title: Social Norms and the Consumption of Fruits and Vegetables across New York City Neighborhoods.
abstract: Consumption of fruits and vegetables is associated with a lower risk of developing many chronic health conditions such as diabetes and cardiovascular disease. While five or more servings of fruits and vegetables per day are recommended, only 50 % of New York City (NYC) residents consume two or more servings per day. In addition, there is wide variation in dietary behaviors across different neighborhoods in NYC. Using a validated agent-based model and data from 34 NYC neighborhoods, we simulate how a mass media and nutrition education campaign strengthening positive social norms about food consumption may potentially increase the proportion of the population who consume two or more servings of fruits and vegetables per day in NYC. We found that the proposed intervention results in substantial increases in daily fruit and vegetable consumption, but the campaign may be less effective in neighborhoods with relatively low education levels or a relatively high proportion of male residents. A well-designed, validated agent-based model has the potential to provide insights on the impact of an intervention targeting social norms before it is implemented and shed light on the important neighborhood factors that may affect the efficacy of the intervention.
authors.affiliation: Center for Health Innovation, The New York Academy of Medicine, 1216 Fifth Avenue, New York, NY, 10029, USA.|Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
authors.forename: Donglan
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Center for Health Innovation, The New York Academy of Medicine, 1216 Fifth Avenue, New York, NY, 10029, USA. jpagan@nyam.org.|Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA. jpagan@nyam.org.|Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. jpagan@nyam.org.
authors.forename: José A
authors.initials: JA
authors.lastname: Pagán
mesh_terms: D000293:Adolescent; D000328:Adult; D004032:Diet / Q000706:statistics & numerical data*; D004522:Educational Status; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006293:Health Promotion; D006801:Humans; D008297:Male; D008402:Mass Media; D008875:Middle Aged; D009519:New York City; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D066262:Social Norms; D014675:Vegetables; D055815:Young Adult
keywords: Agent-based modeling; Neighborhoods; Nutrition education; Social norms; Urban health