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.

Reach Characteristics and Predictors of Virtual Nutrition Education in a Florida SNAP-Ed Implementing Agency During COVID-19

Background As the COVID-19 pandemic continued in FFY21, direct nutrition education programming was offered in-person and virtually through the UF/IFAS Extension Family Nutrition Program (FNP-Florida SNAP-Ed implementing agency) to reach audiences amidst the pandemic's constraints. Objective To compare the demographic reach and program activity characteristics (e.g., ethnicity, class size) across in-person and virtual delivery and identify predictors, including county environmental and social factors (e.g., metro designation, poverty rate), for the use of virtual delivery. This inquiry is useful to examine and guide the equitable and effective delivery of nutrition education that relies on multiple delivery methods. Study Design, Settings, Participants All one-time and series completed nutrition education program activities that FNP delivered in FFY21 were included. Mixed-age (youth and adult) activities were excluded due to low frequencies. Final program activity n = 4,111, final participant n = 60,920. Measurable Outcome/Analysis Demographics and activity characteristics were compared using summary and inferential statistics. Predictive model (logistic regression) variables included program activity characteristics (audience age;class size;start date;class setting) and county-level environmental and social variables (metro designation;COVID-19 Pandemic Vulnerability Index;household internet subscriptions;commute times;poverty rates). County variables were coded in relation to Florida county medians. Results Significant differences across in-person and virtual delivery methods were observed in multiple demographic and activity characteristic measures (e.g., differences in sex of adult participants (P < 0.001, Fisher's Exact Test). All program activity characteristics and county environmental and social variables were significant predictors of the utilization of virtual nutrition education. Conclusions Program activity characteristics and county environmental and social factors successfully predicted the use of virtual nutrition education, which may help explain differences in demographics and generally supports a systems approach to comparing delivery methods. Individual participant and nutrition educator preferences for virtual delivery were not accounted for and might explain much of the variability. Funding Supplemental Nutrition Assistance Program - Education.

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.

Covid-19 and College Students: Food Security Status before and after the Onset of a Pandemic.

While the Covid-19 pandemic has increased the number of food insecure households in the United States (US), it is unclear how it has affected college student food security status. College students are ineligible for many Covid-19-related economic relief programs and may find it even more difficult to cope during the pandemic. Therefore, the purpose of this study was to identify and describe the prevalence of food insecurity at a public university before and after the onset of Covid-19 as well as factors associated with any change in food security. Researchers administered a cross-sectional, non-probability survey to college students (n = 3206) that assessed food security status prior to and after the onset of the Covid-19 pandemic, as well as questions related to various sociodemographic characteristics. Data were analyzed using descriptive statistics. Thirty-eight percent of students experienced a change in food security as a result of the pandemic, with 59.6% becoming less food secure, and 40.4% becoming more food secure. Characteristics that were associated with changes in food security included changes in housing and employment status as a result of the pandemic. These findings suggest that the pandemic led to changes in food security among college students, and that economic relief efforts should include college students, who are disproportionately affected by food insecurity.