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This purpose of this study is to help students developing problem-solving skills by using Problem-based Learning (PBL) as a teaching model, combining with the Objective Structured Clinical Examination (OSCE) as a training tool to evaluate students' clinical competencies. Sixty-five college junior students from a therapeutic nutrition course were participated. The topics of PBL included diabetes, kidney disease, cancer, and cardiovascular disease. For each disease, pre- and post-test quiz and after class exam were assessed to evaluate the students' learning effectiveness. Due to the impact of the COVID-19 epidemic, OSCE was performed online. The focus group interview and learning effectiveness questionnaire were conducted by the end of this course for all participants. Moreover, 37 students who attended the dietitian internship filled in the learning effectiveness questionnaire again after the internship. The results indicated that after the PBL, the post quiz score for each disease was increased, and through the online OSCE training, students' abilities to master nutrition education and counseling had been upgraded. Students indicated that both PBL and OSCE training could contributed to the learning effectiveness. The better academic performance students were, the more willing they are to work in nutrition-related fields in the future. For those who finished the dietitian internship agreed that they could understand the work content better in general regional and regional hospitals than in teaching ones. In conclusion, PBL teaching model combined with OSCE training could effectively improve students' learning motivation, learning effectiveness and practical application in a therapeutic nutrition course.Copyright © 2022 Nutrition Society in Taipei. All rights reserved.
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Online media are potentially useful teaching resources, especially for students studying from home during the coronavirus disease (COVID-19) pandemic. Previous research found that this method can improve understanding of the material other than the face-to-face method. This study evaluated whether online nutrition education could influence the sugar, salt, and fat diet of elementary school students. Semarang City served as the site of this experimental study. Participants in this study were given a weekly online nutrition education intervention for eight weeks. Based on the inclusion and exclusion criteria, 100 students were randomly selected and divided into two groups, so that 45 students remained until the end of the study in the control group, while the intervention group had 39 students. Data on general characteristics, self-reported anthropometry, sugar, salt, and fat eating patterns, and variables influencing social media use, were gathered. The data were analyzed through descriptive, bivariate, and multivariate analyses. In this study, students used YouTube more often (83.7%) than other social media platforms. The intervention caused a shift in the students' dietary patterns. The scores of fried food consumption in both groups and sugary food consumption in the control group varied before and after the interventions. There was no difference in the delta scores between the intervention and control groups;however, it was 4.1 times harder for female students than for male students to change their eating habits. Even though there was no significant difference between the two groups, online nutrition education could alter high-sugar and high-fat diets.
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Background: An emerging finding about COVID-19 is its effect on nutrition and weight loss. The COVID-19 symptoms of fatigue, altered taste or smell, and lack of appetite are well known. But COVID-19 may have a more profound effect on clinical nutrition status. Two recent studies have identified that approximately one-third of ambulatory COVID-19 patients are at risk of experiencing weight loss >= 5% (Anker, et al;di Filippo, et al). The case study presented here discusses home start total parenteral nutrition (TPN) in a patient recently diagnosed with COVID-19 at high risk for refeeding syndrome. Method(s): N/A Results: Case Study: A 92-year-old patient was diagnosed with COVID-19 on June 8, 2022. Over the next week, she was hospitalized twice to manage symptoms of acute mental status changes, lethargy, aphasia, hypotension, and loss of appetite. The patient received nirmatrelvir/ritonavir, remdesivir, and bebtelovimab to treat COVID-19 at different times between June 9, 2022, and June 18, 2022. She remained COVID positive and continued to deteriorate clinically. On June 20, 2022, the patient began receiving 24/7 homecare, including intravenous (IV) fluids of dextrose 5% in normal saline (D5NS) 1000 mL daily for three days. She continued to experience loss of appetite and had no bowel movement for 3 days. On June 23, 2022, she was referred to this specialty infusion provider to initiate TPN therapy in the home setting. The patient's BMI was 18.2 kg/m2. Lab results revealed potassium 3.0 mmol/L, phosphate 1.6 mg/dL, and magnesium 1.6 mg/dL. High risk of refeeding syndrome was identified by the level of hypophosphatemia and hypokalemia. The specialty infusion provider's registered dietitian recommended to discontinue D5NS and begin NS with added potassium, phosphate, and magnesium. Thiamine 200mg daily was added to prevent Wernicke's encephalopathy. The patient's clinical status and lab values were monitored closely each day until her electrolyte levels stabilized (Table 1). Home TPN therapy was initiated on June 28, 2022, with <10% dextrose and 50% calorie requirement with 85% protein and 1.0 g/kg lipids. Three-day calorie count and nutrition education were performed four days post TPN initiation. Oral intake met only 25% of estimated needs. Over several days, theTPN formula was gradually increased to goal calories and the infusion cycle was slowly decreased. The following week, the patient's oral intake improved to 60%-75% of estimated needs. Her constipation resolved, and she showed improvement in functional status and mobility. Her appetite drastically improved when the TPN was cycled. Another three-day calorie count was performed when TPN calories reached goals. Oral intake demonstrated 100% estimated calorie and protein needs. TPN therapy was ultimately discontinued on July 14, 2022. As of September 30, 2022, the patient has stabilized at her pre-COVID weight of 45 kg with full recovery of appetite, function, and cognition. Discussion(s): The ASPEN Consensus Recommendations for Refeeding Syndrome (da Silva, et al) describe the repletion of electrolyte levels before introducing calories to prevent end-organ damage associated with refeeding syndrome (respiratory muscle dysfunction, decreased cardiac contractility, cardiac arrhythmias, and encephalopathy). Conclusion(s): This case study highlights the successful initiation of home TPN therapy in a patient at high risk of refeeding syndrome post COVID-19 infection. Although home start TPN and the risk of refeeding syndrome are not new concepts, they must be considered in the setting of COVID-19. Given the effects COVID-19 has on taste, smell, and appetite and the recent finding that one-third of patients with COVID infection may experience weight loss of >= 5%, nutrition support and patient education are vital components of overall patient care. (Figure Presented).
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Background and Objectives: Autism spectrum disorder (ASD) is a neuro-developmental disorder which is mostly caused by deficits in social interactions. Lack of physical activity and poor nutritional habits are common problems in these patients which may be exaggerated by the Covid-19 pandemic. The study aims to assess the effect of functional training along with online nutrition education on inflammatory biomarkers in children with ASD. Subjects and Methods: In this randomized controlled clinical trial, 80 children with ASD (age=9.73+or-1.29 years, weight=49.94+or-2.08 kg, height=146.08+or-40 cm, body mass index=24.71 +or-1.48 kg/m2) were randomly divided into four groups of training, education, training+ education, and control. The interventions lasted for 8 weeks. The inflammatory biomarkers including white blood cell (WBC) count, C-reactive protein (CRP) level, neutrophil count, eosinophil count, and basophil count were assessed (using blood samples collected from antecubital vein) before and after the interventions. Results: There was no significant difference between the groups before the interventions (P>0.05). After the intervention, the results showed a significant decrease in WBC (P<0.001), CRP (P=0.001), neutrophils (sig.=0.009), and eosinophil (P=0.003) in all groups. Basophil count decreased in all groups (P=0.01) except in the education group. Conclusion: Functional training and online nutrition education are beneficial interventions for management of inflammatory biomarkers in children with ASD which can be used during the Covid-19 pandemic.
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Introduction: Less than 10% of U.S. adults meet the guidelines for whole grains, fruits, and vegetables each day. The Healthy for Life community-based program aims to change confidence and health behaviors, by equipping individuals with new skills for healthy living. As a result of the COVID-19 pandemic in 2020 and 2021, the program pivoted from in-person to a virtual implementation model. This required more advanced planning due to additional logistics to ensure a skills-based learning environment. Objective(s): To examine the effectiveness of the Healthy for Life program over time, specifically: o Changes in participant confidence in the preparation of healthy foods at home o Changes in participant consumption of fruits, vegetables, and whole grains o Changes in participant frequency of healthy shopping habitsMethods: A community engagement program was implemented and evaluated in 17 community centers in 2020-2021 to measure changes in participant confidence to prepare healthy meals at home, consumption of fruits, vegetables and whole grains, and frequency of healthy shopping habits. Community center facilitators administered the same pre/post survey to participants at the first educational experience, and then again at the final experience. Facilitators entered the participant data into an online survey portal. Analysis was conducted with 235 participants who completed both pre and post surveys. Two-way repeated ordinal regression was used to assess changes in key metrics over time. Result(s): Participants were predominately female (90.6%), about two-thirds (65.2%) were between 25-55 years old, and most identified as non-Hispanic White/Caucasian (42.6%) or Black/African American (35.7%). Close to half (45.9%) of participants had a college degree or higher, over a quarter (28.1%) received benefits from SNAP and/or WIC, and more than two-thirds (63.8%) indicated they are the only person in their household preparing meals. Almost half (49.3%) of respondents attended the suggested minimum of 4 educational experiences. On average, respondents statistically significantly increased their daily fruit & vegetable consumption by 1.21 serving(s). In addition, over one-third (34%) of respondents increased their level of confidence to prepare healthy meals at home and (37%) respondents increased their level of confidence to substitute healthier cooking and food preparation methods. Close to half (47.2%) respondents reported increased frequency of reading food labels and checking the nutritional values when purchasing food. Conclusion(s): Despite the shift to virtual implementation, the Healthy for Life community education program, was still effective in improving participant confidence and dietary behaviors over time. However, additional research studies are required to further assess whether virtual implementation of this type of intervention will continue to be effective.
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African Americans experience high rates of obesity and food insecurity in part due to structural racism, or overlapping discriminatory systems and practices in housing, education, employment, health care, and other settings. Nutrition education and nutrition-focused policy, systems, and environmental changes may be able to address structural racism in the food environment. This scoping review aimed to summarize the available literature regarding nutrition interventions for African Americans that address structural racism in the food environment and compare them to the "Getting to Equity in Obesity Prevention" framework of suggested interventions. An electronic literature search was conducted with the assistance of a research librarian encompassing 6 databases-MEDLINE, PyscINFO, Agricola, ERIC, SocINDEX, and ProQuest Dissertations & Theses. A total of 30 sources were identified detailing interventions addressing structural barriers to healthy eating. The majority of nutrition interventions addressing structural racism consisted of policy, systems, and/or environmental changes in combination with nutrition education, strategies focused on proximal causes of racial health disparities. Only two articles each targeted the "reduce deterrents" and "improve social and economic resources" aspects of the framework, interventions which may be better suited to addressing structural racism in the food environment. Because African Americans experience high rates of obesity and food insecurity and encounter structural barriers to healthy eating in the food environment, researchers and public health professionals should address this gap in the literature.
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Within Australia, the prevalence of food insecure individuals increased from 2.6 million in 2014-2016 (10.8%) to 3.1 million in 2018- 2020 (12.3%) due to the COVID-19 pandemic.(1) OzHarvest is a not-for-profit organisation that prioritises food salvaging, food waste prevention and nutrition education.(2) OzHarvest's education sector facilitates a programme known as Nutrition Education Skills Training (NEST). NEST is a 6-week programme providing weekly workshops of 2.5-hour duration offering skills training on cooking simple, healthy, and affordable meals to adults at risk of food insecurity. This study aimed to determine the immediate and longerterm impacts of participation in NEST. A quasi-experimental study with pre-post surveys (n = 258) and follow-up surveys (n = 20) was conducted from June 2019 to July 2022. Survey results were obtained from NEST program participants (18 years) from Adelaide Canberra, Melbourne, Newcastle, Queensland, and Sydney. Baseline (pre-) and post-surveys (at program completion) were administered to participants, with an option for a 6-month follow-up survey. Participants were required to complete both surveys to be eligible for this study. Questionnaires included 23 core questions adapted from previous studies,(3) allowing evaluation of nutrition knowledge confidence and self-efficacy, shopping, and food preparation behaviours, and eating behaviours. Food security was assessed using the standard 6-item indicator set for classifying households by food security status level. Using paired t-tests, Shapiro Wilks, and Wilcoxon sign-ranked tests for pre and post survey data, participants demonstrated overall improvement in nutrition knowledge (p < 0.001), confidence and self-efficacy (n = 222;p < 0.001) and food preparation behaviours (p < 0.001). The intake of discretionary foods overall decreased (p < 0.001) while fruit, vegetable and water intake increased (p < 0.001). Food security improved from 57% to 68% immediately within the population (p < 0.001). Using RMANOVA and Shapiro Wilks tests, the 6-month survey results were compared to the pre surveys suggested longer lasting improvements in nutrition knowledge (p < 0.001), cooking confidence (n = 8;p = 0.033), food preparation behaviours (p = 0.003), and increased vegetable intake (p = 0.032) and fruit intake (p = 0.012) Participation in OzHarvest's NEST programme results in short-term improvements in food security levels and dietary behaviours Over the longer term, these changes were sustained but to a lesser degree, indicating that systemic changes are required to address underlying socioeconomic disadvantage.
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The objective of this research was to identify some general characteristics or rural women. Sources of information on which rural woman rely in the areas of health and prevention and their relative importance. The availability.utilization and relative importance of village health services and activities. Level of rural women's knowledge of health and preventive measures in the five areas studied. namely (health education. healthy nutrition. first aid. reproductive health and family planning. prevention of coronavirus) their relative importance and their relationship with independent variables studied. Measuring the gap between the degree of actual and total knowledge of rural women. Level and relative importance of rural women's practice of health and preventive actions in the five areas considered. correlations between them and the above- mentioned independent variables. and Level of rural women's knowledge of health and preventive actions. Measuring the gap between actual and total practice of rural women. this research was conducted in some villages in Sharkia Governorate. The research sample was 168 rural households and data was collected from January to March 2022. One of the most important findinds of the research is the average level of rural women's knowledge. A significant correlation between the degree of rural women's knowledge of health and preventive actions. the trend towards change and the level of exposure to information source and an inverse correlation with wife age. psychological stress and husband age. Rural women's practice is high. A significant association was found wih monthly gourd. the trend towards change. exposure to information sources.
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Introduction: Patients who have had a stroke or transient ischaemic attack (TIA) are at high risk of recurrent events. Around 90% of strokes are associated with ten modifiable risk factors. The prevalence of modifiable risk factors is high, with 89% of stroke clinic patients at Guy's and St. Thomas' Hospital having at least one. This study aimed to explore the patient experience of a novel virtual dietetic secondary prevention service, between November and December 2020, developed in response to the COVID-19 pandemic. Method(s): A questionnaire was developed to explore patients' experience of receiving virtual consultation with the Specialist Stroke Dietitian for the secondary stroke or TIA prevention. The questionnaire, informed by a literature review, was piloted with dietitians and patients. The Questionnaire was used to develop a topic guide for structured in-depth telephone interviews. Patients (n=8) who completed a telephone consultation with the Stroke Dietitian were invited to participate in a structured telephone interview with the researcher. The Framework method was used for thematic analysis. Result(s): Six patients aged 30-69 years discussed their experience of secondary prevention dietetic consultations. Thematic analysis suggests that new knowledge obtained, nutrition education provided, and the Dietitian's interpersonal communication style were key factors that improved confidence, facilitated behaviour change and contributed to a positive patient experience. Participants expressed a preference for telephone appointments rather than face-to-face or video. Conclusion(s): Exploration of patient experience is central to the design of novel clinical services. Our pilot questionnaire can be modified for use in future stroke service development.
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COVID-19 has further exacerbated trends of widening health inequalities in the UK. Shockingly, the number of years of life lived in general good health differs by over 18 years between the most and least deprived areas of England. Poor diets and obesity are established major risk factors for chronic cardiometabolic diseases and cancer, as well as severe COVID-19. For doctors to provide the best care to their patients, there is an urgent need to improve nutrition education in undergraduate medical school training.With this imperative, the Association for Nutrition established an Interprofessional Working Group on Medical Education (AfN IPG) to develop a new, modern undergraduate nutrition curriculum for medical doctors. The AfN IPG brought together expertise from nutrition, dietetic and medical professionals, representing the National Health Service (NHS), royal colleges, medical schools and universities, government public health departments, learned societies, medical students, and nutrition educators. The curriculum was developed with the key objective of being implementable through integration with the current undergraduate training of medical doctors.Through an iterative and transparent consultative process, thirteen key nutritional competencies, to be achieved through mastery of eleven graduation fundamentals, were established. The curriculum to facilitate the achievement of these key competencies is divided into eight topic areas, each underpinned by a learning objective statement and teaching points detailing the knowledge and skills development required. The teaching points can be achieved through clinical teaching and a combination of facilitated learning activities and practical skill acquisition. Therefore, the nutrition curriculum enables mastery of these nutritional competencies in a way that will complement and strengthen medical students' achievement of the General Medical Council (GMC) Outcome for Graduates.As nutrition is an integrative science, the AfN IPG recommends that the curriculum is incorporated into initial undergraduate medical studies before specialist training. This will enable our future doctors to recognise how nutrition is related to multiple aspects of their training, from physiological systems to patient-centred care, and acquire a broad, inclusive understanding of health and disease. In addition, it will facilitate medical schools to embed nutrition learning opportunities within the core medical training, without the need to add in a large number of new components to an already crowded programme or with additional burden for teaching staff.The undergraduate nutrition curriculum for medical doctors is designed to support medical schools to create future doctors who will understand and recognise the role of nutrition in health. Moreover, it will equip frontline staff to feel empowered to raise nutrition-related issues with their patients as a fundamental part of enhanced care and to appropriately refer on for nutrition support with a registered associate nutritionist/registered nutritionist (ANutr/RNutr) or registered dietitian (RD) where this is likely to be beneficial.
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Purpose: An interdisciplinary team approach is recommended by numerous practice guidelines for management of eating disorder (ED) care in pediatric populations. Registered dietitians (RDs), with their unique clinical nutrition knowledge and skill play a valuable role in treating adolescents with eating disorders and their inclusion on an interdisciplinary team is integral to the team approach. Despite this, there is little guidance on standards of care for RDs working in this setting, as well as limited research on outcomes of RD managed nutrition support which may result in inconsistent and inequitable care. During the COVID-19 pandemic, cases of youth presenting with eating disorders have increased causing unprecedented demands on healthcare resources. The pandemic has also resulted in the rapid evolution of care delivery models, including the wide adoption of telemedicine services. This study fills a considerable gap in the evidence base by seeking to understand RD practices across institutional pediatric outpatient eating disorder care settings. This is a vital step to inform the development of care standards and pave the way for future research to assess outcomes of RD involvement in eating disorder care. Methods: We surveyed 18 dietitians at tertiary care institutions across all regions of the United States using a 24-question web-based questionnaire. Participants were recruited by purposeful sampling of institutional program RDs following email referral by medical leadership in affiliated eating disorder programs. Our survey addressed topics such as frequency and duration of nutrition appointments, individuals present for nutrition appointments, use of family-based treatment (FBT), content and approaches included in nutrition appointments, and disciplines with whom RDs coordinated care. Results: Most RDs surveyed practiced within interdisciplinary teams utilizing a Family Based Treatment (FBT) approach. A majority of respondents used telemedicine for at least a portion of their eating disorder appointments;nearly half of respondents (47%) reported using telemedicine for 50-100% of their eating disorder appointments. Survey responses regarding care delivery topics, such as visit frequency and duration, nutrition education content, and approach were highly variable among participants. Conclusions: This study maintains that RDs prioritize individualized care, however it highlights a gap in guidance and practice standards for their role in outpatient eating disorder care. Furthermore, our results emphasize the importance of addressing variability in nutrition practice when interpreting outcomes of RD involvement in eating disorder care. With recent changes in health care delivery as a result of the COVID-19 pandemic, there is value in understanding how nutrition care is evolving in order to meet all patient's needs. Sources of Support: Seattle Children's Hospital provided statistics support. No funding was provided.
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Introduction At the onset of the Covid-19 pandemic, hospital educational activities were halted in order to focus on healthcare delivery and maintain social distancing. As a response to this disruption, BSPGHAN trainees set up the BSPGHAN Education Series, a twice- weekly virtual learning programme. The core objective of this programme was to deliver high quality paediatric gastroenterology, hepatology and nutrition (PGHAN) teaching during the pandemic. In this study, we analysed the attendances and feedback received from the education series, in order to guide future directions. Methods We reviewed the Zoom meeting attendance logs and Survey Monkey feedback forms for the BSPGHAN Education Series from April 2020 to December 2020. Results In nine months, a total of 55 talks were delivered by 43 speakers. 23 (41.8%) sessions were gastroenterologythemed, 25 (45.4%) were hepatology-themed and 7 (12.7%) were nutrition-themed. Thirteen paediatrics gastroenterology units (12 in the UK and 1 in the United States) and all 3 UK tertiary paediatric liver centres contributed to the talks. The highest contributing centres were Birmingham Children's Hospital (20 sessions), followed by King's College Hospital (9 sessions) and Leeds Children's Hospital (7 sessions). Attendance logs and feedback forms were available for 53 sessions. A total of 2369 attendances were logged, with a median of 41 attendees per session (IQR 31-54). Attendees from 22 countries have participated in these sessions. A total of 810 survey feedback forms were received, with a median of 14 forms received per session (IQR 10-18). 32% were filled in by PGHAN Grid trainees, 23% by consultants, 15% by clinical fellows. Allied Health Professionals (AHPs) comprised 6% of feedback returns. 54% of survey feedback respondents accessed the teaching sessions from home. An average of 98% (95% CI 96.3-99.2) survey respondents strongly agreed/agreed that the sessions were relevant to their learning. 97% (95% CI 96-98.7) of survey respondents strongly agreed/agreed that the sessions delivered were of high quality. Discussion The BSPGHAN series has been a positive initiative arising from the pandemic, providing access to high quality PGHAN education when local availability was paused, and giving a platform for the society internationally. Our report shows that the BSPGHAN Education Series has been wellreceived by attendees. The virtual sessions are more accessible compared to in-person teaching sessions, as evidenced by the high percentage of feedback respondents accessing the sessions from home. Looking ahead, the BSPGHAN Education Group, set up in October 2020, will play a vital role in the further development of the Education Series. Sessions are recorded and made available to BSPGHAN members on the BSPGHAN websitefurther work may include creating online learning modules centred around these recordings. AHP involvement is an area for development- for 2021, we hope to include more topics that will be relevant to their interests.
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BACKGROUND: The COVID-19 pandemic intensified disparities for underserved populations as accessing resources became more difficult. Dairy Council of California launched the Let's Eat Healthy initiative to address nutrition security through collaborative solutions in the school environment. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: To ensure nutrition security for children and families, nutritious food and nutrition education must go hand-in-hand. Improving access to high quality food can help address the health disparities that exist for people who are at increased risk for food insecurity. Nutrition education supports students' holistic learning and social and emotional learning skills. Nutrition education models must be increasingly flexible in the face of ongoing challenges. Collaborative efforts to connect food access hubs, such as schools, with support and resources to provide evidence-based nutrition education and agricultural literacy can equip individuals and communities with the knowledge, skills, and ability to make nutrient-rich food choices. CONCLUSIONS: Investments and strategies in nutrition security that utilize the Individual plus Policy, System, and Environmental (I + PSE) model, such as the Let's Eat Healthy initiative, will effectively influence positive behavior change and improve community health. Navigating challenges in a rapidly changing environment requires people and organizations to work together, across disciplines, to leverage knowledge, experience, resources, expertise, and creative thinking. Improving access to healthy food and nutrition education will be most effective when done through collaboration.
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Assess whether changes implemented to an Extension website increased website traffic and met user needs.Social distancing, quarantining, and staying at home due to COVID-19 had significant impacts on media consumption (Nielson Insights, 2020). According to the Pew Research Center, about 53% of US adults reported the internet was essential for them during the pandemic, with another 34% saying it was important (Vogels et al, 2020).General public and multiplier groups (eg, educators, health professionals, media).The website team coordinated new, updated, and curated content for consumers and health professionals around timely food, nutrition and health information related to the pandemic.Google Analytics was used to assess website statistics. A web feedback form was added to new articles. Social media was used to promote/market content.Google Analytics (2019 vs 2020) showed increases in: pageviews (2.4 vs 3 million), site users (1.6 vs 2 million), and sessions (1.8 vs 2.4 million). There were positive increases in percent change for website traffic: direct traffic (36%), organic search (29%), and social media (53%). Specifically, positive increases in percent change for Facebook (112%) and Twitter (90%). Over 2,500 web feedback form responses were included in the analysis. Respondents said information was helpful to them (89%) and shared information with over 157,800 people (eg, friends, family, neighbors, colleagues, students, parents, clients, and seniors). Approximately 90% of responses were unique. Themes from open-ended comments included: helping keep families safe (food safety), recipes and activities for families at home with children, and food resource management tips.Curating and creating content relevant to COVID-19 and promoting on social media increased website traffic. Using a standard web feedback form provided information about what content was useful to users. Templates and organizational structures helped state and county level Extension, support staff, and college students easily add content that was reviewed.
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The Louisiana Healthy Communities Initiative, led by the LSU AgCenter, guides SNAP-Ed policy, systems, and environmental change efforts. Prior to COVID19, agents held in-person community forums to gather input and community priorities for interventions. COVID19 spurred innovation in this process. Although many states have used videoconferencing services to host meetings, lack of functional internet access posed a barrier for many communities in Louisiana.To gather broad community input through Qualtrics surveys in order to assess needs and assets, guide project prioritization, and gather feedback on previous projects.Qualtrics surveys were distributed via email to community members, stakeholders, and partners serving low-income audiences. Three surveys solicited feedback for existing Healthy Communities coalitions (n = 45), 1 survey gathered initial input for a newly formed Healthy Communities coalition (n = 63). The overall response rate across all surveys was 23.6%.Survey responses to community health and engagement questions were separated by counties and analyzed through qualitative content analysis. The research team worked with Extension agents to conduct member checking through discussing survey results with participants.One hundred and eight responses were received from 4 communities. Extension agents reported high satisfaction with the process. Surveys provided action items and potential new coalition members. Across all 4 communities, common themes included acknowledging racial health disparities, a need for greater community involvement in coalition efforts, and a lack of healthy food options.Qualtrics surveys were an effective way to gather community input and allowed wider participation than would have been possible with a virtual meeting. Post-COVID, agents plan to continue to solicit community input through Qualtrics surveys, in addition to face-to-face forums. This method is a valuable tool for lower-income and rural communities. Results reflected an awareness of low community engagement, racial health disparities and limited healthy food access.
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Practicing family style meal service in early care and education (ECE) settings supports children's autonomy and improves self-regulation of energy intake. However, during COVID-19, CDC passed a directive to ECE to pause family style meal service. Therefore, we conducted an ECE webinar focused on how to feed children responsively during plated meal service to help providers support children's autonomy and self-regulation.To evaluate changes in the level of understanding, behavioral intention to implement knowledge, and confidence about how to feed children (2-5 years) responsively during plated meal service. Also, to determine need for future training opportunities.Retrospective pretest-posttest study. The webinar was advertised through an email newsletter disseminated by a national-level platform, Penn State Extension Better Kid Care. Participants attended the online webinar for 1 hour on August 11, 2020, had access to an Extension publication (http://bit.ly/3pnJ71X) and responded to a follow-up survey (Qualtrics Link: http://bit.ly/3jMWvvv). Participants identified themselves as either ECE providers (n = 77) or other stakeholders (n = 30), who can offer opportunities or guidance to providers.Change in self-reported evaluation score (range 1 = low to 7 = high) for understanding, behavioral intention to implement knowledge, and confidence about how to feed children responsively during plated meal service. Paired sample t tests (alpha = 0.05) followed by Sidak-Bonferroni correction (adjusted P = 0.007).Both providers and stakeholders reported significantly higher (P < 0.001) level of understanding, intention to implement knowledge obtained, and confidence regarding implementing responsive feeding during plated meal service after the webinar compared to before the webinar. Participants expressed need for online nutrition trainings with emerging themes such as feeding infants, safe food preparation and storage, flexibility of CACFP rules, and physical distance during meals.Intentional mealtime conversations, giving children small tasks supporting their autonomy, and setting clear expectations while adjusting mealtime routines can offer a promising avenue for implementing responsive feeding during plated meal service.
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The early months of the COVID-19 pandemic brought about significant disruptions in food supply chains, which increased consumers’ concern about possible food shortages and price gouging. To ensure personal food security, many consumers began stockpiling food and water in unusually large amounts.The goal of this study was to investigate individual- and household-level predictors of food and water stockpiling (FWS) in the early months of the COVID-19 pandemic among Non-Latino Black and Latino adults.This study was a secondary analysis of cross-sectional survey data. Participants were 2,174 Non-Latino Black (66.4%) and Latino (33.6%) adults residing in a Midwestern state, who completed the survey in either May or June/July 2020.Participants were asked to self-report (yes or no) if they stockpiled food and/or water in the prior 7 days in response to the pandemic. A variety of variables was examined, including education level, annual income, employment status, concerns about COVID-19, and self-quarantine status. Crude and adjusted logistic regressions were used to identify variables associated with FWS.Non-Latino Black participants had lower odds of reporting FWS compared to Latinos (OR 0.64, 95% CI, 0.51-0.79). Similarly, participants who were not concerned about COVID-19 had lower odds of FWS compared with those extremely concerned (OR 0.37, 95% CI, 0.20 – 0.71). In contrast, odds of FWS were higher among participants who were self-quarantining all the time compared to those who were not (OR 2.16, 95% CI, 1.31 – 3.59).Results showed that Latinos, adults concerned about COVID-19, and self-quarantine status had significantly higher odds of FWS during the pandemic.
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The COVID-19 pandemic has dramatically increased food insecurity in the United States. In response to the growing need, food banks and soup kitchens across New York City have adapted by distributing free food boxes in high-need communities. While program evaluations have largely focused on distribution, no study has assessed the consumption of the contents of these boxes and their impact on increasing nutrition.This study aimed to evaluate the consumption and nutritional impact of food boxes provided by World Central Kitchen on recipients in New York City.A study of 391 food box recipients was conducted across 4 New York City boroughs from July 13-September 18, 2020. Key informants identified communities with high food insecurity. A phone survey was conducted by WCK staff to participants waiting in line to receive a food box. Boxes contained either fresh fruits and vegetables only or fresh produce and dairy. Contents were included because of their nutritional values.Survey responses were imported into a data frame and analyzed to understand consumption and nutritional impact of food boxes. Variables of interest included: demographics, household size, if they were the primary cook in their home, most and least preferred item(s) in the box, items they wished were included, quantity of the box consumed, and reason for unused items.Of the 391 survey participants, the contents of the food boxes reached 1,398 individuals. Moreover, 90% of participants consumed all of the box's contents, increasing their nutrition.The high percentage of WCK food boxes completely consumed suggests that boxes offering fruits and vegetables are an effective intervention in improving nutrition for recipients. These findings have important implications for shaping nutritional guidance of future food box programs.
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The prevalence of food insecurity on college campuses has been found to be higher than reported in U.S. households. Despite the prevalence and negative health and academic consequences associated with food insecurity in college students, barriers exist in food access resource utilization, especially in the wake of COVID-19.The purpose of this study is to determine the prevalence of food insecurity at Mississippi State University and explore college students’ perceptions of food access resources and resource utilization.This study employed a mixed methods design. Quantitative data was gathered from an online survey to assess the prevalence, demographics, and food insecurity status from undergraduate students at Mississippi State University. The 1157 survey respondents then provided the recruitment pool for qualitative data collection, which was obtained via focus groups and open-ended questionnaires to explore student perspectives of food insecurity and food access resources.SPSS 27 was used to determine food security status based on the USDA's Household Food Security Survey Module 6-item short form. NVivo 12 was used for coding and thematic analyses to examine college student perspectives of food insecurity and food access resources.The prevalence of food insecurity among college students was 34.1%. Key influencers emerged as the major theme associated with students’ views about food insecurity, and the resources available to address the issue. These influencers were personal beliefs, life skills, and the university. Student perceptions of what it means to need food access resources and the value of a resource were interconnected.Food insecurity continues to occur at a higher prevalence in college student populations than in U.S. households. When addressing food insecurity in this group, key influencers of food insecurity status should be considered when exploring viable intervention strategies that produce acceptable resources that students will use.
ABSTRACT
COVID-19 has the potential to impact the health of individuals experiencing food insecurity and reduced food access. A national collaboration examined this impact across the United States, including Utah.The objective of this study was to explore the effect of COVID-19 on perceived food access challenges, barriers, and compensatory strategies among SNAP-eligible Utahns.A 76-item survey was emailed to all SNAP-eligible Utahns (N = 24,763) in July 2020. The USDA's 6-item Food Security Module was used to determine food security prior to and since COVID-19. Additional questions asked about food access and eating/purchasing behaviors. Participants (n = 521) were predominately White (75%) females (77%).Level of agreement for using compensatory food access strategies was summed (score range: 7-42, higher scores reflecting increased use) and assessed for mean differences using ANOVA based on food insecurity classification. Rating scales were used to measure food access challenges and barriers to using nutrition assistance (4-5 item scales) during COVID-19. Spearman correlations examined associations between challenges/barriers and degree of food insecurity.Of participants (n = 358) who were food insecure, 74% were White and 77% were female. Food insecure individuals prior to and since COVID-19 were more likely than food secure participants to use compensatory strategies to ensure food affordability during COVID-19 (mean score = 30 vs 26, respectively, P = 0.002). Degree of food insecurity was associated with barriers to using nutrition assistance, including difficulty traveling to apply/recertify (r = 0.24, P < 0.001) and frequency of experiencing food access challenges during COVID-19 (r = 0.16-0.33, P ≤ 0.002).Challenges with food access and barriers to utilizing nutrition assistance during COVID-19 are associated with food insecurity among SNAP-eligible individuals, potentially resulting in reliance upon more compensatory food affordability strategies. Efforts should be taken to minimize these barriers to ensure adequate food quantity and quality among food insecurity individuals.