A Cluster Randomized Controlled Trial of a Home-Delivered Food Box on Food Security in Chickasaw Nation.

BACKGROUND: The 2010 Child Nutrition reauthorization called for the independent evaluation of innovative strategies to reduce the risk of childhood hunger or improve the food security status of households with children. OBJECTIVE: The research question was whether the Packed Promise intervention reduces child food insecurity (FI-C) among low-income households with children. DESIGN: This study was a cluster randomized controlled trial of 40 school districts and 4,750 eligible, consented households within treatment and control schools. PARTICIPANTS/SETTING: Data were collected at baseline (n = 2,859) and 2 follow-ups (n = 2,852; n = 2,790) from households with children eligible for free school meals in participating schools in 12 rural counties within the Chickasaw Nation territory in south central Oklahoma in 2016 to 2018. INTERVENTION: Each month of the 25-month intervention, for each eligible child, enrolled households could choose from 5 types of food boxes that contained shelf-stable, nutritious foods ($38 food value) and a $15 check for purchasing fruits and vegetables. MAIN OUTCOME MEASURES: The primary outcome was FI-C. Other outcomes included household and adult food security, very low food security among children, and food expenditures. STATISTICAL ANALYSES PERFORMED: Differences between the treatment and control groups were estimated by a regression model controlling for baseline characteristics. RESULTS: The Packed Promise project did not significantly reduce FI-C at 12 months (29.3% prevalence in the treatment group compared with 30.1% in the control group; P = 0.123) or at 18 months (28.2% vs 28.7%; P = 0.276), but reduced food insecurity for adults by 3 percentage points at 12 months (P = 0.002) but not at 18 months (P = 0.354). The intervention led to a $27 and a $16 decline in median household monthly out-of-pocket food expenditures at 12 and 18 months, respectively. CONCLUSIONS: An innovative intervention successfully delivered nutritious food boxes to low-income households with children in rural Oklahoma, but did not significantly reduce FI-C. Improving economic conditions in the demonstration area and participation in other nutrition assistance programs among treatment and control groups might explain the lack of impact.ClinicalTrials.gov ID: NCT04316819 (http://www.clinicaltrials.gov). FUNDING/SUPPORT: This article is published as part of a supplement supported by the US Department of Agriculture, Food and Nutrition Service.

A Cluster Randomized Controlled Trial of a Home-Delivered Food Box on Children's Diet Quality in the Chickasaw Nation Packed Promise Project.

BACKGROUND: Poor diet quality among children can lead to poor health, development, and academic achievement. Child nutrition assistance programs aim to improve diet quality among children. OBJECTIVE: This study tested the impact of the Packed Promise intervention on diet quality among low-income children in Chickasaw Nation territory. DESIGN: This study was a cluster randomized controlled trial of 40 school districts and 4,750 eligible, consented households within treatment and control districts. PARTICIPANTS/SETTING: Household data were collected at baseline (n = 2,859) and follow-up (n = 2,852) in 12 rural Oklahoma counties. INTERVENTION: Packed Promise treatment households chose from 5 types of home-delivered food boxes that contained nutritious foods ($38 food value) and a $15 check for purchasing fruits and vegetables. MAIN OUTCOME MEASURES: Key outcomes included children's daily consumed amounts of fruits and vegetables, whole grains, and added sugars collected by a dietary screener questionnaire. Other outcomes included food shopping frequency, type of grocery store used, distance traveled from home to grocery stores, and the number of weekly family dinners. All outcomes in this article are secondary to the study's primary outcome-food insecurity among children. STATISTICAL ANALYSES PERFORMED: Differences between the treatment and control groups were estimated by a regression model controlling for baseline characteristics and population-based average portion sizes. RESULTS: Children's mean daily consumption of fruits and vegetables combined was about 2.35-cup equivalents in the treatment group and 2.25-cup equivalents in the control group (P < 0.001). Mean consumption of whole grains was 0.73-ounce equivalents in the treatment group compared with 0.67-ounce equivalents in the control group (P < 0.001). Other outcomes were not statistically significant. CONCLUSION: Packed Promise led to significant but small improvements in children's daily consumption of fruits and vegetables and whole grains. Several factors, including household participation levels in Packed Promise, may have moderated the size of impacts. FUNDING/SUPPORT: This article is published as part of a supplement supported by the US Department of Agriculture, Food and Nutrition Service.

Farm Animal Cognition-Linking Behavior, Welfare and Ethics.

Farm animal welfare is a major concern for society and food production. To more accurately evaluate animal farming in general and to avoid exposing farm animals to poor welfare situations, it is necessary to understand not only their behavioral but also their cognitive needs and capacities. Thus, general knowledge of how farm animals perceive and interact with their environment is of major importance for a range of stakeholders, from citizens to politicians to cognitive ethologists to philosophers. This review aims to outline the current state of farm animal cognition research and focuses on ungulate livestock species, such as cattle, horses, pigs and small ruminants, and reflects upon a defined set of cognitive capacities (physical cognition: categorization, numerical ability, object permanence, reasoning, tool use; social cognition: individual discrimination and recognition, communication with humans, social learning, attribution of attention, prosociality, fairness). We identify a lack of information on certain aspects of physico-cognitive capacities in most farm animal species, such as numerosity discrimination and object permanence. This leads to further questions on how livestock comprehend their physical environment and understand causal relationships. Increasing our knowledge in this area will facilitate efforts to adjust husbandry systems and enrichment items to meet the needs and preferences of farm animals. Research in the socio-cognitive domain indicates that ungulate livestock possess sophisticated mental capacities, such as the discrimination between, and recognition of, conspecifics as well as human handlers using multiple modalities. Livestock also react to very subtle behavioral cues of conspecifics and humans. These socio-cognitive capacities can impact human-animal interactions during management practices and introduce ethical considerations on how to treat livestock in general. We emphasize the importance of gaining a better understanding of how livestock species interact with their physical and social environments, as this information can improve housing and management conditions and can be used to evaluate the use and treatment of animals during production.

Shetland ponies (Equus caballus) show quantity discrimination in a matching-to-sample design.

Numerical competence is one of the aspects of animal cognition with a long history of research interest, but few results are available for the horse. In the present study, we investigated the ability of three Shetland ponies to discriminate between different quantities of geometric symbols presented on a computer screen in a matching-to-sample arrangement. In Experiment 1, the ponies had to relate two similar quantities to another, paired in contrasts (1 vs. 2, 3 vs. 4 and 4 vs. 5) of the same stimulus (dot). Specific pairs of quantities (all differing by one) of up to five different geometrical symbols were displayed in Experiment 2. In each session, both quantities (more and less) were used as sample in such a way that each of the two quantities presented in one test served as positive and as negative stimulus, respectively. The three Shetland ponies were able to discriminate between the given quantities of dots by showing more than 80% correct responses in two consecutive sessions. Only one of the ponies distinguished different shapes of geometric symbols at a level of 4 versus 5 items. The results show that all ponies were capable of visual quantity discrimination in the present matching-to-sample design, but task solving seemed more difficult when quantities were composed of heterogeneous stimuli. The present results confirm our hypothesis that the ponies based their decision on the matching concept of sameness and were not biased by a spontaneous preference for higher quantities.

Nutrition-education program improves preschoolers' at-home diet: a group randomized trial.

OBJECTIVE: This study evaluated whether a nutrition-education program in child-care centers improved children's at-home daily consumption of fruits and vegetables, at-home use of low-fat/fat-free milk, and other at-home dietary behaviors. MATERIALS AND METHODS: Twenty-four child-care centers serving low-income families were matched by region, type, and size, and then randomly assigned to either an intervention or control condition. In the 12 intervention centers, registered dietitian nutritionists provided nutrition education to children and parents separately during a 6- to 10-week period. They also held two training sessions for center staff, to educate them on healthy eating and physical activity policies at the centers, and distributed weekly parent newsletters that included activities and recipes. Parents (n=1,143) completed a mail or telephone survey at baseline and follow-up to report information on their child's fruit, vegetable, and milk consumption and other dietary behaviors at home. This study used general and generalized linear mixed models to evaluate program impacts, while accounting for the clustering of children within centers. This study included child age, child sex, household size, respondent race/ethnicity, respondent age, and respondent sex as covariates. RESULTS: The program had a substantial impact on children's at-home daily consumption of vegetables and use of low-fat/fat-free milk. This study also found a significant increase in the frequency of child-initiated vegetable snacking, which might have contributed to the significant increase in vegetable consumption. The program did not have a significant impact on fruit consumption or parental offerings of fruits and vegetables, child-initiated fruit snacking, or child fruit consumption. CONCLUSIONS: This intervention in child-care settings that emphasized children, parents, and teachers significantly increased at-home vegetable and low-fat/fat-free milk consumption among low-income preschoolers.

Factors influencing inadequate and excessive weight gain in pregnancy: Colorado, 2000-2002.

OBJECTIVES: To identify the biological, psychosocial, and behavioral characteristics that are associated with inadequate and/or excessive weight gain in pregnancy. METHODS: Univariate, bivariate, and multiple logistic regression analyses were conducted using data from Colorado's 2000-2002 Pregnancy Risk Assessment Monitoring System (PRAMS). Independent variables included biological risk factors (prepregnancy BMI, parity, preterm labor, maternal morbidity), psychosocial risk factors (pregnancy intention, WIC and Medicaid enrollment, area of residence, age, race/ethnicity, education, and stressors), and behavioral risk factors (smoking and drinking alcohol in the last trimester of pregnancy). RESULTS: In the bivariate analysis, all the biological risk factors were significantly associated with the pregnancy weight gain distribution, as were several of the psychosocial risk factors (WIC and Medicaid enrollment, area of residence, race/ethnicity, and maternal education). Smoking and alcohol use were not significant. After controlling for other variables through logistic regression, the only characteristics associated with inadequate weight gain were parity, underweight or obesity, preterm labor, nausea, residence in a rural area, low levels of education, and smoking. The characteristics associated with excessive weight gain were overweight or obesity, high blood pressure, and having 12 years of education. CONCLUSION: Having a pre-pregnancy BMI above 29 greatly increases the risk for both inadequate and excessive weight gain. Unfortunately, obesity, like the other major risk factors identified here (maternal education and parity) are not modifiable after a given pregnancy begins. To address these problems, a sustained approach to women's health, education, and well-being across the lifespan will be required, rather than a reliance upon targeted interventions during pregnancy.