A cluster-randomized controlled trial to assess the impact of a nutrition intervention on dietary behaviors among early care and education providers: The Create Healthy Futures study.

Create Healthy Futures is a self-paced, web-based intervention on improving healthy eating behaviors among Early Care and Education (ECE) providers. We examined the impact of web-based Create Healthy Futures on diet quality measured by the Alternative Healthy Eating Index (AHEI) 2010, dietary behaviors, and related psychosocial and environmental factors among ECE providers. A cluster randomized controlled trial (CRCT) was implemented with baseline surveys administered from October 2019-January 2020, intervention implementation from April-May 2020, and post-intervention from May 2020-August 2020. Centered-based ECE programs under the Pennsylvania Head Start Association (n = 12) were recruited and randomized to intervention (n = 5) or comparison (n = 7) groups. A total of 186 ECE providers completed the post-intervention surveys (retention rate: 86.1%). At baseline, 31.5% of ECE providers were food insecure. Pre-to-post intervention demonstrated no significant within-or-between-group changes in the AHEI-2010 diet quality scores. ECE providers in the intervention group reported a significant decrease from baseline to post-intervention in the number of days eating out (aMD = -0.8, CI:-1.6, -0.1, P = 0.03). Process evaluation showed that 89.9% of the intervention group completed all online module, and 82.9% attended all of wellness session groups. Although the Create Healthy Futures intervention did not improve ECE providers' diet quality and dietary behaviors, it confirmed critical needs to provide health support to ECE providers. Future studies should employ strategies that improve access to healthy foods and nutrition education, and address social determinants of health such as food insecurity to improve diet quality and health in ECE provider population.

Association Between Food Insecurity and Diet Quality Among Early Care and Education Providers in the Pennsylvania Head Start Program.

INTRODUCTION: Food insecurity affects dietary behaviors and diet quality in adults. This relationship is not widely studied among early care and education (ECE) providers, a unique population with important influences on children's dietary habits. Our study's objective was to explore how food insecurity affected diet quality and dietary behaviors among ECE providers. METHODS: We used baseline data from a cluster-randomized controlled trial (January 2019-December 2020) on 216 ECE providers under the Pennsylvania Head Start Association. We used radar plots to graph scores for the Healthy Eating Index 2015 and the Alternative Healthy Eating Index (AHEI) 2010 and fitted a multivariate regression model for diet quality measures, adjusting for covariates. RESULTS: Among the 216 participants, 31.5% were food insecure. ECE providers who were food insecure had a lower AHEI-2010 mean score (mean difference for food insecure vs food secure = -4.8; 95% CI, -7.8 to -1.7; P = .002). After adjusting for covariates, associations remained significant (mean difference = -3.9; 95% CI, -7.5 to -0.4; P = .03). Food insecure ECE providers were less likely to use nutrition labels (22.8% vs 39.1%; P = .046) and more likely to report cost as a perceived barrier to eating fruits and vegetables. CONCLUSION: We found a significant inverse association between food insecurity and the AHEI-2010 diet quality score among ECE providers after adjusting for covariates. More studies are needed to examine the effects of food insecurity on dietary behaviors of ECE providers and their response to nutrition education programs targeting their health.

Predictions of future dangerousness in capital murder trials: is it time to "disinvent the wheel"?

Although recent U.S. Supreme Court decisions regarding the death penalty (e.g., Atkins v. Virginia, 2002) have renewed interest in mental health issues, one topic that has not received much attention recently is the ongoing use of expert testimony to support claims that defendants represent a "continuing threat to society." In this article, we (a) review prior research relevant to determining the accuracy of clinical predictions that capital defendants will commit future acts of criminal violence; (b) summarize new data from current and former death row inmates in Texas that bolster the claim that such predictions are gross overestimates of risk; and (c) review extant research addressing the potential utility of various risk assessment instruments that increasingly are being used to reinforce clinical predictions in capital trials. Despite significant recent advances in the field of risk assessment, clinical assertions that a defendant is likely to commit future violent acts appear to be highly inaccurate and ethically questionable at best. Moreover, available research offers little support for the claim that the accuracy of these predictions will be appreciably improved by relying on more structured risk assessment measures that have some demonstrated predictive validity in other contexts.

Does psychopathy predict institutional misconduct among adults? A meta-analytic investigation.

Narrative reviews have raised several questions regarding the predictive validity of the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 2003) and related scales in institutional settings. In this meta-analysis, the authors coded 273 effect sizes to investigate the association between the Hare scales and a hierarchy of increasingly specific forms of institutional misconduct. Effect sizes for Total, Factor 1, and Factor 2 scores were quite heterogeneous overall and weakest for physically violent misconduct (r-sub(w) = .17, .14, and .15, respectively). Moderator analyses suggested that physical violence effect sizes were smaller in U.S. prison samples (r-sub(w) = .11) than in non-U.S. prison samples (r-sub(w) = .23). Findings are discussed in terms of the utility of the Hare measures for decision-making in institutional and other contexts.