Uriyoán Colón-Ramos

George Washington University | GW · Department of Global Health

TITLE: Shaping our Kids’ Diets: Home and Neighborhood Authors: Uriyoán Colón-Ramos, Shaneka Thurman, Haley Burns, Claudia Trezza, Tilly Gurman Affiliation: Department of Global Health, Milken Institute School of Public Health, George Washington University Objective: Following the social-ecological framework, we aimed to characterize barriers and f...

TITLE: Barriers, facilitators, and strategies to support healthy eating among recent Hispanic immigrants mothers living in a food swamp: a Photovoice project Authors: Uriyoán Colón-Ramos, Elena Cremm, Ivonne Rivera, Basmah Rahman, Mark Edberg Affiliation: Department of Global Health, Milken Institute School of Public Health, George Washington Unive...

Restaurants are important institutions in the communities’ economy with the potential to promote healthier foods but have been under-engaged in public health nutrition efforts. In particular, independently owned, minority-serving and minority-owned restaurants, remain under-represented in nutrition promotion efforts despite disproportionate burdens...

(1) Background: Independently owned restaurants (IORs) are prevalent in under-resourced racial and ethnic minority communities in the US and present a unique setting for public health nutrition interventions. (2) Methods: We conducted 14 in-depth interviews with IOR owners in Baltimore about their perceptions of healthy food, and customers’ accepta...

Sugar-sweetened beverages (SSBs) are implicated in weight gain and adverse cardiometabolic heath. Social networks of stakeholders involved in providing potable water and sugar-sweetened beverages (SSBs) in high schools in Costa Rica were studied using social analysis network. In public and private schools, the interactions between the stakeholders...

Objective: Sugar-sweetened beverages (SSB) are implicated in the increasing risk of diabetes in the Caribbean. Few studies have examined associations between SSB consumption and diabetes in the Caribbean. Design: SSB was measured as teaspoon/day using questions from the National Cancer Institute Dietary Screener Questionnaire about intake of sod...

Objective This study sought to explain results of the Water Up!@Home randomized controlled trial where low-income parents were randomized to receive an educational intervention +a low-cost water filter pitcher or only the filter. Parents in both groups had reported statistically significant reductions in SSB and increases in water intake post-inter...

In the United States, low-income, underserved rural and urban settings experience poor access to healthy, affordable food. Introducing new food outlets in these locations has shown mixed results for improving healthy food consumption. The Healthy Community Stores Case Study Project (HCSCSP) explored an alternative strategy: supporting mission-drive...

Americans spend the majority of their food dollars at restaurants and other prepared food sources, including quick-service and fast-food restaurants (PFS); independent small restaurants make up 66% of all PFS in the US. In this feasibility study, 5 independent and Latino-owned PFS in the Washington DC metro area worked with academic partners to sta...

Mission-driven, independently-owned community food stores have been identified as a potential solution to improve access to healthy foods, yet to date there is limited information on what factors contribute to these stores’ success and failure. Using a multiple case study approach, this study examined what makes a healthy community food store succe...

Community engagement is well established as a key to improving public health. Prior food environment research has largely studied community engagement as an intervention component, leaving much unknown about how food retailers may already engage in this work. The purpose of this study was to explore the community engagement activities employed by n...

Background Water is recommended as an alternative for sugar-sweetened beverages (SSB). Low-income, minority groups in the US continue to exhibit high SSB and low water consumption, and are more likely to exceed 100% fruit juice recommendation. Objective To test the effects of a home-based intervention designed to replace SSB with tap water and red...

Background: Indonesian school children spend one-third of their time in school, where they are exposed to a variety of foods at school canteens. However, the healthiness of school canteens is not yet well understood. This study was conducted to (1) characterize the healthiness and quality of management of school canteens, and (2) measure readiness...

Consumption of added sugars, especially from sugar-sweetened beverages (SSBs), has been associated with several negative health outcomes during adolescence. This study aimed to identify dietary intake and food sources of added sugars in the home, school, and neighborhood environments of Costa Rican adolescents. Dietary intake of added sugars was de...

Introduction Studies conducted in the US and other high-income countries show that the local food environment influences dietary intakes that are protective for cardiovascular health. However, few studies have examined this relationship in the Caribbean. This study aimed to determine whether perceptions of the local food environment were associated...

Background It is recommended that children under 6 years old avoid sugar-sweetened beverages (SSBs), yet 25% of toddlers and 45% of preschool-aged children consume SSBs on a given day, with the highest intakes reported among Hispanic and African American children. Objective To investigate characteristics that predominantly low-income Hispanic and...

Psychosocial factors may influence consumption patterns of sweet snacks and sugar sweetened beverages (SSB), which are potential risk factors for obesity among African American (AA) adolescents. We used multivariable linear and logistic regression models to examine cross-sectional associations among psychosocial factors, sweet snacks and SSB consum...

Background School feeding programs (SFPs) can play a crucial role in the emergency food and nutrition response, but there is a dearth of information on how SFPs operate during emergencies. Design and Methods A rapid comparative assessment of 11 SFPs throughout Latin America and the Caribbean during the COVID-19 pandemic. Data from (1) systematic d...

This survey (n = 1,356) reports food insecurity (FI) in Puerto Rico (PR) at 38% before, and 40% since, the COVID-19 pandemic. Odds for FI increased for households with annual income ≤$15k vs. ≥$60k (OR: 3.52; 95% CI: 1.20, 10.36); experiencing an income reduction (OR: 2.22 (1.55, 3.18)); participating in the United States Department of Agriculture...

Resumen La obesidad infantil es un grave problema de salud pública en Latinoamérica y Estados Unidos y para luchar contra ella se precisan instrumentos de medición válidos y fiables y que tengan en cuenta los aspectos culturales. Para avanzar en este campo sería útil mejorar las mediciones en los distintos grupos de edades y países del continente a...

La obesidad infantil es un problema grave en Latinoamérica y entre la población latina de EE. UU. Para ser eficaces, las políticas de salud pública tienen que estar guiadas por evidencias contextuales pertinentes, lo cual exige una capacidad de investigación sostenida a través del tiempo. Los objetivos de este estudio son determinar la productivida...

Perceptions of local food environments and the ability of citizens to engage in participatory research may vary, even if participants share similar cultural and socioeconomic contexts. In this study, we aimed to describe participants’ narratives about their local food environment in two cities in Spain. We used the participatory methodology of Phot...

Descriptions of the implementation of community-based participatory mixed-methods research (CBPMMR) in all phases of the engagement approach are limited. This manuscript describes the explicit integration of mixed-methods in four stages of CBPR: (1) connecting and diagnosing, (2) prescribing-implementing, (3) evaluating, and (4) disseminating and r...

Background: Widespread vaccination against COVID-19 is essential to control the pandemic. Estimates of unwillingness and uncertainty toward COVID-19 vaccination and factors associated with it remain unclear among adults in Puerto Rico (PR). Objective: To examine factors associated with uncertainty and unwillingness of COVID-19 vaccination among adu...

Indigenous food sovereignty (IFS) represents a community led movement with potential to reduce health inequities, but no scoping review of the impact of taking an IFS approach on intervention research has been conducted. This review sought to (1) describe intervention studies that employ IFS principles and (2) describe the impact of studies using I...

Indigenous food sovereignty (IFS) represents a community led movement with potential to reduce health inequities, but no scoping review of the impact of taking an IFS approach on intervention research has been conducted. This review sought to (1) describe intervention studies that employ IFS principles and (2) describe the impact of studies using I...

Objective The aim of this study was to describe the results of food environment assessments completed after Hurricane Florence in North Carolina (2018) and Hurricane María in Puerto Rico (2017), and provide recommendations for assessing disaster food environments. Methods Adapted structured observation protocols were used to conduct rapid assessme...

Background Binary categorical approaches to diagnosing depression have been widely criticized due to clinical limitations and potential negative consequences. In place of such categorical models of depression, a ‘staged model’ has recently been proposed to classify populations into four tiers according to severity of symptoms: ‘Wellness;’ ‘Distress...

Little is known about how parenting styles can influence the adolescent’s consumption of sugar-sweetened beverages (SSB), fruits and vegetables (FV) and beans in Latin America. This study uses hierarchical moderated regression models to examine such association by area of residence, sex of the parent and of the adolescent in Costa Rica. Results sho...

Objective: Food insecurity risk increases among disaster-struck individuals. The authors employed the social determinants of health framework to (1) describe the characteristics and food-seeking behaviors of individuals coping with the coronavirus disease 2019 pandemic and (2) evaluate the relationship between these factors and food insecurity ris...

Childhood obesity is a major public health challenge across Latin America and the United States. Addressing childhood obesity depends on valid, reliable, and culturally sensitive measurements. Such progress within and between countries of the Americas could be enhanced through better measurement across different age groups, different countries, and...

Childhood obesity is a major problem in Latin America and among US Latinos. Effective public health policies require contextually relevant evidence to guide them, which demands sustained research capacity. The objectives of this study are to determine research productivity in Latin America and in the United States focused on Latino populations and...

Objective To examine the association between family environment variables (parenting styles, family meal atmosphere), gender-based stereotypes, and food intake in Latin American adolescents. Design Structural equation modeling applied to cross-sectional data, 2017. Setting Urban and rural sites of San José, Costa Rica. Participants n = 813; 13-1...

Objective: To conduct a nationwide assessment of child nutrition administrative agencies’ responses to meal service provision during COVID-19-related school closures. Design: Systematic coding of government websites (Feb-May 2020) regarding school meal provision in all 50 US states and the District of Columbia (DC), 5 US territories, and the US De...

Objective To elucidate mechanisms across family function, home environment and eating behaviours within sociocultural context among Hispanic youth. Design Two models tested via path analysis (youth fruit and vegetable (FV) consumption; empty energy consumption) using data from the Study of Latino Youth (2011–2013). Setting Chicago, IL; Miami, FL;...

Background: Adolescence offers a window of opportunity to prevent adult obesity and noncommunicable disease risk factors. With the rising prevalence of adolescent obesity over the last 20 y, identifying any changes in dietary risk factors is crucial. Objectives: We aimed to assess the dietary intake of major nutrients and their food sources in C...

Background: Emergency foods distributed during a federal disaster relief response must follow the federal Dietary Guidelines for Americans according to the 1990 National Nutrition Monitoring Related Research Act. Nutrition information about emergency foods for household distribution is scarce. Methods: According to structured observation protoco...

Objectives: The aim of our study is to characterize the dietary factors and food items intake of people living with pulmonary tuberculosis in an urban and high disease incidence city in Panama. Methods: We recruited 41 participants newly diagnosed with pulmonary tuberculosis. We applied a culturally adapted version of the NHANES Food Screener to...

Introduction This report presents a synopsis of a three‐part, cross‐sector, seminar series held at the George Washington University (GWU) in Washington, DC from February‐April, 2018. The overarching goal was to provide a neutral forum for diverse stakeholders to discuss and critically evaluate approaches to address added sugar intake, with a key fo...

To understand the process by which immigrants adopt dietary practices, this study offers a binational comparison of factors that predispose, enable, and reinforce healthful eating in the sending and receiving countries. Data are from two qualitative studies that examined barriers and facilitators to healthful eating in El Salvador (four focus group...

Background: Hurricane Maria struck Puerto Rico on Sept 20, 2017, devastating the island. Controversy surrounded the official death toll, fuelled by estimates of excess mortality from academics and investigative journalists. We analysed all-cause excess mortality following the storm. Methods: We did a time-series analysis in Puerto Rico from Sept...

To understand the process by which immigrants adopt dietary practices, this study offers a binational comparison of factors that predispose, enable, and reinforce healthful eating in the sending and receiving countries. Data are from two qualitative studies that examined barriers and facilitators to healthful eating in El Salvador (four focus group...

Objectives: To determine how African-American caregivers living in a food desert navigate neighborhood resources to procure foods for their children and to identify actions to improve those resources. Design: Using the Photovoice approach, we conducted two sets of individual in-depth interviews with 16 African-American primary caregivers of chil...

The past two decades have witnessed many advances in the prevention, treatment, and control of diabetes mellitus (DM) and its complications. Increased screening has led to a greater recognition of type 2 diabetes mellitus (type 2 DM) and prediabetes; however, Hispanics/Latinos, the largest minority group in the US, have not fully benefited from the...

Objective Limited research is available on whether participation in healthy food incentive programmes is associated with higher fruit and vegetable intake. The objective of the present study was to determine fruit and vegetable intake among participants in the Produce Plus Program, a farmers’ market-based healthy food incentive programme in Washing...

Quick update of the food commodities after Hurricane Maria - results from document searches.

Puerto Ricans in the US experience higher deaths from diabetes and other causes compared to non-Hispanic Whites and other Hispanic groups. We compared mortality in Puerto Rico to that of Puerto Ricans in the US as a first step to investigate if similar or worse mortality patterns originate from the sending country (Puerto Rico). Age-adjusted death...

Objective To assess progress towards the elimination of trans -fatty acids (TFA) in foods after the 2008 Pan American Health Organization (PAHO) recommendation of virtual elimination of TFA in Latin America. Design A descriptive, comparative analysis of foods that were likely to contain TFA and were commonly consumed in four cities in Latin Americ...

Objective: To understand how mothers who recently migrated from Central America to the USA feed their children in a neighbourhood saturated with unhealthful food choices ('food swamp') and to formulate a mother-driven plan of action to facilitate their acquisition of foods. Design/Setting/Subjects We purposively sampled mothers with children (<10...

Latinos consume more sugary drinks and less water than other demographic groups. Our objective was to understand beverage choice motivations and test promotional concepts that can encourage Central American Latino urban youth to drink more water. Two rounds of focus group discussions were conducted (n = 10 focus groups, 61 participants, 6–18 years...

Charla del 5 de noviembre del 2016 en el Museo de Vida Silvestre de Puerto Rico - sobre nutricion y Puerto Rico

Background: In Latin America, more than 80% of adolescent girls are physically inactive. Inactivity may be reinforced by female stereotypes and objectification in the Latin American sociocultural context. Methods: We examined the influence of objectification on the adoption of an active lifestyle among 192 adolescents (14 -17 y/old) from urban a...

Objective Arising from youth and parents’ concerns about lack of access to healthy foods in their neighborhood, we formed a community coalition to design interventions to improve access to healthier food options. We hereby present the results from the first year of work, focused on the design of strategies to improve the food environment. Methods...

Objective Following the social‐ecological framework, we aimed to characterize barriers and facilitators that primary caregivers living in a food desert experience when providing foods for their children, and strategies to overcome those barriers. Methods Using a purposive sampling design, we identified 15 primary caregivers of young children (< 10...

Objective To understand how barriers and facilitators to healthy eating may change during the process of migration, we compare and contrast these factors among immigrants from Central America (El Salvador and Guatemala) in Washington, DC, and residents of two rural communities in El Salvador. Methods Secondary analysis of qualitative data (verbati...

Objective Following the social‐ecological framework, we aimed to identify barriers and facilitators that Hispanic primary caregivers living in a “food swamp” experience when providing foods for their children, and their strategies to overcome those barriers . “Food swamp” is a term referring to low‐income areas with high concentrations of food stor...

Objective To design an innovative intervention to increase drinking water behaviors among Latino immigrant youth. Methods We conducted two rounds of focus groups, totaling 10 sessions (n=61), with Latino immigrant youth, aged 6–18 years, living in Langley Park, Maryland. Participants were stratified into focus groups by age group and language pref...

An estimated 78% of Hispanics in the United States (US) are overweight or obese. Household food insecurity, a condition of limited or uncertain access to adequate food, has been associated with obesity rates among Hispanic adults in the US. However, the Hispanic group is multi-ethnic and therefore associations between obesity and food insecurity ma...

Binagwaho and colleagues' perspective piece provided a timely reflection on the experience of Rwanda in achieving the Millennium Development Goals (MDGs) and a proposal of 5 principles to carry forward in post-2015 health development. This commentary echoes their viewpoints and offers three lessons for health policy reforms consistent with these pr...

Despite increased interest in promoting nutrition during pregnancy, the association between maternal dietary patterns and birth outcomes has been equivocal. We examined maternal dietary patterns during pregnancy as a determinant of offspring's birth weight-for-length (WLZ), weight-for-age (WAZ), length-for-age (LAZ), and head circumference (HCZ) Z-...

Background Obesity and overweight are rising worldwide while underweight rates persist in low-income countries. The aim of this study was to examine changes in the prevalence of underweight and overweight/obesity among non-pregnant women aged 15-49 years, and its socio-demographic correlates in Addis Ababa, Ethiopia. Methods The data are from 2000...

J u eve s , 9 de o c t u b re de 201 4 población general en los Estados Uni-dos, incluyendo a los hispanos. El bajo consumo de frutas y vegetales se per-cibe en todos los estratos socioeco-nómicos y educacionales, y en todas partes geográficas de Puerto Rico. Es decir, no importa el nivel de educa-ción o donde vivas: si vives en Puerto Rico, probab...

Health information correlates of fruit and vegetable intake and of knowledge of the fruit and vegetable recommendations were examined using bivariate and multivariate regressions with data from the 2007-2008 U.S. National Cancer Institute's Health Information National Trends Survey in the United States and in Puerto Rico. Residents from Puerto Rico...

Purpose: To identify the influence of gender stereotypes on eating habits among Costa Rican adolescents. Design: Qualitative, descriptive research was used in this study. Setting: Adolescents and parents were recruited from socioeconomically diverse populations in rural and urban areas of San José, Costa Rica. Subjects: Subjects were 92 adol...

A diet high in fruit and vegetables (FV) is associated with a decreased risk for chronic diseases, such as cancer. Limited information exists regarding the factors associated with FV intake in persons living in Puerto Rico. The objective of this study was to examine sociodemographic, behavioral, and health-belief factors associated with dietary hab...

To identify socio-demographic, behavioral, and health-related correlates of food preferences in Puerto Rico that will help determine Caribbean-region populations vulnerable to nutrition transition. Data from a cross-sectional study of a representative sample of 858 adults residing in the San Juan Metropolitan Area of Puerto Rico were analyzed. Mult...

Background: The World Health Organization (WHO) has deemed that there is enough evidence to recommend the elimination of industrially produced trans-fatty acids (TFA) from the food supply. This article evaluates government-led public health strategies in countries in Latin America and the Caribbean (LAC), and factors perceived to affect following...