Suchergebnisse

Purpose: This study aimed to increase the consumption of home-cooked meals among employees at a large urban worksite through a fully subsidized Community Supported Agriculture (CSA) program. Design: Randomized trial. Setting: Worksite in a large northeast city. Participants: Employees were recruited through flyers, e-mail listservs, and outreach from departmental administrators (n = 60). Intervention: Intervention participants received 8 biweekly fresh food deliveries through a CSA program. They also received cooking education and support. Control participants received usual employee benefits. Measures: Consumption of meals prepared at home was the primary end point. Increased consumption of fresh fruits and vegetables was the secondary end point, and food insecurity was an exploratory end point. Analysis: Poisson regression was used to assess mean differences in weekly consumption of home-cooked meals. To assess differences in fruit and vegetable consumption and food insecurity, binary logistic regression was used to estimate odds ratios. Results: Compared to the control group, intervention participants consumed 29% more home-cooked meals per week ( P < .01). Fruit and vegetable consumption also increased among intervention participants. The odds of at least twice-daily fruit consumption were 3.8 times higher among intervention participants than among controls, and the odds of at least twice-daily vegetable consumption were 6.2 times higher among intervention participants than among controls. Compared to control participants, intervention participants experienced a statistically significant 89% reduction in the odds of reporting food insecurity at follow-up, when controlling for baseline food insecurity. Participants reported perceived intervention benefits, including the opportunity to experiment with new, healthful foods without financial risk, as well as the social value of sharing recipes, food, and related conversation with colleagues. Conclusion: The study demonstrated the feasibility and potential positive effects of a subsidized workplace CSA program, augmented with cooking education and support.

Purpose: To evaluate an overdose response training program in public libraries. Design: Mixed methods evaluation including pre- and post-intervention questionnaires and debriefing interviews. Setting: Ten Philadelphia public libraries. Sample: Overdose response training participants (library staff and community members). Intervention: Public, hour-long overdose response trainings run by the Philadelphia Department of Public Health, the Free Library of Philadelphia, and the University of Pennsylvania between March and December 2018. Measures: Questionnaires assessed motivation for attending trainings, overdose response readiness, and intention to acquire and carry naloxone. Debriefing interviews elicited training feedback. Analysis: We assessed changes in overdose response readiness and intention to carry naloxone and performed thematic analysis on interview data. Results: At 29 trainings, 254 people attended, of whom 203 (80%) completed questionnaires and 23 were interviewed. 30% of participants had witnessed an overdose, but only 3% carried naloxone at baseline. Following training, overdose response readiness and intention to acquire/carry naloxone improved significantly ( P < .01). Interviewees nonetheless noted that they experienced barriers to naloxone acquisition, including cost, stigma, and concern regarding future insurability. Trainings subsequently included naloxone distribution. Interviewees reported that public libraries were welcoming, nonstigmatizing venues. Conclusion: In Philadelphia, library-based overdose response trainings were well-attended and reached a population with prior overdose encounters. Similar trainings could be deployed as a scalable overdose prevention strategy in the nation's 16 568 public libraries.

Alternatives Assessment is gaining traction as a systematic method to support the informed substitution of chemicals of concern. The 2018 International Symposium on Alternatives Assessment, on November 1‐2, 2018 convened nearly 150 professionals from government agencies, industry, consultant firms, academia and advocacy organizations to advance a greater understanding of the evolving methods, practices and challenges in the use of alternatives assessment. This article reviews highlights and lessons from the Symposium, including: (1) notable advances in methods, (2) shared insights from practitioners on best practices as well as inherent tensions and challenges, and (3) research and practice needs in the field that can be addressed by organizations such as the newly launched Association for the Advancement of Alternatives Assessment. Being interdisciplinary in nature, the establishment of educational frameworks across disciplines and inclusion of diverse expertise in hazard and exposure assessments, life cycle impacts considerations, design principles, and economic and engineering evaluations will ensure continued growth of the field.