Availability Of Healthful Foods Research Articles

Positive Feeding Practices During Childhood Are Associated With Higher Intuitive Eating in Adulthood

ABSTRACT Background Parental restrictive feeding and pressure to eat have been negatively associated with intuitive eating. However, parental feeding practices that promote intuitive eating are less understood. Purpose To examine caregiver feeding practices that may promote intuitive eating and the moderating effect of gender. Method A cross-sectional survey with 941 U.S. adults who completed the Intuitive Eating Scale-2 and recalled their primary childhood caregiver(s)’ feeding practices. Results Ensuring the availability of healthful foods at home was associated with higher intuitive eating among both female (b = 0.147, P < .001) and male (b = 0.091, P = .018) participants. Encouraging diet diversity (b = 0.095, P = .009) was associated with higher intuitive eating among female participants only, whereas honoring children’s hunger and satiety feelings (b = 0.136, P = .001) was associated with higher intuitive eating among male participants only (adjusted for participants’ current age, education, and income). Discussion Findings established links between positive caregiver feeding practices and higher intuitive eating, with gender playing a moderating role. Translation to Health Education Practice The design and results of the study relate to the National Commission for Health Education Credentialing Inc. responsibilities, competencies, and subcompetencies (areas I, II, IV, and V). A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars

Does neighborhood availability of healthful foods influence healthful diets?

Does neighborhood availability of healthful foods influence healthful diets?

Disparities in Perceived Availability of Healthful Foods, Dietary Behaviors, Diet Quality, and Obesity Among Mothers from Low-Income Households: Additional Evidence in the Call for Broader Approaches to Obesity Prevention.

To examine racial/ethnic differences in dietary behaviors, diet quality, body mass, and the perceived availability of healthful foods in one's neighborhood among mothers from low-income California households. Cross-sectional telephone surveys of mothers from randomly sampled households with incomes ≤185% federal poverty level in 2018 and 2019 using a validated 24-h dietary recall assessment. Dietary outcomes were cups of fruits and vegetables, ounces of sugar-sweetened beverages, teaspoons of added sugars, and kilocalories consumed the previous day. Diet quality was assessed by calculating Health Eating Index-2015 scores. Supplemental survey items assessed mothers' weight and height. Body mass index (BMI) was calculated with a BMI of 30 or higher considered obese. Perceived availability of fresh fruits and vegetables and healthy foods in general within one's neighborhood was recorded. The analytic sample of 9200 mothers was 66.3% Latina, 17.3% white, 12.6% African American, and 3.8% Asian American, Native Hawaiian, or Pacific Islander (AANHPI). African American mothers consumed the fewest cups of fruits and vegetables and the most teaspoons of added sugars, reported poor diet quality, and had the highest obesity rate, 54.7% versus 46.9% for Latinas, 39.9% for whites, and 23.5% for AANHPIs. Accordingly, a greater proportion of African Americans reported limited availability of fresh fruits and vegetables and healthy foods in general in their neighborhood. Findings are interpreted in light of recent calls for broader approaches to address health disparities, including strategies that focus on inequalities in racial/ethnic socioeconomic status and systemic racism.

Associations of the Neighborhood Built Environment with Gestational Weight Gain.

This study aimed to determine whether specific factors of the built environment related to physical activity and diet are associated with inadequate and excessive gestational weight gain (GWG). This analysis is based on data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be, a prospective cohort of nulliparous women who were followed from the beginning of their pregnancies through delivery. At each study visit, home addresses were recorded and geocoded. Locations were linked to several built-environment characteristics such as the census tract National Walkability Score (the 2010 Walkability Index) and the number of gyms, parks, and grocery stores within a 3-km radius of residential address. The primary outcome of GWG (calculated as the difference between prepregnancy weight and weight at delivery) was categorized as inadequate, appropriate, or excessive based on weight gained per week of gestation. Multinomial regression (generalized logit) models evaluated the relationship between each factor in the built environment and excessive or inadequate GWG. Of the 8,182 women in the analytic sample, 5,819 (71.1%) had excessive GWG, 1,426 (17.4%) had appropriate GWG, and 937 (11.5%) had inadequate GWG. For the majority of variables examined, built environments more conducive to physical activity and healthful food availability were associated with a lower odds of excessive or inadequate GWG category. For example, a higher number of gyms or parks within 3 km of a participant's residential address was associated with lower odds of having excessive (gyms: adjusted odds ratio [aOR] = 0.93 [0.89-0.96], parks: 0.94 [0.90-0.98]) or inadequate GWG (gyms: 0.91 [0.86-0.96]; parks: 0.91 [0.86-0.97]). Similarly, a higher number of grocery stores was associated with lower odds of having excessive GWG (0.94 [0.91-0.97]). Among a diverse population of nulliparous women, multiple aspects of the built environment are associated with excessive and inadequate GWG. · There are little data on the association between the built environment and pregnancy outcomes.. · Multiple aspects of the built environment are associated with excessive and inadequate GWG.. · These results suggest the role that neighborhood investment may play in improving pregnancy outcomes..

Advancing racial justice in patient care encounters—yes, we can!

Advancing racial justice in patient care encounters—yes, we can!

Food Availability and Cost Patterns in Mississippi Retail Stores Participating in the Supplemental Nutrition Assistance Program

Research has suggested that availability of healthful food varies according to rurality/urbanicity, Supplemental Nutrition Assistance Program (SNAP) participation, and sociodemographic variables. We investigated differences in variety and cost of fruits and vegetables in convenience stores, grocery stores, and supermarkets across Mississippi. We collected data using the Nutrition Environment Measures Survey–Corner Store. Among stores surveyed (n = 453), fruit and vegetable variety was greater in nonmetro versus metro areas for convenience and grocery stores but not supermarkets. Elucidation of food availability in retail establishments serving SNAP Education (SNAP-Ed) clients is valuable for planning outreach efforts; smaller retailers may be important partners in rural settings.

How Is the Availability of Staple Food Items in Small Retailers in Providence, RI? (P04-145-19)

ObjectivesInventory requirements for retailers authorized in the Supplemental Nutrition Assistance Program (SNAP) have undergone several revisions. The final rule in Jan 2018 requires minimum stocking of 36 instead of 12 staple food items in the original rule. While a more stringent rule was proposed in 2016 to expand the requirements to 84 items, it was not implemented due to concerns that stores may not withstand this expansion. This descriptive study examined food stocking in a sample of small retailers in Providence, RI to evaluate the barriers to more stringent requirements and explore differences in compliance to the original, proposed and final rules between high and low SNAP participating and racial minority resident areas. MethodsThis study used Food Access Research Atlas data to characterize the food environment of 30 small retailers from 5 census tracts in Providence, RI. Stores were assessed with an audit instrument developed by the Illinois Prevention Research Center to tally variety, perishability and depth of stock offerings in four staple food categories. Descriptive statistics, ANOVA and chi-square tests were used to determine compliance to the different requirements and if they differ between tracts with high and low SNAP participating and racial minority residents. ResultsStores sampled included 12 non-chain grocery stores, 12 convenience stores,1 small discount store,4 pharmacies and 1 liquor store. Of all stores, 80% were compliant with final rule and 66.7% would need to expand their offerings to meet the proposed rule. Of the SNAP authorized stores, 88.5% were compliant with final rule and 61.5% would need to expand their offerings to meet the proposed rule. Mean dairy variety was lower than variety in the other three categories (P < 0.05), which would be a potential barrier to the proposed rule. Majority of the stores were meeting the perishability and depth of stock requirements (92.3% and 96.1% respectively) in the proposed and final rules. No difference in compliance was detected between tracts with high and low SNAP participating and racial minority residents. ConclusionsFuture expansion of inventory requirements could potentially lead to increased healthful food availability without imposing undue burden on small retailers in Providence, RI, excluding increased requirements for dairy variety. Funding SourcesThe study was not sponsored.

Staple Food Item Availability among Small Retailers in Providence, RI.

Inventory requirements for authorized Supplemental Nutrition Assistance Program (SNAP) retailers have undergone several revisions to increase the availability of healthful foods. A proposed rule of 84 staple food items was not implemented due to concerns that stores would not withstand this expansion, resulting in a final rule requiring 36 items. This study used the Food Access Research Atlas data to characterize food provisions in 30 small retailers in areas with high and low proportions of SNAP and racial minority residents in Providence, Rhode Island (RI). Stores were assessed with an audit instrument to tally variety, perishability, and depth of stock of four staple food categories. Descriptive, analysis of variance, and chi-square analyses were performed. Across stores, 80% were compliant with the final rule, but 66.7% would need to expand their offerings to meet the proposed rule. Mean dairy variety was lowest among all categories (p < 0.05). Most stores met the perishability (92.3%) and depth-of-stock requirements (96.1%) under both rules. No difference was detected between areas with high and low proportions of SNAP and racial minority residents. Future expansion of requirements may increase healthful food availability without imposing undue burdens on retailers in Providence, RI, excluding increased requirements for dairy variety.

Delay discounting and its association with food purchasing considerations and food availability in the home in south-east Alabama, USA.

Certain factors, such as food quality, label content and grocery characteristics, may be considered when purchasing foods. Food availability in the home has been shown to influence dietary behaviours, also associated with delay discounting (DD). The present study sought to characterize the relationships between DD, food purchasing considerations and healthfulness of foods in the home. A cross-sectional, online survey of adults (n 477) was conducted with the following measures: DD, consideration of food quality (nutrition, taste) and grocery characteristics (price, ease of preparation, shelf-life) while shopping, use of food labels and food availability in the home. DD was assessed by the area under the delay discounting curve (AUC) using a binary choice task. Greater AUC reflects lower DD. Structural equation modelling was used to allow AUC to simultaneously predict purchasing considerations and foods in the home. Online survey.ParticipantsAdult employees in south-east Alabama, USA. DD was negatively associated with food label use and emphasis on food quality when shopping (P&lt;0·001). In the final model, DD was associated with availability of healthful foods in the home and emphasis on food quality and grocery characteristics. About 33 % of the variance in shopping behaviours, 5 % in food label use, 7 % in availability of healthful foods and 4 % in availability of unhealthful foods was explained by DD. Individuals with lower DD appear to be more thoughtful in making food purchasing decisions and have healthful foods available in the home more frequently than individuals with higher DD.

Appraisal of short and long versions of the Nutrition Environment Measures Survey (NEMS-S and NEMS-R) in Australia.

Research has begun to take a more ecological view of eating behaviour, examining multiple levels of influence: personal, social and environmental. The food environment is a major influence on eating behaviour, attracting the attention of researchers who have measured it in a number of ways. The present paper examines the short-form version, in comparison to the long-form version, of the Nutrition Environment Measures Survey (NEMS) - an observational food outlet audit tool. Both the short-form and long-form were examined to qualitatively appraise the dimensions of the food environment assessed by each measure. Data from 135 food outlets in Australia were then used to compare results obtained using the short-form with the results from the long-form method, to consider the utility of the short-form measure. The retail food environment in Australia.ParticipantsOne hundred and thirty-five food outlets in Australia. Results indicate that the short-form predominantly assessed availability of healthful foods (one aspect of the food environment). Several critical dimensions of the food environment known to influence eating behaviour were not assessed. For this data set, the short-form produced scores inconsistent with the longer version of the measure, delivering inflated estimates for stores and deflated estimates for restaurants. Scores between the long-form and short-form versions were not comparable in this Australian study. Further development of food environment measures is recommended and must balance instrument brevity with the need to accurately capture important aspects of the food environment known to influence eating behaviour.

The Grocery Store Food Environment in Northern Greenland and Its Implications for the Health of Reproductive Age Women.

The population of Greenland is diminishing and environmental and social shifts implicate food availability and the health of reproductive age women. There is little knowledge of the grocery store food environment in Greenland. To address this gap and provide baseline information the present study measured food availability in five grocery stores in northern Greenland. As well, 15 interviews were conducted with reproductive age women, three grocery store managers were interviewed and one interview was conducted with a food distribution manager. Results show few fresh fruits and vegetables are available in grocery stores and in some stores no fresh foods are available. In Kullorsuaq, the primary location for this study, the Nutrition Environment Measures Survey in Stores score in spring 2016 was (3/30) and the Freedman Grocery Store Survey Score was (11/49). Interview results highlight a need to increase communication within the food system and to tailor food distribution policies to the Arctic context with longer term planning protocols for food distribution. These findings can be used to inform future food store environment research in Greenland and for informing policies that improve healthful food availability in grocery stores in northern Greenland.

Environmental and Socioeconomic Health Inequalities: a Review and an Example of the Industrial Ostrava Region.

According to the World Health Organization (WHO) more than 2 million premature deaths and 7 million of total deaths each year can be attributed to the effects of air pollution. The contribution of air pollution to the health status of population is estimated to be about 20%. Health is largely determined by factors outside the reach of healthcare sector, including low income, unemployment, poor environment, poor education, and substandard housing. The aim of the paper was to review a current knowledge of relationships among air pollution, socioeconomic health inequalities, socio-spatial differentiation, and environmental inequity. The relationships were demonstrated on an example of the Ostrava region. Also basic approaches to health valuation were reviewed. Social differences are reasons both for health inequalities and spatial patterns of unprivileged area housing. In urban environments with poor air quality there is also a large concentration of low income residents. Less affluent population groups are more often affected by inadequate housing conditions including second-hand smoking and higher environmental burden in their residential neighbourhoods. Environmental injustice is highly correlated with other factors that link poverty with poor health, including inadequate access to medical and preventive care, lack of availability of healthful food, lack of safe play spaces for children, absence of good jobs, crime, and violence. The theoretical background and also results of the studies brought evidence that population health is affected by both socioeconomic and environmental inequalities. Air pollution is unevenly distributed in Ostrava and is related to distribution of socially disadvantaged environment and social exclusion as well.

What Rural Women Want the Public Health Community to Know About Access to Healthful Food: A Qualitative Study, 2011

IntroductionLiving in a rural food desert has been linked to poor dietary habits. Understanding community perspectives about available resources and feasible solutions may inform strategies to improve food access in rural food deserts. The objective of our study was to identify resources and solutions to the food access problems of women in rural, southernmost Illinois.MethodsFourteen focus groups with women (n = 110 participants) in 4 age groups were conducted in a 7-county region as part of a community assessment focused on women’s health. We used content analysis with inductive and deductive approaches to explore food access barriers and facilitators.ResultsSimilar to participants in previous studies, participants in our study reported insufficient local food sources, which they believe contributed to poor dietary habits, high food prices, and the need to travel for healthful food. Participants identified existing local activities and resources that help to increase access, such as home and community gardens, food pantries, and public transportation, as well as local solutions, such as improving nutrition education and public transportation options.ConclusionMultilevel and collaborative strategies and policies are needed to address food access barriers in rural communities. At the individual level, education may help residents navigate geographic and economic barriers. Community solutions include collaborative strategies to increase availability of healthful foods through traditional and nontraditional food sources. Policy change is needed to promote local agriculture and distribution of privately grown food. Understanding needs and strengths in rural communities will ensure responsive and effective strategies to improve the rural food environment.

A Discrete Choice Approach to Modeling Food Store Access

Assessments of access to healthful food frequently use GIS to measure the distance and concentration of food outlets relative to where residents live. These descriptive approaches do not account for food shopping behavior, which may vary based on the attributes of food shoppers and their activity space—places where they live, work, access resources, and socialize. Building on transportation research about accessibility, we reframe the issue of food access and equity from one about ‘what is nearby?’ to ‘where do people shop?’. We use a conditional logit model to analyze disaggregate data from a door-to-door survey of food shopping choice and food store surveys conducted in a predominantly non-Hispanic Black and middle-income and low-income section of Philadelphia. Our results highlight the importance of distance from home to food stores, overall, but they also emphasize the influence on food store choice of the race and sex of food shoppers, travel mode, and where they spend time other than at home, as well as food prices and the availability of healthful foods. This approach to understanding food access holds promise for future research that can link store choice to specific food purchases and health outcomes as well as for refining place-based strategies for improving access to healthful foods.

Healthy kids out of school: using mixed methods to develop principles for promoting healthy eating and physical activity in out-of-school settings in the United States.

IntroductionWidespread practices supporting availability of healthful foods, beverages, and physical activity in out-of-school-time (OST) settings would further obesity prevention efforts. The objective of this article was to describe principles to guide policy development in support of healthy eating and physical activity practices in out-of-school settings to promote obesity prevention.MethodsThe Institute of Medicine’s L.E.A.D. framework (Locate Evidence, Evaluate it, Assemble it, and Inform Decisions) was used to identify practices relevant to children’s healthful eating in most OST settings: 1) locate and evaluate information from a national survey of children’s perceptions of healthful-food access; published research, reports, policies and guidelines; and roundtables with OST organizations’ administrators; 2) assemble information to prioritize actionable practices; and 3) inform programmatic direction.ResultsThree evidence-informed guiding principles for short-duration OST resulted: 1) drink right: choose water instead of sugar-sweetened beverages; 2) move more: boost movement and physical activity in all programs; and 3) snack smart: fuel up on fruits and vegetables.ConclusionHealthy Kids Out of School was launched to support the dissemination and implementation of these guiding principles in short-duration OST settings, complementing efforts in other OST settings to shift norms around eating and physical activity.

Abstract A25: Evaluation of the food environment in rural towns in eastern Washington

Abstract Introduction: Hispanics are at increased risk for obesity, which places them at increased risk for a variety of health conditions, including cancer. Risk factors for both obesity and cancer include limited access to healthy affordable foods. This problem is especially prevalent in low-income communities such as rural towns. This study assessed the availability of healthful foods and food environment scores in two rural towns with large percentages of Hispanic residents in Eastern Washington State. Experimental Procedures: Store inventories were collected in 14 food stores (3 grocery and 11 convenience stores) from July-August 2013 using the Nutrition Environment Measures Survey. We recorded data on availability of a variety of fresh fruits, vegetables, whole grain bread, lean ground beef, low-fat hot dogs, baked or low-fat chips, and low sugar cereal. Food environment scores were generated for stores, which consisted of a composite score of availability of healthy food, quality, and price. Results: Convenience stores comprised 79% of food stores. Availability of specific healthful items differed between grocery and convenience stores with all the grocery stores (100%) selling at least 1 fresh fruit compared to 27% of the convenience stores. More grocery stores also had fresh vegetables (100% vs. 18%), whole grain bread (100% vs. 36%), lean ground beef (100% vs. 9%), low-fat hot dogs (100% vs. 9%), baked or low-fat chips (67% vs. 0%), and low sugar cereal (67% vs. 18%). Grocery stores, however, were slightly less likely to be stocked with 100% fruit juice (67% vs. 73%), while more stocked with diet soda (100% vs. 91%) than convenience stores. Out of a possible maximum food environment score of 62, grocery stores scored 29 while convenience stores scored 3.64. Conclusions: Convenience stores make up a large proportion of available food sources in rural towns and have limited stocks of healthful foods. The low food environment scores of both grocery and convenience stores are indication that stores have room for improvements. Increasing the variety of healthy food offerings in food stores could be the first step in improving the food environment in rural towns. Citation Format: Linda K. Ko, Cynthia Perry, Norma Mariscal, Edgar Rodriguez, Catherine Duggan, Mario Kratz, Beti Thompson. Evaluation of the food environment in rural towns in eastern Washington. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A25. doi:10.1158/1538-7755.DISP13-A25

Home Food Environment in Relation to Children’s Diet Quality and Weight Status

The objective of this cohort study was to explore relationships among the home food environment (HFE), child/parent characteristics, diet quality, and measured weight status among 699 child-parent pairs from King County, WA, and San Diego County, CA. HFE variables included parenting style/feeding practices, food rules, frequency of eating out, home food availability, and parents’ perceptions of food costs. Child dietary intake was measured by 3-day recall and diet quality indicators included fruits and vegetables, sweet/savory snacks, high-calorie beverages, and Dietary Approaches to Stop Hypertension (DASH) score. Individual linear regression models were run in which child BMI z score and child diet quality indicators were dependent variables and HFE variables and child/parent characteristics were independent variables of interest. Fruit and vegetable consumption was associated with parental encouragement/modeling (β=.68, P<0.001) and unhealthful food availability (−0.27, P<0.05); DASH score with food availability (healthful: 1.3, P<0.01; unhealthful: −2.25, P<0.001), food rules (0.45, P<0.01), and permissive feeding style (−1.04, P<0.05); high-calorie beverages with permissive feeding style (0.14, P<0.01) and unhealthful food availability (0.21, P<0.001); and sweet/savory snacks with healthful food availability (0.26, P<0.05; unexpectedly positive). Children's BMI z score was positively associated with parent's use of food restriction (0.21, P<0.001), permissive feeding style (0.16, P<0.05), and concern for healthy food costs (0.10, P<0.01), but negatively with verbal encouragement/modeling (−0.17, P<0.05), and pressure to eat (−0.34, P<0.001). Various HFE factors associated with parenting around eating and food availability are related to child diet quality and weight status. These factors should be considered when designing interventions for improving child health.

Association of the neighborhood retail food environment with sodium and potassium intake among US adults.

IntroductionHigh sodium intake and low potassium intake, which can contribute to hypertension and risk of cardiovascular disease, may be related to the availability of healthful food in neighborhood stores. Despite evidence linking food environment with diet quality, this relationship has not been evaluated in the United States. The modified retail food environment index (mRFEI) provides a composite measure of the retail food environment and represents the percentage of healthful-food vendors within a 0.5 mile buffer of a census tract.MethodsWe analyzed data from 8,779 participants in the National Health and Nutrition Examination Survey, 2005–2008. By using linear regression, we assessed the relationship between mRFEI and sodium intake, potassium intake, and the sodium–potassium ratio. Models were stratified by region (South and non-South) and included participant and neighborhood characteristics.ResultsIn the non-South region, higher mRFEI scores (indicating a more healthful food environment) were not associated with sodium intake, were positively associated with potassium intake (P [trend] = .005), and were negatively associated with the sodium–potassium ratio (P [trend] = .02); these associations diminished when neighborhood characteristics were included, but remained close to statistical significance for potassium intake (P [trend] = .05) and sodium–potassium ratio (P [trend] = .07). In the South, mRFEI scores were not associated with sodium intake, were negatively associated with potassium intake (P [trend] = < .001), and were positively associated with sodium–potassium ratio (P [trend] = .01). These associations also diminished after controlling for neighborhood characteristics for both potassium intake (P [trend] = .03) and sodium–potassium ratio (P [trend] = .40).ConclusionWe found no association between mRFEI and sodium intake. The association between mRFEI and potassium intake and the sodium–potassium ratio varied by region. National strategies to reduce sodium in the food supply may be most effective to reduce sodium intake. Strategies aimed at the local level should consider regional context and neighborhood characteristics.

A nutrition environment evaluation of grocery and convenience stores in low‐income communities using the Nutrition Environment Measurement Survey for Stores (NEMS‐S) (LB382)

INTRO: As part of a 5‐year multi‐state adolescent obesity prevention project, the nutrition environments of grocery and convenience stores were assessed in selected low income communities in Kansas, South Dakota, and Ohio (KS, SD, and OH). One control and one intervention community was selected per state.METHODS: Grocery and convenience stores (n=23) were identified for audit using the validated Nutrition Environment Measurement Survey for Stores (NEMS‐S). NEMS‐S evaluates availability of healthful food, price of healthy versus unhealthy food, and quality of fresh produce. Standard NEMS‐S scoring methods were used; higher overall scores indicate greater quality and availability of healthy items as well as lower or equal prices of healthy compared to unhealthy items (range ‐9‐54). Stores that did not meet NEMS‐S parameters were excluded.RESULTS: Using non‐parametric testing, no significant differences were found between average NEMS‐S scores of control and intervention communities within or among states (p &gt; 0.05). Scores ranged from 2‐41, combined average score for all states was 14.57 ± 12.52 (mean ± SD).CONCLUSIONS: Results indicate that the selected low‐income communities in KS, SD, and OH have limited availability to affordable, quality, healthful food in community stores.Grant Funding Source: Agriculture and Food Research Initiative (AFRI) grant #2012‐68001‐19619 from the USDA National Institute for Food and Agriculture

The Healthy Home Offerings via the Mealtime Environment (HOME) Plus study: Design and methods

BackgroundInformed and engaged parents and healthful home environments are essential for the health of youth. Although research has shown health benefits associated with family meals, to date, no randomized controlled trial (RCT) has been developed to examine the impact of a family meals intervention on behavioral and health outcomes. Methods/designThe Healthy Home Offerings via the Mealtime Environment (HOME) Plus study is a two-arm (intervention versus attention-only control) RCT being conducted in Minneapolis/St. Paul. Built on previous pilot research, HOME Plus aims to increase the frequency and healthfulness of family meals and snacks and reduce children's sedentary behavior, particularly screen time, to promote healthier eating and activity behaviors and prevent obesity. HOME Plus is delivered to families in community settings. The program includes 10 monthly sessions focused on nutrition and activity education, meal planning and preparation skill development. In addition, five motivational goal-setting phone calls are conducted with parents. The primary outcome measure is age- and gender-adjusted child BMI-z score at post-intervention by treatment group. Secondary household-level outcomes include family meal frequency, home availability of healthful foods (fruits/vegetables) and unhealthful foods (high-fat/sugary snacks) and beverages (sugar-sweetened beverages), and the quality of foods served at meals and snacks. Secondary child outcomes include dietary intake of corresponding foods and beverages and screen time. ConclusionsThe HOME Plus RCT actively engages whole families of 8–12year old children to promote healthier eating and activity behaviors and prevent obesity through promotion of family meals and snacks and limited media use.