O04 The Impact of COVID-19 on Perceived Barriers and Facilitators to the Healthfulness of Communities With Low-Income

The COVID-19 pandemic brought new challenges affecting the wellbeing of individuals in communities with low income. Understanding where people live and how those environments can facilitate or hinder living a healthy lifestyle is essential for developing interventions that target behavior change and health promotion. This study compares Extension Nutrition Educators' (NEs) perceptions of the barriers and facilitators impacting the healthfulness of the environment of communities with low income in eleven states before and during the COVID-19 pandemic. Trained researchers conducted focus groups and interviews with NEs prior to (n = 97) and during (n = 77) the first two years of the pandemic in Alabama, Kansas, Florida, Georgia, Maine, Mississippi, Nebraska, New Hampshire, Rhode Island, South Dakota, Tennessee, and West Virginia. Discussions were audio-recorded, transcribed verbatim, and coded by researchers using inductive thematic analysis. Cross-tabulation analysis was used to compare data pre-and-during COVID-19. NEs' revealed COVID-19 not only exacerbated existing barriers (i.e., lack of access to healthy foods, transportation, nutrition education and information, and physical and mental health resources) but also created new challenges in these communities. NEs stated increased unemployment rates led to financial hardships and greater food insecurity. Participants mentioned COVID-19 restrictions (i.e., social distancing, shutdowns, etc.) and fear of exposure made services and resources more difficult to acquire, and impacted dietary behavior, physical activity patterns, and mental health. Likewise, limited access to technology and connectivity decreased the ability to learn about and access services and resources. Nonetheless, NEs suggested new opportunities were designed to mitigate COVID-related barriers, such as virtual programming, COVID-19 relief programs, food distribution programs, grocery store delivery services, and revised social marketing approaches to increase awareness of available resources/services. Given the onset of new barriers resulting from COVID-19, there is a need to consider these barriers when developing or adapting health promotion strategies to support the healthfulness of communities. None.

HomeStyles-2 for SNAP-Ed families with children in middle childhood: Cluster randomized trial protocol.

BACKGROUND: Childhood obesity prevention efforts are needed in the United States, especially for families with low income. The purpose of this study is to determine whether HomeStyles-2, a nutrition education and childhood obesity prevention program for families with children in middle childhood (ages 6 to 11 years), motivates parents to re-shape their home environments and weight-related lifestyle practices to be more supportive of meeting national nutrition and physical activity recommendations and weight status of their children more so than those in the control condition. METHODS: A research-practice partnership with Florida's Supplemental Nutrition Assistance Program-Education (SNAP-Ed) program was formed to conduct a cluster randomized trial to evaluate the HomeStyles-2 intervention. SNAP-Ed-eligible individuals who are parents/caregivers of children aged 6-11 living in the study catchment area will be invited to enroll in the study and participate in a six-lesson series using the HomeStyles-2 program or an attention control program. The primary outcome measures related to parent weight-related behaviors will be assessed on the individual level. Linear mixed models with a hierarchical design will be used to assess outcomes of interest. DISCUSSION: This study has the potential to demonstrate the effectiveness of a new curriculum implemented in a federal nutrition education program. Because of the COVID-19 pandemic, adjustments were made to the intervention design to allow for virtual delivery of the intervention through SNAP-Ed. This unanticipated change will offer much-needed research on the effectiveness of virtual nutrition education, which may help to expand SNAP-Ed's reach across the country. TRIAL REGISTRATION: NCT05019339.

Impact of COVID-19 on college student diet quality and physical activity.

Background: The COVID-19 pandemic can cause in increase in stress experienced by college students and consequently, potentially adversely affect their health behaviours. Aims: The aim of this study was to investigate how COVID-19 impacted college-attending young adults diet quality and physical activity. Methods: Students attending an Appalachian university in spring 2020 participated in this cross-sectional study. Participants were surveyed on their eating habits, diet quality, and physical activity before and since COVID-19. Frequencies of responses were analyzed and Bowker's test was used to determine differences in responses before and since COVID-19. Alpha was set at 0.05. Results: Almost one third (32.6%) of students reported eating somewhat more since COVID-19 and 67.9% of these students stated it was due to boredom. Students showed a significant increase in frequency of eating and in consumption of almost every food group. The number of students engaging in low physical activity increased from 27.8% to 51.9% and the number of students engaging in high physical activity decreased from 59.5% to 34.0% (p < .0001) and many switched to the use of at-home workouts. Conclusion: Results indicate the effects of campus closure on college student's lifestyles and the risk of developing health problems due to the COVID-19 pandemic, potentially inhibiting their academic progress and well-being.

Newly Food-Insecure College Students in Appalachia During the COVID-19 Pandemic.

OBJECTIVE: This study investigated if the coronavirus disease (COVID-19) pandemic influenced college student food insecurity and factors that might contribute to a student becoming newly food insecure. DESIGN: A convenience sample was assessed using a cross-sectional survey. SETTING: Online. PARTICIPANTS: College students (n = 2,018) enrolled at a land-grant institution in Appalachia. MAIN OUTCOME MEASURE(S): Food insecurity was assessed using the Hunger Vital Sign with reference before COVID-19 and since COVID-19. Demographic and pandemic-specific questions and their associations with food insecurity status were assessed. ANALYSIS: Students were categorized as food secure (food secure before and since COVID-19 or food insecure in the year before COVID-19 but not food insecure since COVID-19), consistently food insecure (food insecure before and since COVID-19), and newly food insecure (food secure before but food insecure since COVID-19). Multivariate logistic regression was used to investigate the relationship between new food insecurity and contributing factors. RESULTS: Of respondents, 68.4% were food secure, 16.5% were consistently food insecure, and 15.1% were newly food insecure. Loss of employment, increased grocery expenditure, anxiety, and a perceived threat posed by COVID-19 were significant indicators of students being newly food insecure. CONCLUSIONS AND IMPLICATIONS: More students were facing food insecurity as a result of the COVID-19 pandemic. Continued advocacy for sustainable solutions to college food insecurity is needed.

Impact of resilience on college student mental health during COVID-19.

OBJECTIVE: The aim of this study was to investigate how the COVID-19 pandemic impacted college student mental health and alcohol use and to determine how resilience could alleviate negative outcomes. PARTICIPANTS: Students attending an Appalachian university during spring 2020 were surveyed shortly after on-campus activities stopped. METHODS: Survey items included resilience, demographics, self-rated health, and depression symptoms, anxiety symptoms, and alcohol use before and since COVID-19. RESULTS: There was a significant increase in prevalence of severe depression, severe anxiety, and high stress, and a significant decrease in prevalence high risk for problem drinking before and since COVID-19. Four separate standard least squares regression models were conducted with each of the dependent variables. Self-rated health was the strongest predictor for changes in depression, anxiety, and stress in each of the models, displaying a negative relationship. CONCLUSIONS: Universities should prepare students using resilience training and provide employment and other resources to mitigate effects of stressful situations.

"My Entire World Stopped": College Students' Psychosocial and Academic Frustrations during the COVID-19 Pandemic.

The COVID-19 pandemic disrupted normalcy for college attending young adults which resulted in a loss of the campus environment and classroom setting. This change in setting may interfere with a student's personal and academic wellbeing. This study used an online survey to evaluate college students' academic and psychosocial frustrations during the COVID-19 pandemic. Data were collected from March-April 2020 at a land-grant university in the Appalachian region. Data were available from 2643 undergraduate and graduate students. There was a 65.8% and 15.7% increase in the number of students who reported their learning and health as fair, poor, or very poor after the COVID-19 pandemic, respectively. Qualitative responses were coded and 8 themes and 24 subthemes emerged. College students expressed frustrations regarding technology, classwork, research, family, social, emotional, behavioral, and financial aspects of life. These results can be used by higher education administration, faculty, and staff when planning for online courses. Ensuring that student frustrations and barriers to success are recognized and considered may help prevent students departing from higher education during this time.