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Abstract Background While many Complementary/Alternative Medicine (CAM) practitioners do not object to immunization, some discourage or even actively oppose vaccination among their patients. However, previous studies in this area have focused on childhood immunizations, and it is unknown whether and to what extent CAM practitioners may influence the vaccination behavior of their adult patients. The purpose of this study was to describe vaccination coverage levels of adults aged ≥ 18 years according to their CAM use status and determine if there is an association between CAM use and adult vaccination coverage. Methods Data from the 2002 National Health Interview Survey, limited to 30,617 adults that provided at least one valid answer to the CAM supplement, were analyzed. Receipt of influenza vaccine during the past 12 months, pneumococcal vaccine (ever), and ≥ 1 dose of hepatitis B vaccine was self-reported. Coverage levels for each vaccine by CAM use status were determined for adults who were considered high priority for vaccination because of the presence of a high risk condition and for non-priority adults. Multivariable analyses were conducted to evaluate the association between CAM users and vaccination status, adjusting for demographic and healthcare utilization characteristics. Results Overall, 36% were recent CAM users. Among priority adults, adjusted vaccination coverage levels were significantly different between recent and non-CAM users for influenza (44% vs 38%; p-value < 0.001) and pneumococcal (40% vs 33%; p-value < 0.001) vaccines but were not significantly different for hepatitis B (60% vs 56%; p-value = 0.36). Among non-priority adults, recent CAM users had significantly higher unadjusted and adjusted vaccination coverage levels compared to non-CAM users for all three vaccines (p-values < 0.001). Conclusion Vaccination coverage levels among recent CAM users were found to be higher than non-CAM users. Because CAM use has been increasing over time in the U.S., it is important to continue monitoring CAM use and its possible influence on receipt of immunizations among adults. Since adult vaccination coverage levels remain below Healthy People 2010 goals, it may be beneficial to work with CAM practitioners to promote adult vaccines as preventive services in keeping with their commitment to maintaining good health.

The article focuses on trends in e-cigarette and nicotine pouch use among middle and high school students in the United States in 2024. Topics include declines in current e-cigarette use overall and among high school students, stable use of nicotine pouches despite increasing sales, and the prevalence of flavored products among youth users.

The objective of this cross-sectional study is to compare the dietary behaviors of children from low food secure (LFS) households with children from very low food secure (VLFS) households over an entire day, and during meals specifically consumed at home --breakfast, snack, and dinner. Parents of the recruited children completed a demographic questionnaire, along with USDA's 6-item short form food security questionnaire. Children completed 24-hour dietary recalls in person. Complete data from 102 children 9 to 12 years old were used. Using ANOVA to assess the differences among groups in intakes over an entire day and during meals consumed at home, no significant differences were found, except for vitamin C intake during breakfast. Based on the definitions of LFS and VLFS, it was hypothesized that children from VLFS group would have lower dietary intakes compared to children from the LFS group. However, this study found little difference. Speculations have been made for these findings and implications for research have been presented.

Objectives: This study used 2000–2020 Pregnancy Risk Assessment Monitoring System data to estimate trends in smoking before, during, and after pregnancy, as well as quitting smoking during pregnancy. Materials and Methods: Weighted prevalence and 95% confidence intervals (CIs) were calculated by year for each smoking-related measure. Annual percent change (APC) and average annual percent change (AAPC) in prevalence were estimated using Joinpoint regression to characterize trends over time. Results: Between 2000 and 2020, significant decreases in the prevalence of smoking before (23.0% to 14.0%; AAPC = −2.3% [95% CI = −2.9% to −1.7%]), during (13.2% to 6.5%; AAPC = −3.4% [95% CI = −4.0% to −2.7%]), and after pregnancy (18.9% to 8.8%; AAPC = −3.6% [95% CI = −4.3% to −2.9%]) were observed. For each measure, the fastest declines occurred largely throughout the 2010s (before: APC = −5.5% [2012–2020]; during: APC = −5.1% [2009–2020]; and after: APC = −6.4% [2012–2020]). The proportion of people who quit smoking during pregnancy significantly increased from 43.2% in 2000 to 53.7% in 2020 (AAPC = 1.0%; 95% CI = 0.2%–1.9%); however, Joinpoint regression detected relatively no change in quitting during pregnancy between 2010 and 2020 (APC = 0.0%; 95% CI = −0.4% to 0.5%). Conclusions: The prevalence of smoking before, during, and after pregnancy has reduced dramatically in the United States between 2000 and 2020, with the fastest declines occurring throughout the second decade of the twenty-first century. However, prevention and cessation efforts are still needed since approximately half of people who smoked before pregnancy continue to smoke during pregnancy. [ABSTRACT FROM AUTHOR]

This article presents the results of a randomized clinical trial evaluating the eight-session "Family Eats" web-based intervention promoting healthy home food environments for African American families. African American families (n = 126) with 8- to 12-year-old children completed online baseline questionnaires and were randomized into intervention or control groups. Data collection occurred at baseline, immediately postintervention (Post 1), and 4 months later (Post 2), for parents and children, separately. There were two group by time intervention effects: Control group parents reported a significantly greater frequency of drinking 100% fruit juice at Post 1 compared with intervention group parents. Parent menu planning skills were significantly higher at Post 2 for the intervention group compared with the control group. Significant positive changes overtime were noted for both groups for home fruit/vegetable availability, food preparation practices, and healthy restaurant selection. Intervention group children reported a significant increase in home juice availability at Post 1 compared with the control group; home fruit availability improved for both groups. There was no difference in log on rates by group: 84% and 86% for those who completed Post 1 and Post 2 measurements, respectively. Sixty-four participants completed the evaluation survey: 17 control (50%) and 47 intervention (51%) participants. All participants reported liking the program components; all but one gave it an A or B grade. An Internet-delivered nutrition intervention for families was successful in achieving change in some mediating variables, with good log on rates. Future research with "Family Eats" should include larger sample sizes, with longer follow-up and a more objective measure of diet.

Purpose/Objectives: The purpose of this study was to evaluate the "Team Up for School Nutrition Success" pilot initiative, conducted by the Institute of Child Nutrition (ICN), on meeting the objectives of the individual action plans created by school food authorities (SFAs) during the workshop. The action plans could address improving one or more of the following areas: increasing meal participation, financial management, menu planning, and plate waste. This paper presents the results of the three month evaluation. Methods: Twenty five SFAs participated in telephone interviews about four months after the workshop. The interview script consisted of four sets of questions developed to query the status of action plan goals and outcomes, and barriers encountered. A fifth question obtained comments about the workshop, such as participation in pre- and post-workshop webinars. The transcripts were reviewed and coded, and a spreadsheet was created. Results: During the interviews, most SFAs reported that they did not finish their action plans at the workshop. Six reported they were too busy after returning from the workshop to continue working on their action plans. Many noted that networking at the workshop and after they returned to their districts was very helpful. The majority thought that a follow up phone call with an ICN scientist and the attendees from their state would help them complete their action plans. Some goals were attained, but many had to be postponed until the following school year due to lack of resources. Applications to Child Nutrition Professionals: It appears that the concept and general format of the workshop was sound; most reported the workshop was a positive experience. However, it appears that too many topic areas may have been covered during the workshop, with not enough time allocated for participants to engage in peer-to peer mentoring and the development goals and action plans.

Fruit and vegetable (FV) attitudes and norms have been shown to influence intake in youth; yet research with low-income youth and studies supplementing self-report with objective measures of intake are lacking. Cross-sectional survey data on self-rated FV intake, FV attitudes, and FV norms were collected in a sample of 116 youth attending a residential summer camp serving low-income families. FV intake also was estimated by direct observation. Differences between self-rated and observed FV intake, perceived and observed peer intake, and perceived and peer-reported attitudes toward eating FVs were assessed with paired samples t tests. The role of FV attitudes, descriptive norms (perceived peer FV intake), injunctive norms (perceived peer attitudes toward eating FVs), and actual norms (observed peer FV intake and peer-reported FV attitudes) in predicting FV intake also was examined with multiple regression analysis. Youth misperceived their own and their peers' FV intake (i.e., overestimated intake of fruit and underestimated intake of vegetables) and believed that peers held less favorable attitudes toward eating FVs than was the case. The models predicting self-rated intake were significant, accounting for 34% of the variance in fruit intake and 28% of the variance in vegetable intake. Attitudes and descriptive norms were positively associated with FV intake, and observed peer fruit intake was negatively associated with fruit intake. Findings suggest that in low-income youth, FV attitudes, descriptive norms, and normative peer behavior predict perceived but not actual intake. Youth may benefit from intervention to promote favorable FV attitudes and norms. A focus on descriptive norms holds promise for improving self-rated intake in this population.

BackgroundFamily conflict can reduce adolescent adherence to type 1 diabetes management tasks. The Family Teamwork in-person intervention was shown to be efficacious in reducing conflict and low adherence to diabetes-related tasks. Its reach and potential impact, however, were limited by the need to deliver the intervention sessions in person. Relational agents (ie, computerized versions of humans) have been shown to appeal to diverse audiences and may be an acceptable replacement for a human in technology-based behavior change interventions. ObjectiveThe purpose of this paper is to present the results of a pilot study assessing feasibility and acceptability of Diabetes Family Teamwork Online, an adapted version of the Family Teamwork intervention, delivered over the internet and guided by a relational agent. MethodsParent-adolescent dyads were recruited through a diabetes care clinic at a large tertiary care hospital in the southwestern United States. A one-group design, with assessments at baseline, immediate postintervention, and 3 months later, was used to assess feasibility. A priori feasibility criteria included an assessment of recruitment, completion, attrition, program satisfaction, therapeutic alliance, attitudes toward the relational agent, and data collection. The institutional review board at Baylor College of Medicine approved the protocol (H-37245). ResultsTwenty-seven adolescents aged 10 to 15 years with type 1 diabetes and their parents were enrolled. Criteria used to assess feasibility were (1) recruitment goals were met (n=20), (2) families completed ≥75% of the modules, (3) attrition rate was ≤10%, (4) program satisfaction was high (≥80% of families), (5) therapeutic alliance was high (average score of ≥60/84), (6) families expressed positive attitudes toward the relational agent (average item score of ≥5 on ≥4 items), (7) ≥80% of data were collected at post 1 and post 2, and (8) few technical issues (≤10%) occurred during intervention delivery. All feasibility criteria were met. Qualitative data confirmed that adolescents and parents had positive reactions to both the content and approach. ConclusionsThe Diabetes Family Teamwork Online intervention proved to be a feasible and acceptable method for enhancing communication around diabetes management tasks in families with an adolescent who has type 1 diabetes. International Registered Report Identifier (IRRID)RR2-10.2196/resprot.5817

Purpose/Objectives: The new nutrition standards for the school meal programs implemented in 2012 align the school meal patterns with the US Dietary Guidelines for Americans, including more fruit, vegetable and whole grain offerings and minimum and maximum amount of calories per meal averaged over a week. The purpose of this study was to assess cafeteria staff perceptions about the new school food standards. Methods: Cafeteria staff (N = 72) in 12 schools, 8 elementary (EL) and 4 intermediate (INT), from a school district in the Houston, TX area were surveyed. The school district had 37,000 students [59% White, 26% eligible for free/reduced price meals (FRP)]. Half of the EL and INT schools were low income schools based on eligibility for FRP meals (49-79% EL; ~34% INT). Frequencies were calculated for all variables by grade level (EL and INT). Chi square analysis was conducted to assess whether responses differed by grade level. Results: The survey had a response rate of 100% (N = 72) with different sample sizes per question. More EL staff than INT staff (71% vs 40%; p< 0.01) agreed that children like the vegetables served for school lunch and that they encouraged students to eat more fruits and vegetables (95% vs 77%; p< 0.05). Significantly more EL school food service staff (64% vs 43%; p< 0.01) reported that the reason "students know exactly what they want" was a barrier for food recommendations, and this was also the barrier that most INT staff chose. Applications to Child Nutrition Professionals: A combination of interventions, such as offering healthy food options, providing nutrition education, marketing healthy choices, verbally encouraging students to eat fruits and vegetables, and facilitating opportunities for students to try new healthy foods may be more effective in influencing student dietary patterns than any single intervention.