Developing Content for the Food Environment Assessment Survey Tool (FEAST): A Systematic Mixed Methods Study with People with Disabilities

Rebecca E Lee, Alicia O'Neal, Chelsea Cameron, Rosemary B Hughes, Daniel P O'Connor, Punam Ohri-Vachaspati, Michael Todd, Margaret A Nosek, Rebecca E Lee, Alicia O'Neal, Chelsea Cameron, Rosemary B Hughes, Daniel P O'Connor, Punam Ohri-Vachaspati, Michael Todd, Margaret A Nosek

Abstract

Almost 1 in every 8 adults in the U.S. have a physical disability that impairs mobility. This participatory project aimed to identify and describe environmental and personal barriers to healthy eating among people with mobility impairments using a rigorous, structured mixed methodology. Community-dwelling adults with a self-reported mobility impairment (N = 20, M = 40.4 years old, 60% female) participated in nominal group technique focus groups. The Ecologic Model of Obesity grounded stimulus questions asked about barriers to obtaining and preparing healthy food. Participants emphasized common barriers across everyday settings-focusing, for example, on the ability to reach shelved food inside the home, navigating to and inside stores and restaurants, and using delivery services. Home environments often did not afford suitable spaces for food preparation and storage. Participants reported inadequate transportation and numerous additional barriers in many settings to be able to eat healthfully. Participants reported lack of accessible transportation and architectural barriers inside stores, restaurants, and their own homes, highlighting the need for efforts aimed at improving accessibility and usability. Findings support the use of the Ecologic Model of Obesity to guide research and suggest the need for improvement in assessment practices and policies that enhance access to healthy food.

Keywords: access; disability; ecologic model of obesity; healthy eating; mobility impairment.

Conflict of interest statement

All authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
The Ecologic Model of Obesity adapted to investigate barriers to healthy dietary habits in people with mobility impairments.

References

    1. Courtney-Long E.A., Carroll D.D., Zhang Q.C., Stevens A.C., Griffin-Blake S., Armour B.S., Campbell V.A. Prevalence of disability and disability type among adults—United States, 2013. MMWR. Morb. Mortal. Wkly. Rep. 2015;64:777–782. doi: 10.15585/mmwr.MM6429a2.
    1. Institute of Medicine Committee on Disability in America . The Future of Disability in America. National Academies Press; Washington, DC, USA: 2007.
    1. An R., Chiu C., Zhang Z., Burd N.A. Nutrient intake among US adults with disabilities. J. Hum. Nutr. Diet. 2015;28:465–475. doi: 10.1111/jhn.12274.
    1. An R., Chiu C.-Y., Andrade F.C.D. Nutrient intake and use of dietary supplements among US adults with disabilities. Disabil. Health J. 2015;8:240–249. doi: 10.1016/j.dhjo.2014.09.001.
    1. Froehlich-Grobe K., Lee J., Washburn R.A. Disparities in obesity and related conditions among Americans with disabilities. Am. J. Prev. Med. 2013;45:83–90. doi: 10.1016/j.amepre.2013.02.021.
    1. Weil E., Wachterman M., McCarthy E.P., Davis R.B., O’Day B., Iezzoni L.I., Wee C.C. Obesity among adults with disabling conditions. JAMA. 2002;288:1265–1268. doi: 10.1001/jama.288.10.1265.
    1. Reichard A., Stolzle H., Fox M.H. Health disparities among adults with physical disabilities or cognitive limitations compared to individuals with no disabilities in the United States. Disabil. Health J. 2011;4:59–67. doi: 10.1016/j.dhjo.2010.05.003.
    1. Rasch E.K., Hochberg M.C., Magder L., Magaziner J., Altman B.M. Health of community-dwelling adults with mobility limitations in the United States: Prevalent health conditions. Part I. Arch. Phys. Med. Rehabil. 2008;89:210–218. doi: 10.1016/j.apmr.2007.08.146.
    1. Lee R.E., McAlexander K.M., Banda J.A. Reversing the Obesogenic Environment. Human Kinetics; Champaign, IL, USA: 2011.
    1. Centers for Disease Control and Prevention Healthy Food Environments. [(accessed on 14 August 2020)]; Available online: .
    1. Lee M.Y., Novielli K.D. A Nutritional assessment of homebound elderly in a physician-monitored population. J. Nutr. Elder. 1996;15:1–13. doi: 10.1300/J052v15n03_01.
    1. Beck A.M., Ovesen L. Modification of the nutrition questionnaire for elderly to increase its ability to detect elderly people with inadequate intake of energy, calcium, vitamin C and vitamin D. Eur. J. Clin. Nutr. 1999;53:560–569. doi: 10.1038/sj.ejcn.1600788.
    1. Anyanwu U.O., Sharkey J.R., Jackson R.T., Sahyoun N.R. Home food environment of older adults transitioning from hospital to home. J. Nutr. Gerontol. Geriatr. 2011;30:105–121. doi: 10.1080/21551197.2011.566525.
    1. Locher J.L., Ritchie C.S., Roth D.L., Sen B., Vickers K.S., Vailas L.I. Food choice among homebound older adults: Motivations and perceived barriers. J. Nutr. Health Aging. 2009;13:659–664. doi: 10.1007/s12603-009-0194-7.
    1. Ritchie C.S., Burgio K.L., Locher J.L., Cornwell A., Thomas D., Hardin M., Redden D. Nutritional status of urban homebound older adults. Am. J. Clin. Nutr. 1997;66:815–818. doi: 10.1093/ajcn/66.4.815.
    1. Nosek M.A., Robinson-Whelen S., LeDoux T.A., Hughes R.B., O’Connor D.P., Lee R.E., Goe R., Silveira S.L., Markley R., Nosek T.M., et al. A pilot test of the GoWoman weight management intervention for women with mobility impairments in the online virtual world of Second Life®. Disabil. Rehabil. 2018;41:2718–2729. doi: 10.1080/09638288.2018.1473511.
    1. Spence J.C., Lee R.E. Toward a comprehensive model of physical activity. Psychol. Sport Exerc. 2003;4:7–24. doi: 10.1016/S1469-0292(02)00014-6.
    1. Lee R.E., Cubbin C. Striding toward social justice: The ecologic milieu of physical activity. Exerc. Sport Sci. Rev. 2009;37:10–17. doi: 10.1097/JES.0b013e318190eb2e.
    1. Lee R.E., Adamus-Leach H.J., Soltero E.G., Vollrath K.R., Hallett A.M., Parker N.H., Cross M., Mama S.K., Ledoux T. Obesity: An ecologic perspective on challenges and solutions. In: Stein N., editor. Public Health Nutrition: Principles and Practice for Community and Global Health. Jones & Bartlett Learning; Burlington, MA, USA: 2014.
    1. Americans With Disabilities Act of 1990. Public Law 101–336. 108th Congress, 2nd Session. Jul 26, 1990.
    1. Delbecq A., Vad de Ven A., Gustafson D. Group Techniques for Program Planning: A Guide to Nominal Group and Delphi Processes. Scott Foresman; Glenview, IL, USA: 1975.
    1. MacPhail A. Nominal Group Technique: A useful method for working with young people. Br. Educ. Res. J. 2001;27:161–170. doi: 10.1080/01411920120037117.
    1. Bernard H.R., Ryan G.W. Analyzing Qualitative Data: Systematic Approaches. Sage Publications; Thousand Oaks, CA, USA: 2010.
    1. Huang D.L., Rosenberg D.E., Simonovich S.D., Belza B. Food access patterns and barriers among midlife and older adults with mobility disabilities. J. Aging Res. 2012;2012:231489. doi: 10.1155/2012/231489.
    1. Ebster C., Garaus M. In: Store Design and Visual Merchandising: Creating Store Space that Encourages Buying. 2nd ed. Malhotra N., editor. Business Expert Press; New York, NY, USA: 2015.
    1. Banks L.M., Kuper H., Polack S. Poverty and disability in low- and middle-income countries: A systematic review. PLoS ONE. 2017;12:e0189996. doi: 10.1371/journal.pone.0189996.
    1. ADA Participatory Action Research Consortium Median Individual Income of People with and without Disabilities with Earnings, Age 16 and Above. [(accessed on 14 August 2020)];2016 Available online: .
    1. Iezzoni L.I., Killeen M.B., O’Day B.L. Rural residents with disabilities confront substantial barriers to obtaining primary care. Health Serv. Res. 2006;41:1258–1275. doi: 10.1111/j.1475-6773.2006.00534.x.
    1. Hilmers A., Hilmers D.C., Dave J. Neighborhood disparities in access to healthy foods and their effects on environmental justice. Am. J. Public Health. 2012;102:1644–1654. doi: 10.2105/AJPH.2012.300865.

Source: PubMed

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