Are Consumer Health Concerns Influencing Direct-From-Producer Purchasing Decisions

Research has shown health concerns may motivate consumers to purchase foods sold at direct market outlets, yet connections between management of specific diseases and food purchase decisions remain unclear. We utilize a two-step decision framework to evaluate whether family incidences of six illnesses (cancer, heart disease, diabetes, obesity, back/joint pain, and Alzheimer's disease/dementia) affect decisions to buy food at farmers’ markets and farm stands. We find that cancer, diabetes, obesity, and back/joint pain influence the decision to purchase from farm stands. Disease incidences have varying directional effects on frequency of purchase for both farmers’ markets and farm stands

Spatial dimensions of stated preference valuation in environmental and resource economics: methods, trends and challenges

An expanding literature addresses spatial dimensions related to the elicitation, estimation, interpretation and aggregation of stated preference (SP) welfare measures. Recognizing the relevance of spatial dimensions for SP welfare analysis and the breadth of associated scholarly work, this article reviews the primary methods, findings, controversies and frontiers in this important area of contemporary research. This review is grounded in a typology that characterizes analytical methods based on theoretical foundations and the type of statistical modelling applied. The resulting interpretive appraisal seeks to (1) summarize and contrast different theoretical arguments and points of departure within the spatial SP literature, (2) synthesize findings, insights and methods from the literature to promote a more holistic perspective on the treatment of spatial dimensions within SP welfare analysis, (3) evaluate and reconcile divergent approaches in terms of theoretical grounding, ability to identify relevant empirical effects, and relevance for SP valuation, and (4) discuss outstanding questions and research frontiers

ARE CONSUMER HEALTH CONCERNS INFLUENCING DIRECT-FROM-PRODUCER PURCHASING DECISIONS?

AbstractResearch has shown health concerns may motivate consumers to purchase foods sold at direct market outlets, yet connections between management of specific diseases and food purchase decisions remain unclear. We utilize a two-step decision framework to evaluate whether family incidences of six illnesses (cancer, heart disease, diabetes, obesity, back/joint pain, and Alzheimer's disease/dementia) affect decisions to buy food at farmers’ markets and farm stands. We find that cancer, diabetes, obesity, and back/joint pain influence the decision to purchase from farm stands. Disease incidences have varying directional effects on frequency of purchase for both farmers’ markets and farm stands.</jats:p

Implementation and Operational Research

Background: Integrating antenatal care (ANC) and HIV care may improve uptake and retention in services along the prevention of mother-to-child transmission (PMTCT) cascade. This study aimed to determine whether integration of HIV services into ANC settings improves PMTCT service utilization outcomes. Methods: ANC clinics in rural Kenya were randomized to integrated (6 clinics, 569 women) or nonintegrated (6 clinics, 603 women) services. Intervention clinics provided all HIV services, including highly active antiretroviral therapy (HAART), whereas control clinics provided PMTCT services but referred women to HIV care clinics within the same facility. PMTCT utilization outcomes among HIV-infected women (maternal HIV care enrollment, HAART initiation, and 3-month infant HIV testing uptake) were compared using generalized estimating equations and Cox regression. Results: HIV care enrollment was higher in intervention compared with control clinics [69% versus 36%; odds ratio 3.94, 95% confidence interval (CI): 1.14 to 13.63]. Median time to enrollment was significantly shorter among intervention arm women (0 versus 8 days, hazard ratio 2.20, 95% CI: 1.62 to 3.01). Eligible women in the intervention arm were more likely to initiate HAART (40% versus 17%; odds ratio 3.22, 95% CI: 1.81 to 5.72). Infant testing was more common in the intervention arm (25% versus 18%), however, not statistically different. No significant differences were detected in postnatal service uptake or maternal retention. Conclusions: Service integration increased maternal HIV care enrollment and HAART uptake. However, PMTCT utilization outcomes were still suboptimal, and postnatal service utilization remained poor in both study arms. Further improvements in the PMTCT cascade will require additional research and interventions

Screening, prevalence, and risk factors for cervical lesions among HIV positive and HIV negative women in Swaziland

Abstract Background Cervical Cancer (CC) is the number one cancer among women in sub-Saharan Africa. Although CC is preventable, most women in developing countries do not have access to screening. Methods This cross-sectional study was conducted to determine the prevalence and risk factors for cervical lesions using visual inspection with acetic acid (VIA) among 112 HIV positive and 161 negative women aged 18–69 years. Results The presence of cervical lesions was greater among HIV positive (22.9%) than HIV negative women (5.7%; p < 0.0001). In logistic models, the risk of cervical lesions among HIV positive women was 5.24 times higher when adjusted by age (OR 5.24, CI 2.31–11.88), and 4.06 times higher in a full model (OR 4.06, CI 1.61–10.25), than among HIV negative women. In the age-adjusted model women who had ≥2 lifetime sexual partners were 3 times more likely (OR 3.00, CI 1.02–8.85) to have cervical lesions compared to women with one lifetime partner and the odds of cervical lesions among women with a history of STIs were 2.16 greater (OR 2.16, CI 1.04–4.50) than among women with no previous STI. In the fully adjusted model women who had a previous cervical exam were 2.5 times more likely (OR 2.53, CI 1.06–6.05) to have cervical lesions than women who had not. Conclusions The high prevalence of HIV infection and the strong association between HIV and cervical lesions highlight the need for substantial scale-up of cervical screening to decrease the rate of CC in Swaziland