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Background: In The Gambia, existing research to understand and address malnutrition among adolescent girls is limited. Prior to the conduct of large-scale studies, formative research is needed. The aim of this mixed methods, cross-sectional study was to explore cultural contexts relevant to nutritional status, feasibility and appropriateness of recruitment and data collection methods (questionnaires and anthropometric measures), and plausibility of data collected. Methods: The study took place in May–June 2021 in an urban conurbation in Brikama local government area (LGA) and two rural villages in Mansakonko LGA, The Gambia. The purposive sampling frame of the all-female sample included residence in the selected urban or rural settings and being aged 10–14 or 15–19 years. Thirty-two girls aged 10 to 19 years, with equal numbers in urban and rural settings were recruited. Four focus groups discussions (FGDs), with eight participants in each, were held to understand perspectives on cultural practices; concepts of under- and overweight, and research recruitment methods. The same participants completed questionnaires on socioeconomic circumstances, health, access to community resources, nutrition knowledge, sleep, and physical activity, and had anthropometric measures taken. FGDs were then reconvened to discuss the feasibility and acceptability of the questionnaires and anthropometric measures, and views on providing biological samples in the future. FGD data were analysed using thematic analysis. Body mass index (BMI)-for-age and height-for-age z-scores, mid-upper arm circumference, and waist: hip ratios were assessed and descriptive statistics used to explore the data obtained. Results: Five themes were identified in the focus group discussions: 1. Cultural norms: harmful vs. beneficial to nutrition-related health; 2. Concepts of healthy diet and weight; 3. Approaches to tackling under- and overnutrition; 4. Study recruitment: barriers and facilitators; 5. Study questionnaires and proposed measures are mostly feasible and acceptable. Questionnaire data highlighted limited access to resources (e.g. food markets and electricity) as important individual, household and community factors influencing malnutrition in rural settings. The anthropometric measures reflected the double burden of malnutrition in The Gambia, with the presence of stunting (41%), underweight (31%), and living with overweight or obesity (10%). A higher proportion of participants were underweight in rural compared to urban settings (50% vs 12.5% respectively, p = 0.03). Over 70% of those classified as underweight perceived their weight as normal. Conclusion: This exploratory study provides novel data to inform larger-scale research to understand and address malnutrition among adolescent females in The Gambia. Urban–rural variance in the double burden of malnutrition, factors influencing malnutrition, and in the barriers to and facilitators of adolescents taking part in research, are key considerations. [ABSTRACT FROM AUTHOR]

Summary: Background: Prevalence of both obesity and type 2 diabetes can be higher in patients from certain ethnic groups, yet uptake and adherence to current support within these groups is lower, leading to widening health inequalities in high‐income countries. Objectives: The main objective of this study is to understand the views, perceptions, and experiences of and barriers and facilitators in relation to the uptake and adherence to weight management and type 2 diabetes programs in minoritized ethnic groups in high‐income countries. Methods: CINAHL, MEDLINE, PsycINFO, Scopus, Academic Search Complete, and PubMed were searched for English language studies undertaken in community‐dwelling adults residing in high‐income countries, who are from a minoritized ethnic group within the country of study. Results: Seventeen studies were synthesized using the JBI System for the Unified Management of the Assessment and Review of Information. From these studies, 115 findings were retrieved, and seven key themes were identified: (1) family health status and program education, (2) social support, (3) challenges, (4) cultural beliefs, (5) increased awareness and dietary changes, (6) impact of psychological evaluations, and (7) considerations for future. Conclusions: Nutritional considerations for type 2 diabetes mellitus and weight management programs in high‐income countries should include social, habitual, economic, and conceptual components, which should include consideration of local ethnic and cultural norms and building community relationships while creating culturally tailored programs. [ABSTRACT FROM AUTHOR]

Abstract Background In the United Kingdom, there has been an increase in cigarette smoking in ethnic minority adults since the 1970s; in some groups levels are now similar to that of White British people. We aimed to examine the determinants of exposure to secondhand smoke in ethnic minority children. We hypothesised that exposure to secondhand smoke in children will vary across ethnic groups, but that the correlates of exposure would be similar to that of Whites. Methods The Determinants of Adolescent Social well-being and Health sample comprises 3468 White United Kingdom and ethnic minority (Black Caribbean, Black African, Indian, Pakistani, Bangladeshi) pupils aged 11-13 yrs. Outcome was saliva cotinine concentration. Explanatory variables collected by self-complete questionnaire included ethnicity, child reported household smoking and socio-economic circumstances. Data were analysed using linear regression models with a random intercept function. Results Ethnic minority children had lower saliva cotinine than Whites, partly explained by less smoking among parents. White and Black Caribbean children had higher cotinine levels if they lived in a household with a maternal smoker only, than with a paternal smoker only. Living in a lone compared to a dual parent household was associated with increased cotinine concentration of 45% (95%CI 5, 99%) in Whites, 27% (95%CI 5,53%) in Black Caribbeans and 21% (95%CI 1, 45%) in Black Africans after adjusting for household smoking status. Material disadvantage was a significant correlate only for White children (40% (95%CI 1, 94%) increase in cotinine in least compared to most advantaged group). Conclusions Ethnic minority children were less exposed to secondhand smoke than Whites, but the variations within groups were similarly patterned. These findings suggest that it is important not to be complacent about low smoking prevalence in some minority groups.

Abstract Background Childhood obesity is a major public health concern with serious implications for the sustainability of healthcare systems. Studies in the US and UK have shown that ethnicity is consistently associated with childhood obesity, with Black African origin girls in particular being more vulnerable to overweight and obesity than their White peers. Little is known, however, about what promotes or hinders engagement with prevention programmes among ethnic minority children. Methods/Design This paper describes the background and design of an exploratory study conducted in London, UK. The aim of the study was to assess the feasibility, efficacy and cultural acceptability of child- and family-based interventions to reduce risk factors for childhood and adolescent obesity among ethnic minorities. It investigated the use of a population approach (in schools) and a targeted approach (in places of worship). We used a mixture of focus group discussions, in-depth interviews and structured questionnaires to explore what children, parents, grandparents, teachers and religious leaders think hinder and promote engagement with healthy eating and active living choices. We assessed the cultural appropriateness of validated measures of physical activity, dietary behaviour and self efficacy, and of potential elements of interventions informed by the data collected. We are also currently assessing the potential for wider community support (local councils, community networks, faith forums etc) of the intervention. Discussion Analysis of the data is ongoing but the emergent findings suggest that while the school setting may be better for the main implementation of healthy lifestyle interventions, places of worship provide valuable opportunities for family and culturally specific support for implementation. Tackling the rise in childhood and adolescent obesity is a policy priority, as reflected in a range of government initiatives. The study will enhance such policy by developing the evidence base about culturally acceptable interventions to reduce the risk of obesity in children.

Unfavourable dietary habits, such as skipping breakfast, are common among ethnic minority children and may contribute to inequalities in cardiometabolic disease. We conducted a longitudinal follow-up of a subsample of the UK multi-ethnic Determinants of Adolescent Social well-being and Health cohort, which represents the main UK ethnic groups and is now aged 21–23 years. We aimed to describe longitudinal patterns of dietary intake and investigate their impact on cardiometabolic risk in young adulthood. Participants completed a dietary behaviour questionnaire and a 24 h dietary intake recall; anthropometry, blood pressure, total cholesterol and HDL-cholesterol and HbA1c were measured. The cohort consisted of 107 White British, 102 Black Caribbean, 132 Black African, 98 Indian, 111 Bangladeshi/Pakistani and 115 other/mixed ethnicity. Unhealthful dietary behaviours such as skipping breakfast and low intake of fruits and vegetables were common (56, 57 and 63 %, respectively). Rates of skipping breakfast and low fruit and vegetable consumption were highest among Black African and Black Caribbean participants. BMI and cholesterol levels at 21–23 years were higher among those who regularly skipped breakfast at 11–13 years (BMI 1·41 (95 % CI 0·57, 2·26), P =0·001; cholesterol 0·15 (95 % CI –0·01, 0·31), P =0·063) and at 21–23 years (BMI 1·05 (95 % CI 0·22, 1·89), P =0·014; cholesterol 0·22 (95 % CI 0·06, 0·37), P =0·007). Childhood breakfast skipping is more common in certain ethnic groups and is associated with cardiometabolic risk factors in young adulthood. Our findings highlight the importance of targeting interventions to improve dietary behaviours such as breakfast consumption at specific population groups. [ABSTRACT FROM AUTHOR]