic performance among college and university students. Multicomponent interventions that address immediate food security needs as well as co-occurring mental health and academic concerns are needed to ensure student success. [ABSTRACT FROM AUTHOR]

Objective: To investigate the potential dietary impact of the opening of new retailers of healthy foods.Design: Systematic review of the peer-reviewed research literature.Setting: References published before November 2015 were retrieved from MEDLINE, EMBASE and Web of Science databases using keyword searches.Subjects: The outcome of the review was change in fruit and vegetable consumption among adults.Results: Of 3514 references retrieved, ninety-two articles were reviewed in full text, and twenty-three articles representing fifteen studies were included. Studies used post-test only (n 4), repeated cross-sectional (n 4) and repeated measures designs (n 7) to evaluate the dietary impact of supermarket (n 7), farmers' market (n 4), produce stand (n 2) or mobile market (n 2) openings. Evidence of increased fruit and vegetable consumption was most consistent among adults who began shopping at the new retailer. Three of four repeated measures studies found modest, albeit not always statistically significant, increases in fruit and vegetable consumption (range 0·23-0·54 servings/d) at 6-12 months after baseline. Dietary change among residents of the broader community where the new retailer opened was less consistent.Conclusions: The methodological quality of studies, including research designs, sampling methods, follow-up intervals and outcome measures, ranged widely. Future research should align methodologically with previous work to facilitate meta-analytic synthesis of results. Opening a new retailer may result in modest short-term increases in fruit and vegetable consumption among adults who choose to shop there, but the potential longer-term dietary impact on customers and its impact on the broader community remain unclear. [ABSTRACT FROM AUTHOR]

Young adulthood is a period of pronounced weight gain, though few weight management interventions exist for this population. This qualitative study explored how young adult women feel about their weight, what kinds of weight-related advice they have received, and concerns about future weight gain to inform the adaptation of a weight gain prevention intervention. Forty women completed semistructured, in-depth interviews, which were digitally recorded, transcribed verbatim, coded, and analyzed using thematic analysis. Participants were women aged 20 to 29 years, primarily overweight (12.5%) or obese (55.0%), and African American (65.0%). Participants expressed dissatisfaction with their current weight and reported receiving advice to lose weight from multiple sources. Direct, health-focused advice from health care professionals tended to be received more positively than indirect, appearance-focused advice from family members and romantic partners. Participants expressed concern about future weight gain, either as a result of a family history of obesity or chronic disease, pregnancy, and child-rearing, or unhealthy lifestyle patterns. Future weight gain was anticipated to impact chronic disease risk, changes in physical appearance, and interference with daily activities. Results suggest that young adult women may be receptive to participating in weight management interventions and that health care systems may be strategic implementation partners. [ABSTRACT FROM AUTHOR]

Although young adult women consume the majority of their total daily energy intake from home food sources, the decision-making processes that shape their home food environments have received limited attention. Further, how decision-making may be affected by the transformative experience of motherhood is unknown. In this study, we explore the factors that influence two key decision-making processes-food choices while grocery shopping and the use of non-home food sources-and whether there are differences by motherhood status. In-depth interviews were conducted with 40 women, aged 20-29, living in southwest Georgia. Thematic analysis was used to analyze qualitative data stratified by whether or not children were present in the home. Decision-making was affected by numerous factors, which differed across groups. In regard to grocery shopping, women with children more frequently discussed the influence of nutrition and the preferences of children, while women without children more frequently discussed the influence of taste and the preferences of other household members. Cost, convenience, weight control, and pre-planning meals emerged as salient in both groups. In regard to the use of non-home food sources, convenience and taste were discussed by both groups, while social factors were only discussed by women without children. The cost of eating out was the only reason cited for eating inside the home, and this factor only emerged among women with children. Motherhood may be an important contributor to the decision-making processes that shape young adult women's home food environments. Interventions may find success in framing messaging to emphasize factors identified as motivating healthy decisions, such as protecting the health of children, and practical strategies may be adapted from those already in use, such as pre-planning and budgeting for healthy meals. [ABSTRACT FROM AUTHOR]

Introduction: Obesity remains a significant threat to the current and long-term health of U.S. adolescents. The authors developed county-level estimates of adolescent obesity for the contiguous U.S., and then explored the association between 23 conceptually derived area-based correlates of adolescent obesity and ecologic obesity prevalence.Methods: Multilevel small area regression methods applied to the 2007 and 2011-2012 National Survey of Children's Health produced county-level obesity prevalence estimates for children aged 10-17 years. Exploratory multivariable Bayesian regression estimated the cross-sectional association between nutrition, activity, and macrosocial characteristics of counties and states, and county-level obesity prevalence. All analyses were conducted in 2015.Results: Adolescent obesity varies geographically with clusters of high prevalence in the Deep South and Southern Appalachian regions. Geographic disparities and clustering in observed data are largely explained by hypothesized area-based variables. In adjusted models, activity environment, but not nutrition environment variables were associated with county-level obesity prevalence. County violent crime was associated with higher obesity, whereas recreational facility density was associated with lower obesity. Measures of the macrosocial and relational domain, including community SES, community health, and social marginalization, were the strongest correlates of county-level obesity.Conclusions: County-level estimates of adolescent obesity demonstrate notable geographic disparities, which are largely explained by conceptually derived area-based contextual measures. This ecologic exploratory study highlights the importance of taking a multidimensional approach to understanding the social and community context in which adolescents make obesity-relevant behavioral choices. [ABSTRACT FROM AUTHOR]

An introduction to an article by Larson et al. is presented, which examines food insecurity and its association with diet quality, home food availability and health risk behaviors among emerging adults in St. Paul, Minnesota.

Inconclusive evidence for how food environments affect health may result from an emphasis on residential neighborhood-based measures of exposure. We used an activity space approach to examine whether 1) measures of food access and 2) associations with diet and BMI differ between residential and activity space food environments among low-income African American women in Atlanta, Georgia (n = 199). Although residential and activity space environments differed across all dimensions of food access, being located farther away from 'unhealthy' outlets was associated with lower BMI in both environments. Future research should move beyond asking whether residential and activity space environments differ, toward examining if, how, and under what conditions these differences impact the estimation of health effects. [ABSTRACT FROM AUTHOR]

Objective: To determine whether residence in a US Department of Agriculture-designated food desert is associated with perceived access to healthy foods, grocery shopping behaviours, diet and BMI among a national sample of primary food shoppers.Design: Data for the present study came from a self-administered cross-sectional survey administered in 2015. Residential addresses of respondents were geocoded to determine whether their census tract of residence was a designated food desert or not. Inverse probability of treatment-weighted regression was used to assess whether residence in a food desert was associated with dependent variables of interest.Setting: USA.Participants: Of 4942 adult survey respondents, residential addresses of 75·0 % (n 3705) primary food shoppers were included in the analysis.Results: Residence in a food desert (11·1 %, n 411) was not significantly associated with perceived access to healthy foods, most grocery shopping behaviours or dietary behaviour, but was significantly associated with primarily shopping at a superstore or supercentre v. a large grocery store (OR = 1·32; 95 % CI 1·02, 1·71; P = 0·03) and higher BMI (b = 1·14; 95 % CI 0·36, 1·93; P = 0·004).Conclusions: Results suggest that food desert residents shop at different food stores and have higher BMI than non-food desert residents. [ABSTRACT FROM AUTHOR]

Background: Reducing the retail availability of tobacco has been proposed as a component of tobacco endgame, yet it is not known whether retail availability has a direct impact on smoking behaviours. A narrative review and a meta-analysis have been undertaken to examine the density and proximity of tobacco retail outlets, but were limited in scope, exposure and outcome variables. The aim of this current study was to undertake a systematic review of the international literature on the density and proximity of tobacco retail outlets to homes, schools and communities and their association with smoking behaviours among youth.Methods: We reviewed and critically appraised the evidence documenting the association between density or proximity of tobacco retail outlets and smoking behaviours among school-age youth (18 and under), between 1 January 1990 and 21 October 2019. We reviewed original quantitative research that examined the associations of tobacco retail outlet density and proximity with individual smoking status or population-level smoking prevalence; initiation of smoking; frequency of tobacco use; sales to minors; purchasing by minors; susceptibility to smoking among non-smokers; perceived prevalence of smoking, and quitting behaviours.Findings: Thirty-five peer-reviewed papers met the inclusion criteria. This review provided evidence of a relationship between density of tobacco retail outlets and smoking behaviours, particularly for the density near youths' home. A study using activity spaces also found a significant positive association between exposure to tobacco retail outlets and daily tobacco use. The review did not provide evidence of an association between the proximity of tobacco retail outlets to homes or schools and smoking behaviours among youth.Conclusions: The existing evidence supports a positive association between tobacco retail outlet density and smoking behaviours among youth, particularly for the density near youths' home. This review provides evidence for the development and implementation of policies to reduce the density of tobacco retail outlets to reduce smoking prevalence among youth. [ABSTRACT FROM AUTHOR]