Background: Morbidity and mortality for women with chronic obstructive pulmonary disease (COPD) are increasing, and little is known about gender differences in perception of COPD care. Methods: Surveys were administered to a convenience sample of COPD patients to evaluate perceptions about symptoms, barriers to care, and sources of information about COPD. Results: Data on 295 female and 273 male participants were analyzed. With similar frequencies, women and men reported dyspnea and rated their health as poor/very poor. Although more women than men reported annual household income < $30,000, no significant gender differences in frequency of health insurance, physician visits, or ever having had spirometry were detected. In adjusted models (1) women were more likely to report COPD diagnostic delay (odds ratio [OR] 1.66, 95% confidence interval [CI] 1.13-2.45, p = 0.01), although anxiety (OR 1.83, 95% CI 1.10-3.06, p = 0.02) and history of exacerbations (OR 1.60, 95% CI 1.08-2.37, p = 0.01) were also significant predictors, (2) female gender was associated with difficulty reaching one's physician (OR 2.54, 95% CI 1.33-4.86, p = 0.004), as was prior history of exacerbations (OR 2.25, 95% CI 1.21-4.20, p = 0.01), and (3) female gender (OR 2.15, 95% CI 1.10-4.21, p = 0.02) was the only significant predictor for finding time spent with their physician as insufficient. Conclusions: Significant gender-related differences in the perception of COPD healthcare delivery exist, revealing an opportunity to better understand what influences these attitudes and to improve care for both men and women.

Objective: High plate waste in schools adds social, economic, and environmental burden and undermines child nutrition goals. In this study, we conducted formative research to examine potential for mindful-based approaches in reducing plate waste and improving fruit and vegetable intake. Methods: With a triangulation approach, research was conducted in 3 elementary schools using focus groups with students (N = 50), staff interviews (N = 15), and cafeteria observations (N = 9). Guided by Social Cognitive Theory, qualitative findings were analyzed using Constant Comparative Method. Results: Salient personal, behavioral, and environmental factors potentially contributing to student plate waste and eating behaviors were identified. School meal structure and regulations, cafeteria atmosphere, food quality perceptions, and food preferences were potential contributors to plate waste. Students had limited knowledge of mindfulness and were interested in reducing waste, particularly when others are food-insecure. Emphasizing mindfulness and sustainability in nutrition education, collaborating with parents and student leaders, and building on existing waste reduction initiatives could be considered to reduce plate waste and improve eating behaviors. Conclusions: Findings highlighted opportunities to design a program combining mindfulness and sustainable food system education and cafeteria environment changes to reduce plate waste and improve FV intake and sustainability of school meals.

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Objectives The purpose of this formative study is to understand food waste behaviors of elementary school students and guide the development of a nutrition promotion program that emphasizes reducing food waste without compromising the goals of school meals through mindful selection and consumption. Methods Using a mixed method design, 3 elementary schools were recruited and 5 focus groups (n = 50) with 3rd-5th grade students, 15 in-depth interviews with staff, and 9 cafeteria observations were conducted across the schools to 1) explore students’ perceptions about and understanding of topics related to food waste and mindful eating in order to identify motivating factors and barriers related to reducing food waste while increase produce intake, 2) examine the feasibility of program logistics and potential for integration into the school wellness program, and 3) understand the cafeteria atmosphere and its possible influence on student behavior. Results Students and staff report that vegetables comprise the largest proportion of food waste during lunch. Focus group feedback indicated that students poor limited acceptance of vegetables caused by perceived limited autonomy in selection and that they are motivated to reduce waste when considering moral implications. Interviewees described efforts by schools to offer backpack pantries to increase access for food insecure students but staff expressed concerns regarding healthfulness of foods provided. Cafeteria observations highlighted an opportunity to update cafeteria menus, signage, and sharing tables to improve student intake and reduce waste. Targeted training for cafeteria monitors could encourage produce intake. Recovering uneaten foods to supplement school-based food pantries is an engaging strategy to address nutritional concerns and divert foods from landfills. Strategies can be coupled with mindfulness education to encourage vegetable consumption. Conclusions Results are being used to plan a quasi-experimental controlled pilot intervention that seeks to increase elementary student vegetable consumption and reduce food waste through mindfulness-focused food system education. This program has the potential to increase the healthfulness of students’ diets, meet the needs of food insecure students, and reduce the environmental impact of school nutrition programs. Funding Sources University of Maryland, Department of Nutrition and Food Science.