Nutrition Education Classes Research Articles

Study protocol of a randomised controlled trial to examine the impact of a complex intervention in pre-frail older adults

BackgroundFrailty is a multidimensional geriatric syndrome associated with functional loss. The Senior Chef (SC, nutrition) and SAYGO (strength and balance exercise) programmes are well accepted among older adults but the impact of each, or a combination of both, on the frailty syndrome in pre-frail older adults is unknown.AimsTo determine the effectiveness and cost-effectiveness of a complex intervention consisting of the SC and/or SAYGO programmes to prevent progression of frailty in pre-frail older adults.MethodsA multi-centre randomised controlled assessor-blinded study. The four intervention groups are SC, an 8-week nutrition education and cooking class; SAYGO, a 10-week strength and balance exercise class; SC plus SAYGO, and a social group (Control). Community-dwelling adults aged 75+ (60 + Māori and Pasifika) in New Zealand are recruited through health providers. Participants are not terminally ill or with advanced dementia, and have a score of 1 or 2 on the FRAIL questionnaire. Baseline assessments are completed using standardised questionnaires prior to randomisation. Four follow-up assessments are completed: immediately after intervention, 6, 12 and 24 months post-intervention. The primary outcome is frailty score, secondary outcomes are falls, physical function, quality of life, food intake, physical activity, and sustainability of the strategy. Study outcomes will be analysed using intention-to-treat approach. Cost analyses will be completed to determine if interventions are cost effective relative to the control group.DiscussionThis trial is designed to be a real world rigorous assessment of whether the two intervention strategies can prevent progression of frailty in older people. If successful, this will generate valuable information about effectiveness of this nutrition and exercise strategy, and provide insights for their implementation.Trial registrationAustralian and New Zealand Clinical Trials Registry number—ACTRN12614000827639.

Japan Diet Intake Changes Serum Phospholipid Fatty Acid Compositions in Middle-Aged Men: A Pilot Study.

Aim: The Japan Diet nutritional education program effects on serum fatty acid compositions for prevention of atherosclerotic cardiovascular disease in middle-aged men brought up in the westernized dietary environment of modern Japan were examined.Methods: Thirty-three men, 30–49 years of age, attended a nutrition education class and were recommended to consume Japan Diet volumes (more fish, soybeans and soy products, vegetables, seaweed, konjak, mushrooms, and unrefined cereals and less animal fat, meat and poultry with fat, sweets, desserts and snacks, and alcoholic drinks) for 6 weeks. Three-day weighted dietary records were kept, and fatty acid intakes were calculated. Serum phospholipid fatty acid compositions were examined.Results: During the 6 weeks, fish, soy, and seaweed and/or mushrooms and/or konjak were consumed 1.0, 1.1, and 1.0 times daily on average, whereas daily fatty meat and poultry and sweet consumptions were 0.3 and 0.3, respectively. These changes were attributed to increased intake of n-3 polyunsaturated fatty acids (PUFAs) such as C20:5(n-3), C22:6(n-3), C18:4(n-3), and C20:4(n-3) and decreased intakes of all saturated fatty acids and unsaturated fatty acids such as C18:1 and C18:2(n-6). As to the phospholipid fatty acid composition, C18:0 decreased, whereas C15:0, C17:0, and C20:0 increased. Marked increases in C20:5(n-3) and C22:6(n-3) raised total n-3 PUFA from 10.30% to 13.20% along with n-6 PUFA decreasing from 33.92% to 31.16%. Despite decreases in C20:4(n-6) and C20:3(n-6), the C20:4(n-6)/C20:3(n-6) ratio used as an estimate of delta-5 desaturase activities increased and correlated positively with fish intake at completion of the intervention.Conclusions: The Japan Diet is effective for changing the fatty acids to an anti-atherosclerotic profile. The clinical trial registration number: UMIN000020639.

The Benefit of Supplemental Nutrition Education for Severely Malnourished Patients Awaiting Liver Transplant.

Nutritional interventions improve patient outcomes and reduce mortality in patients with cirrhosis by reducing infection risk, ascites, length of stay in hospital and intensive care unit, and mortality. Follow-up phone calls have been found to be useful in improving patient adherence to therapy. The purpose of this quality improvement project was to determine whether supplemental nutrition education would improve nutrition and outcomes among patients with cirrhosis who are undergoing a liver transplant evaluation. In addition, we sought to measure patient adherence with nutritional recommendations and whether patients perceived this additional education improved their nutrition status. The Plan-Do-Study-Ask methodology was used. Addressed 8 patients were enrolled to participate in the supplemental nutrition education, after which they received 3 follow-up phone calls. A retrospective review of data from 10 patients meeting project inclusion criteria were identified by the nutrition specialist and were used as a comparison group. Data were analyzed using descriptive statistics; comparing data from before and after implementation of the supplemental nutrition education was done. At the end of the 8-week project period, 4 (66.7%) patients reported weight loss since the time of enrollment (nutrition education class), and the median patient-generated subjective global assessment score increased by 4 points, rather than decreasing as expected. However, all patients reported they believed the phone calls improved their nutrition status. With a multidisciplinary approach, this additional patient education may improve patient care and outcomes.

P18 - School Pantry Cook-Off: A Strategy to Create Food Insecurity Awareness and Develop Meal Planning and Cooking Skills in Teens

Objective: To increase awareness of food insecurity in high school students; to provide basic understanding of nutrition, meal planning, and cooking skills using foods available in a school pantry. Target Audience: Students attending a high school with more than 50% free or reduced-priced lunch (FRPL) participants. Theory, Prior Research, Rationale: Social Learning Theory. Description: The Eat Smart Idaho (ESI) program partnered with a Family & Consumer Sciences teacher to increase students' awareness of an on-site school food pantry through a cook-off. Nutrition education classes were taught by ESI Nutrition Advisors on MyPlate guidelines, food safety practices, basic cooking techniques, and meal planning skills. Eighteen teams (10th-12th grade) participated in the cook-off. Each team was given a food pantry mystery box to plan, prepare, and present a nutritious meal consisting of at least three food groups using the foods provided. A panel of three judges evaluated the teams based on MyPlate variety, food safety, teamwork, creativity, flavor, and meal presentation. Evaluation: Post competition questionnaire results from 67 participants showed that 81% (n = 54) of participants were not aware of food insecurity in their local county or the presence of the school food pantry prior to the cook-off. After the competition, 93% (n = 62) of participants reported they would be willing to share information about the school food pantry and 90% (n = 60) would be willing to participate in a food drive for healthy food items. The majority of students reported they would plan before grocery shopping (n = 62, 93%), cook for themselves or their families (n = 62, 93%), and make healthier food choices (n = 60, 90%). Conclusions and Implications: These positive results suggest that a mystery box cook-off can increase awareness of local food insecurity and support for school pantries in high school students. Students developed their abilities to plan and prepare healthy meals with limited resources. Funding: Supplemental Nutrition Assistance Program—Education.

P102 - The Effects of a Fruit and Vegetable Prescription Program (FVRx)® for Low-Income Individuals on Fruit and Vegetable Intake and Food Purchasing Practices

Background (Background, Rationale, Prior Research, and/or Theory): The FVRx® program subsidizes fruit and vegetable purchases for low-income individuals to reduce the burden of diet-related chronic conditions and food insecurity. Despite the growth of these programs, limited evidence is available on the impact of a produce prescription combined with nutrition education. Objective: To examine the effects of an FVRx® program providing both free fresh produce and nutrition education for SNAP-eligible adults. Study Design, Setting, Participants, Intervention: A six-month non-randomized control trial of an FVRx® program was pilot tested with 39 SNAP-eligible adults with diet-related chronic conditions using a unique university-community partnership in Athens, GA (mean age: 47.4 ± 11.6, 82.1% female, 20.5% Hispanic). Both FVRx (n = 22) and control (n = 17) groups were recruited through purposive sampling by the collaborating safety-net clinic and Hispanic community partner. The FVRx® intervention (June—December 2017) included a weekly produce prescription redeemable at one farmers market, a monthly SNAP-Ed nutrition education class based on DASH diet principles and food resource management, and a monthly health screening. Outcome Measures and Analysis: Self-administered surveys were used to assess dietary intake, nutrition knowledge, attitude, and food purchasing practices. Descriptive analysis and non-parametric tests were conducted. Results: After the intervention, the FVRx® group reported significantly higher intake of total fruit and vegetable servings, increased knowledge of fresh fruit and vegetable preparation, and the importance of fruits and vegetables in their family's diet (all P < .05). Most of the FVRx® group also reported switching the majority of their fruit and vegetable purchases from grocery stores to the farmers market, as well as increasing the amount of fresh vegetables purchased (all P < .05). Conclusions and Implications: Participation in an FVRx® program combining free fresh produce and nutrition education improves the knowledge, attitude, and consumption of fruits and vegetables and increases access to the local food system. Further research is needed to examine the role and design of nutrition education to maximize the impact of the FVRx® program. Funding: Supplemental Nutrition Assistance Program—Education, Wholesome Wave Georgia.

Incorporating Farmers’ Market Tours into the Expanded Food and Nutrition Education Program: Best Practices and Lessons Learned

Research indicates that low-income consumers are less likely to shop at farmers’ markets and that these individuals are often those with the lowest intake of fresh fruits and vegetables. This project aimed to improve familiarity with farmers’ markets among low-income consumers through guided tours of farmers’ markets, implemented as part of the Expanded Food and Nutrition Education Program (EFNEP). EFNEP Program Assistants (PAs) in five counties in North Carolina received training and partnered with a local Cooperative Extension agent to deliver a farmers’ market tour at the mid-point of a nine-lesson series on healthy eating. Forty-eight participants completed the series, completing a pre-and post-class series behavior change assessment and dietary recall. At entry, 54% of participants said they ate food that came from a local farm, compared to 94% at exit. Interviews with all PAs found that participants: plan to visit the farmers’ market again in the future, tried new recipes with foods purchased at the market, and learned how to talk with and ask questions of farmers’ market vendors. We argue that farmers’ market tours are a promising strategy for increasing familiarity with local foods, when carried out as part of a series of nutrition education classes.

Juara Sihat™: Study Design of a School-based Childhood Obesity Nutrition Education Programme in Kuala Lumpur, Malaysia

Globally, prevalence of overweight and obesity among children has increased rapidly in the recent decades. Thus, development of effective interventions to prevent childhood obesity in Malaysia is urgently needed. This paper describes the study design of a 12-week multi-component, school-based nutrition education programme aimed at managing childhood obesity. The objective of Juara Sihat™ is to determine the effectiveness of a nutrition education programme in improving anthropometric status, knowledge, attitude and practice (KAP) of nutrition, eating habits and physical activity level among overweight and obese children. This quasi-experimental study involves two primary schools in Kuala Lumpur with similar demographic characteristics. Eligibility criteria of research participants are overweight and obese children aged 9 to 11 years. The main components of the Juara Sihat™ intervention are nutrition education classes on healthy eating and active lifestyle; physical activity sessions; and active involvements of parents and teachers. The control school does not receive any interventions. The primary outcome is BMI z-score, while other outcomes include waist circumference, body fat percentage, KAP of nutrition score, dietary intake, physical activity level, sedentary behaviour and biochemical profile. Outcome measures will be assessed at three intervals: baseline, post-intervention 1 (3-month follow-up), and post-intervention 2 (6-month follow-up). The Juara Sihat™ programme represents a promising approach to examining the effectiveness of a school-based childhood obesity intervention with strong empowerment of Parents’ and Teachers’ Association (PTA). We anticipate that this study may provide insights towards the development of more effective strategies in formulating childhood obesity interventions. DOI : http://dx.doi.org./10.17576/JSKM-2018-17

Juara Sihat™: Study Design of a School-based Childhood Obesity Nutrition Education Programme in Kuala Lumpur, Malaysia

Globally, prevalence of overweight and obesity among children has increased rapidly in the recent decades. Thus, development of effective interventions to prevent childhood obesity in Malaysia is urgently needed. This paper describes the study design of a 12-week multi-component, school-based nutrition education programme aimed at managing childhood obesity. The objective of Juara Sihat™ is to determine the effectiveness of a nutrition education programme in improving anthropometric status, knowledge, attitude and practice (KAP) of nutrition, eating habits and physical activity level among overweight and obese children. This quasi-experimental study involves two primary schools in Kuala Lumpur with similar demographic characteristics. Eligibility criteria of research participants are overweight and obese children aged 9 to 11 years. The main components of the Juara Sihat™ intervention are nutrition education classes on healthy eating and active lifestyle; physical activity sessions; and active involvements of parents and teachers. The control school does not receive any interventions. The primary outcome is BMI z-score, while other outcomes include waist circumference, body fat percentage, KAP of nutrition score, dietary intake, physical activity level, sedentary behaviour and biochemical profile. Outcome measures will be assessed at three intervals: baseline, post-intervention 1 (3-month follow-up), and post-intervention 2 (6-month follow-up). The Juara Sihat™ programme represents a promising approach to examining the effectiveness of a school-based childhood obesity intervention with strong empowerment of Parents’ and Teachers’ Association (PTA). We anticipate that this study may provide insights towards the development of more effective strategies in formulating childhood obesity interventions. DOI : http://dx.doi.org./10.17576/JSKM-2018-17

A Nurse-Led and Teacher-Assisted Adolescent Healthy Weight Program to Improve Health Behaviors in the School Setting.

Adolescents with overweight and obesity are at risk for future health problems. The purpose of this study was to examine the feasibility and initial efficacy of a weight management intervention to help adolescents develop healthy nutrition and physical activity behaviors and improve their anthropometrics. This study used a single-group repeated measures design in a small school in Durham, North Carolina (NC). The intervention consisted of a nurse-led and teacher-assisted nutrition and physical activity education and exercise classes that met twice each week for 45-60 minutes for 7 weeks. Data were collected at Time 1 (baseline), Time 2 (after intervention completion), and Time 3 (after 3 months on their own). Interview feedback, low cost, and successful completion of all planned activities indicated that all stakeholders found the project beneficial and suitable for their school. This study suggests that a weight management intervention for adolescents was feasible in the school setting.

Eating Habits of Teenagers in the Schools of Eastern Highlands Province, Papua New Guinea

Aim: Healthy diet is essential for adolescents to meet the nutritional demands of the growing body. Poor dietary habits jeopardize health and affect the ability to learn, concentrate and perform in school. The aim of this study was to analyze the eating habits of teenagers (13-19 years of age) in the urban and peri-urban schools of the Eastern Highlands Province of Papua New Guinea in order to determine the food frequency and quality of daily diet intake. Methodology: A self-administered questionnaire consisted of 58 items on the demographic characteristics, dietary habits and food frequency was distributed to teenagers in the schools. Out of 540 questionnaires issued 512 received in which 446 were completed giving a response rate of 87 percent. The collected data was analyzed using Statistical Package for Social Sciences (SPSS version 19.0). The frequency and descriptive analysis were included in the data analysis. Results: A majority of (58%) adolescents had breakfast daily. The lunch was regular among (48%) adolescents. All respondents (100%) had dinner regularly. About 33% adolescents had energy yielding foods thrice, 42.4% had body building foods once, 28.7% had 3 fruits, and 5.2% had five vegetables a day. Conclusion: A high number of adolescents were irregular in eating breakfast, mid-morning snack and lunch. This study recommended adolescents to have three balanced meals and 3 snacks regularly and advised schools to administer Nutrition Education classes. Limitation of this study was the quantity of food consumed daily not assessed which may be considered by future study

Assessment of PSE Strategies in Arkansas SNAP-Ed Leads to Development of a Toolkit on PSE Implementation for Local Staff

To develop a comprehensive Policy, Systems and Environmental (PSE) change implementation toolkit and training after evaluating existing PSE strategies in Arkansas, the capacity of Family Consumer Science (FCS) agents to conduct PSE activities within their counties, and the training needs of local staff. USDA’s Food and Nutrition Service stipulates that SNAP-Ed nutrition education classes must be delivered alongside comprehensive, multilevel interventions or community and public health approaches to improve nutrition. All states are required to deliver PSE strategies through multilevel or public health approaches to SNAP-Ed. The University of Arkansas Cooperative Extension Services (UACES) delivers nutrition education and physical activity promotion in 75 counties through SNAP-Ed. UACES contracted with Altarum Institute to help strengthen its approach to implementing and evaluating SNAP-Ed PSE approaches. FCS agents participated in a survey and key informant interviews. A toolkit and training on PSE implementation were developed based on findings from the survey and interviews. The delivery of PSE strategies was already underway in many counties and the need for more training and support was identified. While agents had limited time to spend on SNAP-Ed PSE strategies, they realized the importance of partnerships and coordinated efforts to stretch their resources. Agents had a positive outlook on planning and implementing future PSE activities. A step-by-step toolkit was developed to assist agents with assessing, planning, monitoring and evaluating PSE strategies in their counties. A subsequent training on the toolkit was provided to agents by Altarum Institute with the goal of increasing their self-efficacy.

Measuring How Systems Change in Clinics Facilitates Provider Education About Physical Activity and Increase Referrals to Community Resources

To increase physical activity and refer more patients to University of Maryland EFNEP nutrition education classes and other community resources, CCI Health and Wellness Centers adopted Physical Activity as a Vital Sign (PAVS). Social Ecological Model. Previously used by Kaiser. PAVS screens patients for physical activity during routine vital signs assessments. It was initially pilot-tested in one CCI clinic. The target audience was pediatric clinic patients and their families in Latino communities Clinic medical assistants asked physical activity screening questions. Activity “tip sheets” and local physical activity resource guides were distributed. EFNEP nutrition classes were added as a referral resource and patients were referred between February and September 2016. This effort required changes in the clinic electronic health record and workflow redesign. Patients showed improved physical activity and diet quality. Interviews were conducted pre- and post-intervention with seven providers. All providers agreed that screening questions took little time and PAVS made it easier to address physical inactivity. Resource lists and referrals to EFNEP nutrition classes were especially important for providers to offer some options for patients. An estimated 40 new patients were referred to EFNEP. Providers reported more patients asking them about physical activity as well. All providers felt that PAVS was feasible and should be incorporated into clinic settings. This program offers lessons learned regarding next steps for evaluating PSEs. First, by incorporating the screening questions and EFNEP referrals into the electronic health record, evaluation indicators were easily measured. Second, provider interviews revealed their priorities and level of support.

USDA’s Food, Nutrition and Consumer Services Helps Bring Regional and Local Foods to Consumers

USDA’s Food, Nutrition and Consumer Services Helps Bring Regional and Local Foods to Consumers

Food Safety Instruction Improves Knowledge and Behavior Risk and Protection Factors for Foodborne Illnesses in Pregnant Populations.

Objective This study compared knowledge and food-handling behavior after pathogen-specific (experimental treatment) versus basic food safety instruction (active control) presented during nutrition education classes for low-income English- and Spanish-language pregnant women. Methods Subjects (n = 550) were randomly assigned to treatment groups in two different locations in the United States. Food safety instruction was part of an 8-lesson curriculum. Food safety knowledge and behavior were measured pre/post intervention. Descriptive data were analyzed by Chi-Square or ANOVA; changes after intervention were analyzed by regression analysis. Results Knowledge improved after intervention in the pathogen-specific treatment group compared to active control, especially among Spanish-language women. Behavior change after intervention for the pathogen-specific treatment group improved for thermometer usage, refrigeration and consumption of foods at high risk for safety; however, all other improvements in behavior were accounted for by intervention regardless of treatment group. As expected, higher pre-instruction behavioral competency limited potential gain in behavior post-instruction due to a ceiling effect. This effect was more dominant among English-language women. Improvements were also linked to formal education completed, a partner at home, and other children in the home. Conclusions for Practice This study demonstrated that pathogen-specific food safety instruction leads to enhance knowledge and food handling behaviors that may improve the public health of pregnant women and their unborn children, especially among Spanish-language women. More importantly, food safety instruction, even at the most basic level, benefited pregnant women's food safety knowledge and food-handling behavior after intervention.

Effects of a Japan Diet Intake Program on Metabolic Parameters in Middle-Aged Men.

Aim: We conducted a pilot study to clarify the effects of the Japan Diet nutritional education program on metabolic risk factors for atherosclerotic cardiovascular disease in middle-aged men who were brought up in the westernized dietary environment of modern Japan.Methods: Thirty-three men, 30–49 years of age, attended a nutrition education class to learn food items and recommended volumes comprising the Japan Diet (more fish, soybeans and soy products, vegetables, seaweed, mushrooms and unrefined cereals, and less animal fat, meat and poultry with fat, sweets, desserts and snacks, and alcoholic drinks), and were encouraged to consume the Japan Diet for 6 weeks. Anthropometric and biochemical parameters were measured and 3-day weighted dietary records were kept before and at completion of the intervention.Results: Ninety-one percent of participants showed improvements in more than one cardiovascular risk factor after 6 weeks. Body weight, serum low density lipoprotein (LDL) cholesterol, malondialdehyde modified (MDA)-LDL and triglyceride concentrations decreased significantly, while high density lipoprotein cholesterol was unchanged. Fish, soy, and sum of seaweed, mushrooms and konjak intakes doubled, and green and yellow vegetable intakes also increased as compared to baseline. Meanwhile, intakes of refined cereals, meat and poultry, sweets, desserts and snacks, and margarine and shortening decreased. Total energy, lipid, and saturated and monounsaturated fatty acid intakes decreased, while n-3 polyunsaturated fatty acid, dietary fiber, beta-carotene, vitamins D and K, potassium, and magnesium increased, with no change in sodium intake.Conclusions: The Japan Diet is suggested to improve atherosclerotic cardiovascular disease risk factors in middle-aged Japanese men.The clinical trial registration number: UMIN000020639.

Evaluation of US Veterans Nutrition Education for Diabetes Prevention

ObjectiveEvaluate the effectiveness of nutrition education interventions for diabetes prevention. DesignRetrospective cohort design. SettingTertiary-care US Veterans' Hospital, July 2007 to July 2012, using pre-existing database. ParticipantsPrediabetic, adult veterans (n = 372), mostly men (94.4%, n = 351). InterventionsVisits with existing nutrition education classes were collected. Main Outcome MeasuresPrimary outcome: diabetes status; predictors: visits/encounters, age, body mass index, weight change, and hemoglobin A1c. AnalysisCox proportional hazards method, χ2 test, and logistic regression. ResultsIn this sample, prediabetic veterans who received nutrition education were less likely to develop diabetes when compared with prediabetic veterans who did not receive nutrition education (hazard ratio, 0.71; 95% confidence interval, 0.55–0.92; P < .01). This difference remained significant after adjusting for body mass index and weight change. Conclusions and ImplicationsNutrition education was significantly associated with preventing the progression from prediabetes to diabetes in US Veterans participating in a nutrition education intervention at the Michael E. DeBakey Veterans Affairs Medical Center.

Add a Little Friendly Competition to Your Nutrition Promotion Activities

Looking for a fun way to encourage healthy behaviors? Try introducing a little friendly competition with SuperTracker’s new challenge feature. The newest enhancement to SuperTracker (US Department of Agriculture’s free, interactive tracking tool for food, physical activity, and weight) offers an easy way for registered dietitian nutritionists (RDNs) to help Americans make healthier choices. We know that for some people, trying to improve their diet and logging every food they eat is overwhelming, or seen as too time consuming. SuperTracker challenges offer a new, simpler way for Americans to get feedback on their health behaviors and work toward their goals. Participants use “Quick Tracker” to easily record daily foods and physical activities in a matter of seconds, and they get positive reinforcement by earning points for making healthy choices (Figure 1). Challenges use competition and social support to empower participants to eat the MyPlate way. Along with support from an RDN, SuperTracker challenges can help them discover that adopting a healthy eating pattern is doable. Earlier this year, SuperTracker group challenges were announced, allowing members of a group to compete against one another in a healthy eating challenge. Now the competition can really heat up with group-to-group challenges. With this new feature, one group can challenge another group in a team-style competition. Participants in both groups can compare progress on a joint leaderboard and compete to see which team gets the highest average points per member (Figure 2). By leading a SuperTracker group, RDNs can set up versus challenge, choosing a ready-made MyPlate Challenge or designing a custom challenge—eg, a 5-day fruit and vegetable challenge or a 2-week whole-grains challenge. Consider creating a challenge between two offices for a little friendly competition in the workplace, between two classes, or between two groups of clients. The SuperTracker Groups feature, originally launched last fall, allows RDNs to manage a group of SuperTracker users and inspire them to work toward their healthy eating goals together. In addition to private groups, RDNs can now create public groups and invite up to 500 people to join via Facebook, e-mail, or a group-specific access code. Unlike private groups, any SuperTracker user can join a public group—no invitation is needed. To help people find your group, you can label it by using our list of over 240 tags representing various locations, affiliations, and hobbies/interests. Public groups can help RDNs extend their reach to a broader audience and encourage more Americans to meet their health and wellness goals. Group leaders also now have the ability to transfer group ownership. For example, if you are going to be out of the office for a week, you can transfer ownership to a colleague, so they can run your group while you’re away. SuperTracker groups and challenges offer endless possibilities for RDNs to motivate behavior change among groups and individuals. Consider creating a group or challenge for your clients, students in your nutrition education class, colleagues, or friends and family. You can find more information, including video tutorials and a detailed SuperTracker Groups & Challenges User Guide, on the SuperTracker “About Groups” page: www.SuperTracker.usda.gov/aboutgroups.

Using Community-Led Mini-Grant Projects to Increase Access to Healthy, Affordable Food and Places to be Active

ObjectiveVoices into Action: The Families, Food, and Health Project is a five-year, USDA-funded research and outreach project based out of North Carolina State University, North Carolina State University, A&T State University, and NC Cooperative Extension. Voices into Action (VIA) draws on community-based research to collaborate with community groups to improve access to healthy food and places to be active in three regions in North Carolina.Target AudienceVIA provided mini-grants to organizations working in Southeast Raleigh (in Wake County), western Harnett County, and Lee County to support community-led projects focused on improving access to food and opportunities for physical activity.Theory, Prior Research, RationaleBased on the socio-ecological model, mini-grants facilitate behavior change by creating long-term environmental changes. All projects are required to implement a policy or environmental change, build on or develop community partnerships, and include a plan for sustainability.DescriptionFifty-nine mini-grants were awarded over a four-year period (2013 – 2016). Projects vary in scope, and include community gardens, exercise programs, and nutrition education classes. Mini-grant recipients also receive technical assistance, including support with project impact.EvaluationGrantees were interviewed before and after implementing mini-grant projects. Interviews indicate that the experience increased organizations’ connections to community resources, fostered community partnerships, and enhanced organizational capacity. However, organizations’ success and capacity for long-term sustainability varied.Conclusions and ImplicationsCommunity-led mini-grant projects can be a viable method of putting research findings into practice by supporting efforts to improve access to healthy, affordable food and places to be active.FundingUSDA Grant #2011-68001-30103 ObjectiveVoices into Action: The Families, Food, and Health Project is a five-year, USDA-funded research and outreach project based out of North Carolina State University, North Carolina State University, A&T State University, and NC Cooperative Extension. Voices into Action (VIA) draws on community-based research to collaborate with community groups to improve access to healthy food and places to be active in three regions in North Carolina. Voices into Action: The Families, Food, and Health Project is a five-year, USDA-funded research and outreach project based out of North Carolina State University, North Carolina State University, A&T State University, and NC Cooperative Extension. Voices into Action (VIA) draws on community-based research to collaborate with community groups to improve access to healthy food and places to be active in three regions in North Carolina. Target AudienceVIA provided mini-grants to organizations working in Southeast Raleigh (in Wake County), western Harnett County, and Lee County to support community-led projects focused on improving access to food and opportunities for physical activity. VIA provided mini-grants to organizations working in Southeast Raleigh (in Wake County), western Harnett County, and Lee County to support community-led projects focused on improving access to food and opportunities for physical activity. Theory, Prior Research, RationaleBased on the socio-ecological model, mini-grants facilitate behavior change by creating long-term environmental changes. All projects are required to implement a policy or environmental change, build on or develop community partnerships, and include a plan for sustainability. Based on the socio-ecological model, mini-grants facilitate behavior change by creating long-term environmental changes. All projects are required to implement a policy or environmental change, build on or develop community partnerships, and include a plan for sustainability. DescriptionFifty-nine mini-grants were awarded over a four-year period (2013 – 2016). Projects vary in scope, and include community gardens, exercise programs, and nutrition education classes. Mini-grant recipients also receive technical assistance, including support with project impact. Fifty-nine mini-grants were awarded over a four-year period (2013 – 2016). Projects vary in scope, and include community gardens, exercise programs, and nutrition education classes. Mini-grant recipients also receive technical assistance, including support with project impact. EvaluationGrantees were interviewed before and after implementing mini-grant projects. Interviews indicate that the experience increased organizations’ connections to community resources, fostered community partnerships, and enhanced organizational capacity. However, organizations’ success and capacity for long-term sustainability varied. Grantees were interviewed before and after implementing mini-grant projects. Interviews indicate that the experience increased organizations’ connections to community resources, fostered community partnerships, and enhanced organizational capacity. However, organizations’ success and capacity for long-term sustainability varied. Conclusions and ImplicationsCommunity-led mini-grant projects can be a viable method of putting research findings into practice by supporting efforts to improve access to healthy, affordable food and places to be active. Community-led mini-grant projects can be a viable method of putting research findings into practice by supporting efforts to improve access to healthy, affordable food and places to be active.

Incorporating Farmers’ Market Tours Into the Expanded Food and Nutrition Education Program: Best Practices and Lessons Learned

To improve fruit and vegetable consumption among low-income consumers through guided tours of farmers’ markets, implemented as part of the Expanded Food and Nutrition Education Program (EFNEP). Low-income families with children. Research indicates that low-income consumers are less likely to shop at farmers’ markets and that these populations are often those with the lowest intake of fresh fruits and vegetables. Project was piloted in six counties in North Carolina. EFNEP Program Assistants (PAs) received training and partnered with a local Cooperative Extension agent to deliver a farmers’ market tour at the mid-point of a nine-lesson series on healthy eating. Sixty-five participants completed the series. Classes were conducted at two food pantries, an on-site Women Infants and Children (WIC) office, a substance abuse residential program, a church, and a Latino community center. Pre- and post-class series behavior change assessment and dietary recall. Evaluation data shows that 35% of participants improved fruit intake and 56% improved vegetable intake. Interviews with all six PAs found that participants: plan to visit the farmers’ market again in the future, tried new recipes with foods purchased at the market, and learned how to talk with and ask questions of farmers’ market vendors. Farmers’ market tours are an effective strategy for increasing fruit and vegetable consumption and familiarity with local foods, when carried out as part of a series of nutrition education classes.

Intervention on whole grain with healthy balanced diet to manage childhood obesity (GReat-Child™trial): study protocol for a quasi-experimental trial.

BackgroundThe rapid increase in childhood obesity is a serious public health problem, and has led to the development of many interventions. However, no intervention has emphasized whole grains as a strategy to manage childhood obesity. Therefore, this article describes the protocol of a 12-week multi-component, family-based intervention on whole grain, using a healthy balanced diet for managing childhood obesity.MethodsThe GReat-Child trial utilize a quasi-experimental method in which two schools in Kuala Lumpur are assigned to intervention and control groups. The eligibility criteria are overweight/obese children, aged 9 through 11 years, who has no serious co-morbidities. The children who report consuming whole-grain foods in their 3-day diet-recall during the screening will be excluded. The study sample is characterized by anthropometric measurements (weight, height, percentage of body fat and waist circumference), whole grain and nutrient intakes (3-day 24-h diet recalls), and their knowledge, attitudes and practices towards whole grain. The 12-week intervention is comprised of three components addressing behaviour, personal and environmental factors, based on social cognitive theory: (1) individual diet counselling for the parents; (2) six 30-min nutrition education classes and (3) school delivery of whole-grain foods; The control school does not receive any interventions, however, for ethical purposes, a health talk is conducted after the entire GReat-Child Trial is completed.ConclusionThe GReat-Child trial represents a novel approach to examining the effectiveness of the intervention of whole grain in a healthy balanced diet on managing childhood obesity. We anticipate that this trial will reveal not only whether whole grain intervention will be effective in managing childhood obesity, but also provide greater insights into the acceptance of whole grain among Malaysian children.