MyPlate is a tool designed to educate the general US population on how to eat in alignment with the Dietary Guidelines for Americans; yet, there is a lack of data on who has heard of MyPlate over ...time.
The objective of this analysis was to examine the prevalence of awareness of MyPlate within the US population and if awareness changes differentially over time.
This study was a serial, cross-sectional survey.
Three survey waves of data (2013-2018) were used from the National Health and Nutrition Examination Survey of adults aged 20 years or older (n = 17,023).
Percentage of the US adult population who had heard of MyPlate was measured and stratified by sex, age, citizenship status, education, household food security status, income, receipt of Supplemental Nutrition Assistance Program (SNAP) benefits, and receipt of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits.
Global Wald tests were used to assess whether prevalence of awareness of MyPlate differed by sociodemographic characteristics. Tests of homogeneity using likelihood ratio tests of nested logistic regression models were used to assess whether differences in awareness of MyPlate by various sociodemographic characteristics changed over time from 2013 to 2018.
Twenty percent (19.5%) (n = 875) of the analytic sample of participants aged 20 years and older had heard of MyPlate in 2013-2014, 24.5% (n = 1,020) in 2015-2016, and 24.6% (n = 1,086) in 2017-2018. Awareness of MyPlate changed differentially over time (P value < .1) from 2013 to 2018 by income, household food security status, and receipt of SNAP benefits, with slower increases in awareness for households with lowest income over time, narrowing of differences in awareness by household food security status over time, and persistent differences in awareness by receipt of SNAP benefits over time.
These results highlight the current low awareness of MyPlate, disparities in awareness of MyPlate immediately after implementation by sociodemographic characteristics, and increases in awareness over time at differential rates within levels of income, food security status, and ever receipt of SNAP benefits. Given that the Dietary Guidelines for Americans 2025-2030 are currently in development, new strategies should be considered to disseminate tools that translate the updated Dietary Guidelines in such a way that reach the general population equitably upon implementation within the United States.
This study explored reasons for the adoption of a policy to distribute report cards to parents about children's weight status ("BMI report cards") in Massachusetts (MA) public schools in 2009 and the ...contextual factors influencing the policy removal in 2013.
We conducted semi-structured, qualitative interviews with 15 key decision-makers and practitioners involved with implementing and de-implementing the MA BMI report card policy. We analyzed interview data using a thematic analytic approach guided by the Consolidated Framework for Implementation Research (CFIR) 2.0.
Primary themes were that (1) factors other than scientific evidence mattered more for policy adoption, (2) societal pressure spurred policy adoption, (3) problems with the policy design contributed to inconsistent implementation and dissatisfaction, and (4) media coverage, societal pressure, and organizational politics and pressure largely prompted de-implementation.
Numerous factors contributed to the de-implementation of the policy. An orderly process for the de-implementation of a policy in public health practice that manages drivers of de-implementation may not yet exist. Public health research should further focus on how to de-implement policy interventions when evidence is lacking or there is potential for harm.
Abstract
Background
Antenatal care is a unique opportunity to assess SARS-CoV-2 seroprevalence and antibody response in pregnant people, including those with previously unknown infection.
Methods
...Pregnant people were screened for SARS-CoV-2 IgG during antenatal care or delivery in Seattle, Washington with Abbott Architect chemiluminescent immunoassay which provides quantitative index (positive ≥1.4). Participants with IgG+ results or identified with RT-PCR+ results via medical records were invited to enroll in a longitudinal evaluation of antibody responses. We report preliminary results of an ongoing seroprevalence and longitudinal study with planned 18-month follow-up.
Results
Between September 9, 2020–May 7, 2021, we screened 1304 pregnant people; 62 (4.8%) tested SARS-CoV-2 IgG+, including 28 (45%) with known prior SARS-CoV-2 infection. Among participants testing IgG+, median age was 32 years (interquartile range IQR 26–35) and median gestational age was 21 weeks (IQR 12–38) at screening; median IgG index was 3.2 (IQR 2.1–4.9, range 1.4–9.9), including 3.9 (IQR 2.3–5.8) among those with vs. 2.7 (IQR 1.9–4.2) among those without prior RT-PCR+ results (p=0.05 by Wilcoxon rank-sum). Of 30 longitudinal study participants enrolled, 24 tested IgG+ at baseline (75% with prior RT-PCR+ result) and 6 tested IgG- on enrollment but were identified as previously RT-PCR+ via medical records; 24/30 (80%) reported previous symptoms. Of 24 participants testing IgG+ at baseline, 14 (58%) had first follow-up IgG results at median of 66 days (IQR 42–104) since initial testing, with median IgG index of 2.0 (IQR 1.0–3.8). 9/14 (64%) participants with repeat IgG testing remained IgG+ at first follow-up (≤280 days after first RT-PCR+ result for those with and ≥104 days after first IgG detection for those without prior RT-PCR+ results), while 5/14 (26%) had a negative Abbott IgG test at a median of 81 days (IQR 75–112) since initial testing.
Conclusion
Nearly half of pregnant people testing SARS-CoV-2 IgG+ reported no known prior SARS-CoV-2 diagnosis or symptoms. SARS-CoV-2 IgG antibody response and durability in pregnancy has implications for maternal and neonatal protection and susceptibility and highlights potential benefits of vaccination in this population.
Disclosures
Sylvia LaCourse, MD, Merck (Grant/Research Support) Alisa Kachikis, MD, MS, GlaxoSmithKline (Consultant)Pfizer (Consultant) Alexander L. Greninger, MD, PhD, Abbott (Grant/Research Support)Gilead (Grant/Research Support)Merck (Grant/Research Support) Janet A. Englund, MD, AstraZeneca (Consultant, Grant/Research Support)GlaxoSmithKline (Research Grant or Support)Meissa Vaccines (Consultant)Pfizer (Research Grant or Support)Sanofi Pasteur (Consultant)Teva Pharmaceuticals (Consultant) Alison Drake, PhD, MPH, Merck (Grant/Research Support)
Much of the chronic disease burden in the U.S. population can be traced to poor diet. There has been a sustained focus on influencing children's diets and encouraging healthier eating habits by ...changing policies for what foods and beverages can be served to children through large federally-funded nutrition assistance programs. Yet without attention to how nutrition policies are implemented, and the surrounding context for these policies, these policy changes may not have the intended results. In this perspective, we used Bullock et al.'s (2021) Process Model of Implementation from a Policy Perspective to analyze how the complexities of the implementation process of large-scale nutrition policies can dilute potential health outcomes. We examine the Child and Adult Care Food Program (CACFP), a federal program focused on supporting the provision of nutritious meals to over 4 million children attending childcare, as a case study. We examine how the larger societal contexts of food insecurity, attitudes towards the social safety net, and a fragmented childcare system interact with CACFP. We review the "policy package" of CACFP itself, in terms of its regulatory requirements, and the various federal, state, and local implementation agencies that shape CACFP's on-the-ground implementation. We then review the evidence for how each component of the CACFP policy implementation process impacts uptake, costs, feasibility, equity, and effectiveness at improving children's nutrition. Our case study demonstrates how public health researchers and practitioners must consider the complexities of policy implementation processes to ensure effective implementation of nutrition policies intended to improve population health.
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