Source: COLORADO STATE UNIVERSITY submitted to NRP
UNDERSTANDING THE HOME ENVIRONMENT TO ADDRESS OBESITY PREVENTION IN YOUNG CHILDREN
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
COMPLETE
Funding Source
Reporting Frequency
Annual
Accession No.
0229416
Grant No.
(N/A)
Cumulative Award Amt.
(N/A)
Proposal No.
(N/A)
Multistate No.
(N/A)
Project Start Date
Jul 1, 2012
Project End Date
Jun 30, 2014
Grant Year
(N/A)
Program Code
[(N/A)]- (N/A)
Recipient Organization
COLORADO STATE UNIVERSITY
(N/A)
FORT COLLINS,CO 80523
Performing Department
Food Science & Human Nutrition
Non Technical Summary
Within the home environment, parents of young children can serve as highly influential role models for dietary and physical activity behaviors. They are also gatekeepers for foods and beverages that are brought into the home environment, and serve as regulators of screen time, free play time, and other sedentary and physical activity behaviors. Research on the home food and activity environment is limited in families with young children, and even more limited with low-income families. Understanding the factors that impact decisions made in the home will lead to future intervention strategies which will strive to improve the nutrition and physical activity environment of families with limited resources. The overall goal of this project is to produce a valid and reliable assessment tool that adequately captures the health of the home environment of families with young children with respect to nutrition and physical activity which will ultimately serve as a vehicle for intervention development.
Animal Health Component
(N/A)
Research Effort Categories
Basic
(N/A)
Applied
(N/A)
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
70360103020100%
Knowledge Area
703 - Nutrition Education and Behavior;

Subject Of Investigation
6010 - Individuals;

Field Of Science
3020 - Education;
Goals / Objectives
The overall goal of this project is to produce a valid and reliable assessment tool that adequately captures the health of the home environment of families with young children with respect to nutrition and physical activity which will ultimately serve as a vehicle for intervention development. Specific aims are to: Aim 1: Test a modified home food and activity environment assessment tool, LEAP Home Food and Activity Environment Assessment (HFAEA) 2.0, with parents of young children and conduct cognitive interviews to improve validity and reliability of the assessment. The working hypothesis is that cognitive interviews will improve comprehension of the LEAP HFAEA 2.0 among the target audience leading to increased reliability and validity of the tool. Aim 2: Develop and test key messages and behavioral strategies to improve the home health environment with parents of young children. The working hypothesis is formative research will lead to messages and behavioral strategies which resonate with the target audience. Aim 3: Disseminate findings through the development of Extension education materials and a grant proposal for a home/family-based intervention study.
Project Methods
Aim 1: Testing of LEAP HFAEA 2.0 Parent participants (n=25) will be recruited from LEAP Study Sites to test the LEAP HFAEA 2.0. Researchers, trained to reliability, will concurrently complete the modified tool with the parent participant. Cognitive interviewing will occur in the first 5 homes after the completion of the home assessment to assess reasons for missing data, inconsistencies in reporting, and any other issues that may arise from the parent completing the home assessment. A semi-structured set of interview questions will be developed and tested for face and content validity by the research team and individuals representing the target audience. Modifications to the tool will be done upon completion of the cognitive interviews. Reliability of the tool will be assessed with the remaining 20 homes . Inter-rater reliability, scale reliability, and criterion validity will be assessed on the completed tools. Through the analyses for reliability and cognitive interviewing, additional modifications may be made to ensure that the tool will be sensitive to assessing the home environment of families with young children. Aim 2: Message and Strategy Development A second objective of this study is to explore key messages and behavioral strategies that can be communicated to parents to create a healthy nutrition and physical activity home environment. Messages and behavioral strategies will be derived from common themes that were identified through the LEAP HFAEA tools and were found to be predictive of obesogenic home environments. Principles from Social Marketing and constructs from the Social Cognitive Theory will be incorporated into the development of messages and strategies. Messages may be low-fat milk products, Screentime, or vegetables in the home. Behavioral strategies may include choosing low-fat milk products, implementing rules about Screentime, placing prepared vegetables for easy snacking. Messages and behavioral strategies will be developed with input from experts in the fields of nutrition, physical activity, child development, marketing, psychology, and public health. A total of six focus groups with parents (n=36-48) will be conducted. Four focus groups in English will be conducted at each of the four LEAP study sites. Focus groups will be conducted by a trained moderator based on Krueger's methodology. The focus group questions will solicit feedback regarding comprehension and acceptability of the messages and strategies; and probe for insight into future intervention strategies, such as preferred methods of communication (e.g. in-person workshops, web-based, or newsletter based). Aim 3: Dissemination of Findings Information gained through this formative research phase will lead to further revisions of messages and behavioral strategies which will enable the development of educational materials and intervention plans. Tested messages and behavioral strategies will be incorporated into Extension materials, such as factsheets, consumer handouts, and a brief workshop. A small team involving graduate students and Extension personnel will work to develop these materials.

Progress 07/01/12 to 06/30/14

Outputs
Target Audience: Nothing Reported Changes/Problems: It was our intent to conduct focus groups for Aim 2. Due to the length of time that Aim 1 took to initiate, we incorporated qualitative questions into the home interviews in Aim 1 to cover content intented for focus groups in Aim 2. We feel that this information provided us with adequate information to accomplish Aim 3. By altering this procedure, it allowed us to do a more comprehensive job with Aim 1. What opportunities for training and professional development has the project provided? Training opportunities were provided to students working directly on this project as well as students working in the PI lab. This included training on the home environment and its relation to obesity risk, qualitative interview techniques, positive engagements with study participants, health disparities, health literacy, survey development techniques,psychometric testing, IRB and ethics trainings. Professional development - 2 doctoral students were able to present at and attend multiple conferences, including the International Society for Behavioral Nutrition and Physical Activity, Society for Nutrition Education and Behavior, and University of South Florida's Social Marketing workshop and conference. How have the results been disseminated to communities of interest? Information related to the study has been distributed to participants, including a letter from the PI which outlines key study achievements. Additionally the letter and promotional materials introduce participants to the a new website in which educational materials developed for this project are housed - Live Eat Play Colorado (www.liveeatplay.colostate.edu). What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? Aim 1: 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. Face-to-face home interviews were conducted to inform instrument design and function while home assessments (parent and trained independent raters) completed the modified Home IDEA for psychometric validation. A final valid and reliable instrument to assess the home eating and activity environment was developed and publication of the tool is in process. Aim 2: During home interviews described in Aim 1, families were asked about education needs related to healthy eating, physical activity and screen time for thier children. Aim 3: Educational materials, including handouts and web copy, were developed and are disseminated at the Live Eat Play Colorado website (www.liveeatplay.colostate.edu). Promotion of the site, including an informational flyer and postcard, have been sent to study participants.

Publications

  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2014 Citation: Burdell, A.*, Bellows, L., Johnson, S.L., Davies, P., Gavin, W, Boles, R. The Modification of a Home Assessment Tool for Rural Families with Young Children. Presented at International Society for Behaviors in Nutrition and Physical Activity, San Diego, CA.
  • 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. Doctoral Dissertation, Colorado State University, Fort Collins, CO.


Progress 01/01/13 to 09/30/13

Outputs
Target Audience: Parents of young children attending Head Start centers in rural Colorado. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? Five graduate students and 1 undergraduate student were trained to reliably perform the Home IDEA. Additionally, these students observed the lead investigator conduct interviews and home assessments, providing them with insight into survey measurement, rural communities, and low-income families. How have the results been disseminated to communities of interest? Results have not yet been disseminated. What do you plan to do during the next reporting period to accomplish the goals? Aims 2 and 3 will be explored.

Impacts
What was accomplished under these goals? Aim 1 (note - LEAP HFAEA 2.0 is now referred to as the Home IDEA instrument): 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. Face-to-face home interviews were conducted to inform instrument design and function while home assessments (parent and trained independent raters) completed the modified Home IDEA for psychometric validation. Qualitative home interviews identified areas for improvement which included: clearer instructions, more detailed description of foods, reorganization of items, and reduction of items (159 to 136). Reliability testing of the modified assessment resulted in Kappa Statistics that were high (0.6-1.00) for 96 items (71 food, 16 PA, 8 sedentary), moderate (0.4-0.55) for 28 items (27 food, 1 PA), and poor for 13 items (<0.39) (12 food, 1 sedentary). Overall reliability improved from 53% for original items to 71% for modified items. Observations of working with the families in the rural communities over the past few years, as well as, through the home visits for interviews and reliability testing revealed a need to better understand external determinants that impact the food and activity environment of rural homes with young children. Home visits with the rural families revealed a level of chaos, stress, and family disorganization that was we believe is impacting the home food and activity environment and the ability of parents to complete the Home IDEA. Aims 2 & 3 have not been completed at this time.

Publications

  • 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.


Progress 01/01/12 to 12/31/12

Outputs
OUTPUTS: To date, a portion of Aim 1 has been conducted. Eleven (n=11) interviews with families in 4 rural communities (Buena Vista, Brush, Leadville, and Sterling) have been conducted. Interviews are guiding the modification of a home food and activity environment assessment. A modified tool is under development and will be tested with additional families as a next step. PARTICIPANTS: Laura Bellows (PI) - Worked with graduate student (A. Burdell) on IRB protocol, development of interview question set, recruitment of participants, and interviews. Susan Johson (Co-PI) - Worked with graduate student (A. Burdell) on development of interview question set and training on conducting interviews Richard Boles (Co-PI) - Worked with graduate student (A. Burdell) on development of interview question set. Patricia Davies (Co-PI) - Worked with graduate student (A. Burdell) on development of interview question set. Alexandra Burdell (Graduate Student) - Developed IRB protocol, question set for interviews, worked with Head Start centers to recruit participants, Conducted interviews and analyses. TARGET AUDIENCES: The target audience are families with children enrolled in preschool in rural communities. Families are of mixed ethnicity (majority white and Hispanic) and primarily with limited resources. Communities participating in the study include: Sterling, Colorado; Buena Vista, Colorado; Leadville, Colorado; Brush, Colorado. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.

Impacts
Interview transcripts are currently being analyzed.

Publications

  • No publications reported this period