Caregiver Perceptions of Environmental Facilitators and Barriers to Healthy Eating and Active Living during the Summer: Results from the Project SWEAT Sub-Study.

OBJECTIVE: The aim of this study was to examine caregiver perceptions of summertime neighborhood-level environmental barriers and facilitators to healthy eating and active living in their elementary-age racial minority children. METHODS: Caregivers with students in the prekindergarten-fifth grade were recruited from two schools located in low-income urban neighborhoods of Columbus, OH, with a predominantly Black population. Participants engaged in the research portion of the Healthy Eating Active Living: Mapping Attribute using Participatory Photographic Surveys (HEALth MAPPSTM) protocol, which included (1) orientation; (2) photographing and geotagging facilitators and barriers to HEALth on daily routes; (3) in-depth interview (IDI) discussing images and routes taken; (4) focus groups (FG). IDIs and FGs were transcribed verbatim. Analyses were guided by grounded theory and interpretive phenomenology and were coded by researchers (n = 3), who used comparative analysis to develop a codebook and determine major themes. RESULTS: A total of 10 caregivers enrolled and 9 completed the IDIs. Five caregivers participated in focus groups. A majority (77.8%, n = 7) of caregivers identified as Black, female (88.9%, n = 8), and low income (55.6%, n = 5). IDI and FG themes included (1) walkway infrastructure crucial for healthy eating and active living; (2) scarce accessibility to healthy, affordable foods; (3) multiple abandoned properties; (4) unsafe activity near common neighborhood routes. CONCLUSIONS: Caregivers perceived multiple neighborhood-level barriers to healthy eating and activity during the summer months when school is closed. Findings from this study provide initial insights into environmental determinants of unhealthy summer weight gain in a sample of predominantly racial minority school-age children from low-income households.

Frequency of Food Pantry Use Is Associated with Diet Quality among Indiana Food Pantry Clients.

BACKGROUND: Food-insecure households access food pantries to receive supplemental food, yet limited examination of the relationships of food pantry use or household food insecurity with diet quality and health has been documented among food pantry users. OBJECTIVE: This study investigated the associations among food pantry use, household food security, body mass index, self-reported chronic disease and related conditions, and diet quality among food pantry users. DESIGN: Food pantry users in central Indiana were recruited for this cross-sectional study and surveyed for sociodemographic characteristics, food pantry use frequency, household food security, diet quality, and chronic disease and related conditions. Measurements of height and weight were obtained. PARTICIPANTS/SETTING: Data from 270 participants, aged 21 to 80 years, were collected from June 2014 to December 2015. STATISTICAL ANALYSES PERFORMED: Healthy Eating Index-2010 (HEI-2010) total score, component scores, and body mass index were analyzed across food pantry use and household food security groups using multiple linear regression. Odds of reporting chronic disease and related conditions were compared across food pantry use and household food security groups using logistic regression. RESULTS: Visiting food pantries more than once a month was associated with higher HEI-2010 total score (P=0.03) and Total Protein Foods score (P=0.05) than visiting less often. HEI-2010 scores were not significantly different across household food security groups. Body mass index was not different across food pantry use groups or household food security groups. Household food insecurity was associated with higher odds of reporting heart disease (age- and sex-adjusted odds ratio=2.65; 95% CI, 1.05-6.69) compared with household food security. CONCLUSIONS: Food pantry use frequency differentiates diet quality, and household food security status differentiates chronic disease and related conditions among low-resource food pantry user subpopulations.

Voices for food: methodologies for implementing a multi-state community-based intervention in rural, high poverty communities.

BACKGROUND: Rural communities experience unique barriers to food access when compared to urban areas and food security is a public health issue in rural, high poverty communities. A multi-leveled socio-ecological intervention to develop food policy councils (FPCs), and improve food security in rural communities was created. Methods to carry out such an intervention were developed and are described. METHODS: A longitudinal, matched treatment and comparison study was conducted in 24 rural, high poverty counties in South Dakota, Indiana, Missouri, Michigan, Nebraska and Ohio. Counties were assigned to a treatment (n = 12) or comparison (n = 12) group. Intervention activities focus on three key components that impact food security: 1) community coaching by Extension Educators/field staff, 2) FPC development, and 3) development of a MyChoice food pantry. Community coaching was only provided to intervention counties. Evaluation components focus on three levels of the intervention: 1) Community (FPCs), 2) Food Pantry Organization, and 3) Pantry Client & Families. Participants in this study were community stakeholders, food pantry directors, staff/volunteers and food pantry clients. Pantry food access/availability including pantry food quality and quantity, household food security and pantry client dietary intake are dependent variables. DISCUSSION: The results of this study will provide a framework for utilizing a multi-leveled socio-ecological intervention with the purpose of improving food security in rural, high poverty communities. Additionally, the results of this study will yield evidence-based best practices and tools for both FPC development and the transition to a guided-client choice model of distribution in food pantries. TRIAL REGISTRATION: ClinicalTrials.gov; NCT03566095 . Retrospectively registered on June, 21, 2018.

Consensus modeling to develop the farmers' market readiness assessment and decision instrument.

Nutrition-related policy, system, and environmental (PSE) interventions such as farmers' markets have been recommended as effective strategies for promoting healthy diet for chronic disease prevention. Tools are needed to assess community readiness and capacity factors influencing successful farmers' market implementation among diverse practitioners in different community contexts. We describe a multiphase consensus modeling approach used to develop a diagnostic tool for assessing readiness and capacity to implement farmers' market interventions among public health and community nutrition practitioners working with low-income populations in diverse contexts. Modeling methods included the following: phase 1, qualitative study with community stakeholders to explore facilitators and barriers influencing successful implementation of farmers' market interventions in low-income communities; phase 2, development of indicators based on operationalization of qualitative findings; phase 3, assessment of relevance and importance of indicators and themes through consensus conference with expert panel; phase 4, refinement of indicators based on consensus conference; and phase 5, pilot test of the assessment tool. Findings illuminate a range of implementation factors influencing farmers' market PSE interventions and offer guidance for tailoring intervention delivery based on levels of community, practitioner, and organizational readiness and capacity.