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Objective: This research examines the effects of educational materials, delivered with "take-home and cook-with-friends" meal kits, on college students' food agency. Participants: In the spring of 2021, 186 students were recruited at a US public university and randomly allocated into either an intervention group that received meal kits and educational materials or a control group that received only meal kits. Methods: Meal kits containing local ingredients were distributed weekly to the participants and surveys were conducted to measure participants' food agency, using the Cooking and Food Provisioning Action Scale (CAFPAS). Hypothesis tests and regression analysis were then conducted to examine the educational intervention's effects on the CAFPAS scores. Results: The educational intervention had a positive and statistically significant effect on students' CAFPAS scores. Conclusions: Educational interventions hold promise in enhancing college students' food agency, at least in the short term. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Describe fruit and vegetable (FV) preferences and other factors that may influence participation in community-supported agriculture (CSA). Design In-depth, semi-structured interviews. Setting Eight rural/micropolitan communities in 4 US states. Participants There were 41 caregivers and 20 children (8–12 years of age) from low-income, English-speaking households. Phenomena of Interest Knowledge, attitudes, and behaviors regarding FVs; perceived barriers to CSA participation. Analysis Transcribed verbatim and iteratively coded. Results Caregivers and children believed FVs were important to health, yet FVs were not featured in dinners or snacks and consumption was challenged by limited preferences and neophobia. Few caregivers and children knew about the seasonality of FV. Most caregivers were unfamiliar with CSA and had concerns about CSA cost, accessibility, produce quality, and selection. Conclusions and Implications These qualitative data support improvements in: 1) CSA distribution practices to offer flexible payment and pick-up options, more fruits, and self-selection of FV; 2) public awareness of produce seasonality and the CSA distribution model as necessary precursors to participation, and lower cost for low-income families who highlighted this barrier; and 3) capacity to prepare FV by enhancing skills and providing time-saving kitchen tools. Approaches to aligning CSA practices with the needs and preferences of low-income families warrant further research. [ABSTRACT FROM AUTHOR]

Medical costs are often skewed to the right and heteroscedastic, having a sophisticated relation with covariates. Mean function regression models with low-dimensional covariates have been extensively considered in the literature. However, it is important to develop a robust alternative to find the underlying relationship between medical costs and high-dimensional covariates. In this paper, we propose a new quantile regression model to analyze medical costs. We also consider variable selection, using an adaptive lasso penalized variable selection method to identify significant factors of the covariates. Simulation studies are conducted to illustrate the performance of the estimation method. We apply our method to the analysis of the Medical Expenditure Panel Survey dataset., (Copyright © 2018 John Wiley & Sons, Ltd.)

Background: The cost of trauma center care is high, raising questions about the value of a regionalized approach to trauma care. To address these concerns, we estimate 1-year and lifetime treatment costs and measure the cost-effectiveness of treatment at a Level I trauma center (TC) compared with a nontrauma center hospital (NTC)., Methods: Estimates of cost-effectiveness were derived using data on 5,043 major trauma patients enrolled in the National Study on Costs and Outcomes of Trauma, a prospective cohort study of severely injured adult patients cared for in 69 hospitals in 14 states. Data on costs were derived from multiple sources including claims data from the Centers for Medicare and Medicaid Services, UB92 hospital bills, and patient interviews. Cost-effectiveness was estimated as the ratio of the difference in costs (for treatment at a TC vs. NTC) divided by the difference in life years gained (and lives saved). We also measured cost-effectiveness per quality-adjusted life year gained where quality of life was measured using the SF-6D. We used inverse probability of treatment weighting to adjust for observable differences between patients treated at TCs and NTCs., Results: The added cost for treatment at a TC versus NTC was $36,319 per life-year gained ($790,931 per life saved) and $36,961 per quality-adjusted life years gained. Cost-effectiveness was more favorable for patients with injuries of higher versus lower severity and for younger versus older patients., Conclusions: Our findings provide evidence that regionalization of trauma care is not only effective but also it is cost-effective.