BACKGROUND: Farm‐to‐school interventions are recommended strategies to improve dietary behaviors among school‐aged children. Tools are needed to assess community readiness and capacity to optimize farm‐to‐school implementation. The objective of this study was to identify and prioritize factors to inform tailored farm‐to‐school implementation by practitioners working in diverse contexts.METHODS: Practitioners and community residents (N = 194) participated in semistructured interviews (N = 18) and focus groups (N = 23). Thematic analysis was conducted to identify themes and subthemes influencing farm‐to‐school implementation. The subthemes were operationalized into measureable indicators. The themes and their associated indicators were prioritized through a consensus conference with an expert panel (N = 18).RESULTS: The qualitative data analysis and consensus conference yielded 4 themes and 17 indicators associated with community readiness and capacity to implement farm‐to‐school. The themes represent school capacity, networks and relationships, organizational and practitioner capacity, and community resources and motivations.CONCLUSIONS: Findings highlight a range of indicators of community readiness and capacity needed to support farm‐to‐school implementation. Results offer guidance for tailoring intervention delivery based on levels of community, school, practitioner, and organizational readiness and capacity.
Purpose: While previous research underscores the important role that neighborhood contexts play for child and adolescent health and well-being, how these neighborhood contexts influence substance use initiation among adolescents from low-income and ethnic minority families has been understudied. Methods: This study is a secondary analysis of data from the Denver Child Study a retrospective survey that uses a natural experiment aimed at assessing neighborhood effects on developmental outcomes of Latinx and African American adolescents (N = 736). Cox cause-specific hazards models were estimated to test: (1) the effects of cumulative exposure to neighborhood social disorder, neighborhood violent and property crime rates, and neighborhood social capital during preadolescence (ages 8–11) on the likelihood of initiating alcohol, cigarette, and marijuana use during adolescence (ages 12–18), after controlling for youth, caregiver, and household factors; and (2) whether the effects of these cumulative neighborhood factors vary by Latinx and African American ethnicity. Results: 5.6% of adolescents in this study initiated cigarette use, 5.4% initiated alcohol use and 5.2% used marijuana for the first time during adolescence. The results indicate that exposure to neighborhood social disorder during preadolescence is a significant risk factor, especially for the initiation of cigarette use (HR = 1.36, 95% CI = 1.062–1.745, p = 0.015) particularly among Latinx adolescents (HR = 1.42, 95% CI = 1.031–1.966, p = 0.032). Conclusions: The findings suggest the need for further research on the relationship between exposure to neighborhood social disorder and adolescent substance use initiation in order to develop and implement community-based prevention and intervention programs to reduce substance use initiation and facilitate healthy adolescent development.
5 January 2022 in Journal of Pediatric Health Care
To explore the impact of social and relational adversity on access to key health services among US children with autism spectrum disorders (ASD), cross-sectional analyses of the 2016–2019 National Survey of Children’s Health assessed use of key health services by children with ASD, accounting for differences in demographic characteristics, medical needs, and experience of social and relational adversities. sUS children with ASD were more than twice as likely as peers without ASD to report two or more social adversities and more than three times as likely to report two or more relational adversities. In multivariable models, relational adversities were significantly associated with greater odds of medication use for ASD (OR 1.50, 95%CI:1.02, 2.17). Social adversities were neither associated with receipt of behavioral therapies nor prescription of medication to treat ASD. Screening for various forms of adversity among youth with ASD is of great importance; even one adverse experience may be enough to influence care of a child with ASD, with differences in effect according to the nature of the particular adversity. Further research should evaluate the role that childhood adversity plays in physical and mental health outcomes in ASD.
17 May 2021 in Journal of Agriculture, Food Systems, and Community Development
Healthy food retail (HFR) interventions are a recommended strategy to improve the dietary behaviors of low-income residents with limited access to healthy food; however, tools are needed to assess, tailor, and implement HFR plans to local contexts. The present study identifies factors influencing HFR implementation and presents findings related to identifying, operationalizing, and prioritizing facilitators of and barriers to implementing HFR interventions within low-resource rural and urban contexts. Practitioners and community residents, recruited from nine counties in Ohio, participated in semistructured interviews and focus groups. Grounded theory methodology was used to develop themes and indicators of readiness and capacity for successful HFR implementation. Consensus conference feedback from an expert panel prioritized themes and indicators based on their perceived relevance and importance for successfully implementing HFR interventions. Five themes were identified as influential factors: (1) corner store awareness and perception, (2) organizational and practitioner capacity, (3) community attitudes and perceptions, (4) logistical factors, and (5) networks and relationships. Additionally, 18 indicators within the five themes were identified to further illustrate influential factors to HFR implementation. The themes and indicators presented in this research have been synthesized into the PSE READI tool[1] (developed outside of this research). The PSE READI tool uniquely provides an opportunity to assess, tailor, and implement HFR plans to the local contexts by considering the key themes and influential factors that emerged from this community-level, qualitative research. [1] The PSE READI website is https://PSEREADI.org