An Academic-Community Partnership to Address Gun Violence in the Roseland Neighborhood of Chicago.

BACKGROUND AND OBJECTIVES: Gun violence is the leading cause of death for youth. This study examined an academic-community partnership to address gun violence through a strength-based approach called Asset-Based Community Development. METHODS: We used a case study design. Participants were Black youth who encounter frequent gun violence (average age = 16.7 years; 72% male). Our partnership involved survey development/completion and semistructured discussions. We also interviewed community stakeholders to collect data on local assets. We interpreted data through a communitywide forum to guide social action to address gun violence. RESULTS: The majority of youth (76%) witnessed neighborhood violence in the last year. The top youth concerns related to gun violence included poverty, guns, and gangs. Community stakeholders saw local people and local organizations as primary community assets. A community forum to interpret these data led to social action in the form of an environmental strategy-cleaning up an unused commercial building for the development of a youth tech center. The majority of youth participants (89.5%) agreed or strongly agreed that they had a voice in the research process. CONCLUSION: Participatory research that takes an asset-based approach can enable relevant inquiry that engages youth and guides social action to address gun violence.

Cause-Specific Mortality and Racial Differentials in Life Expectancy, Chicago 2018-2019.

BACKGROUND: In Chicago in 2018, the average life expectancy (ALE) for NH Blacks was 71.5 years, 9.1 fewer years than for NH Whites (80.6 years). Inasmuch as some causes of death are increasingly recognized products of structural racism, in urban areas, such causes may have potential for reducing racial inequities through public health intervention. Our purpose is to allocate racial inequities in ALE in Chicago to differentials in cause-specific mortality. METHODS: Using multiple decrement processes and decomposition analysis, we examine cause-specific mortality in Chicago to determine the causes of death that contribute to the gap in life expectancy between NH Blacks and NH Whites. RESULTS: Among females, the racial difference in ALE was 8.21 years; for males, it was 10.53 years. We find that cancer and heart disease mortality account for 3.03 years or 36% of the racial gap in average life expectancy among females. Differences in homicide and heart disease mortality rates comprised over 45% of the disparity among males. CONCLUSIONS: Strategies for improving inequities in life expectancy should account for differences between males and females in cause-specific mortality rates. In urban areas with high levels of segregation, reducing inequities in ALE may be possible by dramatically reducing mortality rates from some causes. CONTRIBUTION: This paper illustrates the state of inequities in ALE between NH Blacks and NH Whites in Chicago for the period just prior to the onset of the COVID-19 pandemic, using a well-established method of decomposing mortality differentials for sub-populations.

The Effects of Interpersonal Violence on Sleep Following the COVID-19 Stay-at-Home Order.

PURPOSE: Lack of sleep is a harm that can lead to chronic diseases ranging from diabetes to heart disease. We examined the exposure to interpersonal violence and its association with sleep, following the COVID-19 stay-at-home order. DESIGN: Cross-sectional. SETTING: Surveys were completed online and via paper-and-pencil in English and Spanish (N = 2049; RR = 68.4%). SUBJECTS: Respondents were 18+ and residing in Chicago. MEASURES: The Chicago Department of Public Health's "2022 Healthy Chicago Survey COVID-19 Social Impact Survey". ANALYSIS: We developed two weighted models. Model 1 examined the effects of neighborhood violence on meeting the national sleep recommendation. Model 2 examined the effects of violence in the home among friends or family on meeting the sleep recommendation, incorporating additional predictors: victimization, stress, gender, race/ethnicity, household income, and general health. Odds ratios were estimated using multivariate logistic regression. RESULTS: Exposure to neighborhood violence and sleep was not significant, but knowing a friend or family member who experienced violence or mistreatment in their home affected the odds of meeting the sleep recommendation (OR = .61, 95% CI = .44-.84). Non-Hispanic Blacks had 52% lower odds of meeting sleep recommendations (OR = .48, 95% CI = .37-.63). CONCLUSION: Addressing the harms to sleep that followed COVID-19 should engage diverse stakeholders in implementing culturally responsive interventions to promote adequate sleep and prevent chronic disease.

Examining the protective effects of social capital and social support on the perpetration of violence among a national sample of adolescents.

INTRODUCTION: Millions of children witness violence and are victims of violence each year. Previous research suggests that this is a risk factor for perpetrating violence. There is a paucity of studies that examine factors that protect violence-exposed youth from perpetrating violence. METHODS: This study used a panel design to measure the effects of exposure to violence on the perpetration of violence. It examined the protective effects of social support and school social capital on the risk of exposure to violence, using multivariate logistic regression modelling. The sample was weighted to reflect a national population. RESULTS: The median age of the sample was 15. When considering risk factors only, those who 'saw someone shoot or stab another person' were at 4.77 times (95% CI 3.19 to 7.13) greater risk for perpetrating interpersonal violence. In the full model (risk and protective factors, (N=8375)), those with lower school social capital were at 2.43 (95% CI 1.15 to 5.15) to 2.91 (95% CI 1.02 to 8.29) times greater risk of perpetrating violence compared with those with the highest school social capital; adding the protective factors into the model reduced the odds of perpetrating violence from 4.77 times to 3.47 times (95% CI 1.97 to 6.11) (p<0.001). CONCLUSION: On a national level, the protective effects of school social capital could translate to a substantial reduction of violence. School-wide policies and programmes that reach all adolescents in a school and promote social capital should be pursued as a strategy to prevent the perpetration of interpersonal violence.

The Effects of Exposure to Domestic Violence on Sleep Among Urban Adults.

PURPOSE: Domestic violence contributes to poor health including sleep disruptions, which has been associated with risk for chronic conditions and ultimately, premature mortality. The present study examined the effects of ever witnessing domestic violence on sleep among urban neighborhoods of color. DESIGN: Cross-sectional. SETTING: Ten of Chicago's 77 community areas. PARTICIPANTS: Adults, aged 18 years and older (N = 1,543, Response Rate = 28.4%). Over 49% of participants reported a Hispanic ethnicity, 34.8 percent reported being non-Hispanic Black and 14.2 percent reported being White. MEASURES: We used the Sinai Community Health Survey, 2.0, to examine: average hours of sleep in a 24-hour period, ever witnessing domestic violence, ever being emotionally or physically abused, frequent stress in the past 12 months, and other key covariates (race and ethnicity, annual household income, sex, and health status). ANALYSIS: Multivariate logistic regression. RESULTS: In the full model, participants who reported witnessing domestic violence were significantly less likely to report meeting sleep recommendations even after controlling for ever being emotionally or physically abused, frequently feeling stress, demographic factors, and health status. Non-Hispanic Blacks were most likely to report not meeting sleep recommendations (OR = .54, 95% CI = .30-.96, P = .036). CONCLUSION: Witnessing domestic violence contributes to not meeting sleep recommendations and this appears to be most salient for Non-Hispanic Blacks. These point-in-time findings document an important potential contributor to racial health disparities.

To plant a garden is to believe in tomorrow: A case study of a Chicago community-based organization focused on health education through school gardens.

Nutrition education through school-based garden programs is a promising intervention to promote youth health and development. Gardeneers is a Chicago-based nonprofit, leading garden programming across area schools. To better understand their impact on youth health, Gardeneers aimed to define their model more clearly. Using a collective case study design, this mixed-method, formative program evaluation focused on describing program implementation variation across schools. General program design included nutrition education through hands-on garden-based learning. Stakeholder engagement was a strength for some schools and a challenge for others. Sustainability was an ongoing challenge for all schools, particularly funding. Priority student outcomes also varied between schools. Adaptability is core to Gardeneers' approach-the challenge lies in replicable program design and manageable growth, but the strength lies in the ability to meet specific school and student needs. Using these findings, Gardeneers refined their program model and identified program improvements opportunities.

Developing the public health workforce through community-based fieldwork.

A skilled public health workforce is critical to assure the public's health. Recent scholarship has highlighted the benefits of practice-based fieldwork to train the public health workforce. This scholarship has highlighted these benefits primarily through quantitative evaluation. DePaul University's Master of Public Health (MPH) Program provides practice-based education and training to enable students to develop key competencies in public and community health. A key component of the MPH Program is a 9-month practicum experience. This practicum experience requires students to (1) Complete at least 250 h of fieldwork at a local health organization and (2) write a capstone thesis about their practicum project. In this themed issue, seven MPH Program students provide empirical papers, describing their practicum project and the competencies they gained. These empirical papers build upon existing scholarship on practice-based fieldwork and aim to advance academic and community efforts to assure a skilled public and community health workforce.

Suicide Rates and Differences in Rates Between Non-Hispanic Black and Non-Hispanic White Populations in the 30 Largest US Cities, 2008-2017.

OBJECTIVES: Suicide is a leading cause of death in the United States, and rates vary by race and ethnicity. An analysis of suicide across large US cities is absent from the literature. The objective of this study was to examine suicide rates among the total population, non-Hispanic Black population, and non-Hispanic White population in the United States and in the 30 largest US cities. METHODS: We used data from the National Vital Statistics System to calculate non-Hispanic White, non-Hispanic Black, and total age-adjusted suicide rates for the 30 largest US cities and for the entire nation during 2 periods: 2008-2012 and 2013-2017. We also examined absolute and relative differences in suicide rates among non-Hispanic White populations and non-Hispanic Black populations in each city. RESULTS: The overall age-adjusted suicide rate per 100 000 population in the United States increased significantly from 12.3 in 2008-2012 to 13.5 in 2013-2017. Total suicide rates were stable in most cities; rates increased significantly in only 1 city (Louisville), and rates decreased significantly in 2 cities (Boston and Memphis). The non-Hispanic White suicide rate was significantly higher-1.3 to 4.3 times higher-than the non-Hispanic Black suicide rate in 24 of 26 study cities during 2013-2017. From 2008-2012 to 2013-2017, non-Hispanic White suicide rates decreased significantly in 3 cities and increased significantly in 3 cities; non-Hispanic Black suicide rates increased significantly in 5 cities and decreased in none. Absolute differences in suicide rates among non-Hispanic White populations and non-Hispanic Black populations increased significantly in 1 city (Louisville) and decreased significantly in 2 cities (Memphis and Boston). CONCLUSIONS: Our study may inform the use of evidence-based programs and practices to address population-level risk factors for suicide.

NMReDATA: Tools and applications.

The nuclear magnetic resonance extracted data (NMReDATA) format has been proposed as a way to store, exchange, and disseminate nuclear magnetic resonance (NMR) data and physical and chemical metadata of chemical compounds. In this paper, we report on analytical workflows that take advantage of the uniform and standardized NMReDATA format. We also give access to a repository of sample data, which can serve for validating software packages that encode or decode files in NMReDATA format.

Examining Perceptions of Spanish Language Health Information Among Hispanics Living in the United States: A Qualitative Study Assessing Videos, Brochures, and Websites.

BACKGROUND: Nationally, Hispanics experience health disparities manifested as a higher prevalence of chronic diseases in comparison to non-Hispanic Whites. Factors that influence health disparities in this population include inadequate dissemination of culturally and linguistically appropriate health information. METHOD: Our qualitative analysis is based on data obtained from three focus groups with Spanish-speaking Hispanic adults conducted at a clinic in Nebraska. Participants were asked about their perceptions of health information in the form of videos, brochures, and websites. We followed the consolidated criteria for reporting qualitative research and used the theoretical framework of content analysis. RESULTS: For videos, attributes associated with higher levels of trust included a friendly health professional, the logo or name of a health care institute, and a reference specifying "se habla Español." For brochures, attributes associated with trust included use of visual aids, use of numerous colors and big font sizes, the year of printing, and a health care agency logo. For websites, characteristics associated with trust were inclusion of plain language, use of pictures and videos, and date of last update. In all focus groups, participants perceived the use of mixed English/Spanish language in health information from pamphlets and websites as unprofessional. The use of unknown governmental logos in health promotional videos and websites was perceived as untrustworthy information. CONCLUSIONS: Spanish-speaking Hispanics prefer health information supported by a health care agency or delivered by a health care professional. Health communication strategies should avoid the use of mixed English/Spanish language in sensitive information especially when combined with governmental logos.

High Blood Pressure Medication Adherence Among Urban, African Americans in the Midwest United States.

Hypertension is a chronic condition that disproportionately affects African Americans. Managing high blood pressure (HBP) requires adherence to daily medication. However, many patients with hypertension take their HBP medication inconsistently, putting them at heightened risk of heart disease. Researchers have shown that these health risks are greater for African Americans than for Caucasians. In this article, we examine barriers and facilitators of medication adherence among urban African Americans with hypertension. We interviewed 24 African Americans with hypertension (58.5% women, average age 59.5 years) and conducted a comprehensive thematic analysis. Twenty-two barriers and 32 facilitators to medication adherence emerged. Barriers included side effects and forgetting while facilitators included reminders, routines, and social support. Using this data, we developed a diagram of theme connectedness of factors that affect medication adherence. This diagram can guide multi-level HBP intervention research that targets African Americans to promote medication adherence, prevent heart disease, and reduce ethnic and racial health disparities.

Metabolomics: The Stethoscope for the Twenty-First Century.

Metabolomics encompasses the systematic identification and quantification of all metabolic products in the human body. This field could provide clinicians with novel sets of diagnostic biomarkers for disease states in addition to quantifying treatment response to medications at an individualized level. This literature review aims to highlight the technology underpinning metabolic profiling, identify potential applications of metabolomics in clinical practice, and discuss the translational challenges that the field faces. We searched PubMed, MEDLINE, and EMBASE for primary and secondary research articles regarding clinical applications of metabolomics. Metabolic profiling can be performed using mass spectrometry and nuclear magnetic resonance-based techniques using a variety of biological samples. This is carried out in vivo or in vitro following careful sample collection, preparation, and analysis. The potential clinical applications constitute disruptive innovations in their respective specialities, particularly oncology and metabolic medicine. Outstanding issues currently preventing widespread clinical use are scalability of data interpretation, standardization of sample handling practice, and e-infrastructure. Routine utilization of metabolomics at a patient and population level will constitute an integral part of future healthcare provision.

Homicide Mortality Inequities in the 30 Biggest Cities in the U.S.

INTRODUCTION: Homicide is a leading cause of death across the U.S., and it disproportionally affects Blacks in urban areas. This study fills a gap in the literature by examining homicide mortality and Black-White homicide disparities in the 30 biggest U.S. cities and for the entire U.S. across 2 time periods (2008-2012 and 2013-2017). METHODS: Using data from the National Vital Statistics System for 2008-2017, this study calculated age-adjusted homicide mortality rates (per 100,000) for the total, White, and Black populations in the 30 biggest cities, and the U.S. Black-to-White rate ratios were calculated to examine homicide mortality across the time periods. Data were analyzed in 2020. RESULTS: A total of 26 cities were included in the final analysis. Results show that U.S. homicides increased slightly but significantly across the time periods (p<0.05). A total of 6 cities saw significant increases in homicides and 5 saw significant decreases. Homicide mortality rates were 1.8 times to >20 times greater for Blacks than for Whites, and these disparities persisted across the time periods for most cities. Only 2 of 26 cities had mortality rates and racial inequities in rates that were lower than the national average. CONCLUSIONS: Homicide mortality increased slightly across the U.S. and most cities from 2008 to 2017. The majority of cities faced high homicide mortality rates and large inequities. Black-White disparities in homicide remain substantial at the national and city levels. These findings can inform city leaders in their efforts to address the homicide, violence, and racial inequities associated with them through the implementation of policies and programs.

Adapting an Evidence-Based Cardiovascular Disease Risk Reduction Intervention to Urban American Indians.

PURPOSE: Using the RE-AIM framework, the primary purpose of this qualitative study was to conduct focus groups to identify areas for future adaptation of an evidence-based cardiovascular disease (CVD) risk intervention (COACH) developed for an urban primary care setting to urban American Indian (AI)-serving settings. METHODS: This qualitative study involved conducting three focus groups with 31 urban AI patients with two or more CVD risk factors to maximize reach and efficacy of COACH. The patients had not yet participated in an adapted COACH program. RESULTS: Findings from the focus groups indicate that a culturally adapted CVD risk reduction program modeled after COACH would be acceptable among urban AI populations. Recommendations for cultural adaptation include a need for images of AI people, traditional AI exercise activities and AI foods, information on the portion sizes of traditional foods, and expanded information on tobacco use and resources. CONCLUSION: With cultural adaptations, the COACH program can be pilot-tested in urban AI-serving primary care settings to address health concerns and behaviors that affect cardiovascular health outcomes.

Interoperable and scalable data analysis with microservices: applications in metabolomics.

MOTIVATION: Developing a robust and performant data analysis workflow that integrates all necessary components whilst still being able to scale over multiple compute nodes is a challenging task. We introduce a generic method based on the microservice architecture, where software tools are encapsulated as Docker containers that can be connected into scientific workflows and executed using the Kubernetes container orchestrator. RESULTS: We developed a Virtual Research Environment (VRE) which facilitates rapid integration of new tools and developing scalable and interoperable workflows for performing metabolomics data analysis. The environment can be launched on-demand on cloud resources and desktop computers. IT-expertise requirements on the user side are kept to a minimum, and workflows can be re-used effortlessly by any novice user. We validate our method in the field of metabolomics on two mass spectrometry, one nuclear magnetic resonance spectroscopy and one fluxomics study. We showed that the method scales dynamically with increasing availability of computational resources. We demonstrated that the method facilitates interoperability using integration of the major software suites resulting in a turn-key workflow encompassing all steps for mass-spectrometry-based metabolomics including preprocessing, statistics and identification. Microservices is a generic methodology that can serve any scientific discipline and opens up for new types of large-scale integrative science. AVAILABILITY AND IMPLEMENTATION: The PhenoMeNal consortium maintains a web portal (https://portal.phenomenal-h2020.eu) providing a GUI for launching the Virtual Research Environment. The GitHub repository https://github.com/phnmnl/ hosts the source code of all projects. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Adapting an Evidence-based Cardiovascular Disease Risk Reduction Intervention to Rural Communities.

PURPOSE: Using the RE-AIM framework, the primary purpose of this qualitative study was to assess focus group data to generate information on the applicability of an evidence-based cardiovascular disease (CVD) risk intervention developed for an urban setting for rural areas in Nebraska. We also sought to determine potential adaptations that may be necessary to implement the study in a rural setting. The CVD risk reduction intervention is based on the Community Outreach and Cardiovascular Health (COACH) program, which included nurse practitioner/community health worker teams. METHODS: This qualitative study involved conducting 3 focus groups with patients with CVD risk factors to assess community readiness for participating in the intervention, the mode of the delivery of the intervention, the setting of the intervention, program content, and raising awareness of the intervention. FINDINGS: Findings from the focus groups indicate acceptability toward a CVD risk reduction program modeled after the COACH. Participants favored initial in-person face-to-face interactions with a nurse practitioner that could transition to phone-based meetings and Skype. In addition, participants underscored that confidentiality can be a concern in small communities and therefore community health workers need to be trusted individuals. Calls for additions to COACH materials were very specific and participants underscored the need for social support. CONCLUSIONS: With minor adaptations, the COACH program can be pilot tested in rural settings to address key health concerns and behaviors that affect risk for cardiovascular health.

PhenoMeNal: processing and analysis of metabolomics data in the cloud.

BACKGROUND: Metabolomics is the comprehensive study of a multitude of small molecules to gain insight into an organism's metabolism. The research field is dynamic and expanding with applications across biomedical, biotechnological, and many other applied biological domains. Its computationally intensive nature has driven requirements for open data formats, data repositories, and data analysis tools. However, the rapid progress has resulted in a mosaic of independent, and sometimes incompatible, analysis methods that are difficult to connect into a useful and complete data analysis solution. FINDINGS: PhenoMeNal (Phenome and Metabolome aNalysis) is an advanced and complete solution to set up Infrastructure-as-a-Service (IaaS) that brings workflow-oriented, interoperable metabolomics data analysis platforms into the cloud. PhenoMeNal seamlessly integrates a wide array of existing open-source tools that are tested and packaged as Docker containers through the project's continuous integration process and deployed based on a kubernetes orchestration framework. It also provides a number of standardized, automated, and published analysis workflows in the user interfaces Galaxy, Jupyter, Luigi, and Pachyderm. CONCLUSIONS: PhenoMeNal constitutes a keystone solution in cloud e-infrastructures available for metabolomics. PhenoMeNal is a unique and complete solution for setting up cloud e-infrastructures through easy-to-use web interfaces that can be scaled to any custom public and private cloud environment. By harmonizing and automating software installation and configuration and through ready-to-use scientific workflow user interfaces, PhenoMeNal has succeeded in providing scientists with workflow-driven, reproducible, and shareable metabolomics data analysis platforms that are interfaced through standard data formats, representative datasets, versioned, and have been tested for reproducibility and interoperability. The elastic implementation of PhenoMeNal further allows easy adaptation of the infrastructure to other application areas and 'omics research domains.

nmrML: A Community Supported Open Data Standard for the Description, Storage, and Exchange of NMR Data.

NMR is a widely used analytical technique with a growing number of repositories available. As a result, demands for a vendor-agnostic, open data format for long-term archiving of NMR data have emerged with the aim to ease and encourage sharing, comparison, and reuse of NMR data. Here we present nmrML, an open XML-based exchange and storage format for NMR spectral data. The nmrML format is intended to be fully compatible with existing NMR data for chemical, biochemical, and metabolomics experiments. nmrML can capture raw NMR data, spectral data acquisition parameters, and where available spectral metadata, such as chemical structures associated with spectral assignments. The nmrML format is compatible with pure-compound NMR data for reference spectral libraries as well as NMR data from complex biomixtures, i.e., metabolomics experiments. To facilitate format conversions, we provide nmrML converters for Bruker, JEOL and Agilent/Varian vendor formats. In addition, easy-to-use Web-based spectral viewing, processing, and spectral assignment tools that read and write nmrML have been developed. Software libraries and Web services for data validation are available for tool developers and end-users. The nmrML format has already been adopted for capturing and disseminating NMR data for small molecules by several open source data processing tools and metabolomics reference spectral libraries, e.g., serving as storage format for the MetaboLights data repository. The nmrML open access data standard has been endorsed by the Metabolomics Standards Initiative (MSI), and we here encourage user participation and feedback to increase usability and make it a successful standard.

The future of metabolomics in ELIXIR.

Metabolomics, the youngest of the major omics technologies, is supported by an active community of researchers and infrastructure developers across Europe. To coordinate and focus efforts around infrastructure building for metabolomics within Europe, a workshop on the "Future of metabolomics in ELIXIR" was organised at Frankfurt Airport in Germany. This one-day strategic workshop involved representatives of ELIXIR Nodes, members of the PhenoMeNal consortium developing an e-infrastructure that supports workflow-based metabolomics analysis pipelines, and experts from the international metabolomics community. The workshop established metabolite identification as the critical area, where a maximal impact of computational metabolomics and data management on other fields could be achieved. In particular, the existing four ELIXIR Use Cases, where the metabolomics community - both industry and academia - would benefit most, and which could be exhaustively mapped onto the current five ELIXIR Platforms were discussed. This opinion article is a call for support for a new ELIXIR metabolomics Use Case, which aligns with and complements the existing and planned ELIXIR Platforms and Use Cases.

Implementing the Academy of Nutrition and Dietetics Benchmarks for Nutrition Education for Children: Child-Care Providers' Perspectives.

BACKGROUND: National childhood obesity prevention policies recommend that child-care providers educate young children about nutrition to improve their nutrition knowledge and eating habits. Yet, the provision of nutrition education (NE) to children in child-care settings is limited. OBJECTIVE: Using the 2011 Academy of Nutrition and Dietetics benchmarks for NE in child care as a guiding framework, researchers assessed child-care providers' perspectives regarding delivery of NE through books, posters, mealtime conversations, hands-on learning, and sensory exploration of foods to young children (aged 2 to 5 years). DESIGN: Using a qualitative design (realist method), individual, semistructured interviews were conducted until saturation was reached. PARTICIPANTS/SETTING: The study was conducted during 2012-2013 and used purposive sampling to select providers. Final sample included 18 providers employed full-time in Head Start or state-licensed center-based child-care programs in Central Illinois. MAIN OUTCOME MEASURE: Child-care providers' perspectives regarding implementation of NE. STATISTICAL ANALYSES PERFORMED: Thematic analysis to derive themes using NVivo software. RESULTS: Three overarching themes emerged, including providers' motivators, barriers, and facilitators for delivering NE to children. Motivators for delivering NE included that NE encourages children to try new foods, NE improves children's knowledge of healthy and unhealthy foods, and NE is consistent with children's tendency for exploration. Barriers for delivering NE included that limited funding and resources for hands-on experiences and restrictive policies. Facilitators for delivering NE included providers obtain access to feasible, low-cost resources and community partners, providers work around restrictive policies to accommodate NE, and mealtime conversations are a feasible avenue to deliver NE. Providers integrated mealtime conversations with NE concepts such as food-based sensory exploration and health benefits of foods. CONCLUSIONS: Present study findings offer insights regarding providers' perspectives on implementing NE in child care. Drawing from these perspectives, registered dietitian nutritionists can train providers about the importance of NE for encouraging healthy eating in children, integrating NE with mealtime conversations, and practicing low-cost, hands-on NE activities that meet the food safety standards for state licensing. Such strategies may improve providers' ability to deliver NE in child-care settings.