Rural Lower Mississippi Delta Research Articles

Maternal diet quality and nutrient intake in the gestational period: results from the delta healthy sprouts comparative impact trial.

BackgroundA woman’s diet while pregnant can play an important role in her reproductive health as well as the health of her unborn child. Diet quality and nutrient intake amongst pregnant women residing in the rural Lower Mississippi Delta (LMD) region of the United States is inadequate. The Delta Healthy Sprouts Project was designed to test the comparative impact of two home visiting programs on weight status, dietary intake, and health behaviors of women and their infants residing in the LMD region. This paper reports results pertaining to maternal diet quality and nutrient intake in the gestational period.MethodsThe experimental arm (PATE) received monthly home visits beginning in the second trimester using the Parents as Teachers curriculum enhanced with a nutrition and lifestyle behavior curriculum. The control arm (PAT) received monthly home visits using the Parents as Teachers curriculum only. Maternal diet was assessed via 24-h dietary recall at gestational months (GM) 4 (baseline), 6, and 8. Diet quality was computed using the Healthy Eating Index-2010 (HEI-2010).ResultsGestational period retention rates for PAT and PATE arms were 77 % (33/43) and 67 % (26/39), respectively. Significant effects were not found for time, treatment, or time by treatment for the HEI-2010 total or component scores, macro- or micronutrient intake or percentage of women meeting recommended nutrient intakes.ConclusionsPerhaps due to low participant enrollment and higher than expected rates of drop out and noncompliance, we were not able to demonstrate that the enhanced nutrition and lifestyle curriculum (PATE) intervention had a significant effect on diet quality or nutrient intake during pregnancy in this cohort of rural, Southern, primarily African American women.Trial registrationclinicaltrials.gov, NCT01746394. Registered 5 December 2012.

A church‐based, diet and supervised physical activity intervention for rural, southern African American adults improves diet quality, physical activity, and blood lipids (251.6)

Epidemic levels of obesity, diabetes, hypertension, and heart disease are rampant in the largely rural Lower Mississippi Delta (LMD) region. We assessed the effectiveness of a six‐month, church‐based, diet and supervised physical activity (PA) intervention for improving diet quality (measured by the Healthy Eating Index‐2005) and increasing PA of LMD African American adults. Eight churches were assigned to intervention (n=5) or control (n=3). The intervention involved 9 one hour group didactic sessions and weekly supervised PA. Assessments included dietary, PA, anthropometric, and clinical measures. Statistical tests for group comparisons included chi square and McNemar’s tests for categorical variables, and mixed model regression for continuous variables. Retention was 79% (96/122) for control and 76% (217/287) for intervention churches. Several diet quality components, including fruit, vegetables, and total quality improved significantly in the intervention group. Similarly, increases in PA were apparent in the intervention group, while PA decreased in the control group. Significant decreases in blood lipids and trending (0.05 < p 蠄 0.10) reductions in weight and BMI were observed for the intervention group. Results from this study indicate that a church‐based, diet and supervised PA intervention improves diet quality and increases PA of LMD African American adults.Grant Funding Source: Funding was provided by US DHHS HRSA Grant # 6 U1FRH07411 and the USDA Agricultural Research Service

A Church-Based Diet and Physical Activity Intervention for Rural, Lower Mississippi Delta African American Adults: Delta Body and Soul Effectiveness Study, 2010–2011

IntroductionObesity, diabetes, and hypertension have reached epidemic levels in the largely rural Lower Mississippi Delta (LMD) region. We assessed the effectiveness of a 6-month, church-based diet and physical activity intervention, conducted during 2010 through 2011, for improving diet quality (measured by the Healthy Eating Index-2005) and increasing physical activity of African American adults in the LMD region.MethodsWe used a quasi-experimental design in which 8 self-selected eligible churches were assigned to intervention or control. Assessments included dietary, physical activity, anthropometric, and clinical measures. Statistical tests for group comparisons included χ2, Fisher’s exact, and McNemar’s tests for categorical variables, and mixed-model regression analysis for continuous variables and modeling intervention effects.ResultsRetention rates were 85% (176 of 208) for control and 84% (163 of 195) for intervention churches. Diet quality components, including total fruit, total vegetables, and total quality improved significantly in both control (mean [standard deviation], 0.3 [1.8], 0.2 [1.1], and 3.4 [9.6], respectively) and intervention (0.6 [1.7], 0.3 [1.2], and 3.2 [9.7], respectively) groups, while significant increases in aerobic (22%) and strength/flexibility (24%) physical activity indicators were apparent in the intervention group only. Regression analysis indicated that intervention participation level and vehicle ownership were significant positive predictors of change for several diet quality components.ConclusionThis church-based diet and physical activity intervention may be effective in improving diet quality and increasing physical activity of LMD African American adults. Components key to the success of such programs are participant engagement in educational sessions and vehicle access.

A School-Based Fruit and Vegetable Snacking Pilot Intervention for Lower Mississippi Delta Children

Background. In this pilot study, we examined school-aged children’s familiarity and willingness to try fruits and vegetables (FV) and the impact of a 6-week school-based snack feeding intervention on familiarity and consumption of FV. Methods. In all, 190 fourth- to sixth-grade students from a rural Lower Mississippi Delta (LMD) school participated. Measures included surveys assessing familiarity and willingness to try FV and direct observation of FV snack consumption. Results. At baseline, the majority of students provided correct name recognition for 6 of the 11 snacks offered, whereas name recognition increased significantly for the other 5 FV postintervention. Similarly, previous eating experience increased for 7 of the 11 FV offered. On average, a higher percentage of the fruit (54% to 98%) and vegetable (49% to 50%) snacks offered were consumed by the students. Willingness to try and grade level were the strongest predictors of fruit and vegetable snack consumption. Conclusions. These results suggest that an FV snack feeding intervention can increase the familiarity, and thereby potentially, the amount of FV consumed by LMD school children. Further research is warranted to determine if the positive effects of such programs extend beyond the school environment and into the home.

Health Literacy Is Associated with Healthy Eating Index Scores and Sugar-Sweetened Beverage Intake: Findings from the Rural Lower Mississippi Delta

Background Although health literacy has been a public health priority area for more than a decade, the relationship between health literacy and dietary quality has not been thoroughly explored. Objective To evaluate health literacy skills in relation to Healthy Eating Index (HEI) scores and sugar-sweetened beverage (SSB) consumption while accounting for demographic variables. Design Cross-sectional survey. Participants/setting A community-based proportional sample of adults residing in the rural Lower Mississippi Delta. Methods Instruments included a validated 158-item regional food frequency questionnaire and the Newest Vital Sign (scores range 0 to 6) to assess health literacy. Statistical analyses performed Descriptive statistics, analysis of variance, and multivariate linear regression. Results Of 376 participants, the majority were African American (67.6%), without a college degree (71.5%), and household income level <$20,000/year (55.0%). Most participants (73.9%) scored in the two lowest health literacy categories. The multivariate linear regression model to predict total HEI scores was significant ( R 2=0.24; F=18.8; P<0.01), such that every 1-point increase in health literacy was associated with a 1.21-point increase in HEI scores, while controlling for all other variables. Other significant predictors of HEI scores included age, sex, and Supplemental Nutrition Assistance Program participation. Health literacy also significantly predicted SSB consumption ( R 2=0.15; F=6.3; P<0.01) while accounting for demographic variables. Every 1 point in health literacy scores was associated with 34 fewer kilocalories per day from SSBs. Age was the only significant covariate in the SSB model. Conclusions Although health literacy has been linked to numerous poor health outcomes, to our knowledge this is the first investigation to establish a relationship between health literacy and HEI scores and SSB consumption. Our study suggests that understanding the causes and consequences of limited health literacy is an important factor in promoting compliance to the Dietary Guidelines for Americans.

Conducting needs assessment using the Comprehensive Participatory Planning and Evaluation model to develop nutrition and physical activity interventions in a rural Lower Mississippi Delta community

Community members from a rural Lower Mississippi Delta community and university research partners used the Comprehensive Participatory Planning and Evaluation (CPPE) model to identify and prioritize three food and nutrition-related problems in the community as a basis for intervention planning. Community workshops implementing the first two CPPE steps, problem assessment and identification and selection of interventions, identified intake of unhealthy foods, lack of nutrition knowledge, and lack of adequate physical activity as community priorities. Community members and university partners developed models to identify potential causes for each problem. Finally workshop participants developed a menu of interventions as well as criteria by which to rank the interventions. The menu of interventions consisted of ten objectives to address poor nutrition in this community and a total of 27 intervention activities to meet the objectives. ARS/USDA Coop Agreement #6251-52000-0020-000.

Low fruit and vegetable availability in two small, rural Lower Mississippi Delta Communities

Low fruit and vegetable availability in two small, rural Lower Mississippi Delta Communities

Self-Reported Health of Residents of the Mississippi Delta

The rural Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi has a large economically and socially disadvantaged population at high risk for health problems. Their health status is poorly understood as they are not well represented in national health surveys. A random-digit-dialing telephone survey was conducted in 2000, with 2,236 respondents representing residents of 36 counties along the Mississippi River. Self-reported chronic conditions, health status, and obesity (derived from weight and height) were compared with the nationally representative Continuing Survey of Food Intake of Individuals. High cholesterol, diabetes, and hypertension were significantly higher than in the national sample. Obesity was strikingly higher in Delta children (27.9% versus 16.2%) of all ages and in Delta adults (33.9% versus 17.3%). Controlling for age, income, and gender, African Americans were at particular risk for obesity, hypertension, and diabetes. A public health crisis appears to exist in the Delta given the high prevalence health problems.

High prevalence of food insecurity and hunger in households in the rural Lower Mississippi Delta.

Residents of the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi are at risk for food insecurity since a high proportion of the population live in households with incomes below the poverty level and have reduced access to food and decreased availability of a variety of foods. However, the magnitude of the problem is unknown because presently only nationwide and state estimates of food insecurity are available. This study was conducted by the Lower-Mississippi Delta Nutrition Intervention Research Consortium to determine the prevalence of household food insecurity, identify high-risk subgroups in the Lower Delta, and compare to national data. A 2-stage stratified cluster sample representative of the population in 36 counties in the Lower Delta was selected using list-assisted random digit dialing telephone methodology. A cross-sectional telephone survey of 1662 households was conducted in 18 of the 36 counties using the US Food Security Survey Module. Twenty-one percent of Lower Delta households were food insecure, double the 2000 nationwide rate of 10.5%. Within the Lower Delta, groups with the highest rates of food insecurity were households with income below $15,000, black households, and households with children. The prevalence of hunger in Delta households with white children was 3.2% and in households with black children was 11.0%, compared to nationwide estimates of 0.3% and 1.6%. The Lower Mississippi Delta is characterized by a high prevalence of food insecurity and hunger. Future efforts to identify the household and community determinants of food insecurity to reduce its high prevalence are indicated.

Using national dietary data to measure dietary changes.

To demonstrate that dietary datasets from the Continuing Survey of Food Intakes by Individuals, a US population survey, allow comparisons with national data and provide food composition datasets that can be used to generate similar dietary data. Two studies are described: the Lower Mississippi Delta Nutrition Intervention Research Initiative (Delta NIRI), which used a 24-hour recall, and a Department of Defense Military Nutrition Research Task, which used 3-day dietary records. Both studies used the same food composition tables. Rural Lower Mississippi Delta and an Army post. Four hundred and nine residents (adults and children) from the rural Delta region of Arkansas, Louisiana and Mississippi, and 74 career soldiers from the Sergeants Major Academy, Fort Bliss, Texas. The Delta NIRI study found that fruit and vegetable consumption for these rural residents was lower than that found nationally. Additionally, the quality of vegetable servings is of concern since a large percentage came from french fries and potato chips. In the Sergeants Major Academy study, the national survey food composition tables allowed for easy analysis of intake data and comparisons with dietary recommendations. Strategies similar to those used for the Delta NIRI and Military Nutrition Research Task can be used widely, allowing comparisons of 'defined populations' with nationally distributed data. Additionally, measurement of dietary change is more efficient when the same protocol is used subsequently to collect more data, a method similar to that used by the US Department of Agriculture to describe food consumption patterns from one survey to another.

The influence of socio-demographic factors onpsycho-social beliefs and food security in rural lower mississippi delta residents

The influence of socio-demographic factors onpsycho-social beliefs and food security in rural lower mississippi delta residents

Energy underreporting among rural lowerMississippi delta adults

Energy underreporting among rural lowerMississippi delta adults

Validity of a Telephone-Administered 24-Hour Dietary Recall in Telephone and Non-Telephone Households in the Rural Lower Mississippi Delta Region

Objective To determine if 24-hour dietary recall data are influenced by whether data are collected by telephone or face-to-face interviews in telephone and non-telephone households. Design Dual sampling frame of telephone and non-telephone households. In telephone households, participants completed a 24-hour dietary recall either by face-to-face interview or telephone interview. In non-telephone households, participants completed a 24-hour dietary recall either by face-to-face interview or by using a cellular telephone provided by a field interviewer. Subjects/setting Four hundred nine participants from the rural Delta region of Arkansas, Louisiana, and Mississippi. Main outcome measures Mean energy and protein intakes. Statistical analyses performed Comparison of telephone and non-telephone households, controlling for type of interview, and comparison of telephone and face-to-face interviews in each household type using unpaired t tests and linear regression, adjusting for gender, age, and body mass index. Results Mean differences between telephone and face-to-face interviews for telephone households were −171 kcal ( P=0.1) and −6.9 g protein ( P=0.2), and for non-telephone households −143 kcal ( P=0.6) and 0.4 g protein ( P=1.0). Mean differences between telephone and non-telephone households for telephone interviews were 0 kcal ( P=1.0) and −0.9 g protein ( P=0.9), and for face-to-face interviews 28 kcal ( P=0.9) and 6.4 g protein ( P=0.5). Findings persisted when adjusted for gender, age, and body mass index. No statistically significant differences were detected for mean energy or protein intake between telephone and face-to-face interviews or between telephone and non-telephone households. Applications/conclusions These data provide support that telephone surveys adequately describe energy and protein intakes for a rural, low-income population. J Am Diet Assoc 2001:101:216-222.