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- Creator:
- Rusmevichientong, Pimbucha, Jaynes, Jessica, and Chandler, Laura
- Description:
- The quality of diet is crucial to the health and well-being of America’s adolescents. While a critical step in the goal toward healthier eating is facilitated by school nutrition guidelines that address the food environment, additional information on snack preferences can contribute to this goal. The purpose of this study was to determine which snack nutrient and snack characteristic attributes affect adolescent snack choices and quantify their relative importance. The method used in this study was a discrete choice experiment (DCE) designed with a unique approach of block fractional factorial designs. The study participants were middle school students, aged 11 to 13 years old (n=166) from an underrepresented, minority-serving middle school in Orange County, California. A mixed logit model was used to analyze the data from DCEs that examined five snack nutrients and five snack characteristics. The results indicated whole grains had the highest relative importance of snack nutrients followed by salt, protein, calories and sugar. Students were more attentive to negative nutrients when two attributes interacted. Price had the highest relative importance of snack characteristics followed by nutritiousness, social, taste, and convenience. Students were more likely to choose a snack in which their family eats even if the snack was low in nutrient content. Understanding students’ preferences can potentially enhance healthy eating practices on school campuses. This provides implications for stakeholders working to implement and comply with federal school nutrition guidelines.
- Resource Type:
- Article
- Campus Tesim:
- Fullerton
- Department:
- Department of Public Health
- Creator:
- Lee, Alice
- Description:
- Objectives: The aims of our study were to describe current hepatitis B prevalence among Vietnamese Americans and to examine predictors of hepatitis B risk in this specific ethnic community. Design: Cross-sectional analysis of data from a community-based screening program. Setting: This analysis was based on hepatitis screening community events in Southern California. Participants: 2508 Vietnamese Americans in Southern California. Outcome measures: Serological tests for hepatitis B surface antigen, hepatitis B surface antibody, and total hepatitis B core antibody were used to classify participants as one of four hepatitis B infection statuses: currently infected, previously infected, susceptible, or immune due to a previous hepatitis B vaccination. Results: Across 2508 participants, 9.0% were currently infected with hepatitis B and 17.7% were at risk for hepatitis B. Females and those reporting a previous hepatitis B vaccination were at significant decreased risk of hepatitis B (OR=0.48, 95% CI 0.33 to 0.69 and OR=0.53, 95% CI 0.31 to 0.93, respectively) whereas those born outside of the USA and with a family history of the disease showed substantial increased risk (OR=13.36, 95% CI 1.62 to 110.05 and OR=4.68, 95% CI 2.66 to 8.22, respectively). Among those who reported a previous hepatitis B vaccination, less than half (42.9%) possessed the protective antibodies that result from a hepatitis B vaccination. Conclusions: Vietnamese Americans remain disproportionately burdened by hepatitis B. Public health efforts that focus on improving hepatitis B awareness and vaccination knowledge and that are tailored to specific high-risk subgroups, such as immigrants and those with infected family members, could help in addressing the disease's burden in this high-prevalence population.
- Resource Type:
- Article
- Campus Tesim:
- Fullerton
- Department:
- Department of Public Health
- Creator:
- Yang, Joshua
- Description:
- Background In response to the growing awareness and use of electronic nicotine delivery systems (ENDS), or e-cigarettes, the U.S. Food and Drug Administration asserted its regulatory authority over ENDS in May 2016. Federal, state, and local regulatory action on ENDS may have significant and unique impacts on specialty ENDS retailers, including tobacco and vape shops. The purpose of this study is to describe the commercial motivations of vape shops in minority communities as business entities whose financial interests and actions may be particularly impacted by regulation of ENDS. Methods Specialty tobacco and vape retail stores in three minority communities were identified through an online search and community canvassing. Key informant interviews were conducted with tobacco and vape shop owners or managers discussing the business interests and tactics of selling ENDS for their store. Interview data were coded and analyzed for major themes. Results Interviews with 18 tobacco shops and 9 vape shops were completed. Tobacco shops’ reasons for carrying e-cigarettes were business oriented, focused on maintaining their customer base. In comparison, vape shops opened because of the owner’s positive experiences with e-cigarettes and belief in the potential of e-cigarettes to help people quit or reduce smoking. Tobacco shops mainly see their customers as using e-cigarettes to quit smoking whereas vape shops reported their customers using e-cigarettes for more varied reasons. Tobacco shops are much more limited in their marketing than vape shops, which rely heavily on social media and experimentation with other forms of marketing. Conclusions Tobacco shops and vape shops differ in their rationale and approaches to the business of e-cigarettes. Vape shops engage in a wide range of activities that stabilize their financial interest and increase their influence with customers and within the vape community. In order for regulatory policymaking and tobacco control interventions to maximize effectiveness, the actions of vape shops in promoting ENDS use and influencing policy debates must be taken into account.
- Resource Type:
- Article
- Campus Tesim:
- Fullerton
- Department:
- Department of Public Health
- Creator:
- Yang, Joshua
- Description:
- Background Non-communicable diseases (NCDs) account for over two-thirds of deaths worldwide, and global efforts to address NCDs have accelerated. Current prevention and control efforts rely primarily on individual behavior/lifestyle approaches that place the onus of responsibility for health on the individual. These approaches, however, have not stopped the increasing trend of NCDs worldwide. Thus, there is urgent need for exploring alternative approaches in order to attain the aim of reducing global premature NCDs mortality by 25% by 2025, and meeting the NCD reduction objective in the Sustainable Development Goals. Discussion We suggest the need for a structural approach to addressing the NCDs epidemic that integrates social science and public health theories. We evaluate two overarching principles (empowerment and human rights) and three social determinants of health (labor and employment, trade and industry, and macroeconomics) addressed in the 2013 Global Action Plan for the Prevention and Control of NCDs to demonstrate how a structural approach to NCDs can be incorporated into existing NCD interventions. For each area considered, theoretical considerations for structural thinking are provided and conclude with recommended actions. Conclusion Achieving the global health agenda goals of reducing NCDs mortality will require a shift to a paradigm that embraces concerted efforts to address both behavioral/lifestyle factors and structural dimensions of NCDs.
- Resource Type:
- Article
- Campus Tesim:
- Fullerton
- Department:
- Department of Public Health
- Creator:
- Jacobs, Wura
- Description:
- Aim: A binary measurement of type 2 diabetes (T2D) has been found not to influence behaviors. We aimed to examine the influence of other measures of family history such as number of relatives, genetic closeness of relatives, and severity of T2D of family members on nutrition and physical activity behaviors among college students. Methods: Students across four colleges in Texas were sampled. Multiple linear regression models, controlling for covariates, were used to model results. Cross-sectional data were used. Results: More number of relatives with T2D was associated with vegetable consumption (β = 0.131, p = 0.007) and exercise (β = 0.129, p = 0.037). Having relatives with severe T2D was associated with vegetable consumption (β = 0.157, p = 0.002) and exercise (β = 106, p = 0.027). Closer genetic relationship with someone with T2D was associated with increased vegetable consumption (β = 0.107, p = 0.023) and exercise (β = 0.096, p = 0.047). Conclusion: It is likely that the severe complications that may accompany the relatives T2D or having an immediate family member living with T2D may in fact motivate other family members without T2D to modify their attitudes, beliefs, and knowledge about T2D, thus encourage health-protective behaviors.
- Resource Type:
- Article
- Campus Tesim:
- Fullerton
- Department:
- Department of Public Health
- Creator:
- Yang, Joshua
- Description:
- Background:E-cigarette use has been increasing in the United States, though knowledge of potential risks and harms associated with e-cigarette use is low. Marketing of e-cigarettes may serve as a source of information to shape beliefs and attitudes toward e-cigarettes. The purpose of this study was to identify the most common marketing claims made within “vape” and tobacco shops in sales interactions with customers in demographically diverse cities. Methods:Vape and tobacco shops from three diverse cities in Southern California were selected for inclusion in the study. From May 2015 to July 2015, simulated customers asked salespeople in vape and tobacco shops how e-cigarettes compare to conventional cigarettes, and then recorded the resulting claims that were made using a standardized form designed for this purpose. Data were analyzed from January to March 2016. Results:The most frequent claims made by sales staff were that: smoking e-cigarettes helps one quit smoking (57% of the simulated shopping interactions), e-cigarettes come in multiple flavors (54%), and e-cigarettes are healthier than conventional cigarettes (50%). Simulated customer interactions that took place in vape shops included more positive marketing claims than those that occurred in tobacco shops; this relationship approached statistical significance (p = .087). There was a significant relationship between city and the average number of positive e-cigarette claims made (p < .001). Conclusions:A wide range of marketing claims are made about e-cigarettes in retail settings. These may vary by geographic location, community demographics, and type of retail outlet.
- Resource Type:
- Article
- Campus Tesim:
- Fullerton
- Department:
- Department of Public Health
- Creator:
- Jacobs, Wura
- Description:
- We live in a digital age and this has changed the landscape of health information. With the changing US demographic, otherwise acute diseases morphing into chronic diseases as a result of treatment advancements, and evolving health needs of the population, there is need for increase in available and accessible health information. It is estimated that one in three US adults use the internet to diagnose or learn about a health concern. Nevertheless, a nagging question is whether the Web is reducing or creating disparities in health information availability and use for making health decisions. This study examined factors associated with heath information seeking from the internet, traditional media, and health care professionals among a diverse population of US adults. Data for the analysis was from four cycles (2011–2014) of the Health Information National Trends Survey (HINTS), a national survey of US adults. Controlling for age, race/ethnicity, gender, and socioeconomic status (SES), regression analyses were conducted. STATA 13 was used for analyses. Findings indicated that there is a possibility that while the Web is an easily available source of health information, it could also create inequalities in health information accessibility. The Web should not be considered a substitute for using alternative health information sources. Doing so, might create disproportionate access to health information essential for health decisions.
- Resource Type:
- Article
- Campus Tesim:
- Fullerton
- Department:
- Department of Public Health
- Creator:
- Distefano, Anthony
- Description:
- Japan is widely perceived to have a low level of HIV occurrence; however, its HIV epidemics also have been the subject of considerable misunderstanding globally. I used a ground truthing conceptual framework to meet two aims: first, to determine how accurately official surveillance data represented Japan's two largest epidemics (urban Kansai and Tokyo) as understood and experienced on the ground; and second, to identify explanations for why the HIV epidemics were unfolding as officially reported. I used primarily ethnographic methods while drawing upon epidemiology, and compared government surveillance data to observations at community and institutional sites (459 pages of field notes; 175 persons observed), qualitative interviews with stakeholders in local HIV epidemics (n = 32), and document research (n = 116). This revealed seven epidemiologic puzzles involving officially reported trends and conspicuously missing information. Ethnographically grounded explanations are presented for each. These included factors driving the epidemics, which ranged from waning government and public attention to HIV, to gaps in sex education and disruptive leadership changes in public institutions approximately every two years. Factors constraining the epidemics also contributed to explanations. These ranged from subsidized medical treatment for most people living with HIV, to strong partnerships between government and a well-developed, non-governmental sector of HIV interventionists, and protective norms and built environments in the sex industry. Local and regional HIV epidemics were experienced and understood as worse than government reports indicated, and ground-level data often contradicted official knowledge. Results thus call into question epidemiologic trends, including recent stabilization of the national epidemic, and suggest the need for revisions to the surveillance system and strategies that address factors driving and constraining the epidemics. Based upon its utility in the current study, ground truthing has value as a conceptual framework for research and shows promise for future theoretical development.
- Resource Type:
- Article
- Campus Tesim:
- Fullerton
- Department:
- Department of Public Health