Source: COLORADO STATE UNIVERSITY submitted to NRP
A LONGITUDINAL STUDY TO ASSESS IF THE EFFECTIVENESS OF A PRESCHOOL NUTRITION AND PHYSICAL ACTIVITY PROGRAM IS SUSTAINED IN ELEMENTARY SCHOOL
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
COMPLETE
Funding Source
AFRI COMPETITIVE GRANT
Reporting Frequency
Annual
Accession No.
0221233
Grant No.
2010-85215-20648
Cumulative Award Amt.
$1,498,898.00
Proposal No.
2009-05124
Multistate No.
(N/A)
Project Start Date
Mar 15, 2010
Project End Date
Mar 14, 2016
Grant Year
2010
Program Code
[93330]- Human Nutrition and Obesity
Recipient Organization
COLORADO STATE UNIVERSITY
(N/A)
FORT COLLINS,CO 80523
Performing Department
Food Science & Human Nutrition
Non Technical Summary
This proposal is an integrated project aimed at understanding behavioral factors and programming impacts to prevent obesity in preschoolers. With the rise in childhood overweight, it is suggested that the preschool years are a critical time for prevention efforts as they represent a time when children establish healthy eating habits and physical activity patterns. Understanding the context in which child behavioral patterns are developed is critical to developing a model to address childhood overweight. Child behaviors, such a dietary intake and physical activity, can place children at risk for overweight and are shaped by many characteristics, including individual characteristics as well as school, family and environmental characteristics. Predictive behaviors within these environments can influence child behaviors. While many predictive behaviors have been shown to influence dietary intake, physical activity, and weight status, two additional behaviors - food preference and motor performance - need further exploration. Two theory-based interventions - Food Friends and Mighty Moves - have successfully demonstrated increases in both children's willingness to try new foods (food preference) and motor performance in preschool-aged children. To further explore the efficacy of these programs the proposed project will use a contextual model to explore: 1) the influence of Food Friends and Mighty Moves on food preference and motor performance; 2) food preference and motor performance as predictors of dietary intake and physical activity; and 3) proposed influence of Food Friends and Mighty Moves on child weight status. Longitudinal research will provide more convincing evidence of potential relationships proposed.
Animal Health Component
100%
Research Effort Categories
Basic
(N/A)
Applied
100%
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
7036010302070%
7036020302020%
7036050302010%
Knowledge Area
703 - Nutrition Education and Behavior;

Subject Of Investigation
6010 - Individuals; 6020 - The family and its members; 6050 - Communities, areas, and regions;

Field Of Science
3020 - Education;
Goals / Objectives
Two theory-based interventions - Food Friends- Making New Foods Fun for Kids and Food Friends Get Movin' with Mighty Moves - have successfully demonstrated increases in both children's willingness to try new foods (food preference) and motor performance in preschool-aged children. To further explore the efficacy of these two programs, and how they relate to child weight status, the proposed project will ascertain: 1) Do children who have demonstrated increased willingness to try new foods and who developed enhanced motor performance by participating in Food Friends and Mighty Moves during preschool maintain those behaviors through early elementary school 2) Do the Food Friends and Mighty Moves programs have an impact on reducing the percentage of children considered overweight and at risk for overweight over a three year timeframe 3) Does food preference and motor performance directly affect child weight status or are they mediators to dietary intake and physical activity. Outputs for this project include: 1) Evaluation tools will be developed and/or modified for use in this grant, and potentially beyond. 2) A database will be developed for data collection. 3) A website will be enhanced to provide education to study participants. 4) Teachers, food service staff, extension agents, and community members will be trained and participate in various grant activities. 5) Development of booster education materials for kindergarten and 1st grade as well as parent nights. Materials will complement pre-k materials which are already developed. 6) A longitudinal study will be conducted with 2 cohorts over a 3 year timeframe. 7) A dissemination plan for program materials and efforts will be made so that other Extension Agents can disseminate the program. 8) Results will be published in peer reviewed publications and at national, state, and local meetings.
Project Methods
Two cohorts, separated by one year, will be followed in each of three treatment intensities across a 3 year period: Treatment 1 (Booster) - children participate in Food Friends and Mighty Moves programs in preschool and booster programming in kindergarten and 1st grade; Treatment 2 (No Booster) - children participate in Food Friends and Mighty Moves program in preschool but get no further programming in kindergarten and 1st grade; and Treatment 3 (Control) - children do not participate in Food Friends and Mighty Moves in preschool or elementary school. To account for any potential attrition, a convenience sample of more than 72 children per center/school will be sought for a potential sample of 216 children (72 per treatment group). Data will be collected at baseline when children are in preschool and for two subsequent years when children are enrolled in kindergarten and 1st grade. Outcome measures will include BMI, willingness to try novel foods, consumption of novel foods, motor performance, physical activity levels, and self-concept. Specific approaches and/or evaluation tools have been proposed by may need to be modified to fit this research study. Evaluation will include children being removed from the classroom for a short duration, during the school lunch period in the cafeteria, as well as input from parents and school staff. Measures proposed include: a) Nutrition Measures Tasting Booth (observation in school cafeteria) & Tasting Panel (observation in classroom) Consumption (observation in school cafeteria) and Food Frequency Questionnaire/Survey (parent input) b) Physical Activity Measures The Bruininks-Oseretsky Test (BOT-2) of Motor Proficiency, Second Edition (classroom testing) Pedometers (parents) and Parent Survey (parents) c) Anthropometric Measures Height, Weight, and Body Mass Index (classroom testing) d) Self-Concept Measure The Pictorial Scale of Perceived Competence and Social Acceptance for Young Children (classroom testing) e) Environmental Measures Home Environment Assessment (parent input) and School Environment Assessment (school personnel input)

Progress 03/15/10 to 03/14/16

Outputs
Target Audience: Nothing Reported Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?The project continued to train graduate students on database managment and integrity as well as advanced statistical methodology. Three doctoral students participated in various data analyses activities. How have the results been disseminated to communities of interest?Results of our longitudinal analyses and a study updatewill be disseminated to community partners/schools at the start of the 2016-17 school year. What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? Longitudinal analyses have demonstrated sustained behaviors of the preschool intervention (Food Friends and Mighty Moves): •The Food Friends preschool program resulted in significant improvements in consumption of a novel vegetable through 1st grade, when children had repeated exposure to the vegetable during the program. Children in the intervention group consumed significantly more Jicama (the repeatedly exposed food) at post-intervention compared with the control group (65. 7% and 33.8%, respectively, p<0.0001). No differences were noted in Edamame consumption (non-exposed food) at post-intervention across groups (32.0% and 33.8%, respectively; p=0.807). •Delivery of the Mighty Moves program in preschool confers a lasting impact on Fundamental Movement Skills, specifically ball skills, in at-risk elementary school children. A significant intervention effect for ball skills was found with ball skills at 2-year follow-up (β=0.194, t=3.25, p=0.001). The overall model accounted for 41% of variancein ball skills scores at 2-year follow-up: F(4,161)=30.695, p<0.001 - Additional longitudinal analyses are being conducted.

Publications

  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2016 Citation: Bellows, L., Davies, P., Johnson, S.L., Boles, R., Gavin, W. Motor Skill Development in At-Risk Preschoolers: A Community-Based Longitudinal Intervention Study. Presented at International Society for Behavioral Nutrition and Physical Activity Annual Conference, Cape Town, South Africa.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Johnson, S.L., Ryan, S., Kroehl, M., Boles, R., Davies, P., Gavin, W., Bellows, L. The Effects of a Preschool Intervention Aimed at Improving Young Childrens Novel Foods. FASEB Journal, April 2016, 30:1155.12
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Johnson, S.L., Gavin, W., Davies, P., Taylor, B., Boles, R.,, Bellows, L. Caregivers Estimations of 47-y-old Childrens Food Neophobia and Eating Temperament and Observations of Childrens Food Refusals. FASEB Journal, April 2016, 30:276.6.


Progress 03/15/14 to 03/14/15

Outputs
Target Audience: The target audience are families with children enrolled in elementary school. Families are of mixed ethnicity (majority white and hispanic) and primarily with limited resources. Communities participating in the study during this reporting period included Brush, Colorado. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? Conference attendance: 2 PD's attended USDA's Project Director meeting and Society for Nutrition Education annual meeting. 2 PDs, 1 Co-I and 3 students attended the International Society for Behavioral Nutrition and Physical Activity conference. The PD attended the American Public Health Association's annual meeting. Evaluation measures: 2 graduate students were trained to perform various dietary, physical activity, and anthropometric assessments. How have the results been disseminated to communities of interest? A report for each elementary school and preschool involved in the study was distributed. The report included the school's environmental survey results and general overall descriptive statistics of the LEAP study, and abstracts of key study findings to date. Additionally, we promoted the Live Eat Play Colorado (LEP) website to schools to use and distribute to families. Study participants were mailed a study summary of key findings as well as information on the LEP website. What do you plan to do during the next reporting period to accomplish the goals? We will continue to share our study findings with participating schools and families via direct mail or the LEP website (www.liveeatplay.colostate.edu).

Impacts
What was accomplished under these goals? The overall impact of this study has yet to be evaluated due to the longitudinal nature of the study. Key accomplishments under the stated goals include: Completion of data collection on all cohorts (n=249) Dissemination: The Colorado Live Eat Play website was launched (www.liveeatplay.colostate.edu). This site provides information for healthy living related to nutrition and physical activity. Promotional materials have been distributed to study participants and schools. Publications: 1 in Press, 2 Submitted, 4 published proceedings, 1 doctoral dissertation Presentations: 5 abstracts presented at national and international meetings. Data analysis of key research questions has continued and several publications are in process.

Publications

  • Type: Journal Articles Status: Accepted Year Published: 2015 Citation: Bellows, L.L, Conlon, T.*, Cunningham-Sabo, L., Johnson, S.L. (In Press). Opportunities in the Classroom or Cafeteria for a Tasting Challenge to Influence First Grade Students Willingness to Try New Foods. Journal of Child Nutrition Management.
  • Type: Journal Articles Status: Under Review Year Published: 2015 Citation: Bellows, L.L., Boles, R.E., Davies, P., Gavin, W., Burdell, A.*, Johnson, S.L. Psychometric Testing of a Questionnaire to Assess the Home Food and Activity Environment: A Mixed Methods Approach. Submitted to Childhood Obesity.
  • Type: Journal Articles Status: Under Review Year Published: 2015 Citation: Johnson, S.L., Davies, P.L., Boles, R.E., Gavin, W.J., Bellows, L.L. Relations among Parent Ratings of Young Childrens Food Neophobia, Sensory Behaviors and Food Intake from the Colorado LEAP Study. Submitted to Journal of Nutrition.
  • Type: Theses/Dissertations Status: Awaiting Publication Year Published: 2014 Citation: Burdell, A.C. (2014). Understanding the Home Food and Activity Environment of Low-Income, Rural Families with Young Children. Dissertation. Colorado State University, Fort Collins, CO.
  • Type: Websites Status: Published Year Published: 2014 Citation: Bellows, L., Shackelton, E., Clifford, J. (2014). Colorado Live Eat Play website - www.liveeatplay.colostate.edu. Colorado State University, Fort Collins, CO.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2015 Citation: Cardel, M.#, Bellows, L., Boles, R., Davies, P., Gavin, W., Johnson, S.L. (2015). Self-Concept and Obesity Risk in Low Income Diverse Preschoolers. FASEB Journal. April 2015 29:902.29
  • Type: Conference Papers and Presentations Status: Published Year Published: 2014 Citation: Bellows, L., Johnson, S.L., Davies, P.L., Anderson, J., Gavin, W., Boles, R.E. (2014). Findings from the Colorado LEAP Study: A Longitudinal Study for Obesity Prevention in Early Childhood. Journal of Nutrition Education and Behavior, 46(4S), S189.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2014 Citation: Conlon, T*, Johnson, S.L., Cunningham-Sabo, L, Bellows, L. (2014). A Tasting Challenge: Development and testing of an approach to influence childrens willingness to try new foods. Journal of Nutrition Education and Behavior, 46(4S), S147.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2014 Citation: Burdell, A.*, Conlon, T*, Lopez, A.*, DHooge, A.*, Bellows, L. (2014). Super Tasters and Mighty Movers: Connecting Nutrition and Activity Messages from the School to the Home. Journal of Nutrition Education and Behavior, 46(4S), S142.
  • Type: Conference Papers and Presentations Status: Other Year Published: 2014 Citation: Johnson, S.L., Davies, P., Boles, R., Gavin, W., Bellows, L. (2014). Developmental aspects of preschoolers exploratory eating behaviors, food refusal and food preference. Presented at International Society for Behaviors in Nutrition and Physical Activity, San Diego, CA.


Progress 03/15/13 to 03/14/14

Outputs
Target Audience: The target audience are families with children enrolled in elementary school. Families are of mixed ethnicity (majority white and hispanic) and primarily with limited resources. Communities participating in the study include: Iliff,Colorado; Sterling, Colorado; Buena Vista, Colorado; Salida, Colorado; Leadville, Colorado, and Brush, Colorado. Changes/Problems: No major changes have been made to study design or implementation. A no-cost extension was applied for and approved to extend the grant for 1 year. What opportunities for training and professional development has the project provided? Database management training: 3 doctoral students, the PI, and Database/Statistical manager (Co-I) meet weekly to learn about different management strategies within Access. Students are provided with weekly assignments to enhance their learning as well as assist with cleaning data for analysis. Conference attendence: 3 students and 2 PD's attended USDA's Project Director meeting and Society for Nutrition Education annual meeting. 2 PDs and 1 Co-I attended the International Society for Behavioral Nutrition and Physical Activity conference. The PD attended the American Public Health Association's annual meeting. Extension agents and student staff were trained to perfrom nutrition education in elementary classrooms. Evaluation measures: 8 graduate students were trained to perform various dietary, physical activity, and anthropometricassessments. How have the results been disseminated to communities of interest? Not at this time. We are currently working on a report for each school involved in the study which will include the school's environmental survey results and general overall descriptive statistics of the LEAP study, and abstracts of key study findings to date. What do you plan to do during the next reporting period to accomplish the goals? In this upcoming grant year, all data will be collected. The emphasis will turn to data analysis and dissemination of results through publications, presentations, and community venues. Because of the size and complexity of our database, we will be seeking additional funds to support additional and more robust statistical analyses.

Impacts
What was accomplished under these goals? The overall impact of this study has yet to be evaluated due to the longitudinal nature of the study. Key accomplishmentsunder the stated goalsinclude: 1. Completion of data collection on cohort 1 (n==86); continued data collection on cohorts 2 (n=103) and 3(n=18) during spring 2013. 2. Our Access database continues to be dynamic as data is entered and cleaned. A repository has been created for timepoints 1 and 2 since all data has been collected. A protocol has been developed for PI's performing data analysis to ensure data integrity. 3. Students attending 2 elementary schools in rural Colorado participated in the 5 month nutrition and physcial activity education program in both kindergarten and 1st grade. Classroom-based lessons, and signage for the cafeteria and gym, were implemented in 34 classrooms (~800 students). A home-based component, The Super Taster and Mighty Mover Club, was developed and 5 monthly packages were mailed to 1st grade study participants (n=98) to promote school-based messages in the home environment. Mailings consisted of a child newsletter, a bilingual parent newsletter, and educational enhancer (e.g. spatula, jump rope, cookbook). Child intercept interviews were conducted to determine if children could recall key program messages. A parent survey was sent home to gauge impressions of materials and understanding and incorporation of messages/materials in the home. The majority (80%) of children (cohort 1) could articulate program messages without prompting (100% with prompting). Parents (93%) reported that materials encouraged their children to partake in targeted behaviors; ~50% of families did the suggested activities/recipes and 20% planned to in the future. Data for cohort 2 will be assessed in Spring 2014. 4. The tasting challenge was conducted individually with children as part of a classroom activity and consisted of children being offered jicama and edamame to taste and asked to rate each food (yummy, ok, yucky). The protocol was pilot tested at 1 school (n=79) and after modifications, implemented in 4 schools (n=311).Participants trying jicama and edamame were 91.3% and 88.3%, respectively, and slightly higher for study participants compared to non-study participants (94.8% jicama and 94.7% edamame). 5. An evaluation instrument on the home food and activity environment was modified and tested to enhance psycometric properties. Rural families of children attending preschool participated in separate qualitative (n=11) and quantitative (n=26) studies. The modified Home IDEA (Inventory Describing Eating and Activity) is a self-report questionnaire for the physical home environment for food and activity items, including 110 food/drinks, 17 physical activity (PA) devices, and 9 sedentary devices. ). Overall reliability improved from 53% for original items to 71% for modified items.

Publications

  • Type: Journal Articles Status: Published Year Published: 2013 Citation: Bellows, L.L., Johnson, S.L., Davies, P.L., Anderson, J., Gavin, W.J., Boles, R.E. (2013). The Colorado LEAP Study: Rationale and design of a study to assess the short term longitudinal effectiveness of a preschool nutrition and physical activity program. BMC Public Health. 13:1146. DOI: 10.1186/1471-2458-13-1146
  • Type: Journal Articles Status: Under Review Year Published: 2014 Citation: Boles RE., Burdell AC, Johnson SL, Gavin W., Davies PL, Bellows LL. Home food and activity assessment: Development and validation of an instrument for diverse families of young children. Appetite. (In Revision)
  • Type: Conference Papers and Presentations Status: Other Year Published: 2013 Citation: Bellows, L., Johnson, SL, Davies, P., Gavin, W., Boles, R. The Colorado LEAP Study: A longitudinal study to assess if the effectiveness of a preschool nutrition and physical activity program is sustained in elementary school. Presented at the American Public Health Association Meeting as part of a USDA sponsored session entitled: Overweight and Obesity Prevention and Interventions in School Aged Children: USDA Supported Projects. Boston, MA, November 5, 2013
  • Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Johnson, S.L., Davies, P.L., Boles, R.E., Gavin, W., Bellows, L. Parent reports of young children's sensory characteristics are related to children's food neophobia. Presented at Experimental Biology, Boston, MA.
  • Type: Conference Papers and Presentations Status: Other Year Published: 2013 Citation: Bellows, L., Johnson, S.L., Davies, P.L., Gavin, W., Boles, R.E. Design and participant characteristics for the Colorado LEAP Study: A longitudinal study for obesity prevention in early childhood. Presented at International Society for Behaviors in Nutrition and Physical Activity, Ghent, Belgium.
  • Type: Conference Papers and Presentations Status: Other Year Published: 2013 Citation: Bellows, L., Gavin, W., Johnson, S.L., Boles, R.E., Davies, P.L. Effectiveness of a Preschool Physical Activity Intervention on Gross Motor Skills: The Colorado LEAP Study. Presented at International Society for Behaviors in Nutrition and Physical Activity, Ghent, Belgium.
  • Type: Conference Papers and Presentations Status: Other Year Published: 2013 Citation: Boles, R.E., Johnson, S.L., Davies, P.L., Gavin, W., Burdell, A., Bellows, L. Physical and social determinants of early child fruit and vegetable intake: A mediation analysis. Presented at International Society for Behaviors in Nutrition and Physical Activity, Ghent, Belgium.
  • Type: Conference Papers and Presentations Status: Other Year Published: 2013 Citation: Burdell, A., Bellows, L., Johnson, S.L., Davies, P.L., Gavin, W., Boles, R.E. Assessing home food availability and dietary consumption of preschool aged children in rural communities. Presented at International Society for Behaviors in Nutrition and Physical Activity, Ghent, Belgium.
  • Type: Conference Papers and Presentations Status: Other Year Published: 2013 Citation: Johnson, S.L., Boles, R.E., Davies, P.L., Gavin, W., Bellows, L. Children's oral sensory characteristics mediate parent child feeding responses to their child's neophobia. Presented at International Society for Behaviors in Nutrition and Physical Activity, Ghent, Belgium.
  • Type: Conference Papers and Presentations Status: Other Year Published: 2013 Citation: Johnson,S.L. Biglin, C., Williams, K., Boles, R.E., Davies, P.L., Gavin, W., Bellows, L. What is there to be afraid of? Young children's conceptions and experiences of trying new foods. Presented at International Society for Behaviors in Nutrition and Physical Activity, Ghent, Belgium.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Burdell, A., Bellows, L., Johnson, S.L., Davies, P., Gavin, W., Boles, R.E. (2013). Assessing the Home Nutrition and Physical Activity Environment of Families with Young Children in Rural Communities. Journal of Nutrition Education and Behavior, 45(4S), S44.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Burdell, A., Johnson, S.L., Boles, R.E., Davies, P., Gavin, W., Bellows, L. (2013). The Home Food and Activity Environment of Rural Families with Young Children: Qualitative Interviews. Journal of Nutrition Education and Behavior, 45(4S), S44.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Bellows, L., Johnson, S.L., Davies, P.L., Anderson, J., Gavin, W., Boles, R.E. (2013). A Longitudinal Study for Obesity Prevention in Early Childhood. Journal of Nutrition Education and Behavior, 45(4S), S78.
  • Type: Theses/Dissertations Status: Other Year Published: 2013 Citation: Conlon, T. Protocol Development and Pilot Test of a School-based Tasting Booth. Masters Thesis. Colorado State University. Fall 2013.
  • Type: Theses/Dissertations Status: Published Year Published: 2013 Citation: D'Hooge, A. Super Tasters and Mighty Movers: Extending The Food Friends messages into Early Elementary School. Masters Thesis. Colorado State University. Spring 2013.


Progress 03/15/12 to 03/14/13

Outputs
OUTPUTS: During this grant year, several key outputs were continued: 1) recruitment of children and families as well as an additional control school for cohort 3; 2) data collection for 3 cohorts 3) implementation of the elementary (kindergarten and 1st grade) intervention; 4) development of a home booster program for 1st graders and; 5) dissemination of grant activities in various presentations and abstracts. An additional 18 child/parent dyads were recruited to participate as part of a third cohort at 1 control site. Data collection was conducted for cohorts 1 (time 3; 78% retention) and 2 (time 2; 95% retention) in the spring 2012 and for cohort 3 in fall 2012. Overall, at time 2 we have a 93% retention rate with our 2 large cohorts with 71% or parents completed parent evaluations. Classroom implementation for kindergarten (10 classrooms) in spring 2012 and kindergarten and 1st grade (20 classrooms) in fall 2012 was conducted at 2 elementary schools by local Extension agents and graduate students, reaching over 500 children. A complimentary home booster program was developed for 1st graders. The Home Booster is designed to reinforce the monthly SuperTaster and Mighty Mover messages that children see at school. Titled the Super Taster and Mighty Mover Club children are mailed a monthly (5 months) activity-based newsletter, a monthly surprise (educational extender - spatula, jump rope, water bottle). Parents also receive a newsletter providing tips on how to incorporate healthy eating and activity into their daily routines. Other outputs include presentations on the study, including preliminary results. Ten presentations were conducted by the research team at local, state, national and international meetings. PARTICIPANTS: Laura Bellows (PD) - Dr. Bellows oversaw study logistics, site and participant recruitment, , a portion of staff training, graduate student advisor, database development, data collection, and grant administration. Susan Johnson (co-PD) - Dr. Johnson administered the subcontract, oversaw staff training and administration of data collection on tasting and self-competence, and contributes to statistical analysis. Patricia Davies (Co-PD) - Dr. Davies trained staff on gross motor assessment, conducted reliability testing in the field, and contributed to the sensory profile measures and statistical analysis. Richard Boles (Co-Investigator) - Dr. Boles continues to work with students on the development of the home environment assessment and contributes to statistical analysis. William Gavin (Co-Investigator) - Dr. Gavin continues to lead the efforts for the study database and a plan for electronic data collection. Victoria (Wallen) Lee (Study Assistant) - Ms. Lee assisted with on-site data collection at each of the four study sites. Adrienn Hollands (Study Coordinator, University of Colorado)- Ms. Hollands coordinated study activities between the 2 universities Andrea Jarmillo (Study Assistant) - Ms. Jarmillo assisted with on-site data collection at each of the four study sites and provided Spanish translation for written materials and oral communication. Kim Williams (Study Assistant) - Ms. Williams assisted with on-site data collection at each of the four study sites. Students: Five students (1 PhD, 8 Masters, and 1 undergraduate) worked in various capacities on this project. Participating Sites: Iliff Head Start (Iliff, CO), Salida Early Childhood Center (Salida, CO), Avery Parsons Elementary School Early Childhood Program (Buena Vista, CO), The Center Early Childhood Program (Leadville, CO), Thompson Primary School (Brush, CO) Community Partners: Chaffee County Extension, Logan County Extension TARGET AUDIENCES: The target audience are families with children enrolled in preschool. Families are of mixed ethnicity (majority white and Hispanic) and primarily with limited resources. Communities participating in the study include: Iliff, Colorado; Sterling, Colorado; Buena Vista, Colorado; Salida, Colorado; Leadville, Colorado; Brush, Colorado. The Food Friends and Mighty Moves programs are being conducted in treatment preschool sites (13 classrooms) and elementary schools (20 classrooms). PROJECT MODIFICATIONS: Based on baseline analyses, it was determined by the research team that additional participants were needed in the control group. A cohort 3 was added for 1 site (Brush) in fall 2012. Data collection was conducted on an additional 18 participants.

Impacts
Baseline (time 1) and time 2 data were analyzed. The following outcomes were found and have been submitted as abstracts for 2013 annual meetings of the International Society for Behavioral Nutrition and Physical Activity (6 abstracts) and Experimental Biology (1 abstract). a. Child oral sensory characteristics (OSC) and parent feeding practices were significantly correlated with child neophobia (r=.21 - .31, p<.01) but not child BMIz. Child OSC partially mediated the relationship between parent feeding practices (Pressure to Eat, p<.005; Restriction, p<.05; Concern about Child Not Eating Enough, p<.005; Urging New Foods, p=.084) and child neophobia. b. For gross motor skills, a significant group by time interaction was found for balance (p=.006) and speed/agility (p=.017), indicating that the intervention group demonstrated a significant increase in these skills from time 1 to time 2 compared to the control group. c. Examination of the home environment and child food frequency questionnaire (FFQ), showed home availability of fruits and vegetables significantly predicted child consumption of fruits (R2= .08,p<.01) and vegetables (R2=.10, p<.001), respectively. Whole grains availability significantly predicted whole grain consumption (R2=.12, p=.01). Sugar sweetened beverages (SSB) failed to predict daily calories from SSB when controlled for demographics. Younger, less educated, lower income Hispanic families were significantly more likely to have higher caloric intake from SSB. d. When examining parent feeding practices in addition to the home environment and child's dietary intake (FFQ) Home Vegetable Availability (p<.001) and Urging (p<.05) independently and positively predicted parent report of child vegetable intake, controlling for covariates. Offering (p<.01), Urging (p<.05), and Home Fruit Availability (p<.005) independently predicted child fruit intake; only Urging (p<.05) predicted child fruit intake when controlling for covariates.

Publications

  • DHooge, A., Bellows, L., Fitzgerald, C., Johnson, S.L., Anderson, J. (2012) Super Tasters and Mighty Movers: Extending the Food Friends Message into Elementary School. Journal of Nutrition Education and Behavior, 43(4S), S73.


Progress 03/15/11 to 03/14/12

Outputs
OUTPUTS: During this grant year, several key outputs were completed: 1) recruitment of children and families as well as an additional control school for cohort 2; 2) data collection for both cohorts 3) development and implementation of an electronic data collection system; 4) formative research, development, and implementation of curriculum components for kindergarten students and; 5) dissemination of grant activities in various presentations and abstracts. Data for cohort 1, time 2 (spring 2011) were collected on 86 children (90.5% retention from baseline. During the fall of 2011, 119 children and families were recruited for cohort 2 bringing the total sample to 214 (cohort 1 n=95 and cohort 2 n=119) for baseline measures (time 1). Children were assessed on gross motor skills, tasting, anthropometrics, and self-competence. A subsample of children wore accelerometers to assess physical activity (total n at baseline=133 or 62.1% of sample). Parents returned 78 completed evaluation packets for cohort 1, time 2 (90.7% response rate); and 78 for cohort 2, time 1 (65.5% response rate). The total number of parent packets returned at baseline/time 1 is 157 (73% of the sample). Another large effort during this grant period was the development and implementation of an electronic data collection and entry system. Eight tablet computers were formatted with our Microsoft Access database and connected via an ad hoc server when on site. This setup allowed for instantaneous data entry into the main database. Further, all parent surveys were formatted to allow for electronic scanning, scoring and direct entry into the database. Both the onsite entry procedure and use of scanning software eliminated manual data entry and re-entry steps. Formative research, program development, and implementation for the Food Friends: Super Taster and Mighty Movers for Elementary School were completed. This program is intended to extend the Food Friends and Mighty Moves messages from preschool into kindergarten and 1st grade to retain behavior changes occurring in preschool. Formative research - surveys (n=22) and telephone interviews (n=10) - was conducted with teachers to ascertain current classroom nutrition and physical activity programming, interest in future programming, needs and use of supporting materials, and training options. Resulting materials included a teacher guide and supporting materials (puppets, musical CD, stickers, beanbags, and a storybook) as well as signage for the school cafeteria and gym -vinyl banners and posters with 10 different messages. Teachers (n=10) and extension agents (n=2) from 2 schools/communities were trained on program implementation. Extension agents conducted a monthly, hands-on, experiential foods lesson, and teachers supported messages in various academic subjects throughout the month. Five months/units were conducted, reaching 10 kindergarten classrooms and approximately 180 children. Process evaluation data was collected monthly to ascertain program fidelity as well as likes and dislikes. Lastly, 6 invited presentations at national, state, and campus conferences, colloquiums and seminars were conducted. PARTICIPANTS: Laura Bellows (PD) - Dr. Bellows oversaw study logistics, site and participant recruitment, , a portion of staff training, graduate student advisor, database development, data collection, and grant administration. Susan Johnson (co-PD) - Dr. Johnson administered the subcontract, oversaw staff training and administration of data collection on tasting and self-competence, and contributes to statistical analysis. Patricia Davies (Co-PD) - Dr. Davies trained staff on gross motor assessment, conducted reliability testing in the field, and contributed to the sensory profile measures and statistical analysis. Richard Boles (Co-Investigator) - Dr. Boles continues to work with students on the development of the home environment assessment and contributes to statistical analysis. William Gavin (Co-Investigator) - Dr. Gavin continues to lead the efforts for the study database and a plan for electronic data collection. Carlynn Fitzgerald (Study Coordinator, Colorado State University) - Ms. Fitzgerald coordinated all study activities between CSU and study sites and partners. Victoria (Wallen) Lee (Study Assistant) - Ms. Wallen assisted with on-site data collection at each of the four study sites. Adrienn Hollands (Study Coordinator, University of Colorado)- Ms. Hollands coordinated study activities between the 2 universities Andrea Jarmillo (Study Assistant) - Ms. Jarmillo assisted with on-site data collection at each of the four study sites and provided Spanish translation for written materials and oral communication. Kim Williams (Study Assistant) - Ms. Williams assisted with on-site data collection at each of the four study sites. Students: Five students (1 PhD, 3 Masters, and 1 undergraduate) worked in various capacities on this project. Participating Sites: Iliff Head Start (Iliff, CO), Salida Early Childhood Center (Salida, CO), Avery Parsons Elementary School Early Childhood Program (Buena Vista, CO), The Center Early Childhood Program (Leadville, CO), Thompson Primary School (Brush, CO) Community Partners: Chaffee County Extension, Logan County Extension Training was conducted with 10 kindergarten teachers, 2 Extension agents, and 2 school administrators on the program implementation. TARGET AUDIENCES: The target audience are families with children enrolled in preschool. Families are of mixed ethnicity (majority white and Hispanic) and primarily with limited resources. Communities participating in the study include: Iliff, Colorado; Sterling, Colorado; Buena Vista, Colorado; Salida, Colorado; Leadville, Colorado; Brush, Colorado. The Food Friends and Mighty Moves programs are being conducted in treatment preschool sites (13 classrooms) and elementary schools (10 classrooms). PROJECT MODIFICATIONS: A change in the study design was made during this grant period based on input and approval from our program officer (Etta Saltos). After careful consideration of our power analysis and resources, it was determined that we were underpowered to have 3 treatment intensities (Treatment 1: children who receive the Food Friends and Mighty Moves program in preschool as well as supplemental booster programs in kindergarten and 1st grade; Treatment 2: children who receive the Food Friends and Mighty Moves program in preschool but no additional programming in kindergarten and 1st grade; and Treatment 3: children who do not receive any program in preschool, kindergarten, or 1st grade.) The modified design collapses treatments 1 and 2 with both treatments receiving additional programming in kindergarten and first grade. In an effort to ensure that our control group (treatment 3) sample is best matched in numbers with our treatment 1&2 groups, an additional site (Brush) was added for cohort 2. Further, based on baseline analyses, it was determined by the research team that additional participants were needed in the control group. A cohort 3 will be added for 1 site (Brush) in fall 2012.

Impacts
Baseline data has been collected on 214 participants in 2 cohorts from 5 rural communities. Child participants have a mean age of 56.2 (4.5 sd) months and 56% are female, and 41.3% are Hispanic. Mean BMI z-score is .49 (1.2 sd) with 66.8% being classified as normal weight, 15.9% as overweight and 13.6% as obese. Of the 160 parents who completed the parent evaluation surveys, 89.4% were mothers, 33.3% had a high school degree or less, 37.8% had a college degree or higher, 56.6% had an annual income less than $34,000 and 15.3% had an annual income greater than $69,000. Parents mean BMI was 27.0 (6.7 sd) with 44.4% classified as normal weight, 34.9% as overweight, and 20.7% as obese. Models exploring eating/food, physical activity, and the home environment have been drafted. Descriptive statistics on baseline data are being analyzed as well as potential relationships between outcome measures. Process evaluation was collected on the new program components for kindergarten. Overall, the program was well liked and materials and content were adequate to promote the SuperTaster and Mighty Mover messages.

Publications

  • Bellows L, Davies, P, Anderson J, Kennedy, C. Physical Activity and Gross Motor Performance: A Randomized Intervention Study. American Journal of Occupational Therapy. Anticipated publication date January 2013.


Progress 03/15/10 to 03/14/11

Outputs
OUTPUTS: Planning, recruitment, staff training, baseline data collection for cohort 1, and database development were the major outputs for year 1. Planning for evaluation tools, data collection, and staffing needs were the major activities at the start of the grant. Evaluation tools were modified and or finalized for on-site data collection methods (tasting panel, gross motor skill assessment, anthropometrics, and self-competence) and parent evaluation packet (demographics, food frequency questionnaire, child feeding survey, physical activity survey, pedometer logs, and the home health assessment). Four preschool centers with matched elementary school wre recruited. In each of the preschools, children who are in their last year of preschool were recruited through their parents to participate in the study. Baseline data was collected for Cohort 1. Children (n=117) were assessed on gross motor skills, tasting, anthropometrics, and self-competence. Parent evaluation packets were sent home to all 117 families. In all, 79 completed packets were returned (67.5% response rate). Additionally, 15 families participated in a home visit for reliability-testing of the Home Health Assessment. An Access database has been developed for data management. Further, electronic recording of data at time of assessment has been explored with handheld computer devises. PARTICIPANTS: Laura Bellows (PD) - Dr. Bellows oversaw study logisics, site and participant recruitment, evaluation tool development, a portion of staff training, graduate student advisor, data collection, and grant administration. Susan Johnson (co-PD) - Dr. Johnson adminstered the subcontract, oversaw staff training and administration of data collection on tasting and self-competence. Patrica Davies (Co-PD) - Dr. Davies trained staff on gross motor assessment and contributed to the development of the child feeding survey. Richard Boles (Co-Investigator) - Dr. Boles oversaw teh finalization of the home health assessment, training on implemenation, and reliability portion of the study. William Gavin (Co-Investigator) - Dr. Gavin developed the study database and a plan for electronic data collection. Julie Roach (Study Coordinator, Colorado State University) - Ms. Roach coordinated all study activities between CSU and study sites and partners. Victoria Wallen (Study Assistant) - Ms. Wallen assisted with on-site data collection at each of the four study sites. Adrienn Hollands (Study Coordinator, University of Colorado)- Ms. Hollands coordinated study activities between the 2 universities Andrea Jarmillo (Study Assitant) - Ms. Jarmillo assisted with on-site data collection at each of the four study sites and provided spanish translation for written materials and oral communication. Participating Sites: Iliff Head Start (Iliff, CO), Salida Early Childhood Center (Salida, CO), Avery Parsons Elementary School Early Childhood Program (Buena Vista, CO), The Center Early Childhood Program (Leadville, CO) Community Partners: Chaffee County Extension, Logan County Extension TARGET AUDIENCES: The target audience are families with children enrolled in preschool. Families are of mixed ethnicity (majority white and hispanic) and primarily with limited resources. Communities participating in the study include: Iliff, Colorado; Sterling, Colorado; Buena Vista, Colorado; Salida, Colorado; Leadville, Colorado. The Food Friends and Mighty Moves programs are being conducted in treatment preschool sites (13 classrooms). Parent dinners were conducted at each site to provide study information. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.

Impacts
Outcome data are not available at this time.

Publications

  • No publications reported this period