#ncds

Last week was my last week under my internship, and if you can recall from my previous post I was caught up with a lot of work in the last days. During this week I tried to implement the research project with Mexican schools but nothing was concrete, however, on Thursday and Friday I got the opportunity to apply the “Mexicans Adolescence Environment Survey 2017” to the same size of sample as we did in Barbados. This study will allow me to make a comparison between Barbados and Mexico, since both countries have opted to implement a Sweet Sugary Beverage (SSB) tax as an intervention to decrease the prevalence of obesity and NCDs in the country. Yet, the survey-research focuses more on the overall environment the adolescents are surrounded by and how it influences their health. Nevertheless this survey can reflect how the taxes could possibly influence their consumption of SSB.

That being said, I am not on time to share the results from the Mexican research before closing up formally my internship, but it will be a project that I will bring home with me and will be delivered to HCC.

Entering data from Mexico’s survey

 I also mentioned on previous posts that I wanted to share with you the results from the “Barbadian Adolescence School Environment Survey 2017” which sadly cannot share the report with you yet BUT I can share with you the amazing infographics Maria helped with, which shows the most outstanding results.

  As you can see from the infographics, the Bajan environment and circumstances of the country (such as culture and high dependence on imported foods) have led adolescents to have certain lifestyle which is reflected on the country’s health profile. As part of our report we included the following set of recommendations which we believe are needed in order to decrease the prevalence of childhood and adolescent’s obesity and NCDs;

 - Awareness campaigns about the tap water in Barbados; clean, healthy and free

- Implement the set of recommendation on the marketing of foods and non-alcoholic beverages to children.

- Ensure data collection on body mass index-for-age of children / adolescents: include ages not currently monitored – and set national target for childhood obesity.

- Nutritional standards for meals at schools – guidelines set by Nutritional Institute Centre.

- Promote communication and community participation to raise awareness and create an enabling environment and social demand for policy action to improve diet and physical activity.

- Food education; practical skills, make food preparation classes more available for classes, food literacy.

 Welcoming this set of recommendations is completely up to HCC or any other  interested body. I am happy knowing that our research will help HCC to fight the ban of SSB from schools since this is an area they have been trying to work with. 

Another week has come to an end and so has our research project. During the week, Maria and I conducted 3 focus group interviews (FGI) – one per participating school – and they consisted of a group of 8-10 students representing the school. The FGI were the last step in the research project as it was aimed to provide more details of the consumption patterns among adolescents.

Even though we have never conducted a FGI before, the interview guide served precisely to guide us on how to follow up the discussion with the students. The FGI focused mainly on Sweet Sugary Beverages (SSB) and the marketing behind these products, together with other factors driving the consumption decisions such as their social context. The total time per session was 40 minutes, although some time was used to get the place in order before starting.

It was interesting to understand from the adolescents’ point of view the reasons behind why they choose to drink SSB so frequently, or why is it so high its daily consumption. As educated in the field of nutrition and health, one needs to be aware that we hold some “bias” when we try to make sense about people’s lifestyles, disapproving immediately unhealthy patterns and trying to make sense to them why healthier choices are better. It was no exception the case of these adolescents, however, instead of having those thoughts with me, I opened my mind and ears and try to understand and gain much as possible from these interviews.  

It seemed that the major reasons for drinking SSB are, firstly, the taste, together with the price of healthier options and seeing others with the beverages, opening the “craving” for them. It is not surprising that kids prefer to buy 1 cheap soda during their school lunch recess instead of a bottle of water, since the price of a bottle of water or even lemonade adds up to be 2 to 3 times more expensive than SSB, depending on the type of these. I see two main problems from this, 1. the price of healthy food and beverages at schools should be accessible and 2. banning or some regulations of SSB in schools should be implemented. The last one I believe will benefit one of the consumption reasons (the craving by seeing) by eradicating this completely. This might not change children and adolescents taste and preference for SSB, but it will help them to start reducing their consumption and to try other options to satisfy their thirstiness.

A little extra thing we did after out final FGI, was to ask the students to volunteer for writing health messages to their fellow students and to share with pictures. This will help to build up a campaign and/or policies for adolescents’ health and healthy meals and beverages in schools environments. Unfortunately boys will always be boys and they wanted to pose in this way... hope it can still be used the picture!

A short conclusion for the FGI, the results we attained supported the findings from the survey, but more than supporting, strengthened them and open new ideas of possible interventions for policy makers and/or organizations advocating for health.

Besides conducting the FGI, we started to interpreted the data and to write our report draft.  Most of our week has consisted mainly on recapping a lot of what we have learned in previous modules from GNH, touching upon qualitative research (FGI, transcription of interviews, coding), and quantitative research (statistics, analysing data, coding). Some of this allowed us to run some statistical tests although we have been working on more descriptive statistics.

Little snap of how our data looks (there are more rows and columns than what is showed)

Time has been flying for the last couple of weeks, and even though my internship finalizes officially this week, I have found myself with a lot of current and future work.

As I mentioned in my previous post, Maria and I were working on our report draft which is the result of our project “2017Barbados school Adolescent’s Environment”. During the last weeks, we focused on what are the most relevant findings to be communicated in the report, as well in which way should they be conveyed to cause an impact and to call attention regarding adolescents environment and its health influence.

I am happy to say that we have finalized that phase, and that our supervisor is currently reviewing the draft. That being said, we are waiting for her response and input to finally publish our report and to share it with you all.

That on a side, Maria and I took different paths for the last weeks of our internship, where I decided to come to Mexico and work from here. When I suggested to my supervisor if I could work on different projects from home – after finishing our report draft – she came up with a specific task that have kept me busy… I am currently trying to implement the “2017 Barbados School Adolescent’s Environment” in Monterrey, Mexico. Trying to implement the project means that I have translated the survey we have used (making it suitable for its culture), have contacted schools across the city and have tried to arrange the whole setting for the project.

I do not like using the term “trying”, but even at this point is hard to say if the project ni Mexico will be implemented at the same level as it was in Barbados. And justly, we prepared for 6 months previous arriving in Barbados whereas one week in Mexico cannot do the same justice. Nevertheless, there are few schools across the city that are willing to participate and hopefully the project can be conducted before I leave the country.

 The relevance of such project is that the results of both studies – Barbados and Mexico – can be compared.  Both countries have high obesity and NCDs rates, and both governments have implemented a taxation on Sweet Sugary Beverages (SSB), as one of many health interventions, in order to decrease these rates.

By the end of the week I will be able to let you know if I was able to obtained a representative sample that could represent Mexican adolescents. As well, I will hopefully be able to share with you our report or some sort of summary from the Bajan project.

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