Dyadic Analysis of a Self-report Physical Activity Measure for Adult-Youth Dyads.

Adult physical activity levels influence youth physical activity levels, but the nature of this relationship is still unknown. Most research focusing on this topic has been conducted with accelerometers, which are ideal since self-report physical activity measures can be biased. However, self-report measures for physical activity are useful to include in studies to gather information at low-cost. The purpose of this study was to further develop a self-report adult-youth dyad measure of physical activity. This study was conducted using secondary data analysis of the physical activity measures used in an intervention on behavioral nutrition (iCook 4-H). Participants were a sample of 214 adults (M = 39.0, SD = 8.0 years) and youth (M = 9.4, SD = 0.7 years) pairs. Accelerometer data was collected for a subset of youth (n = 122). There was dependency between the adult-youth physical activity data, and a dyadic confirmatory factor analysis model showed good fit to the data and achieved metric invariance, a measure to determine if the same construct was being measured in both youth and adults. Invariance was confirmed across matched versus unmatched sex pairs and some evidence of invariance with youth accelerometer data. Based on study findings, when using self-report measures of physical activity, researchers should measure both members of the adult-youth dyad to get more accurate measurements. Further validation of these findings is needed using an objective physical activity measure, like accelerometers, with all participants and more diverse samples.

A Community-Based Cultural Adaptation Process: Developing a Relevant Cooking Curriculum to Address Food Security for Burundian and Congolese Refugee Families.

Refugee-specific nutrition and cooking curricula addressing dietary acculturation barriers to food security are limited. A cooking curriculum was culturally adapted for Burundian and Congolese refugees to address their unique dietary acculturation experiences. A four-phase curriculum adaptation process (information gathering [literature review, researcher informed, and formative interviews; n = 18], preliminary adaptation design [data incorporation and steering committee; n = 5], pilot testing [n = 10 youth/adult dyads], and refinement) was applied to the existing evidence-based iCook 4-H curriculum using a five-strategy (peripheral, evidential, linguistic, constituent-involving, and sociocultural) cultural adaptation framework. A multiphase, two-cycle coding analytic process was completed within NVivo 12, followed by direct content analysis. Seventeen adaptations were made to the iCook curriculum, derived from varying combinations of four data sources (literature review, researcher informed, priority population, and steering committee), applying all five cultural adaptation strategies. A majority of the curriculum adaptations were derived from two or more data sources (71%) and were categorized within multiple adaptation strategies (88%). This study provided a community-based cultural adaptation process that could be used with various populations to address unique barriers and facilitators to food security. This innovative model addresses cultural needs while simultaneously aiming to improve health habits of refugee communities.

Breakfast Consumption Is Positively Associated with Usual Nutrient Intakes among Food Pantry Clients Living in Rural Communities.

BACKGROUND: Breakfast consumption has declined over the past 40 y and is inversely associated with obesity-related diet and health outcomes. The breakfast pattern of food pantry clients and its association with diet is unknown. OBJECTIVE: The objective is to investigate the association of breakfast consumption with diet quality and usual nutrient intakes among food pantry clients (n = 472) living in rural communities. METHODS: This was an observational study using cross-sectional analyses. English-speaking participants ≥18 y (or ≥19 y in Nebraska) were recruited from 24 food pantries in rural high-poverty counties in Indiana, Michigan, Missouri, Nebraska, Ohio, and South Dakota. Participants were surveyed at the pantry regarding characteristics and diet using 24-h recall. A second recall was self-completed or completed via assisted phone call within 2 wk of the pantry visit. Participants were classified as breakfast skippers when neither recall reported breakfast ≥230 kcal consumed between 04:00 and 10:00; breakfast consumers were all other participants. The Healthy Eating Index-2010 was modeled with breakfast pattern using multiple linear regression. Mean usual intake of 16 nutrients was estimated using the National Cancer Institute Method and compared across breakfast pattern groups. Usual nutrient intake was compared with the Estimated Average Requirement (EAR) or Adequate Intake (AI) to estimate the proportion of population not meeting the EAR or exceeding the AI. RESULTS: A total of 56% of participants consumed breakfast. Compared with breakfast skippers, breakfast consumers had 10-59% significantly higher usual mean intakes of all nutrients (P ≤ 0.05), and had 12-21% lower prevalence of at-risk nutrient intakes except for vitamin D, vitamin E, and magnesium. CONCLUSIONS: Adult food pantry clients living in rural communities experienced hardships in meeting dietary recommendations. Breakfast consumption was positively associated with usual nutrient intakes in this population. This trial was registered at clinicaltrials.gov as NCT03566095.

Feasibility and Acceptability of Implementing a Culturally Adapted Cooking Curriculum for Burundian and Congolese Refugee Families.

Pika Pamoja (Cook Together) is an eight-session cooking curriculum for Burundian and Congolese refugee families, culturally adapted from the evidence-based iCook 4-H curriculum to address dietary acculturation barriers to and facilitators of food security. The goal of this study was to determine the feasibility and acceptability of implementing Pika Pamoja. Researchers and a multilingual community aid implemented Pika Pamoja in a pre-post pilot intervention with randomized control (n = 5)/treatment (n = 5) dyads (youth/mother). Feasibility (recruitment/retention, implementation, fidelity testing, and assessment procedures) and acceptability (process and program evaluations) measures were collected. All 10 dyads (control and treatment) were retained throughout the study. All fidelity measures were 91% or above. The final youth assessment instrument included scales for cooking skills (α = 0.93), cooking self-efficacy (α = 0.90), openness to new foods (α = 0.81), and eating (α = 0.68), playing (α = 0.90), and setting healthful goals (α = 0.88) together as a family. The final adult instrument included scales for cooking, eating, and playing together (α = 0.68), kitchen proficiency (α = 0.89), and food security (α = 0.79). Participant feedback was uniformly positive. Based on these results, Pika Pamoja was feasible to implement and was accepted by the priority population. Larger scale studies to measure the effectiveness of Pika Pamoja to increase food security among refugee families are needed.

Voices for food: methodologies for implementing a multi-state community-based intervention in rural, high poverty communities.

BACKGROUND: Rural communities experience unique barriers to food access when compared to urban areas and food security is a public health issue in rural, high poverty communities. A multi-leveled socio-ecological intervention to develop food policy councils (FPCs), and improve food security in rural communities was created. Methods to carry out such an intervention were developed and are described. METHODS: A longitudinal, matched treatment and comparison study was conducted in 24 rural, high poverty counties in South Dakota, Indiana, Missouri, Michigan, Nebraska and Ohio. Counties were assigned to a treatment (n = 12) or comparison (n = 12) group. Intervention activities focus on three key components that impact food security: 1) community coaching by Extension Educators/field staff, 2) FPC development, and 3) development of a MyChoice food pantry. Community coaching was only provided to intervention counties. Evaluation components focus on three levels of the intervention: 1) Community (FPCs), 2) Food Pantry Organization, and 3) Pantry Client & Families. Participants in this study were community stakeholders, food pantry directors, staff/volunteers and food pantry clients. Pantry food access/availability including pantry food quality and quantity, household food security and pantry client dietary intake are dependent variables. DISCUSSION: The results of this study will provide a framework for utilizing a multi-leveled socio-ecological intervention with the purpose of improving food security in rural, high poverty communities. Additionally, the results of this study will yield evidence-based best practices and tools for both FPC development and the transition to a guided-client choice model of distribution in food pantries. TRIAL REGISTRATION: ClinicalTrials.gov; NCT03566095 . Retrospectively registered on June, 21, 2018.

Food-related behavior and intake of adult main meal preparers of 9-10 year-old children participating in iCook 4-H: A five-state childhood obesity prevention pilot study.

It is important to understand adult outcomes in childhood obesity prevention programs as parents and caregivers have a significant influence on the eating and physical activity habits of youth. Grounded in the social cognitive theory, the iCook 4-H study was centered on a dyad model (9-10 year-olds and their primary meal preparers) to teach healthy cooking skills, shopping and meal habits, and being active as a family. The program took place in five states and dyads (n = 54) were recruited through flyers, e-mails, and in-person contact. The focus of this article is to provide findings from adult program participants. Demographics and self-reported food intake, procurement, preparation and safety practices, feeding relationships, mealtime routines, and height and weight were collected through surveys at baseline and program completion, which spanned 3 months. Descriptive statistics including two-related samples tests and paired samples t tests were used to assess pre- and post-program survey data responses at p < 0.05 significance level. Most had a bachelor's degree (31%) or some college (29%), about half were white, 66% were married, about 30% of households participated in assistance programs, and 82% were female. At program conclusion, participants significantly improved meal planning, prioritizing healthy meal choices, shopping with a grocery list, and reading Nutrition Facts Labels. There were also significant, positive differences noted in cooking skill confidence (p = 0.015), desire to cook more meals at home, and fewer fast food meals. Adult-youth feeding interactions also significantly improved. There were also significant increases in fruit juice (100%), vegetable soup, and whole grain consumption. Based on results, adults reported improvements in meal planning, cooking, and purchasing skills that were taught in classes.

Environmental, personal, and behavioral influences on BMI and acculturation of second generation Hmong children.

This project investigated influences (environmental, personal, and behavioral) on body mass index (BMI) and acculturation of Hmong children born in the United States (US) using the social cognitive theory as the theoretical framework. Using formative information from 12 child focus groups (n = 68) and a review of the literature, a quantitative survey was developed and administered to Hmong children (n = 300) ≥ 9 ≤ 18 years-old. Heights, weights, and acculturation level were measured. B-US(1) were raised in the US and 9-13 years-old (n = 144) and B-US(2) were raised in the US and 14-18 years-old (n = 156). Approximately 50 % of children were classified as overweight/obese (BMI ≥ 85th percentile). Across age and gender sub-groups, questions from the environmental construct appeared to be the most predictive of variances in BMI percentiles (50-60 %). In contrast, acculturation scores were equally predicted by environmental, behavioral, and personal constructs for age and gender sub-groups. Sum acculturation score was significantly higher for B-US(2) compared to B-US(1), with B-US(2) being more acculturated in language use and thought, overall dietary acculturation, and foods eaten at lunch. The high prevalence of obesity in Hmong children suggests that future studies investigate factors influencing obesity to identify the most effective method to reduce/prevent this problem. In particular, acculturation level of the child should be assessed to determine changed dietary behavior and possible risk for obesity.

Dietary acculturation and body composition predict American Hmong children's blood pressure.

OBJECTIVES: Determine how dietary acculturation, anthropometric measures (height, weight, circumferences, and skinfolds), body mass index (BMI), and waist hip ratios (WHRs) are associated with blood pressure (BP) measures in Hmong children living in Minnesota. METHODS: Acculturation was measured using responses to questions regarding language usage, social connections, and diet. Dietary assessment was completed using the multiple-pass 24-h dietary recall method on two different days. Anthropometric and BP measurement were taken using standard procedures, and BMI and WHR were calculated. Data analyses included descriptive statistics, ANOVA, and stepwise regression analyses. RESULTS: Using stepwise regression analysis, hip circumference (HC) predicted boys' systolic (S)BP (R(2) = 0.55). For girls' SBP, mid-upper arm circumference, WHR, low calcium consumption, and height percentile jointly explained 41% of the total variation. Mid upper arm circumference (MAC) and carbohydrate consumption predicted 35% of the variance for boys' diastolic (D)BP, and HC, dairy consumption, and calcium intake predicted 31% of the total variance for girls' DBP. Responses to dietary acculturation questions revealed between group differences for breakfast with half of the younger Born-Thailand/Laos (Born-T/L) consuming mostly Hmong food, while at dinner Born-US consumed a mixed diet and Born-T/L were more likely to consume Hmong food. CONCLUSION: Dietary acculturation and body composition predict Hmong children's BP.

Investigating dietary acculturation and intake among US-born and Thailand/Laos-born Hmong-American children aged 9-18 years.

OBJECTIVE: The Hmong are a growing population of South-East Asian immigrants with increasing rates of obesity and diabetes, yet little is known about their dietary consumption patterns. The present study aimed to investigate the dietary intake of Hmong children and whether acculturation and/or time lived in the USA influences dietary intake, BMI and nutritional status. DESIGN: Two 24 h dietary recalls were collected on non-consecutive days using the multiple-pass interviewing method and were averaged. Heights and weights were measured, from which BMI was calculated. An acculturation score was computed. SETTING: Schools, churches, Hmong organizations, and community centres. SUBJECTS: Three hundred and thirty-five Hmong children aged 9-18 years from Twin Cities, Minnesota, USA. RESULTS: Approximately half of our participants were either overweight or obese. US-born children were significantly heavier, taller, had a higher BMI, and in general consumed more energy, saturated fat and Na than those who were born in Thailand/Laos and were living in the USA for <5 years. Children who were more acculturated to US norms including language use, social connections and dietary habits had higher BMI-for-age and consumed significantly more saturated fat, trans fatty acids, Na and Ca compared with their less acculturated counterparts. CONCLUSIONS: Diets of most Hmong children appear below the recommendations for fibre, vitamins A, D and E, Ca, P, Mg and K, and are higher in fats, sugars and Na. Living in an obesogenic US environment is a probable reason for poor dietary quality of Hmong and may be a contributing factor to the rising rates of obesity and diabetes in this population.

Evaluating a Food Pantry-Based Intervention to Improve Food Security, Dietary Intake, and Quality in Midwestern Food Pantries.

BACKGROUND: Voices for Food was a longitudinal community, food pantry-based intervention informed by the social ecological model, and designed to improve food security, dietary intake, and quality among clients, which was carried out in 24 rural food pantries across 6 Midwestern states. OBJECTIVE: Our objective was to evaluate changes in adult food security, dietary intake, and quality from baseline (2014) to follow-up (2016), and to assess the role of adult food security on dietary outcomes. DESIGN: A multistate, longitudinal, quasi-experimental intervention with matched treatment and comparison design was used to evaluate treatment vs comparison group changes over time and changes in both groups over time. PARTICIPANTS/SETTING: Adult food pantry clients (n = 617) completed a demographic food security survey, and up to three 24-hour dietary recalls at baseline (n = 590) and follow-up (n = 160). INTERVENTION: Community coaching served as the experimental component, which only "treatment" communities received, and a food council guide and food pantry toolkit were provided to both "treatment" and matched "comparison" communities. MAIN OUTCOME MEASURES: Change in adult food security status, mean usual intakes of nutrients and food groups, and Healthy Eating Index-2010 scores were the main outcome measures. STATISTICAL ANALYSES PERFORMED: Linear mixed models estimated changes in outcomes by intervention group and by adult food security status over time. RESULTS: Improvements in adult food security score (-0.7 ± 0.3; P = .01), Healthy Eating Index-2010 total score (4.2 ± 1.1; P < .0001), and empty calories component score (3.4 ± 0.5; P <.0001) from baseline to follow-up were observed in treatment and comparison groups, but no statistically significant changes were found for adult food security status, dietary quality, and usual intakes of nutrients and food groups between the 2 groups over time. The intervention effect on dietary quality and usual intake changes over time by adult food security status were also not observed. CONCLUSIONS: Food pantry clients in treatment and comparison groups had higher food security and dietary quality at the follow-up evaluation of the Voices for Food intervention trial compared with baseline, despite the lack of difference among the groups as a result of the experimental coaching component.

Parent/Caregiver Perceptions of Youth Health Outcomes After Participating in the WeCook: Fun With Food and Fitness Program.

Many youth programs focused on improving health outcomes have not examined parent/caregiver perceptions postparticipation even though they may significantly influence youth behaviors. The primary purpose of this study was to examine changes in adult perceptions of youth- and family-related behavior after youth participated in a 12-week out-of-school time food preparation, nutrition, and physical activity program with a treatment only design. A secondary objective was to assess differences in survey responses by demographic characteristics. The program targeted fourth- and fifth-grade youth at two Title I elementary schools while also engaging families. Pre- and postprogram surveys were administered to parent/caregivers (n = 60) across four cohorts spanning the spring 2016 school semester to fall 2017 school semester. Adult demographic characteristics and perceptions of youth- and family-related outcomes were collected. Results demonstrated a significant increase (p value <.05) in adults' perceptions of their youth's ability to choose healthy snacks and decrease screen time. Additionally, lower income adults reported increased youth sedentary habits, adults using food assistance reported decreased family breakfast frequency, and adults with smaller household sizes reported decreased youth activity before school. Further research is needed on adult and family outcomes from youth cooking programs to better understand the adult and youth health relationship and encourage obesity prevention programs to increase their focus on the family component and associated assessments.

Fruit and Vegetable Healthy Eating Index Component Scores of Distributed Food Bags Were Positively Associated with Client Diet Scores in a Sample of Rural, Midwestern Food Pantries.

BACKGROUND: Food pantries have the potential to improve the quality of clients' diets. OBJECTIVE: This study evaluated the relationship between the quality of the mix of foods in pantry inventories and client food bags (separately), as assessed by the Healthy Eating Index-2010 (HEI-2010), with client diet quality and how these relationships varied by food security status. DESIGN: This cross-sectional, secondary analysis used baseline data from the Voices for Food intervention study (Clinical Trial Registry: NCT03566095). A demographic questionnaire, the US Household Food Security Survey Module, and up to three 24-hour dietary recalls on nonconsecutive days, including weekdays and weekends, were collected. Foods available in pantry inventories and distributed in client food bags were recorded at one time point during baseline data collection. PARTICIPANTS AND SETTING: A convenience sample of adult food pantry clients (N = 575) from 24 rural, food pantries in the US Midwest was recruited from August to November 2014. MAIN OUTCOME MEASURES: Pantry inventories, client food bags, and client diets were scored using the HEI-2010. Main outcomes were client HEI-2010 scores. STATISTICAL ANALYSES PERFORMED: Linear regression models estimated associations between HEI-2010 total and component scores for pantry inventories and client food bags (in separate models) and the corresponding scores for client dietary intake. The interaction of client food security status, and potential pantry- and client-level confounders, was considered. RESULTS: Client food bag HEI-2010 scores were positively associated with client diet scores for total vegetables, greens and beans, and total fruit components, whereas pantry inventory HEI-2010 scores were negatively associated with client diet scores for total fruit, total protein foods, and seafood and plant proteins components. Client food bag whole-grains scores were more strongly associated with very low food secure compared with food secure client diet scores (all P values < 0.05). CONCLUSIONS: The quality of client food bags, but not of pantry inventories, was positively associated with client diet quality in a rural sample in the US Midwest.

Dietary Quality and Usual Intake of Underconsumed Nutrients and Related Food Groups Differ by Food Security Status for Rural, Midwestern Food Pantry Clients.

BACKGROUND: Food pantry users represent a predominantly food insecure population, yet dietary intake may differ among food secure (FS), low FS, and very low FS clients. Usual intake of food groups and nutrients by food security status has not previously been compared among food pantry clients. OBJECTIVE: This study aimed to estimate the usual intakes of underconsumed nutrients (ie, potassium; dietary fiber; choline; magnesium; calcium; vitamins A, D, E, and C; and iron) and related food groups (ie, vegetables, fruits, whole grains, and dairy) and dietary quality, and to evaluate their relationship with food security status. DESIGN: This cross-sectional, secondary analysis used baseline data from a prior intervention study (Clinical Trial Registry: NCT03566095). A demographic questionnaire, the US Household Food Security Survey Module, and up to three 24-hour dietary recalls on nonconsecutive days, including weekdays and weekends, were collected. PARTICIPANTS/SETTING: This community-based study included a convenience sample of adult, midwestern food pantry clients (N=579) recruited from August to November 2014. MAIN OUTCOME MEASURES: Main outcomes evaluated were Healthy Eating Index-2010 scores and usual intakes of underconsumed nutrients and related food groups. STATISTICAL ANALYSES PERFORMED: Linear regression models and the National Cancer Institute method, adjusting for confounders, were used to estimate associations of food security with diet quality and usual intake, respectively. RESULTS: Being FS was associated with a higher whole grains HEI-2010 score and higher mean usual intake of whole grains compared with being low FS. Being FS was associated with higher usual intakes of iron and dairy compared with being very low FS. Being FS was associated with a higher mean usual intake of dark green vegetables compared with being low FS and very low FS. Usual intakes were below federal guidance for all subgroups of food security. CONCLUSIONS: Although food security status may differentiate dietary intake among food pantry clients, improvements are needed among all clients.

Contextual Factors Influence Professional Development Attendance Among Child Care Providers in Nebraska.

OBJECTIVE: To examine contextual factors that may influence child care providers' motivators for attending nutrition-related training and their preferences and barriers to attending professional development training. DESIGN: Cross-sectional survey completed between January and April 2017. SETTING: Licensed child care programs (n = 1,490) across urban and rural Nebraska. PARTICIPANTS: Child care center directors (n = 336) and family child care home providers (n = 1,154). MAIN OUTCOME MEASURE(S): Motivators, preferences, and barriers of child care providers for attending professional development. ANALYSIS: Descriptive statistics and multiple logistic regression analyses were conducted. RESULTS: Top motivators for attending nutrition-related training included meeting licensure requirements and improving job performance. Child care providers most commonly selected preferences for receiving training included in-person and online delivery. Top barriers to obtaining training were schedule conflicts, accessibility, and cost. Child care centers and participants in the Child and Adult Care Food Program (CACFP) and Nutrition and Physical Activity Self-Assessment in Child Care (Go NAP SACC) were more likely to be motivated by licensure requirements. Rural providers were also more likely to report barriers such as inability to travel and limited access to training. Results revealed that child care type, geographic location, CACFP and Go NAP SACC participation can influence child care providers' motivators, preferences, and barriers to attending training. CONCLUSIONS AND IMPLICATIONS: Results highlight the importance of offering professional development training that best fits child care providers' needs and preferences.

Provider reported implementation of nutrition-related practices in childcare centers and family childcare homes in rural and urban Nebraska.

Approximately 15 million children under age 6 are in childcare settings, offering childcare providers an opportunity to influence children's dietary intake. Childcare settings vary in organizational structure - childcare centers (CCCs) vs. family childcare homes (FCCHs) - and in geographical location - urban vs. rural. Research on the nutrition-related best practices across these childcare settings is scarce. The objective of this study is to compare nutrition-related best practices of CCCs and FCCHs that participate in the Child and Adult Care Food Program (CACFP) in rural and urban Nebraska. Nebraska providers (urban n = 591; rural n = 579) reported implementation level, implementation difficulty and barriers to implementing evidence-informed food served and mealtime practices. Chi-square tests comparing CCCs and FCCHs in urban Nebraska and CCCs and FCCHs in rural Nebraska showed sub-optimal implementation for some practices across all groups, including limiting fried meats and high sugar/ high fat foods, using healthier foods or non-food treats for celebrations and serving meals family style. Significant differences (p < .05) between CCCs and FCCHs also emerged, especially with regard to perceived barriers to implementing best practices. For example, CCCs reported not having enough money to cover the cost of meals for providers, lack of control over foods served and storage problems, whereas FCCHs reported lack of time to prepare healthier foods and sit with children during mealtimes. Findings suggest that policy and public health interventions may need to be targeted to address the unique challenges of implementing evidence-informed practices within different organizational structures and geographic locations.

Development of an Instrument Measuring Perceived Environmental Healthfulness: Behavior Environment Perception Survey (BEPS).

OBJECTIVE: To create a tool to measure college students' perception of the healthfulness of their environment. DESIGN: (1) Item generation, (2) cognitive interview testing and exploratory factor analysis, (3) item refinement/modification, (4) factor structure validation, and (5) criterion validation. SETTING: Ten college campuses. PARTICIPANTS: Time point 1 (n = 120 cognitive interviews; n = 922 factor analysis); time point 2 (n = 2,676), convenience sample of undergraduate students. MAIN OUTCOME MEASURES: Cognitive interviews and survey data were used to assess perceptions about the environment. ANALYSIS: Exploratory factor analysis, structural equation confirmatory factor analysis, correlations, and regressions. RESULTS: Item generation resulted in 93 items. Items were eliminated based on cognitive interviews, exploratory factor analysis of pilot data, and elimination of cross-loading or weak loading items. In confirmatory analyses, a 21-item, 5-factor structure was the best fit for the data (χ2 = 3,286.77, degrees of freedom = 189; comparative fit index = 0.840; root-mean-square error of approximation = 0.078). Environmental factors include physical activity (α = 0.68, 4 items), healthful eating (α = 0.86, 5 items), mental health (α = 0.85, 5 items), barriers to healthful eating (α = 0.70, 4 items), and peer influences (α = 0.73, 3 items). There were significant associations between scales and validation criteria (P < .05). CONCLUSIONS AND IMPLICATIONS: The Behavior Environment Perception Survey is a novel instrument measuring perceptions of the healthfulness of the campus environment. Strengths include a development process involving 10 different universities, strong psychometric properties, and breadth of constructs.

eB4CAST Approach Improves Science Communication With Stakeholders in a College-Based Health Program.

Communicating scientific results with community partners is often lacking in intervention programs, thus eB4CAST was developed to facilitate impact sharing. This article investigated using the eB4CAST dissemination tool to communicate impact from a campus-based obesity prevention program. Data from Get Fruved RCT university sites collected at baseline were used to generate eB4CAST reports. Experts (n = 13) and RCT sites (n = 15) were asked to provide feedback on eB4CAST reports based on appeal, understanding, and clarity. On all Likert items, participants rated above 7 on each (out of 10). Positive responses from open-ended questions included eB4CAST reports being clear, visually appealing, and aid in program understanding. Overall, eB4CAST was successful in relaying data and information for the Get Fruved program, thus a means for science communication that could be used in interventions. Utilizing infographics to report data and information is a feasible way to disseminate and communicate in a cost-effective, timely manner.

Chronic Health Condition Influences on Client Perceptions of Limited or Non-choice Food Pantries in Low-income, Rural Communities.

Objectives: Food insecurity and diet-related chronic health conditions are interrelated problems in rural communities. The population facing such outcomes may rely on food pantries as a way to gain access to food. Many food pantries use a traditional distribution model that restricts choice. Yet, dietary recommendations and the need to economize food resources place many challenges on households. In this research, we sought to determine whether clients self-reporting chronic health conditions in their households have unique perceptions about food pantries and their ability to meet needs. Methods: We surveyed clients (N = 612) of limited or non-choice rural pantries, each representing a unique household. We classified clients into 3 groups: no chronic condition; one chronic condition or more, but no diabetes; one chronic condition or more including diabetes. We compared group perceptions of pantries. Results: All conditions desired more choice, and more preference for certain food groups such as produce and dairy. Clients with chronic conditions and diabetes in their household had a greater percentage of negative comments about the choices offered and were less comfortable talking to volunteers. Conclusions: Rural pantries may serve clients with chronic health conditions by offering client choice and by engaging with them regarding needs and preferences.

Cooking Frequency Associated With Dietary Quality in iCook-4H Youth Participants at Baseline.

BACKGROUND: Increased intakes of ready-made and fast foods paralleled with decreased homemade food consumption have been associated with increased rates of obesity. Researchers have shown associations between cooking self-efficacy (SE) and cooking frequency (CF) with dietary quality and weight status. Some cooking interventions have shown positive associations with dietary outcomes, such as increased fruit and vegetable intake and decreased fast food consumption. There is still much unknown about SE and CF, especially among youth. OBJECTIVE: Determine baseline SE and CF and the associations with dietary quality and body mass index (BMI) of youth enrolled in iCook 4H. METHODS: Youth (n = 228, ages 9-10 years) completed online surveys assessing SE, CF, dietary quality, and demographics. Anthropometrics were collected to calculate BMI-for-age percentiles and weight categories. Descriptive statistics were completed for CF, SE, BMI categories, and demographics. Differences in CF and SE by sex, race, and participation in government assistance programs were determined through independent-sample t tests. Pearson correlations were used to assess the association between dietary quality and CF and SE. Associations between CF and dietary quality were assessed further through 2-way analyses of variance (ANOVAs) that included CF and sex and CF and race as independent variables. Associations between SE and CF and BMI were assessed through ANOVAs. RESULTS: Thirty-seven percent of youth were overweight or obese. Females reported significantly higher CF than males (P = .042). Cooking frequency was positively associated with dietary quality (P < .001), but BMI was not associated with dietary quality. SE was not associated with dietary quality or BMI. CONCLUSION: Based on results, CF was positively associated with dietary quality among youth. More research is needed to assess how different types of cooking relate to diet and BMI. Interventions are needed to determine whether increasing CF leads to better diet outcomes.

The iCook 4-H Study: An Intervention and Dissemination Test of a Youth/Adult Out-of-School Program.

OBJECTIVE: To describe outcomes from intervention and dissemination of iCook 4-H. DESIGN: Five-state, community-based participatory research and a randomized, controlled trial followed by a 5-state, nonrandomized dissemination test of the iCook 4-H curriculum with control and treatment groups. SETTING: Community and university sites. PARTICIPANTS: Youths aged 9-10 years and their adult food preparer; 228 dyads in the intervention and 74 dyads in dissemination. INTERVENTION(S): Theoretical frameworks were Social Cognitive Theory and the experiential 4-H learning model. Six 2-hour, biweekly sessions on cooking, eating, and playing together followed by monthly newsletters and boosters until 24 months, expanded to 8 sessions for dissemination. MAIN OUTCOME MEASURE(S): Youth body mass index (BMI) z-scores, measured height and weight, and youth/adult program outcome evaluations surveys. ANALYSIS: Linear mixed models, group, time, and group × time interaction for BMI z-score and program outcomes changes. Significance levels = P ≤ .05; interaction term significance = P ≤ .10. RESULTS: In intervention, treatment BMI z-scores increased compared with controls based on significant interaction (P = .04). For odds of being overweight or obese at 24 months, there was no significant interaction (P = .18). In dissemination, based on significant interaction, treatment youths increased cooking skills (P = .03) and treatment adults increased cooking together (P = .08) and eating together (P = .08) compared with controls. CONCLUSIONS AND IMPLICATIONS: iCook 4-H program outcomes were positive for mealtime activities of cooking and eating together. The program can be successfully implemented by community educators. The increase in BMI z-scores needs further evaluation for youths in cooking programs.