Source: UNIVERSITY OF ARKANSAS submitted to NRP
AN INTEGRATED, MULTIMEDIA APPROACH TO DELIVERING FOOD, EXERCISE, AND NUTRITION EDUCATION FOR PREVENTION OF CHRONIC DISEASE (DFEND)
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
ACTIVE
Funding Source
AFRI COMPETITIVE GRANT
Reporting Frequency
Annual
Accession No.
1029784
Grant No.
2023-68015-39408
Cumulative Award Amt.
$970,146.00
Proposal No.
2022-08695
Multistate No.
(N/A)
Project Start Date
May 1, 2023
Project End Date
Apr 30, 2027
Grant Year
2023
Program Code
[A1344]- Diet, Nutrition and the Prevention of Chronic Disease
Recipient Organization
UNIVERSITY OF ARKANSAS
(N/A)
FAYETTEVILLE,AR 72703
Performing Department
(N/A)
Non Technical Summary
The increased incidence of obesity and chronic disease in the United States is a complex problem and is the result of many factors including unhealthy eating patterns, lack of physical activity, food insecurity, and low health literacy. For this reason, efforts to reduce obesity and obesity-related chronic disease must address these issues on multiple fronts. The project we propose here, An integrated, multimedia approach to Delivering Food, Exercise, and Nutrition education for prevention of chronic Disease (DFEND), represents such an effort, and aligns with the program priority area "to develop, implement, and evaluate innovative research, educational, and outreach strategies to improve eating patterns that prevent and control development of chronic diseases." DFEND engages a team of multidisciplinary scholars with expertise in nutrition, physical activity, public health, extension and outreach, and statistics. This integrated project involves innovative research, extension, and educational programming that is designed to increase health literacy by emphasizing healthy eating patterns, lifestyle changes, and behaviors which support the prevention of chronic disease. The overall aims of this project are to improve health literacy related to nutrition and physical activity in adults at risk for chronic disease, enable and reinforce healthy eating patterns and physical activity in adults at risk for chronic disease, and ensure that tomorrow's nutrition, exercise science, and health care professionals are able to make a meaningful impact on the burden of chronic disease throughout their professional careers.
Animal Health Component
80%
Research Effort Categories
Basic
(N/A)
Applied
80%
Developmental
20%
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
72460991010100%
Knowledge Area
724 - Healthy Lifestyle;

Subject Of Investigation
6099 - People and communities, general/other;

Field Of Science
1010 - Nutrition and metabolism;
Goals / Objectives
Assess health literacy related to nutrition and PA to gain a better understanding of the drivers of poor diets and nutritional choices in adults at-risk for chronic disease. (Research)Identify dietary patterns and physical activity levels of adults at-risk for chronic disease through assessment of health, nutrition, and physical activity literacy. (Extension)Implement and evaluate a multimedia educational curriculum to improve chronic disease-related health behaviors among at-risk adults. (Research)Develop an interdisciplinary course for future health care professionals to increase their knowledge and skills for promoting healthy nutrition and PA behaviors through community outreach and extension to reduce the burden of chronic disease. (Education)
Project Methods
Objective 1.Identify dietary patterns and physical activity levels of adults at-risk for chronic disease through assessment of health, nutrition, and physical activity literacy.Approach for Objective 1:Participants and recruitment. A representative sample of adults (age 18 years and older) across Arkansas will be recruited to take a cross-sectional survey to assess nutrition and PA-related health literacy and identify lifestyle factors and health behaviors that are associated with health literacy. There are a total of 75 counties in Arkansas ranging in population size from 5,192 to 392,967. According to the Rural Profile of Arkansas - 2021 produced by the University of Arkansas Division of Agriculture, the counties in Arkansas are divided into Urbanand Rural, with the Rural counties further divided into Coastal Plains, Highlands, and Deltaregions based on social, economic, and demographic characteristics. Rural counties have older populations, higher obesity rates, lower education, lower median household incomes, with higher poverty rates in the Delta and Coastal Plains counties. Through agents and Qualtrics survey services, we will recruit a representative proportion of the population from each region in Arkansasfor a total of 2,500 participants. Agents will be provided electronic and hard copy flyers to distribute within their county for recruitment. Participants will be entered into a raffle for their participation. We will obtain Institutional Review Board (IRB) approval before beginning the survey and all participants will provide digital, informed consent prior to participation.Objective 2.Adapt and assess a comprehensive educational program for extension agents to promote and facilitate healthy nutrition and physical activity behaviors for at-risk adults in their communities.Approach for Objective 2:Phase 1: Engage stakeholders in the planning and development process of the DFEND program. Phase 2: Adapt the pilot DFEND program into county extension agent training and a toolkit for county extension agents to use in their communities.Phase 3: Train and evaluate county extension agents in DFEND curriculum.Objective 3.Implement and evaluate a multimedia educational curriculum to improve chronic disease-related health behaviors among at-risk adults.Approach for Objective 3:Study Design and Participants.This will be a randomized controlled trial with participant recruitment from 18 counties in Arkansas (6 per District). The trial will be implemented in waves (Years 2, 3, and 4,) with 3 counties per wave. Participating counties will be selected in coordination with stakeholders, Participants will be recruited through county extension offices, flyers in the community, newspaper ads, e-mail, social media, radio, and word of mouth. Within each county, participants will be randomized to the DFEND intervention (DFEND-Int) group or the control group. Participants in the control group will not receive access to the DFEND materials, however they will receive access to DFEND materials after the final data collection.Pre- and post-assessments will be conducted before and after the 8-week DFEND-Int. DFEND will be registered as a clinical trial, undergo IRB approval, and all participants will provide written, informed consent prior to participation.Objective 4.Develop an interdisciplinary course for future health care professionals to increase their knowledge and skills for promoting healthy nutrition and PA behaviors through community outreach and extension to reduce the burden of chronic disease.Approach for Objective 4.Understanding and applying nutrition and physical activity (PA)knowledge and skills to all aspects of health care and are extremely important. All health care professions need basic training to effectively assess dietary intake and PA to provide appropriate guidance, counseling, and treatment to their patients.Thiscourse will emphasize how healthy eating patterns, PA, and behavior change can impact the magnitude of chronic disease by incorporating and emphasizing the most recent peer-reviewed science and partnering with Cooperative Extension Service (CES) to include content related to communication, leadership, and community outreach.

Progress 05/01/24 to 04/30/25

Outputs
Target Audience:The target audience is cooperative extension agents, community members, undergraduate and graduate students. Changes/Problems:The biggest change was that the existing nutriiton literacy toolkits in the literature proved to be impractical for a community setting and were not easily adaptable to mobile technology. Therefore we had to develop our own toolkits. What opportunities for training and professional development has the project provided?15 undergraduates were trained under this project. How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals?We will publish the validated nutrition literacy tools, build and finalize the multimedia toolkits, and start disseminating the toolkit.

Impacts
What was accomplished under these goals? Assess health literacy related to nutrition and PA to gain a better understanding of the drivers of poor diets and nutritional choices in adults at-risk for chronic disease. (Research)We conducted focus groups with extension agents, community members, and nutrition experts related to nutrition and physical activity literacy. We developed literacy tools and validated the tools.? Identify dietary patterns and physical activity levels of adults at-risk for chronic disease through assessment of health, nutrition, and physical activity literacy. (Extension) This is in progress. Implement and evaluate a multimedia educational curriculum to improve chronic disease-related health behaviors among at-risk adults. (Research)This is in progress. Develop an interdisciplinary course for future health care professionals to increase their knowledge and skills for promoting healthy nutrition and PA behaviors through community outreach and extension to reduce the burden of chronic disease. (Education)We have offered this course twice and have produce 5 toolkits for cooperative extension agents.

Publications


    Progress 05/01/23 to 04/30/24

    Outputs
    Target Audience:The target audience during the reporting period are county extension agents, undergraduate students, extension faculty, and the general public. Changes/Problems:The current nutrition literacy assessement tools are too long and not adaptable to modern technology. Therefore, we are working with experts to develop, assess, and validate a new nutrition literacy assessment tool. A validated tool to assess physical activity literacy does not exist, so we are also working with experts to devleop, assess, and validate a new tool. What opportunities for training and professional development has the project provided? Nothing Reported How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals?We will continue to offer the undergraduate course and create additional toolkits (Goal 4). We will publish the meta-analysis and develop and validate nutrition and physical activity literacy assessements. We will develop comprehensive nutrition and physical activity toolkits and train agents on materials and how to effectively deliver the information to their counties. We will also implement the validated assessments state-wideto identify dietary patterns and physical activity levels of adults at risk for chronic disease.

    Impacts
    What was accomplished under these goals? Goal 1: Working to create and validate new nutrition and physical activity literacy assessments that work with modern technology and can be completed in less than 10 minutes. Progress made on conducting a meta-analysis of current nutrition and physical acitivity literacy tools to identify the gaps and areas to be assessed. Goal 2: Submitted IRB for approval. Goal 3: Focus groups have been conducted with community members and county extension agents to gain an understanding of preference for mode of delivery and implementation. Goal 4: Taugh the first semester of the course to 15 undergraduate students. Students were mentored by county extension agents and nutrition and physical activity experts to develop multi-media toolkts to be used in several counties in Arkansas.

    Publications