Multipronged Approach to Controlling a Tuberculosis Outbreak Among Persons Experiencing Homelessness.

In May 2009, the Marion County Public Health Department in Indiana declared a tuberculosis (TB) outbreak among persons experiencing homelessness in Marion County, began active case finding to detect additional cases, and formed a TB outbreak response team to plan and coordinate outbreak activities. Outbreak-associated cases had 1 of 2 outbreak genotypes and either reported experiencing homelessness themselves or had an epidemiologic link to a shelter or a person experiencing homelessness. The last of 53 outbreak-associated cases was detected in 2019 after more than 2 years without a case. The Marion County Public Health Department continues to address TB-related issues and implement prevention measures at homeless shelters and among persons experiencing homelessness in 2019. This example, in addition to other published guidance, can be used by jurisdictions to plan and implement their own TB outbreak prevention and response activities among persons experiencing homelessness.

Skin Carotenoid Status Over Time and Differences by Age and Sex Among Head Start Children (3-5 Years).

OBJECTIVE: Examine differences in skin carotenoid status (SCS) based on time, age, and sex of preschool-aged children enrolled in Head Start (HS) in North Carolina. DESIGN: Data were collected using surveys from participating families. preschool-aged children's SCS were measured 3 times over a 6-month period. SETTING: Three HS centers in North Carolina. PARTICIPANTS: One hundred twelve children aged 3-5 years, enrolled in HS. MAIN OUTCOME MEASURE(S): Differences in SCS assessed using the Veggie Meter (Longevity Link, Salt Lake City, UT) based on time, sex, and age. ANALYSIS: One-way ANOVA to assess SCS at time 1 between sex and age (n = 112). Repeated measures ANOVA with a Greenhouse-Geisser correction for assessment of SCS over time (n = 45) using Bonferroni correction. RESULTS: On average, children were aged 4 years, African American (81.3%), male (57%), and had a mean SCS of 266 (SD = 82.9). Skin carotenoid status (Veggie Meter units) were significantly different over time (P < 0.001). Significant differences were observed between ages (P = 0.01) and sex (P < 0.01). CONCLUSIONS AND IMPLICATIONS: The Veggie Meter is a promising tool to assess fruit and vegetable intake but needs to be validated in preschool-aged children as it has been in adults. Sex and age are potential confounders which should be assessed in future studies using the Veggie Meter.

Food-Based Science, Technology, Engineering, Arts, and Mathematics (STEAM) Learning Activities May Reduce Decline in Preschoolers' Skin Carotenoid Status.

OBJECTIVE: To assess the effectiveness of food-based science, technology, engineering, arts, and mathematics (STEAM) learning activities on preschoolers' liking of 9 target vegetables and objectively-assessed fruit and vegetable (FV) intake. METHODS: Seven hands-on, food-based STEAM learning activities were implemented to expose children to 9 target vegetables in 3 Head Start preschools (11 classrooms) across North Carolina. Child-reported vegetable liking scores and skin carotenoid status (SCS) were dependent variables collected at baseline, midpoint, and posttest. Adjusted repeated-measures ANOVA was used to examine intervention impact. RESULTS: A total of 113 children (intervention = 49; comparison = 64) participated. Children were an average age of 3.7 ± 0.57 years at baseline. Mean target vegetable liking scores for the intervention and comparison groups, respectively, were 3.2 ± 0.19 and 3.2 ± 0.17 at baseline, 2.9 ± 0.17 and 3.1 ± 0.15 at midpoint, and 2.8 ± 0.15 and 3.1 ± 0.13 at posttest. A time × group interaction was not significant for target vegetable liking scores. Mean SCS were 268.6 ± 13.24 and 270.9 ± 12.13 at baseline, 271.3 ± 12.50 and 275.6 ± 11.46 at midpoint, and 267.8 ± 11.26 and 229.6 ± 10.32 at posttest for the intervention and comparison groups, respectively. A time × group interaction was significant for SCS (F1,77 = 3.98; P = 0.02; r = 0.10). Both groups declined from baseline to posttest (intervention = 0.06%; comparison = 15.09%), which occurred after winter break, with a smaller decline observed in the intervention group (P = 0.02). CONCLUSIONS AND IMPLICATIONS: Food-based STEAM learning activities may present a unique opportunity to affect FV intake while meeting academic standards. More research is needed to understand how liking for familiar FV changes over time and its relationship with consumption. In addition, more implementation research featuring larger sample sizes, teachers as the interventionist, and a longer study duration is needed to confirm the outcomes of food-based STEAM learning observed in the current study and the long-term impact this approach may have on children's' dietary quality.