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Dietary intake assessment is often complicated by intrinsic bias. This study investigated whether food purchase data could constitute a valid indication of dietary intake, by evaluating the extent to which diet quality as measured by supermarket food purchases is correlated with diet quality as measured by reported dietary intake. We used data from the Supreme Nudge cluster-randomised controlled supermarket trial (n 227). Data were collected at baseline from supermarket purchases (loyalty cards) and a dietary questionnaire (short forty-item FFQ) to compute two scores reflecting diet quality from purchasing data (purchased diet quality) and FFQ (consumed diet quality). Both scores constituted thirteen food groups and could theoretically range from 0 (low diet quality) to 130 (high diet quality). The relationship between purchased diet quality and consumed diet quality was assessed using correlation coefficients and the Bland–Altman limits-of-agreement method. Multiple linear regression was fitted between purchased diet quality and consumed diet quality, adjusted for age, sex, waist circumference, educational level and household size. Consumed and purchased diet qualities were modestly positively correlated (Pearson's ρ = 0·31, 95 % CI 0·18, 0·42). A positive association from linear regression was found after confounding adjustments (βbaseline = 0·22, 95 % CI 0·10, 0·34). The purchased diet quality was systematically lower than the consumed diet quality. This study found that diet quality as measured by supermarket purchases provided a reasonable indication of diet quality as reported by short-FFQ, albeit modest. [ABSTRACT FROM AUTHOR]

Co-creation is a participatory design approach that leverages the experiential knowledge of non-academic actors. It is increasingly adopted in public health research to enhance the relevance, acceptability, and impact of interventions. This perspective article provides a practical introduction to co-creation, its application, and benefits and considerations for public health researchers. Based on the authors’ experiences with co-creation in public health, four key considerations for co-creation are outlined: 1) the selection of collaborators (those participating in the co-creation process) and their power dynamics and interests; 2) frameworks and guidelines for the co-creation process; 3) capacities needed to successfully apply a co-creation approach, such as emotional intelligence and adaptability; and 4) practical matters, such as resources and ethics approval. These insights serve as a practical introduction for public health researchers considering the application of co-creation in their projects to facilitate more effective and impactful, user-centered research designs and interventions. [ABSTRACT FROM AUTHOR]

Objective: Low dietary guideline adherence is persistent, but there is limited understanding of how individuals with varying socio-economic backgrounds reach a certain dietary intake. We investigated how quantitative and qualitative data on dietary guidelines adherence correspond and complement each other, to what extent determinants of guideline adherence in quantitative data reflect findings on determinants derived from qualitative data and which of these determinants emerged as interdependent in the qualitative data. Design: This mixed-methods study used quantitative questionnaire data (n 1492) and qualitative data collected via semi-structured telephone interviews (n 24). Quantitative data on determinants and their association with total guideline adherence (scored 0–150) were assessed through linear regression. Directed content analysis was used for qualitative data. Setting: Dutch urban areas. Participants: Adults aged 18–65 years. Results: A range of determinants emerged from both data sources, for example higher levels of cognitive restraint (β 5·6, 95 % CI 4·2, 7·1), habit strength of vegetables (β 4·0, 95 % CI 3·3, 4·7) and cooking skills (β 4·7, 95 % CI 3·5, 5·9), were associated with higher adherence. Qualitative data additionally suggested the influence of food prices, strong dietary habits and the social aspect of eating, and for the determinants cognitive restraint, habit strength related to vegetables, food prices and home cooking, some variation between interviewees with varying socio-economic backgrounds emerged in how these determinants affected guideline adherence. Conclusions: This mixed-methods exploration provides a richer understanding of why adults with varying socio-economic backgrounds do or do not adhere to dietary guidelines. Results can guide future interventions promoting healthy diets across populations. [ABSTRACT FROM AUTHOR]

Introduction: Addressing the public health problem of physical inactivity, this study evaluates SNapp, a just-in-time adaptive app intervention to promote walking through dynamically tailored coaching content. It assesses SNapp's impact on daily steps and how users' perceptions regarding ease of use and usefulness moderated its effectiveness., Methods: SNapp was evaluated in an RCT from February 2021 to May 2022.This trial was preregistered in the Dutch Trial Register (NL7064). Analyses were conducted in November 2022. A total of 176 adults (76% female, mean age of 56 years) were randomized to a control group receiving a step counter app (n=89) or an intervention group receiving the app plus coaching content (n=87). SNapp's coaching content encompasses individually tailored feedback on step counts and advice to engage in more walking, taking preferences regarding behavior change techniques into account. Additionally, SNapp provides contextualized content calling attention to suitable walking locations in the user's environment. The primary outcome was daily step count as recorded by the step counter app. User perceptions regarding ease of use and usefulness were assessed via survey at 3-month follow-up., Results: Mixed models indicated that the intervention did not significantly impact step counts on average over time (B= -202.30, 95% CI= -889.7, 485.1), with the coefficient indicating that the intervention group walked fewer steps per day on average, though this difference was not statistically significant. Perceived ease of use did not moderate the intervention effect (B group × perceived ease of use =38.60, 90% CI= -276.5, 353.7). Perceived usefulness significantly moderated the intervention effect (B group × perceived usefulness =344.38, 90% CI=40.4, 648.3)., Conclusions: SNapp increased steps only in users who deemed the app useful, underscoring the importance of user perceptions in app-based interventions., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Obesity is a persistent societal and health problem. Its prevalence has doubled since 1990. The increasing availability, low prices and promotion of unhealthy food has contributed to the current obesity epidemic. There are two structural solutions to address the current unhealthy food environment: self-regulation by the food industry and governmental regulation. In practice, self-regulation has limited effectiveness. The increasing burden of obesity and associated health care costs warrants governmental regulation. However, lobbying from the food industry and the liberal political climate in the Netherlands seem to be hindering the introduction of effective measures. We provide an overview of promising policy measures for a healthy food environment to prevent obesity: financial measures, restricting price promotions and marketing of unhealthy products, banning unhealthy products at checkouts and restricting unhealthy product availability. This requires a reduction of industry influences on policy, which can be achieved by acknowledging and discussing these influences.