Browsing by Author "Story, Mary"

Background: Maladjustment, categorized as internalizing and externalizing behaviors, is a process whereby an adolescent is unable to satisfy the psychological needs successfully. Youth behavioral problems may strengthen during the COVID-19 pandemic that put individuals through many mental health difficulties. The objectives of this study are to (1) examine the difference of youth behavioral problems between before and during the pandemic; (2) to investigate the association of parental mental health changes with youth behavioral problems during COVID-19; (3) to identify the predictors of parental mental health changes during the COVID-19. Methods: This study used the data from Wave 8 and Wave 10 of the China sample in the Parenting Across Cultures project. The study sample included 115 families in Chongqing, China. Linear mixed-effects models and Full Information Maximum Likelihood estimation were performed. Results: Adolescents experienced a significant increase in internalizing behaviors during COVID-19 (p = 0.002). The COVID-19 disruption brought a 0.20 increment in youth internalizing behaviors. Paternal mental health was significantly associated with youth internalizing behaviors (p = 0.020) and externalizing behaviors (p = 0.034). Youth’s gender, socioeconomic status, family structure, and family mental wellbeing significantly predicted parental mental health changes during COVID-19. Conclusions: As the first longitudinal study in China measuring the changes in youth behavioral problems before and during COVID-19, this study stressed the impact of COVID-19 disruption on the increment of youth internalizing behaviors between 2018 and 2020 in China. The results have important policy implications for adolescents-oriented mental health prevention and mitigation during COVID-19.

Background: Appropriate nutrition during early life is essential for optimal growth and development. China has seen a drastic improvement in child nutrition over the past few decades with decreased rates of stunting, wasting and undernutrition. However, there are wide gaps in the nutritional status of young children and preschoolers in rural and urban areas, which is a major public health concern. Currently, there is limited understanding about dietary intake of young children and the rural-urban gap in China, especially in the years after 2000. Therefore, the aims of this study were to examine trends in dietary intake of children at 2-6 years of age using data from the Chinese Health and Nutrition Surveys (CHNS) collected in 2000, 2004, 2006, 2009 and 2011 and to conduct interviews from key stakeholders in China to gather their perspectives and insights regarding child nutrition improvement in China.

Methods: Data obtained from the China National Nutrition and Health Survey (CNNHS) and Global Burden of Diseases, Injuries, and Risk Factors (GBD) database were used to describe the trend of child nutritional status in last 20 years from 1992 to 2016. Anthropometric nutritional indicators including stunting, wasting, underweight, overweight and obesity were presented in bar graphs and tables.

In-depth interviews were conducted with 23 stakeholders whose work involved child nutrition at national levels, as well as two provinces in Yunnan and Hubei. The interviews addressed topics about the changes and the current status of child undernutrition, as well as major tasks for child nutrition improvement. The qualitative analysis for the in-depth-interviews consisted of thematic analysis. The interviews were conducted in Mandarin. Coding and charting were processed in Chinese text using MAXQDA version 12. The final thematic framework and insightful quotations were translated into English.

The quantitative analysis used the individual level, consecutive 3-day 24-hour dietary recall data from five waves of the China Health and Nutrition Surveys (CHNS) in 2000, 2004, 2006, 2009 and 2011. Energy, macronutrient intakes (carbohydrate, protein, and fat) and food group intakes of whole grains, vegetables, fruits, meat and other protein sources (i.e., fish and egg), dairy products and snacks were estimated using data from Chinese Food Composition Tables (2002)1. These results were presented by survey year, age group, gender, and region (rural/urban areas). ANOVA, Chi-square test or t-test were used to examine differences between subgroups. Statistical analyses were performed using SAS version 9.4 (SAS Institute, Cary, NC).

Results: Impressive declines were reported in the prevalence of child stunting (35.8% to 8.1%), underweight (19.8% to 3.2%) and wasting (3.7% to 2.4%) from 1992 to 2012 in China, while an upward trend of overweight (6.5% to 8.4%) and obesity (2.7% to 3.3%) was observed in children under 6 years old from 2002 to 2012 in the CNNHS database. Most interview respondents expressed concerns about the increasing prevalence of childhood obesity, and the urgency of action for alleviating undernutrition among children living in poverty-stricken areas. The interview respondents from the child nutrition-related governmental departments in Hubei and Yunnan province stressed the necessity of enlarging the scale of the coverage of governmental child nutrition improvement programs in poverty-stricken rural areas. The average energy and macronutrients intake of children 2-6 years of age in the CHNS increased from 2000 to 2009 with a slight decrease in 2011. Among both rural and urban children, the percent energy from fat increased from 2000 to 2011 and exceeded 30% of energy intake. In general, the percentage of these children who consumed vegetables, meat and protein from fish and eggs, and dairy products increased from 2004-2011, and significant dietary intake disparities of protein source foods, such as dairy products were observed between rural and urban areas (p < 0.05) with lower intakes among children in rural areas.

Conclusions: From the years 2000 to 2011, the nutritional status and diet quality among urban and rural young children in China has undergone significant improvement. Also, young children in China are undergoing a remarkable nutrition transition characterized by a high energy intake from fat and low energy intake from carbohydrates. Both urban and rural children are facing the threat brought about by this nutrition transition, and this may lead to the increasing burden of child overweight. Further, dietary disparities still exist. Governmental commitment should be devoted to helping vulnerable, marginalized populations living in poor rural areas in China to further reduce undernutrition, and strategic action targeted at reducing childhood overweight should be taken to control the increasing trend in obesity in both rural and urban areas.

AbstractObjective: To examine the association between low food access and mental health outcomes among adults living in Miami-Dade County, FL and to visualize needs around Miami-Dade County Parks, Recreation and Open Spaces’ program parks. Methods: A cross-sectional analysis of area-level data from 2019 was performed. Linear regression models were used to examine the association between low food access and mental health outcomes adjusted for sociodemographic covariates. Exposure and outcome variables were geographically mapped using ArcGIS Online. Datasets were obtained from 2019 Food Access Research Atlas, PLACES: Local Data for Better Health, Census Tract Data 2021 release, and 2019 Social Determinants of Health Database from the Agency for Healthcare Research and Quality. Results: After adjusting for age, sex, race/ethnicity, income, education, transportation, and employment, no statistically significant association was found between low food access at 0.5 miles or 1 mile and mental health outcomes. Spatial analysis found prevalence of depression, frequent mental health distress and low food access are spatially clustered across Miami-Dade County. Conclusion: In conclusion, no significant association between low food access and mental health outcomes was seen using public area-level data. Spatial analysis suggests health disparities within MDC thus, further research is needed.

Background

Methods

Discussion

Trial registration

Background: Due to recent rapid economic development, China has seen changes in what foods households are purchasing as well as the general health of the population.

In the United States and other high-income countries, in-home scanner programs allow consumer packaged goods companies to measure household level grocery store food purchases and analyze trends of certain food categories while also linking to demographic information of the purchaser. Since few similar research has been conducted in China, especially with beverages, this study aims to examine beverage purchasing patterns among urban households in China across different demographics. Using the results, the study hopes to initiate conversations about what, if any, opportunities exist for health policy to intervene for a healthier Chinese population.

Methods: Secondary data analysis was conducted using scanner data to quantitatively analyze the beverage purchasing patterns among urban households in China from 2011-2013. Scanner data were acquired by Research Triangle Institute (RTI) from Kantar Worldpanel (Kantar Group) and provided for this study. Data were collected from four income levels in 24 provinces/municipalities from a panel of 40,000 Chinese households.

Results: Sugar-Sweetened Beverages (SSB) made up 74% of the total volume of beverages, with the majority of the SSB volume coming from Juice Drinks (29%), Carbonated Soft Drinks (CSD) (21%), and Ready-To-Drink (RTD) Tea (19%). Between income groups, higher income households purchased significantly higher volumes of RTD Coffee (p<0.0001), 100% Juice (p=0.01), Functional Drinks (p<0.0001), Juice Drinks (p=0.01), RTD Tea (p=0.02), and CSD (p=0.03) than their lower income counterparts. Coastal provinces had lower beverage price points and higher purchasing amounts than interior provinces. Total and per household purchase volumes of Functional Drinks, Juice Drinks, 100% Juice, Packaged Water, and RTD Coffee increased annually, but only the volume increases of Functional Drinks (p=0.004) and RTD Coffee (p=0.006) were statistically significant between 2011 and 2013, while Soybean Milk decreased significantly (p<0.0001). Per household purchase volumes of CSD, Juice Drinks, and 100% Juice all peaked during the busiest holiday season, the Chinese New Year, while Packaged Water and RTD Tea peaked during the second biggest season, National Week.

Conclusions: Because of the majority of beverage volume purchased being SSB, the significance of higher income households purchasing certain SSB more, the volume of certain SSB increasing every year, and the patterns of purchasing volume based on geography and certain periods of the year, creative health policies and campaigns should be addressed now in China to address the growing trends that other countries have seen linking SSB consumption to obesity, diabetes, and cardiovascular disease. Future research should examine whether front-of-package labeling, SSB taxes, advertisement restrictions, regulations around schools, and nutrition education campaigns could reduce SSB purchases in China.