Publications by authors named "Dianne C Barker"

32 Publications

Vape shop owners'/managers' attitudes about CBD, THC, and marijuana legal markets.

Prev Med Rep 2020 Dec 12;20:101208. Epub 2020 Sep 12.

Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, 3300 Hillview Ave, Suite 120, Palo Alto, CA 94304, USA.

Over the past decade in the US there have been marked pivotal changes in the policy and retail environment regarding cannabinoids, particularly cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC). Many vape shops may carry products relevant to these two markets. This study interviewed vape shop owners/managers to assess their perceptions of consumer interests/behaviors regarding CBD and THC and of the impact of legalized marijuana retail on vape shops. The current study involved phone-based semi-structured interviews of 45 vape shop owners/managers in six metropolitan statistical areas (MSAs; Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, and Seattle) during Summer 2018. Overall, 82.2% of participants were male, 77.8% were non-Hispanic White, 64.4% were managers, 8.9% reported past 30-day smoking, and 95.6% reported past 30-day vaping. Overall, 44.4% sold e-liquids containing CBD. Vape shop owners/managers indicated minimal perceived risk and some beliefs in therapeutic benefits of CBD products; however, there was a broader range of perspectives regarding marijuana retail and selling marijuana for recreational use. Some chose to distance themselves from marijuana products, their use, and the possibility of entering marijuana retail if it were to evolve in their state, while some indicated high levels of enthusiasm for the growing retail marijuana market. Future research should examine how vape shops and other retailers of CBD and marijuana communicate with consumers about products and modes of using such products, as well as how various industry sectors (e.g., vape shops) adapt or evolve with increasing regulation of nicotine and increasing legalization of marijuana retail.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.pmedr.2020.101208DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516178PMC
December 2020

Vape Shop Owners/Managers' Opinions About FDA Regulation of E-Cigarettes.

Nicotine Tob Res 2021 02;23(3):535-542

Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA.

Introduction: In the United States, prominent sources of vaping products are specialty vape shops, which are subject to Food and Drug Administration (FDA) regulation. This study interviewed vape shop owners/managers to assess: (1) reasons for entering into or engaging in vape shop retail; (2) personnel training, particularly with regard to FDA and state regulations; and (3) how existing regulations are perceived and the anticipated impact of future regulation.

Aims And Methods: The current study involved phone-based semi-structured interviews of 45 vape shop owners/managers in six metropolitan statistical areas (Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, and Seattle) during Summer 2018 as FDA regulations regarding minimum age verification, bans on product sampling, and health warnings (among others) were first being implemented.

Results: Vape shop owners/managers reported: (1) entering the industry with positive intentions for their customers, (2) training their personnel to adhere to regulations and provide good customer service, and (3) significant concerns about the impact of FDA regulations. With regard to the latter, participants reported mistrust of the intentions of the FDA regulations, financial implications of the regulations (particularly for small businesses), difficulty understanding and interpreting the regulations, insufficient evidence to support the regulations, negative impact on customer service, negative impact on product offerings and product innovation/advancement, and negative implications of flavor bans and/or restrictions on sale of flavors.

Conclusions: These findings indicate the complexities in implementing tobacco regulations, particularly from the perspective of the vape shop industry. Current findings should inform future regulatory actions and efforts to assess compliance with regulations.

Implications: Current and impending FDA regulation of vaping products present a critical period for examining regulatory impact on the vape shop industry. Current results indicated that many vape shop owners/managers reporting positive intentions for engaging in the vaping product industry and in training vape shop personnel to adhere to regulations. However, the majority reported concerns about FDA regulation and other state/local regulations that could have negative implications for their industry. Particular concerns include difficulty understanding the regulations due to complexity, vagueness, and changes in language and/or interpretation over time. These issues have implications for compliance that must be addressed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ntr/ntaa138DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885784PMC
February 2021

Vape shop identification, density and place characteristics in six metropolitan areas across the US.

Prev Med Rep 2020 Sep 31;19:101137. Epub 2020 May 31.

Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, 3300 Hillview Ave, Suite 120, Palo Alto, CA 94304, USA.

Vaping is increasingly prevalent and controversial. Vape shops and convenience stores are common but distinct sources of vaping products, and where they locate may reflect likely target markets. This study examined the density and neighborhood demographics of vape shops and convenience stores in six metropolitan statistical areas (MSAs): Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, Seattle. We identified 459 vape shops using Yelp and Google application programming interfaces and 10,777 convenience stores using ReferenceUSA and Dun & Bradstreet. Retailers were geocoded to census tracts (n = 4,442), and logistic regressions were conducted using as predictors percent non-White, percent youth (5-17 years or 5-20 years), and median household income from the American Community Survey, 2013-2017. Per 10,000 young adults, vape shop density ranged from 0.6 (Boston, San Diego) to 1.7 (Oklahoma City), and convenience store density ranged from 12.6 (San Diego) to 26.3 (Oklahoma City). Logistic regressions indicated that vape shops more likely resided in tracts with lower percentages of youth in Boston, but higher percentages of youth in Atlanta, as well as with lower incomes in Boston and Seattle. Convenience stores more likely resided in tracts with lower percentages of non-Whites in Atlanta and Boston; lower incomes in Atlanta, Boston, San Diego, and Seattle; and higher percentages of youth in Atlanta, Boston, and Minneapolis. These common retail sources of vaping products differentially locate in relation to neighborhood sociodemographics across MSAs. Findings suggest that, in some MSAs, vape shops and convenience stores may target youth and lower income populations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.pmedr.2020.101137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298674PMC
September 2020

Exploring the Point-of-Sale Among Vape Shops Across the United States: Audits Integrating a Mystery Shopper Approach.

Nicotine Tob Res 2021 02;23(3):495-504

Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA.

Introduction: Vape shops represent prominent, unique retailers, subject to Food and Drug Administration (FDA) regulation in the United States.

Aims And Methods: This study assessed compliance of US vape shop retail marketing strategies with new regulations (eg, required age verification, prohibited free samples) and pre-implementation conditions for other regulations (eg, health warning labels on all nicotine products, required disclosures of e-liquid contents).

Results: 95.0% of shops displayed minimum-age signage; however, mystery shoppers were asked for age verification at 35.6% upon entry and at 23.4% upon purchase. Although 85.5% of shops had some evidence of implementing FDA health warnings, 29.1% had signage indicating prohibited health claims, 16.3% offered free e-liquid samples, 27.4% had signage with cartoon imagery, and 33.3% were within two blocks of schools. All shops sold open-system devices, 64.8% sold closed-system devices, 68.2% sold their own brand of e-liquids, 42.5% sold e-liquids containing cannabidiol, 83.2% offered price promotions of some kind, and 89.9% had signage for product and price promotions.

Conclusions: Results indicated that most shops complied with some implementation of FDA health warnings and with free sampling bans and minimum-age signage. Other findings indicated concerns related to underage access, health claims, promotional strategies, and cannabidiol product offerings, which call for further FDA and state regulatory/enforcement efforts.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ntr/ntaa041DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885776PMC
February 2021

ENDS retailers and marketing near university campuses with and without tobacco-free policies.

Tob Induc Dis 2018 Oct;16

Stanford Prevention Research Center, Stanford School of Medicine, 3300 Hillview Avenue, suite 120, Palo Alto, CA 94304, USA.

Introduction: This study characterizes the retail environment for Electronic Nicotine Delivery Systems (ENDS) near public universities in California, assesses marketing in the first random sample of ENDS retailers, and compares ENDS retailer density and retail marketing near campuses with and without tobacco-free policies.

Methods: Two data sources were used to construct a sampling frame of possible ENDS retailers, which were mapped within 1 to 4 miles of the 33 University of California and California State University campuses. To assess retailer density, a telephone survey of possible ENDS retailers (n=1186) determined which sold e-cigarettes or e-liquids (completion rate=72.9%). To assess retail marketing, trained data collectors completed observations in a random sample (n=438, M=13.3 stores per campus, SD=11.2) in fall 2015.

Results: In a telephone survey, 59.1% of retailers reported selling e-cigarettes or e-liquids. Half of the campuses had 10 or more ENDS retailers nearby. Most ENDS retailers were convenience stores (42.5%), and more were head shops (8.4%) than smoke shops (6.8%) or vape shops (6.2%). Nearly half (43.6%) of ENDS retailers sold products marketed as zero-nicotine and 13.9% sold NRT. ENDS advertising was visible in 72.1% and on the exterior of 28.1% of retailers. However, the presence of exterior advertising for ENDS was significantly lower near campuses with established tobacco-free policies than campuses with recent or no tobacco-free policies (OR=0.45, 95% CI=0.22, 0.94).

Conclusions: The large number of tobacco retailers that sell ENDS near colleges suggests a need for better monitoring and regulations of ENDS availability and marketing. The widespread availability of zero-nicotine products suggests a need to examine whether nicotine-free products are as advertised and safe to use. Longitudinal research is needed to understand how retail marketing for ENDS responds to change in tobacco-free policies at nearby campuses.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.18332/tid/94600DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342456PMC
October 2018

A Menu to Evaluate Factors Influencing Implementation of Obesity Prevention Early Care and Education Regulations.

J Public Health Manag Pract 2019 May/Jun;25(3):E11-E18

Barker Bi-Coastal Health Consultants, Inc, Calabasas, California (Mss Sawicki, Barker, and Yochelson and Mr Caughlan); Gutman Research Associates, Princeton, New Jersey (Dr Gutman); and Center for Public Program Evaluation, Purcellville, Virginia (Mr Grob).

Context: In recent years, several states have adopted new regulations concerning nutrition, physical activity, and screen time in early care and education (ECE) settings to help prevent childhood obesity.

Objective: To disseminate a menu of factors that facilitate and/or impede implementation of obesity prevention regulations in ECE settings.

Design: To create the menu, we condensed and categorized factors identified in the literature and through field work by placing them within domains. We applied the menu by conducting semistructured interviews during a pilot test assessing implementation of ECE regulations in Colorado.

Setting And Participants: We first interviewed state and local government agency leaders responsible for policy oversight, and state employees and contractors who acted as intermediaries to direct implementers. We then interviewed directors at ECE centers in the Denver, Colorado, area. We selected 21 ECE centers for a site visit on the basis of feasibility, percentage of low-income families, and diversity in race and ethnicity at each center. Seven centers participated.

Main Outcome Measures: Minor and major facilitators and impediments to implementation of childhood obesity prevention regulations in ECE settings.

Results: The resulting menu includes 7 domains and 39 factors influential for implementation of ECE regulations. Of these 39 factors, interviewees identified 7 facilitating factors (4 major and 3 minor) and 2 impeding factors (both major). Major facilitating factors were buy-in from parents/caregivers, training and communication provided by governing authority and their contractors, and low level of change required by the regulations themselves. Major impeding factors were timing of implementation and balancing the demands of the regulations against other priorities.

Conclusions: The menu developed by our research team, combined with existing frameworks in dissemination and implementation research, can be used by researchers, practitioners, and policy makers to anticipate factors that facilitate and/or impede implementation of ECE policies to prevent childhood obesity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/PHH.0000000000000796DOI Listing
April 2020

'No, the government doesn't need to, it's already self-regulated': a qualitative study among vape shop operators on perceptions of electronic vapor product regulation.

Health Educ Res 2018 04;33(2):114-124

Health Policy Center, Institute for Health Research and Policy, University of Illinois, Chicago, IL, USA.

While the market share of electronic vapor products (EVPs), sold primarily through vape shops and other outlets, has increased rapidly, these products remained largely unregulated until 2016. This study, conducted prior to announcement of the deeming regulations, provides insights into vape shop operator attitudes toward potential government regulations of EVPs. In 2015, we conducted 37 in-person interviews of vape shop operators across nine US cities. Shops were identified through extensive web-searches. We used QSR International's NVivo 11 qualitative data analysis software to analyze the transcripts. Many vape shop operators viewed regulations requiring safe production of e-liquids, child-resistant bottles and listing e-juice ingredients as acceptable. They disagreed with the elimination of free samples and bans on flavored e-liquid sales, which generate significant revenue for their stores. Many held negative perceptions of pre-market review of new product lines and EVP-specific taxes. All agreed that EVPs should not be sold to minors, but most felt that owners should not be fined if minors visited vape shops. Findings from this study offer insights into the acceptability of proposed regulations, as well as barriers to effective regulation implementation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/her/cyy003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019017PMC
April 2018

Estimating cigarette tax avoidance and evasion: evidence from a national sample of littered packs.

Tob Control 2016 10;25(Suppl 1):i38-i43

University of Illinois at Chicago, Institute for Health Research and Policy, Chicago, Illinois, USA.

Introduction: A number of recent studies document the proportion of all cigarette packs that are 'contraband' using discarded packs to measure tax avoidance and evasion, which we call tax non-compliance. To date, academic studies using discarded packs focused on relatively small geographical areas such as a city or a neighbourhood.

Methods: We visited 160 communities across 38 US states in 2012 and collected data from littered cigarette packs as part of the State and Community Tobacco Control (SCTC) Research Initiative and the Bridging the Gap Community Obesity Measures Project (BTG-COMP). Data collectors were trained in a previously tested littered pack data collection protocol.

Results: Field teams collected 2116 packs with cellophane across 132 communities. We estimate a national tax non-compliance rate of 18.5% with considerable variation across regions. Suburban areas had lower non-compliance than urban areas as well as areas with high and low median household income areas compared with middle income areas.

Discussion: We present the first academic national study of tax non-compliance using littered cigarette packs. We demonstrate the feasibility of meaningful large-scale data collection using this methodology and document considerable variation in tax non-compliance across areas, suggesting that both policy differences and geography may be important in control of illicit tobacco use. Given the geography of open borders among countries with varying tax rates, this simple methodology may be appropriate to estimate tax non-compliance in countries that use tax stamps or other pack markings, such as health warnings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/tobaccocontrol-2016-053012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5099225PMC
October 2016

Prices for Tobacco and Nontobacco Products in Pharmacies Versus Other Stores: Results From Retail Marketing Surveillance in California and in the United States.

Am J Public Health 2016 10 23;106(10):1858-64. Epub 2016 Aug 23.

Lisa Henriksen and Nina C. Schleicher are with the Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA. Dianne C. Barker is with Barker Bi-Coastal Health Consultants, Inc, Calabasas, CA. Yawen Liu and Frank J. Chaloupka are with the Department of Economics and the Institute for Health Research and Policy, University of Illinois, Chicago.

Objectives: To examine disparities in the price of tobacco and nontobacco products in pharmacies compared with other types of stores.

Methods: We recorded the prices of Marlboro, Newport, the cheapest cigarettes, and bottled water in a random sample of licensed tobacco retailers (n = 579) in California in 2014. We collected comparable data from retailers (n = 2603) in school enrollment zones for representative samples of US 8th, 10th, and 12th graders in 2012. Ordinary least squares regressions modeled pretax prices as a function of store type and neighborhood demographics.

Results: In both studies, the cheapest cigarettes cost significantly less in pharmacies than other stores; the average estimated difference was $0.47 to $1.19 less in California. We observed similar patterns for premium-brand cigarettes. Conversely, bottled water cost significantly more in pharmacies than elsewhere. Newport cost less in areas with higher proportions of African Americans; other cigarette prices were related to neighborhood income and age. Neighborhood demographics were not related to water prices.

Conclusions: Compared with other stores, pharmacies charged customers less for cigarettes and more for bottled water. State and local policies to promote tobacco-free pharmacies would eliminate an important source of discounted cigarettes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5024371PMC
http://dx.doi.org/10.2105/AJPH.2016.303306DOI Listing
October 2016

Disparities in the Availability and Price of Low-Fat and Higher-Fat Milk in US Food Stores by Community Characteristics.

J Acad Nutr Diet 2015 Dec 2;115(12):1975-85. Epub 2015 Jun 2.

Background: National surveillance data identify disparities in low-fat milk consumption by race/ethnicity and income. Some localized studies have shown disparities in access to low-fat milk by community characteristics.

Objective: Our aim was to assess the availability and price of low-fat and higher-fat milk in food stores throughout the United States and examine associations with community characteristics.

Design: We conducted a cross-sectional study involving observational data collection in 2010, 2011, and 2012.

Participants/settings: The study included 8,959 food stores in 468 communities where nationally representative samples of students attending traditional public middle and high schools resided.

Main Outcome Measures: We studied the availability and price of whole, 2%, 1%, and skim milk.

Statistical Analyses Performed: Multivariate logistic regression and ordinary least squares regression analyses were performed. Models included store type, race/ethnicity, median household income, urbanicity, US Census division, and year of data collection.

Results: Less than half of all stores carried 1% and skim milk, and more than three-quarters of stores carried whole and 2% milk. Regression results indicated that the odds of carrying any type of milk were 31% to 67% lower in stores in majority black and 26% to 45% lower in other/mixed race compared with majority white communities. The odds of carrying specifically low-fat milk were 50% to 58% lower in majority Hispanic compared with majority white communities, and 32% to 44% lower in low-income compared with high-income communities. Some significant differences in milk prices by community characteristics were observed in grocery and limited-service stores. On average, low-fat milk options were more expensive in grocery stores in majority black and rural and suburban communities compared with such stores in majority white and urban communities.

Conclusions: This is the first nationwide study to examine the availability and price of low-fat and higher-fat milk in food stores and show disparities in access by community characteristics. Policies and programs can play a role in increasing accessibility of low-fat milk in stores in nonwhite and low-income communities.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jand.2015.04.002DOI Listing
December 2015

Commentary: Forces That Drive the Vape Shop Industry and Implications for the Health Professions.

Eval Health Prof 2016 09 11;39(3):379-88. Epub 2015 May 11.

Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.

At least three factors may be driving the evolution of the vape shop industry, a rapidly growing market sector that specializes in the sales of electronic cigarettes: (1) the tobacco industry, (2) the public health sector and its diverse stakeholders, and (3) consumer demand. These influences and the responses of the vape shop sector have resulted in a rapidly changing landscape. This commentary briefly discusses these three factors and the implications for the health professions, as they address the vape shop industry and its consequences for public health.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0163278715586295DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5021181PMC
September 2016

Prepared Food Availability in U.S. Food Stores: A National Study.

Am J Prev Med 2015 Oct 23;49(4):553-62. Epub 2015 Apr 23.

Department of Economics, University of Illinois at Chicago, Chicago, Illinois.

Introduction: Prepared, ready-to-eat foods comprise a significant part of Americans' diets and are increasingly obtained from food stores. Yet, little is known about the availability and healthfulness of prepared, ready-to-eat food offerings at stores. This study examines associations among community characteristics (racial/ethnic composition, poverty level, urbanicity) and availability of both healthier and less-healthy prepared foods in U.S. supermarkets, grocery stores, and convenience stores.

Methods: Observational data were collected from 4,361 stores in 317 communities spanning 42 states in 2011 and 2012. Prepared food availability was assessed via one healthier food (salads or salad bar), three less-healthy items (pizza, hot dog/hamburger, taco/burrito/taquito), and one cold sandwich item. In 2014, multivariable generalized linear models were used to test associations with community characteristics.

Results: Overall, 63.6% of stores sold prepared foods, with 20.0% offering prepared salads and 36.4% offering at least one less-healthy item. Rural stores were 26% less likely to carry prepared salads (prevalence ratio [PR]=0.74, 95% CI=0.62, 0.88) and 14% more likely to carry at least one less-healthy prepared food item (PR=1.14, 95% CI=1.00, 1.30). Convenience stores in high-poverty communities were less likely to carry prepared salads than those in low-poverty communities (PR=0.64, 95% CI=0.47, 0.87). Among supermarkets, prepared salads were more likely to be carried in majority-white, low-poverty communities than in non-white, high-poverty communities.

Conclusions: Increasing the healthfulness of prepared foods within stores may offer an important opportunity to improve the food environment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amepre.2015.02.025DOI Listing
October 2015

Child-directed marketing inside and on the exterior of fast food restaurants.

Am J Prev Med 2015 Jan 29;48(1):22-30. Epub 2014 Oct 29.

Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; Department of Economics, University of Illinois at Chicago, Chicago, Illinois.

Background: Children who eat fast food have poor diet and health outcomes. Fast food is heavily marketed to youth, and exposure to such marketing is associated with higher fast food consumption.

Purpose: To examine the extent of child-directed marketing (CDM) inside and on the exterior of fast food restaurants.

Methods: Data were collected from 6,716 fast food restaurants located in a nationally representative sample of public middle- and high-school enrollment areas in 2010, 2011, and 2012. CDM was defined as the presence of one or more of seven components inside or on the exterior of the restaurant. Analyses were conducted in 2014.

Results: More than 20% of fast food restaurants used CDM inside or on their exterior. In multivariate analyses, fast food restaurants that were part of a chain, offered kids' meals, were located in middle- (compared to high)-income neighborhoods, and in rural (compared to urban) areas had significantly higher odds of using any CDM; chain restaurants and those located in majority black neighborhoods (compared to white) had significantly higher odds of having an indoor display of kids' meal toys. Compared to 2010, there was a significant decline in use of CDM in 2011, but the prevalence increased close to the 2010 level in 2012.

Conclusions: CDM inside and on the exterior of fast food restaurants is prevalent in chain restaurants; majority black communities, rural areas, and middle-income communities are disproportionately exposed. The fast food industry should limit children's exposure to marketing that promotes unhealthy food choices.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amepre.2014.08.011DOI Listing
January 2015

Relative and absolute availability of healthier food and beverage alternatives across communities in the United States.

Am J Public Health 2014 Nov 11;104(11):2170-8. Epub 2014 Sep 11.

Shannon N. Zenk is with the College of Nursing, Lisa M. Powell is with the School of Public Health, Leah Rimkus and Zeynep Isgor are with the Institute for Health Research and Policy, and Frank Chaloupka is with the Department of Economics, University of Illinois at Chicago. Dianne C. Barker is with Barker Bi-Coastal Health Consultants Inc, Calabasas, CA. Punam Ohri-Vachaspati is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix.

Objectives: We examined associations between the relative and absolute availability of healthier food and beverage alternatives at food stores and community racial/ethnic, socioeconomic, and urban-rural characteristics.

Methods: We analyzed pooled, annual cross-sectional data collected in 2010 to 2012 from 8462 food stores in 468 communities spanning 46 US states. Relative availability was the ratio of 7 healthier products (e.g., whole-wheat bread) to less healthy counterparts (e.g., white bread); we based absolute availability on the 7 healthier products.

Results: The mean healthier food and beverage ratio was 0.71, indicating that stores averaged 29% fewer healthier than less healthy products. Lower relative availability of healthier alternatives was associated with low-income, Black, and Hispanic communities. Small stores had the largest differences: relative availability of healthier alternatives was 0.61 and 0.60, respectively, for very low-income Black and very low-income Hispanic communities, and 0.74 for very high-income White communities. We found fewer associations between absolute availability of healthier products and community characteristics.

Conclusions: Policies to improve the relative availability of healthier alternatives may be needed to improve population health and reduce disparities.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2105/AJPH.2014.302113DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4202991PMC
November 2014

The availability of electronic cigarettes in U.S. retail outlets, 2012: results of two national studies.

Tob Control 2014 Jul;23 Suppl 3:iii10-6

Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA.

Background: Since their introduction in 2007, electronic cigarette ('e-cigarette') awareness and use has grown rapidly. Little is known about variation in e-cigarette availability across areas with different levels of tobacco taxes and smoke-free air policies. This paper looks at US retail availability of e-cigarettes and factors at the store, neighbourhood and policy levels associated with it.

Methods: In-person store audit data collected in 2012 came from two national samples of tobacco retailers in the contiguous US. Study 1 collected data from a nationally representative sample of tobacco retailers (n=2165). Study 2 collected data from tobacco retailers located in school enrolment zones for nationally representative samples of 8th, 10th and 12th grade public school students (n=2526).

Results: In 2012, e-cigarette retail availability was 34% in study 1 and 31% in study 2. Tobacco, pharmacy and gas/convenience stores were more likely to sell e-cigarettes than beer/wine/liquor stores. Retail availability of e-cigarettes was more likely in neighbourhoods with higher median household income (study 1), and lower percent of African-American (studies 1 and 2) and Hispanic residents (study 2). Price of traditional cigarettes was inversely related to e-cigarette availability. Stores in states with an American Lung Association Smoke-Free Air grade of F (study 1) or D (study 2) compared with A had increased likelihood of having e-cigarettes.

Conclusions: Currently, e-cigarette availability appears more likely in areas with weak tax and smoke-free air policies. Given the substantial availability of e-cigarettes at tobacco retailers nationwide, states and localities should monitor the sales and marketing of e-cigarettes at point of sale (POS).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/tobaccocontrol-2013-051461DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4078712PMC
July 2014

Development and Reliability Testing of a Fast-Food Restaurant Observation Form.

Am J Health Promot 2015 Sep-Oct;30(1):9-18. Epub 2014 May 12.

Purpose: To develop a reliable observational data collection instrument to measure characteristics of the fast-food restaurant environment likely to influence consumer behaviors, including product availability, pricing, and promotion.

Design: The study used observational data collection.

Setting: Restaurants were in the Chicago Metropolitan Statistical Area.

Subjects: A total of 131 chain fast-food restaurant outlets were included.

Measures: Interrater reliability was measured for product availability, pricing, and promotion measures on a fast-food restaurant observational data collection instrument.

Analysis: Analysis was done with Cohen's κ coefficient and proportion of overall agreement for categorical variables and intraclass correlation coefficient (ICC) for continuous variables.

Results: Interrater reliability, as measured by average κ coefficient, was .79 for menu characteristics, .84 for kids' menu characteristics, .92 for food availability and sizes, .85 for beverage availability and sizes, .78 for measures on the availability of nutrition information,.75 for characteristics of exterior advertisements, and .62 and .90 for exterior and interior characteristics measures, respectively. For continuous measures, average ICC was .88 for food pricing measures, .83 for beverage prices, and .65 for counts of exterior advertisements.

Conclusion: Over 85% of measures demonstrated substantial or almost perfect agreement. Although some measures required revision or protocol clarification, results from this study suggest that the instrument may be used to reliably measure the fast-food restaurant environment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4278/ajhp.130731-QUAN-389DOI Listing
January 2017

Evaluation of active living research: ten years of progress in building a new field.

Am J Prev Med 2014 Feb;46(2):208-15

Gutman Research Associates, Cranbury, New Jersey.

Background: The Robert Wood Johnson Foundation Active Living Research (ALR) program commissioned an evaluation of its initiative to assess 10 years (2001-2011) of progress in establishing a new interdisciplinary field to develop and translate research focused on policy and environmental factors affecting physical activity in children and families.

Purpose: The second-phase evaluation (ALR-2) was conducted from March to July 2011 to measure progression from evidence- and field-building (Goals 1 and 2) to policy and practice contributions (Goal 3) to inform childhood obesity strategies, and to develop recommendations for a third phase (ALR-3).

Methods: The evaluation was a retrospective, in-depth descriptive study utilizing qualitative and quantitative methods. Key informant interviews (N=100) across seven stakeholder groups were conducted and analyzed in 2011. Data from web-based surveys of grantee investigators conducted from 2007 to 2011 and analyzed in 2011 served as the primary quantitative source.

Results: Key indicators of ALR's overall progress confirmed ALR's success across its three goals: (1) establishing a strong research base: 309 publications filling major knowledge gaps; (2) building an interdisciplinary and diverse field: grantees represented 31 disciplines, with more than one quarter (28%) of investigators having ≤5 years of experience, of which 39% were people of color; and (3) using research to inform policy and practice: 62 examples, of which slightly more than one half (n=32) resulted in actual policy or practice change.

Conclusions: Overall, ALR met its three goals during ALR-2 and was well positioned to implement a third phase of the program to further accelerate the translation of its research into policy and practice.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amepre.2013.10.003DOI Listing
February 2014

Development and reliability testing of a food store observation form.

J Nutr Educ Behav 2013 Nov-Dec;45(6):540-8. Epub 2013 May 30.

Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL. Electronic address:

Objective: To develop a reliable food store observational data collection instrument to be used for measuring product availability, pricing, and promotion.

Design: Observational data collection.

Setting: A total of 120 food stores (26 supermarkets, 34 grocery stores, 54 gas/convenience stores, and 6 mass merchandise stores) in the Chicago metropolitan statistical area.

Main Outcome Measures: Inter-rater reliability for product availability, pricing, and promotion measures on a food store observational data collection instrument.

Analysis: Cohen's kappa coefficient and proportion of overall agreement for dichotomous variables and intra-class correlation coefficient for continuous variables.

Results: Inter-rater reliability, as measured by average kappa coefficient, was 0.84 for food and beverage product availability measures, 0.80 for interior store characteristics, and 0.70 for exterior store characteristics. For continuous measures, average intra-class correlation coefficient was 0.82 for product pricing measures; 0.90 for counts of fresh, frozen, and canned fruit and vegetable options; and 0.85 for counts of advertisements on the store exterior and property.

Conclusions And Implications: The vast majority of measures demonstrated substantial or almost perfect agreement. Although some items may require revision, results suggest that the instrument may be used to reliably measure the food store environment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jneb.2013.02.005DOI Listing
April 2014

Walkable communities and adolescent weight.

Am J Prev Med 2013 Feb;44(2):164-8

Institute for Health Research and Policy, Chicago, Illinois, USA.

Background: Neighborhood design features have been associated with health outcomes, including the prevalence of obesity.

Purpose: This study examined the association between walkability and adolescent weight in a national sample of public secondary school students and the communities in which they live.

Methods: Data were collected through student surveys and community observations between February and August 2010, and analyses were conducted in Spring 2012. The sample size was 154 communities and 11,041 students. A community walkability index and measures of the prevalence of adolescent overweight and obesity were constructed. Multivariable analyses from a cross-sectional survey of a nationally representative sample of 8th-, 10th- and 12th-grade public school students in the U.S. were run.

Results: The odds of students being overweight (AOR 0.98, 95% CI=0.95, 0.99) or obese (AOR=0.97, 95% CI=0.95, 0.99) decreased if they lived in communities with higher walkability index scores.

Conclusions: Results suggest that living in more-walkable communities is associated with reduced prevalence of adolescent overweight and obesity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amepre.2012.10.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553501PMC
February 2013

Menthol brand switching among adolescents and young adults in the National Youth Smoking Cessation Survey.

Am J Public Health 2012 Jul 17;102(7):1310-2. Epub 2012 May 17.

Schroeder Institute for Tobacco Research and Policy Studies at Legacy, Washington, DC, USA.

This study examines patterns of menthol and nonmenthol cigarette use from 2003 to 2005 in a cohort of smokers, aged 16 to 24 years in the National Youth Smoking Cessation Survey. At follow-up, 15.0% of baseline menthol smokers had switched to nonmentholated cigarettes; by contrast, 6.9% of baseline nonmenthol smokers had switched to mentholated cigarettes. Differences in switching patterns were evident by gender, race/ethnicity, parental education, and smoking frequency. These data support previous evidence that young smokers start with mentholated cigarettes and progress to nonmentholated cigarettes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2105/AJPH.2011.300632DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3478026PMC
July 2012

Field validation of secondary commercial data sources on the retail food outlet environment in the U.S.

Health Place 2011 Sep 2;17(5):1122-31. Epub 2011 Jun 2.

Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Road, M/C 275, Chicago, IL 60608, USA.

This study used direct field observations with interior assessments of outlets to validate food store and restaurant data from two commercial business lists conditional on classification of outlet type, including supermarkets, grocery stores, convenience stores, full-service restaurants and fast food restaurants. The study used a stratified random sample that included 274 urban census tracts across 9 counties from the Chicago Metropolitan Statistical Area (MSA) and 46 suburban and 61 rural census tracts across 13 counties from a 50-mile buffer surrounding the MSA. Results showed that agreement between the field observations and the commercial business lists for the food store and restaurant outlets was generally moderate (ranging from fair to good). However, when the listed data were validated based on an exact classification match, agreement was only fair (ranging from poor to moderate) and, in particular, poor for fast food restaurants. The study also found that agreement levels for some outlet types differed by tract characteristics. Commercial databases must be used with caution as substitutes for on the ground data collection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.healthplace.2011.05.010DOI Listing
September 2011

Evaluation of free to grow: head start partnerships to promote substance-free communities.

Eval Rev 2011 Apr;35(2):153-88

Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.

Free to Grow: Head Start Partnerships to Promote Substance-free Communities (FTG) was a national initiative in which local Head Start (HS) agencies, in partnership with other community organizations, implemented a mix of evidence-based family-strengthening and community-strengthening strategies. The evaluation of FTG used a quasi-experimental design to compare 14 communities that participated in the FTG intervention with 14 matched comparison communities. Telephone surveys were conducted with two cohorts of the primary caregivers of children in HS at baseline and then annually for 2 years. The survey was also administered to repeated cross-sectional samples of primary caregivers of young children who were not enrolled in HS. No consistent evidence was found in changes in family functioning or neighborhood conditions when the 14 FTG sites were compared to 14 matched sites. However, caregivers of young children who were not in HS in three high-implementing FTG sites showed evidence of improvements in neighborhood organization, neighborhood norms against substance abuse, and child disciplinary practices. Results provide highly limited support for the concept that family and neighborhood conditions that are likely to affect child development and well-being can be changed through organized efforts implemented by local HS programs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0193841X11403989DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766591PMC
April 2011

State-level tobacco control policies and youth smoking cessation measures.

Health Policy 2010 Oct 18;97(2-3):136-44. Epub 2010 May 18.

Department of Pharmaceutical Systems & Policy, West Virginia University School of Pharmacy, Translational Tobacco Reduction Research Program, Mary Babb Randolph Cancer Center, Morgantown, WV 26506, USA.

Objective: Research on the effects of state-level tobacco control policies targeted at youth has been mixed, with little on the effects of these policies and youth smoking cessation. This study explored the association between state-level tobacco control policies and youth smoking cessation behaviors from 1991 to 2006.

Methods: The study design was a population-based, nested survey of students within states. Study participants were 8th, 10th, and 12th graders who reported smoking "regularly in the past" or "regularly now" from the Monitoring the Future study. Main cessation outcome measures were: any quit attempt; want to quit; non-continuation of smoking; and discontinuation of smoking.

Results: Results showed that cigarette price was positively associated with a majority of cessation-related measures among high school smokers. Strength of sales to minors' laws was also associated with adolescent non-continuation of smoking among 10th and 12th graders.

Conclusions: Findings suggest that increasing cigarette price can encourage cessation-related behaviors among high school smokers. Evidence-based policy, such as tax increases on tobacco products, should be included as an important part of comprehensive tobacco control policy, which can have a positive effect on decreasing smoking prevalence and increasing smoking cessation among youth.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.healthpol.2010.04.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2930051PMC
October 2010

An initial assessment of the consumer demand roundtable: Results and promise.

Am J Prev Med 2010 Mar;38(3 Suppl):S437-46

Barker Bi-Coastal Health Consultants, Inc., Calabasas, California 91302, USA.

Background: An initial assessment of the National Tobacco Cessation Collaborative's (NTCC) 2005-2007 Consumer Demand Roundtable (CDR) was conducted in 2008 to assess the results and products of CDR, and to offer recommendations to guide ongoing NTCC efforts to expand the demand, reach, and use of effective tobacco-cessation treatments.

Methods: The evaluation was a small, retrospective, descriptive study, primarily using in-depth telephone interviews, supplemented by a review of CDR agendas, products, and web-based participant surveys. A sample of 30 tobacco-cessation leaders who had participated in at least one CDR meeting or conference was interviewed in May and June of 2008.

Results: Specific products implemented or influenced by CDR were identified, and organized by its six core strategies. Almost all respondents reported that the CDR was successful in its first goal to generate new ways of thinking about increasing demand for chronically underused evidence-based quit-smoking treatment, providing concrete examples of ways they had infused CDR concepts into the work of their organizations. The development of new products and communication messages suggested some progress in meeting the goal of identifying and catalyzing feasible innovations in treatment design, promotion, research, practice, and policy.

Conclusions: Results suggest that the CDR, conceived as a "think tank" for the tobacco-cessation field, made sizable progress, especially in shifting the field to a new way of thinking. Continued leadership, funding, and proactive, sustained communication are needed to ensure these new innovations are further tested, implemented, and sustained. A longer-term follow-up evaluation to measure this impact is recommended.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amepre.2009.12.013DOI Listing
March 2010

Evaluation of Active Living Research progress and lessons in building a new field.

Am J Prev Med 2009 Feb;36(2 Suppl):S22-33

Gutman Research Associates, Cranbury, New Jersey, USA.

Background: An evaluation was undertaken of the initial 6 years of the Active Living Research (ALR) program. Conducted in 2006 and analyzed in 2007, the evaluation was designed to assess productivity and progress on all three program goals and to inform consideration of program re-authorization.

Methods: The evaluation was a retrospective, in-depth, descriptive study utilizing multiple methods, both qualitative and quantitative. Qualitative data were derived mainly from 88 interviews with key informants. Quantitative data were derived primarily from a web-based survey of grantee investigators.

Results: Examples of key indicators of ALR's progress in addressing its goals were (1) in building a knowledge base: 40% of grantee investigators reported producing at least one scientific publication based on their ALR study, averaging two papers per principal investigator who had published; (2) in growing a transdisciplinary field: investigators funded in the first five rounds of grants reported representing more than 20 disciplines; and (3) in contributing to policy change: ten examples were reported of contribution to specific policy changes. In addition, more than one-third (37%) of principal investigators had leveraged additional funds, averaging $275,000 per ALR grant, suggesting that ALR also had made progress in growing financial resources for the field.

Conclusions: Overall, ALR made strides during 6 years in addressing its mission to develop a transdisciplinary field of research on environmental and policy factors that promote physical activity. The evaluation provided insight into useful approaches and strategies for building a nascent research field and suggested how to enhance the contribution of research to policy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amepre.2008.10.009DOI Listing
February 2009

Use of flavored cigarettes among older adolescent and adult smokers: United States, 2004--2005.

Nicotine Tob Res 2008 Jul;10(7):1209-14

BlueCross BlueShield of Western New York, Buffalo, NY, USA.

Cigarettes with candy, fruit and alcohol flavors have been introduced in recent years as extensions to popular cigarette brands, raising concerns in the public health community that the enticing names, creative packaging, and intense flavorings of these products may be especially appealing to youth. This study used two national surveys to examine the prevalence of use of Camel Exotic Blends, Kool Smooth Fusion, and Salem Silver Label brands during 2004--2005 among older adolescents and young adult smokers aged 17-26 years and adult smokers aged > or =25 years. Overall use of any of these flavored brands in the past 30 days was 11.9% among smokers aged 17-26 years and 6.7% among smokers aged > or =25 years. A significant gradient in use was seen across age, with the highest rates of utilization among 17-year-old (22.8%) and 18-19-year-old smokers (21.7%) (p<.001). Uniquely flavored cigarette brands seem to be most attractive to the youngest smokers and should be prohibited.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/14622200802163159DOI Listing
July 2008

Indicators of activity-friendly communities: an evidence-based consensus process.

Am J Prev Med 2006 Dec;31(6):515-24

Transtria LLC, St. Louis, Missouri 63139, USA.

Background: Regular physical activity, even at modest intensities, is associated with many health benefits. Most Americans, however, do not engage in the recommended levels. As practitioners seek ways to increase population rates of physical activity, interventions and advocacy efforts are being targeted to the community level. Yet, advocates, community leaders, and researchers lack the tools needed to assess local barriers to and opportunities for more active, healthy lifestyles. Investigators used a systematic review process to identify key indicators of activity-friendly communities that can assess and improve opportunities for regular physical activity.

Methods: Investigators conducted a comprehensive literature review of both peer-reviewed literature and fugitive information (e.g., reports and websites) to generate an initial list of indicators for review (n=230). The review included a three-tiered, modified Delphi consensus-development process that incorporated input of international, national, state, and local researchers and practitioners from academic institutions, federal and state government agencies, nonprofit organizations, and funding agencies in public health, transportation, urban planning, parks and recreation, and public policy.

Results: Ten promising indicators of activity-friendly communities were identified: land use environment, access to exercise facilities, transportation environment, aesthetics, travel patterns, social environment, land use economics, transportation economics, institutional and organizational policies, and promotion.

Conclusions: Collaborative, multidisciplinary approaches are underway to test, refine, and expand this initial list of indicators and to develop measures that communities, community leaders, and policymakers can use to design more activity-friendly community environments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amepre.2006.07.026DOI Listing
December 2006

Treatment of tobacco use in preconception care.

Matern Child Health J 2006 Sep;10(5 Suppl):S147-8

Office on Smoking and Health, Centers for Disease Control and Prevention, Mailstop K-50, 3005 Chamblee Tucker Road, Atlanta, Georgia 30341, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10995-006-0117-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1592147PMC
September 2006

Leveraging funds for public health improvement: tobacco settlement funds as an opportunity to transform public health.

J Public Health Manag Pract 2005 Mar-Apr;11(2):170-3

Public Health Institute, Oakland, California, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/00124784-200503000-00012DOI Listing
April 2005

Opportunities for youth smoking cessation: findings from a national focus group study.

Nicotine Tob Res 2004 Feb;6(1):9-17

Balch Associates and Department of Managerial Studies University of Illinois at Chicago, USA.

To identify opportunities for smoking cessation among adolescents, we conducted six computer-assisted telephone focus groups with 48 male and female high school student smokers and former smokers from six states across the United States, all aged 15-17 years, in two groups each of "established smokers," "late experimenters," and "quitters." These adolescents considered addiction to cigarettes real, powerful, stealthy, insidious, harmful, and avoidable. They considered quitting smoking achievable and desirable. Many of the established smokers and some experimenters would not consider quitting until an indefinite future, when they expected adult responsibilities to help them quit. Quitters had been encouraged by friends who did not smoke around them or offer them cigarettes; they also associated more with nonsmoking friends. Some adolescents, especially quitters, reported that parents had tried to help them quit; some smokers reported that parents had provided them with cigarettes. Some adolescents reported school rules and enforcement that made it hard to smoke; others reported school rules and enforcement that made it easy and tempting to smoke. These adolescents were not aware of the availability of professional help or interested in it. Many did not consider smoking urgent or "intense" enough for professional help. Perceptions of cessation programs were nonexistent or negative. Participants were aware of nicotine replacement therapies but less so of prescription medications. These findings suggest that it is critical to educate adolescents about what good cessation programming is and is not, why it is needed, how it might help, and where it is offered.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/1462200310001650812DOI Listing
February 2004