scholarly journals Effectiveness of a low-value financial-incentive program for increasing vegetable-rich restaurant meal selection and reducing socioeconomic inequality: a cluster crossover trial

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Wataru Nagatomo ◽  
Junko Saito ◽  
Naoki Kondo
Keyword(s):  
Intervention Program ◽  
Crossover Trial ◽  
Financial Incentive ◽  
Control Period ◽  
Healthy Food ◽  
Intervention Period ◽  
Marginal Value ◽  
Percentage Point Increase ◽  
Point Increase ◽  
Proxy Measure

Abstract Background In light of recent theories in behavioural economics, an intervention program with monetary incentives could be effective for helping patrons order healthy food, even if the incentive is small and less than one’s perceived marginal value. Methods In this single-arm cluster crossover trial at 26 local restaurants, a 1-week campaign offered a 50-yen (approximately 0.5 US dollars) cash-back payment to customers ordering vegetable-rich meals, while no pre-order incentives were offered during the control period. Results In total, 511 respondents out of 7537 customers (6.8%), and 704 respondents out of 7826 customers (9.0%), ordered vegetable-rich meals during the control and intervention periods, respectively. During the intervention period, the covariate-adjusted proportion of vegetable-rich meal orders was 1.50 times higher (95% confidence interval [CI]: 1.29 to 1.75), which increased daily sales by 1.77 times (95% CI: 1.11 to 2.83), even when subtracting the cost of cash-back payments. Respondents who reported spending the least amount of money on eating out (used as a proxy measure for income) were the least likely to order vegetable-rich meals during the control period. However, these individuals increased their proportion of purchasing such meals during the intervention period (a 3.8 percentage point increase (95% CI: 2.82 to 4.76) among those spending the least vs a 2.1 percentage point increase (95% CI: 1.66 to 2.62) among those spending the most; P for interaction = 0.001). Similarly, irregular employees exhibited a larger increase (+ 5.2 percentage points, 95% CI: 4.54 to 5.76) than did regular workers (− 1.4, 95% CI: − 1.66 to − 1.05, P for interaction = 0.001). Conclusions A program with an immediate low-value monetary incentive could be a public health measure for reducing inequalities in making healthy food choices. Trial registration UMIN Clinical Trials Registry, UMIN000022396. Registered 21 May 2016.

scholarly journals Effects of a compensatory dry-land training program on shoulder posture and scapular position of competitive female swimmers

2019 ◽  
Vol 3 (6) ◽  
pp. 45-52
Author(s):  
João Paulo Sousa ◽  
João Malta ◽  
Ana Carrageta ◽  
Nuno Batalha
Keyword(s):  
Training Program ◽  
Intervention Program ◽  
Control Period ◽  
National Level ◽  
Intervention Period ◽  
Dry Land ◽  
Medial Border ◽  
Spinal Process ◽  
Thoracic Spinal ◽  
Competitive Swimmers

Background: Competitive swimmers place a significant demand on the shoulder adductors and internal rotator muscles due to the repetitive nature of swimming movements.Objectives: To evaluate the effect of a compensatory dry-land training program on the shoulder posture and scapular position of competitive female swimmersMethod: 25 National Level female competitive swimmers received an 8-week intervention program focused on strengthening of posterior shoulder girdle muscles and stretching of anterior shoulder muscles. The study sample was exposed to a control period of 2 weeks and an intervention period of 8 weeks.Results: Significant differences were found after the intervention period, on both dominant and non-dominant sides, with respect to shoulder protraction (distance between the anterior aspect of the acromion to the wall – p < .05) and scapular abduction (distance between a medial line marked over the thoracic spinal process and the medial border of spina scapulae – p < .05; and distance between a medial line marked over the thoracic spinal process and the medial border of the spina scapulae – p < .05).Conclusions: The results revealed that the incorporation of a compensatory dry-land training program alongside a normal in-water training significantly reduced the distance of shoulder posture in protraction and scapular position in abduction.Key words: shoulder protraction, scapular abduction, dry-land training, swimming, female.

Abstract P314: Healthy Food Choices Are Correlated in a Large Employee Social Network

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Douglas Levy ◽  
Mark Pachucki ◽  
James O'Malley ◽  
Bianca Porneala ◽  
Awesta Yaqubi ◽  
...  
Keyword(s):  
Social Networks ◽  
Social Network ◽  
Peer Influence ◽  
Food Choices ◽  
Healthy Food ◽  
Spatial Autoregression ◽  
Percentage Point Increase ◽  
Food Purchases ◽  
Point Increase ◽  
Debit Cards

Introduction: Research suggests obesity may be transmitted through social networks. A possible pathway is social influence on food choice. We investigated peer influence on the healthfulness of worksite food choices using social network analysis in a large hospital employee population, hypothesizing that socially-connected employees’ food choices would be correlated. Methods: Data on all food purchases in 2016 were obtained from the hospital’s cash register database. The cafeteria system uses traffic light labels to mark foods as healthy (green), less healthy (yellow), or unhealthy (red). Employees’ food purchases were identified through the use of cafeteria debit cards; social ties among employees were inferred based on a validated algorithm using demographics and time/location of purchases. We used spatial autoregression (SAR) and generalized estimating equation (GEE) models to calculate associations between the proportions of employees’ and coworkers’ purchases that were labeled green (or red). SAR models assessed concurrent purchases of an employee and coworker, weighting the association between their purchases by the frequency and inferred strength of the social tie. GEE models assessed longitudinal relationships between purchases coworkers’ made in the presence of an employee in one 8-week period and the employee’s purchases in the next 8-week period. Food and beverages were analyzed separately. Models adjusted for employee and coworker confounders (age, sex, race/ethnicity, job type, education). Results: In all, 5,118 employees used cafeteria debit cards to make purchases. Up to 536,240 employee/coworker interactions were observed, depending on the model (SAR, GEE) and outcomes (green/red, food/beverages). SAR models showed that a 1 percentage point increase in the network-weighted average of coworkers’ green-labeled (healthy) food purchases was associated with a 0.39 percentage point increase in an employee’s concurrent green-labeled food purchases (p<.001). Positive associations were also observed for red foods (0.20), and green (0.14) and red (0.31) beverages (all p<.001). Longitudinal GEE models showed that employees, as a population, increased purchases of green-labeled items by 0.013 percentage points on average when coworkers with whom they visited cafeterias in the prior 8 weeks increased their purchases of green items by 1 percentage point (p<.001). Similar associations were observed for red foods (0.013), and for green (0.006) and red beverages (0.020) (all p<.003). Conclusions: Employees’ healthy and unhealthy food choices are correlated. Although one explanation is that people eat with others who have similar preferences, the longitudinal findings suggest that people create social norms for eating that influence peers. Worksite and other social networks may be novel targets for population-level interventions to promote healthy diet.

The Effect of Taxation and Corruption on Firm Growth: An Empirical Investigation for Vietnam

2016 ◽  
pp. 5-29
Author(s):  
Bich Le Thi Ngoc
Keyword(s):  
International Development ◽  
Firm Growth ◽  
Empirical Investigation ◽  
Manufacturing Firms ◽  
Economic Management ◽  
Tax Rate ◽  
Percentage Point Increase ◽  
Percentage Points ◽  
Point Increase ◽  
The Impact

The aim of this study is to analyze empirically the impact of taxation and corruption on the growth of manufacturing firms in Vietnam. The study employed pooled OLS estimation and then instrument variables with fixed effect for the panel data of 1377 firms in Vietnam from 2005 to 2011. These data were obtained from the survey of the Central Institute for Economic Management and the Danish International Development Agency. The results show that both taxation and corruption are negatively associated with firm growth measured by firm sales adjusted according to the GDP deflator. A one-percentage point increase in the bribery rate is linked with a reduction of 16,883 percentage points in firm revenue, over four and a half times bigger than the effect of a one-percentage point increase in the tax rate. From the findings of this research, the author recommends the Vietnam government to lessen taxation on firms and that there should be an urgent revolution in anti-corruption policies as well as bureaucratic improvement in Vietnam.

scholarly journals African American Unemployment and the Disparity in Periviable Births

2021 ◽  
Author(s):  
Ralph Catalano ◽  
Deborah Karasek ◽  
Tim Bruckner ◽  
Joan A. Casey ◽  
Katherine Saxton ◽  
...  
Keyword(s):  
African American ◽  
African American Women ◽  
Unemployment Rate ◽  
Racial Disparity ◽  
Live Births ◽  
Percentage Point Increase ◽  
Point Increase ◽  
The Us ◽  
Race Ethnicity ◽  
Hispanic White

AbstractPeriviable infants (i.e., born before 26 complete weeks of gestation) represent fewer than .5% of births in the US but account for 40% of infant mortality and 20% of billed hospital obstetric costs. African American women contribute about 14% of live births in the US, but these include nearly a third of the country’s periviable births. Consistent with theory and with periviable births among other race/ethnicity groups, males predominate among African American periviable births in stressed populations. We test the hypothesis that the disparity in periviable male births among African American and non-Hispanic white populations responds to the African American unemployment rate because that indicator not only traces, but also contributes to, the prevalence of stress in the population. We use time-series methods that control for autocorrelation including secular trends, seasonality, and the tendency to remain elevated or depressed after high or low values. The racial disparity in male periviable birth increases by 4.45% for each percentage point increase in the unemployment rate of African Americans above its expected value. We infer that unemployment—a population stressor over which our institutions exercise considerable control—affects the disparity between African American and non-Hispanic white periviable births in the US.

Health Insurance Status as a Predictor of Mode of Colon Cancer Detection but Not Stage at Diagnosis: Implications for Early Detection

2021 ◽  
pp. 003335492199917
Author(s):  
Lindsey A. Jones ◽  
Katherine C. Brewer ◽  
Leslie R. Carnahan ◽  
Jennifer A. Parsons ◽  
Blase N. Polite ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Health Insurance ◽  
Early Detection ◽  
Late Stage ◽  
Early Stage ◽  
Insurance Status ◽  
Stage At Diagnosis ◽  
Health Insurance Status ◽  
Percentage Point Increase ◽  
Point Increase

Objective For colon cancer patients, one goal of health insurance is to improve access to screening that leads to early detection, early-stage diagnosis, and polyp removal, all of which results in easier treatment and better outcomes. We examined associations among health insurance status, mode of detection (screen detection vs symptomatic presentation), and stage at diagnosis (early vs late) in a diverse sample of patients recently diagnosed with colon cancer from the Chicago metropolitan area. Methods Data came from the Colon Cancer Patterns of Care in Chicago study of racial and socioeconomic disparities in colon cancer screening, diagnosis, and care. We collected data from the medical records of non-Hispanic Black and non-Hispanic White patients aged ≥50 and diagnosed with colon cancer from October 2010 through January 2014 (N = 348). We used logistic regression with marginal standardization to model associations between health insurance status and study outcomes. Results After adjusting for age, race, sex, and socioeconomic status, being continuously insured 5 years before diagnosis and through diagnosis was associated with a 20 (95% CI, 8-33) percentage-point increase in prevalence of screen detection. Screen detection in turn was associated with a 15 (95% CI, 3-27) percentage-point increase in early-stage diagnosis; however, nearly half (47%; n = 54) of the 114 screen-detected patients were still diagnosed at late stage (stage 3 or 4). Health insurance status was not associated with earlier stage at diagnosis. Conclusions For health insurance to effectively shift stage at diagnosis, stronger associations are needed between health insurance and screening-related detection; between screening-related detection and early stage at diagnosis; or both. Findings also highlight the need to better understand factors contributing to late-stage colon cancer diagnosis despite screen detection.

Aligning Medicaid and Medicare Advantage Managed Care Plans for Dual-Eligible Beneficiaries

2021 ◽  
pp. 107755872110189
Author(s):  
Laura M. Keohane ◽  
Zilu Zhou ◽  
David G. Stevenson
Keyword(s):  
Nursing Home ◽  
Managed Care ◽  
Prescription Drugs ◽  
Service Use ◽  
Medicare Advantage ◽  
Percentage Point Increase ◽  
Care Plans ◽  
Point Increase ◽  
Dual Eligible ◽  
Home Users

To coordinate Medicare and Medicaid benefits, multiple states are creating opportunities for dual-eligible beneficiaries to join Medicare Advantage Dual-Eligible Special Needs Plans (D-SNPs) and Medicaid plans operated by the same insurer. Tennessee implemented this approach by requiring insurers who offered Medicaid plans to also offer a D-SNP by 2015. Tennessee’s aligned D-SNP participation increased from 7% to 24% of dual-eligible beneficiaries aged 65 years and above between 2011 and 2017. Within a county, a 10-percentage-point increase in aligned D-SNP participation was associated with 0.3 fewer inpatient admissions ( p = .048), 13.9 fewer prescription drugs per month ( p = .048), and 0.3 fewer nursing home users ( p = .06) per 100 dual-eligible beneficiaries aged 65 years and older. Increased aligned plan participation was associated with 0.2 more inpatient admissions ( p = .004) per 100 dual-eligible beneficiaries younger than 65 years. For some dual-eligible beneficiaries, increasing Medicare and Medicaid managed plan alignment has the potential to promote more efficient service use.

scholarly journals Mendelian randomization analysis of arsenic metabolism and pulmonary function within the Hispanic Community Health Study/Study of Latinos

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Molly Scannell Bryan ◽  
Tamar Sofer ◽  
Majid Afshar ◽  
Yasmin Mossavar-Rahmani ◽  
H. Dean Hosgood ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Mendelian Randomization ◽  
Smoking History ◽  
Health Study ◽  
Arsenic Metabolism ◽  
Percentage Point Increase ◽  
Point Increase ◽  
Increased Risk ◽  
Genotype Information ◽  
Rice Consumption

AbstractArsenic exposure has been linked to poor pulmonary function, and inefficient arsenic metabolizers may be at increased risk. Dietary rice has recently been identified as a possible substantial route of exposure to arsenic, and it remains unknown whether it can provide a sufficient level of exposure to affect pulmonary function in inefficient metabolizers. Within 12,609 participants of HCHS/SOL, asthma diagnoses and spirometry-based measures of pulmonary function were assessed, and rice consumption was inferred from grain intake via a food frequency questionnaire. After stratifying by smoking history, the relationship between arsenic metabolism efficiency [percentages of inorganic arsenic (%iAs), monomethylarsenate (%MMA), and dimethylarsinate (%DMA) species in urine] and the measures of pulmonary function were estimated in a two-sample Mendelian randomization approach (genotype information from an Illumina HumanOmni2.5-8v1-1 array), focusing on participants with high inferred rice consumption. Among never-smoking high inferred consumers of rice (n = 1395), inefficient metabolism was associated with past asthma diagnosis and forced vital capacity below the lower limit of normal (LLN) (OR 1.40, p = 0.0212 and OR 1.42, p = 0.0072, respectively, for each percentage-point increase in %iAs; OR 1.26, p = 0.0240 and OR 1.24, p = 0.0193 for %MMA; OR 0.87, p = 0.0209 and OR 0.87, p = 0.0123 for the marker of efficient metabolism, %DMA). Among ever-smoking high inferred consumers of rice (n = 1127), inefficient metabolism was associated with peak expiratory flow below LLN (OR 1.54, p = 0.0108/percentage-point increase in %iAs, OR 1.37, p = 0.0097 for %MMA, and OR 0.83, p = 0.0093 for %DMA). Less efficient arsenic metabolism was associated with indicators of pulmonary dysfunction among those with high inferred rice consumption, suggesting that reductions in dietary arsenic could improve respiratory health.

scholarly journals Planning prompts to promote uptake of HIV services among men: a randomised trial in rural Uganda

2020 ◽  
Vol 5 (11) ◽  
pp. e003390
Author(s):  
Nolan M Kavanagh ◽  
Elisabeth M Schaffer ◽  
Alex Ndyabakira ◽  
Kara Marson ◽  
Diane V Havlir ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Community Health ◽  
Control Group ◽  
Health Campaign ◽  
Percentage Point Increase ◽  
Percentage Points ◽  
Point Increase ◽  
Cost Planning ◽  
Testing Uptake ◽  
The Impact

IntroductionInterventions informed by behavioural economics, such as planning prompts, have the potential to increase HIV testing at minimal or no cost. Planning prompts have not been previously evaluated for HIV testing uptake. We conducted a randomised clinical trial to evaluate the effectiveness of low-cost planning prompts to promote HIV testing among men.MethodsWe randomised adult men in rural Ugandan parishes to receive a calendar planning prompt that gave them the opportunity to make a plan to get tested for HIV at health campaigns held in their communities. Participants received either a calendar showing the dates when the community health campaign would be held (control group) or a calendar showing the dates and prompting them to select a date and time when they planned to attend (planning prompt group). Participants were not required to select a date and time or to share their selection with study staff. The primary outcome was HIV testing uptake at the community health campaign.ResultsAmong 2362 participants, 1796 (76%) participants tested for HIV. Men who received a planning prompt were 2.2 percentage points more likely to test than the control group, although the difference was not statistically significant (77.1% vs 74.9%; 95% CI –1.2 to 5.7 percentage points, p=0.20). The planning prompt was more effective among men enrolled ≤40 days before the campaigns (3.6 percentage-point increase in testing; 95% CI –2.9 to 10.1, p=0.27) than among men enrolled >40 days before the campaigns (1.8 percentage-point increase; 95% CI –2.3 to 5.8, p=0.39), although the effects within the subgroups were not significant.ConclusionThese findings suggest that planning prompts may be an effective behavioural intervention to promote HIV testing at minimal or no cost. Large-scale studies should further assess the impact and cost-effectiveness of such interventions.

scholarly journals Spatial–temporal trends in forced migrant mortality, 2014–2018

2020 ◽  
Vol 5 (10) ◽  
pp. e002885
Author(s):  
Danielle N Poole ◽  
Bethany Hedt-Gauthier ◽  
Till Bärnighausen ◽  
Stéphane Verguet ◽  
Marcia C Castro
Keyword(s):  
Temporal Trends ◽  
Forced Migration ◽  
Global Scale ◽  
International Organization ◽  
Temporal Heterogeneity ◽  
Percentage Point Increase ◽  
Humanitarian Response ◽  
Risk Of Mortality ◽  
Point Increase ◽  
Time Periods

IntroductionThe identification of spatial–temporal clusters of forced migrant mortality is urgently needed to inform preventative policies and humanitarian response. As a first step towards understanding the geography of forced migrant mortality, this study investigates spatial–temporal patterns in death at a global scale.MethodsWe used information on the location and dates of forced migrant deaths reported in the International Organization for Migration’s Missing Migrant Project from 2014 to 2018. Kulldorff’s spatial–temporal and seasonal scans were used to detect spatial–temporal and temporal heterogeneity in mortality.ResultsA total of 16 314 deaths were reported during the study period. A preponderance of deaths occurred at sea each year (range 26%–54% across 5 years). Twelve spatial–temporal clusters of forced migrant mortality were detected by maximum likelihood testing. Annually, the period of August–October was associated with a 40-percentage-point increase in the risk of mortality, relative to other time periods.ConclusionsDeath during forced migration occurs close to national borders and during periods of intense conflict. This evidence may inform the design of policies and targeting of interventions to prevent forced migration-related deaths.

scholarly journals How does the grade obtained at school for English and Mathematics affect the probability of graduation at a university?

Pythagoras ◽  
2017 ◽  
Vol 38 (1) ◽  
Author(s):  
Michael Murray
Keyword(s):  
Structural Equation ◽  
Equation Model ◽  
Mathematical Literacy ◽  
Percentage Point Increase ◽  
Point Increase ◽  
Kwazulu Natal ◽  
Specific Factors ◽  
And Mathematics ◽  
The University ◽  
Better Than

Over half of all students enrolling at a particular university in KwaZulu-Natal fail to complete a degree. This article is wanting to determine to what extent the marks they obtain for English and Mathematics at school impact on their probability of graduation at this university. In addressing this problem, other student specific factors associated with their gender, race and the type of school they have attended need also to be properly accounted for. To provide answers for this study, the performance of 24 392 students enrolling at the university over the period 2004 to 2012 was followed until they graduated or dropped out from their studies. A structural equation model was fitted because it allows one to separate a direct effect from that of an indirect effect. Gender, race and school background were found to be very significant with males, Black Africans and students coming from a less privileged school background having a smaller probability associated with eventually graduating from this university. Males tend to perform better than females in Mathematics, with females performing better males in English. More importantly, however, a single percentage point increase in one’s mark for English increases the probability associated with graduating from this university far more than would be the case if their Mathematics mark were to increase by a single percentage point. In the light of these mediated results, perhaps this university should be directing their efforts more towards improving the English (rather than mathematical) literacy of students entering the university.

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