Progress 09/01/03 to 08/31/08
Outputs
Progress Report Objectives (from AD-416) A primary objective of the Lower Mississippi Delta Nutrition Intervention Research Initiative (Delta NIRI) Consortium mission being conducted in part under this cooperative agreement is to develop sustainable nutrition intervention strategies in the Lower Mississippi Delta (LMD) through community-based participatory research. The specific objective of this cooperative research project is to establish and support a cooperative partnership between the United States Department of Agriculture (USDA), Agricultural Research Service (ARS) and the Mississippi State University Cooperative Extensive Service (MSU-CES) which will work with ARS and other Delta NIRI partners to coordinate, assist, design, organize, conduct, interpret, and evaluate community participatory based nutritional interventions established within the Hollandale, Mississippi, community (Hollandale Delta NIRI) to evaluate nutritional health, identify nutritionally responsive problems, and develop and evaluate interventions which are sustainable at the community level. Approach (from AD-416) The MSU-CES will appoint a Hollandale Delta NIRI Coordinator, who will be stationed in Hollandale, Mississippi, to support nutrition intervention research initiatives in the Hollandale community. This individual will work in partnership with the Hollandale Delta NIRI and with the U.S. Department of Agriculture (USDA), Agriculture Research Service (ARS), and other Delta NIRI Consortium partners, to conduct, support, and facilitate nutrition interventions related to the nutritional health of the Hollandale community. Following implementation and evaluation of these nutrition intervention strategies in the Hollandale community, the Delta NIRI Consortium with cooperation from the Hollandale Delta NIRI Coordinator, will identify successful intervention strategies, evaluate the impact of community participation, and determine specific characteristics of the community that contributed to intervention success. Significant Activities that Support Special Target Populations The Hollandale NIRI Summer SNAP program was implemented beginning May 28 ended August 2, 2008. An evaluation of the program will be completed by the partners at the University of Southern University. Monitoring of cooperator's performance and adherence to conditions of the agreement was by: a site visit; quarterly reports consisting of budgetary material, progress towards goals and objectives, and review of publications and manuscripts in progress; and numerous conference calls and emails.
Impacts
(N/A)
Publications
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Progress 10/01/06 to 09/30/07
Outputs
Progress Report Objectives (from AD-416) A primary objective of the Lower Mississippi Delta Nutrition Intervention Research Initiative (Delta NIRI) Consortium mission being conducted in part under this cooperative agreement is to develop sustainable nutrition intervention strategies in the Lower Mississippi Delta (LMD) through community-based participatory research. The specific objective of this cooperative research project is to establish and support a cooperative partnership between the United States Department of Agriculture (USDA), Agricultural Research Service (ARS) and the Mississippi State University Cooperative Extensive Service (MSU-CES) which will work with ARS and other Delta NIRI partners to coordinate, assist, design, organize, conduct, interpret, and evaluate community participatory based nutritional interventions established within the Hollandale, Mississippi, community (Hollandale Delta NIRI) to evaluate nutritional health, identify nutritionally responsive problems, and develop and evaluate interventions which are sustainable at the community level. Approach (from AD-416) The MSU-CES will appoint a Hollandale Delta NIRI Coordinator, who will be stationed in Hollandale, Mississippi, to support nutrition intervention research initiatives in the Hollandale community. This individual will work in partnership with the Hollandale Delta NIRI and with the U.S. Department of Agriculture (USDA), Agriculture Research Service (ARS), and other Delta NIRI Consortium partners, to conduct, support, and facilitate nutrition interventions related to the nutritional health of the Hollandale community. Following implementation and evaluation of these nutrition intervention strategies in the Hollandale community, the Delta NIRI Consortium with cooperation from the Hollandale Delta NIRI Coordinator, will identify successful intervention strategies, evaluate the impact of community participation, and determine specific characteristics of the community that contributed to intervention success. Significant Activities that Support Special Target Populations Monitoring of cooperator�s performance and adherence to conditions of the agreement was by: a strategic planning session; two site visits (one for data collection and one for technical assistance); quarterly reports consisting of budgetary material, progress towards goals and objectives, and review of publications and manuscripts in progress; community visits to determine progress at research sites and numerous conference calls and emails. Threadgill, P., Kennedy, B., Yadrick, K., Warren, D., Prewitt, E., Champagne, C., McCabe-Sellers, B., Sims, D., Bogle, M. 2007. Achieving sustainability in three Delta NIRI Communities (abstract). In Meeting Proceedings of Community Campus Partners for Health, Toronto, CA. Accomplishments SNAP Into Health: Rates of childhood obesity continue to be higher in the Delta region, especially in Mississippi, than in the rest of the US, with poor food choices and lack of physical activity in schools being viewed as contributing to the problem. The purpose of the Lower Mississippi Delta NIRI Summer Nutrition Athletic Program (SNAP) intervention was to evaluate the effects of a nutrition and physical activity intervention on food choices, body composition, physical fitness, and dimensions of physical activity. Hollandale students (5-12 yr) attended nutrition education classes and gained skills in how to play soccer, all of which were taught by youth peer educators ages 16-19 yrs. The outcome of this intervention has developed interest by the Independent School District to change its menu and evaluate means to incorporate soccer into the school system. (NP 107, Human Nutrition Action Plan 2004-2008: Component 7: Health Promoting Intervention Strategies for Targeted Populations: ARS Strategic Plan Objective 4.l: Promote Healthier Individual Food Choices and Lifestyles and Prevent Obesity: and Performance Measure 4.1.1: Execute and report on two completed Delta NIRI projects) Fit For Life Steps and Challenge: Understanding the factors that contribute to making nutrition and physical activity interventions effective and sustainable is critical in small, rural communities, where declining population and limited resources present formidable challenges to community health status. Lower Mississippi Delta NIRI cooperative scientists and Mississippi State Cooperative Extension researchers studied many aspects of the Fit for Life Steps intervention by conducting focus groups and interviews with participants and staff, and by reviewing many types of records kept throughout the intervention. A 12�week program of nutrition education and an exercise class was provided to Hollandale citizens. The results of our evaluation confirmed that trained volunteer leaders from the community can effectively recruit and support their overweight and obese community peers in increasing their level of physical activity and improving their blood pressure and other health outcomes. This finding is of importance for other community programs that are planning interventions in densely populated rural areas of the US. (NP 107, Human Nutrition Action Plan 2004-2008: Component 7: Health Promoting Intervention Strategies for Targeted Populations: ARS Strategic Plan Objective 4.l: Promote Healthier Individual Food Choices and Lifestyles and Prevent Obesity: and Performance Measure 4.1.1: Execute and report on two completed Delta NIRI projects) School Kids Access to Treats to Eat (SKATE): Rates of childhood obesity continue to be higher in the Delta region, especially in Mississippi, than in the rest of the US with poor food choices being viewed as contributing to the problem. A Lower Mississippi Delta NIRI school-based nutrition intervention research project, School Kids Access to Treats to Eat (SKATE), focused on obesity prevention by evaluating increased consumption of fruits and vegetables for Hollandale, MS, children in grades 4 � 6. Approximately 200 Children were offered healthy snacks and a variety of fruits and vegetables during the school day, and data was obtained using the Delta NIRI Child Food Frequency Questionnaire (FFQ) and the Willingness to Try New Foods Questionnaire. The Mississippi State Cooperative Extension developed fruit and vegetable flash cards and trained the teachers in the use of them for educating the students. Preliminary results show that elementary children were willing to taste new foods, and school administrators, parents, and the community as a whole were willing to improve the health and eating habits when exposed to positive interventions. (NP 107, Human Nutrition Action Plan 2004-2008: Component 7: Health Promoting Intervention Strategies for Targeted Populations: ARS Strategic Plan Objective 4.l: Promote Healthier Individual Food Choices and Lifestyles and Prevent Obesity: and Performance Measure 4.1.1: Execute and report on two completed Delta NIRI projects) Technology Transfer Number of Non-Peer Reviewed Presentations and Proceedings: 5
Impacts
(N/A)
Publications
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Progress 10/01/05 to 09/30/06
Outputs
Progress Report 1. What major problem or issue is being resolved and how are you resolving it (summarize project aims and objectives)? How serious is the problem? Why does it matter? The Lower Mississippi Delta (LMD) area of Arkansas, Louisiana, and Mississippi is characterized by high rates of poverty, low education attainment, and food insecurity. There is a high prevalence of hypertension, diabetes, obesity, anemia, and heart disease, all of which are influenced by nutrition. We are attempting to resolve these problems through the efforts of the Lower Mississippi Delta Nutrition Intervention Research Initiative (Delta NIRI). The Delta NIRI Consortium consists of the original partners: scientists from Alcorn State University, Alcorn State, MS (ASU); Arkansas Children's Hospital Research Institute, Little Rock, AR (ACHRI); Pennington Biomedical Research Center, Baton Rouge, LA (PBRC); Southern University and A&M College, Baton Rouge, LA (SU); The University of
Arkansas at Pine Bluff, Pine Bluff, AR (UAPB); The University of Southern Mississippi, Hattiesburg, MS (USM); and the Agricultural Research Service (ARS) of USDA, Little Rock, AR. The Delta NIRI Consortium also now includes representatives from the Arkansas, Louisiana, and Mississippi Cooperative Extension Service; the College of Public Health of the University of Arkansas for Medical Sciences, Little Rock, AR; a private researcher, Jackson, MS; and members from the Delta communities of Marvell, AR; Hollandale, MS; and Franklin Parish, LA. The ARS has initiated agreements with other scientists with needed expertise for specific research requirements. For example, the Children's Nutrition Research Center (CNRC) in Houston is collaborating with a Baylor College of Medicine scientist that has nutrition epidemiology skills, and the Human Nutrition Research Center on Aging (HNRCA) at Tufts University in Boston is providing expertise on the development of an original adult food frequency
questionnaire. These scientists, Extension, and community members participate fully in the Delta NIRI Consortium. The Consortium is diverse in its composition: including minorities, many research disciplines (nutrition, food science, family economics, sociology, medicine, community development, community grass root, agriculture, etc.), and a variety of professionals (nutritionists, pediatricians, nurses, food scientists, sociologists, agriculture economists, etc.). This diversity is necessary because of the complexity of the food concerns, poverty, isolation, and low educational attainment in parts of the Delta region. The Delta NIRI Consortium is evaluating the nutritional health in the LMD, to identify nutritionally responsive problems, and to design and evaluate interventions using a community participatory research model. Use of this model will promote capacity- building and sustainability at the community level. Lessons learned about successful intervention approaches will be
disseminated in order to facilitate implementation on a larger scale in similar areas of the United States. Rates of rural poverty and nutrition-related chronic diseases in the LMD are among the Nation's highest. Arkansas, Mississippi, and Louisiana traditionally rank at or near the bottom in health rankings of the United States and continue to worsen compared with other states. Food insecurity, adult and child obesity, and high blood pressure and diabetes among adults are higher in each of these states than for the national average. The area is underserved by food and nutrition and other health professionals, thus the burden of food-related health problems is carried by minority, low-income, and educationally disadvantaged individuals and families in the Delta communities. The presence of these problems severely limits the quality of life, productivity, and the future of this rural, at-risk population, while propelling them into the high-user category for nutrition assistance
programs and high-cost health care and treatment of nutrition-related disease. The Lower Mississippi Delta Nutrition Intervention Research Initiative falls under the National Program 107 - Human Nutrition, and addresses ARS Strategic Plan performance goal 4.1.1 through developing and transferring effective nutrition intervention strategies. 2. List by year the currently approved milestones (indicators of research progress) Year 2005: Objective 1. Develop nutrition interventions in Hollandale, MS, through community-based participatory research. Milestone a) The Hollandale NIRI community-based research team, including Mississippi State University Cooperative Extension (MSU EXT) will be in place in MS. Milestone b) The Hollandale research worksite will provide a neutral site in Hollandale, MS, and enhance visibility of the Delta NIRI. Milestone c) An assessment of community resources and environmental conditions in Hollandale, MS, relevant to nutrition interventions will be complete.
Objective 2. Design the nutrition intervention research for Hollandale, MS, using a Comprehensive Participatory Planning and Evaluation (CPPE) process. Milestone a) Potential interventions and strategies will be identified and evaluated. Milestone b) A research protocol for each of the selected interventions in Hollandale, MS, will be written. Milestone c) New and modified data collection instruments will be developed as needed for each intervention. Milestone d) Manuscripts will be completed by MSU EXT scientists describing the CBPR/CPPE processes, development of the Hollandale NIRI research worksite, community readiness, resource assessment, and other elements of the pilot testing and preparation for each intervention. Milestone e) MSU EXT will participate in the planning and implementation of one regional conference of scientific and lay communities. Objective 3A. Implement nutrition intervention strategies in Hollandale, MS. Milestone a) A well-written research protocol for a
nutrition intervention in Hollandale, MS, will be finalized. Milestone b)Appropriate data collection instruments and procedures necessary for the intervention research will be pre-tested if necessary. Milestone c) Hollandale residents and individuals from MSU EXT will be trained to collect data and to monitor data collection. Milestone d) A detailed operational plan for the implementation process for the intervention in Hollandale, MS, will be completed. Milestone e) Appropriate institutional review board approval for human subject's participation will be in place for MSU EXT. Milestone f) Manuscripts describing pilot testing intervention strategies, data collection procedures, and training of data collectors will be completed for peer reviewed journals by MSU EXT scientists. Year 2006 Objective 3A. Implement nutrition intervention strategies in Hollandale, MS. Milestone a) Implement nutrition intervention strategies specific to Hollandale, MS. Milestone b) Monitor data collection and
progress of intervention strategies. Milestone c) Evaluate process variables associated with nutrition interventions Hollandale, MS. Milestone d) MSU EXT scientists will prepare and submit manuscripts to peer reviewed journals for publication. Year 2007 Objective 3B. Evaluate nutrition intervention strategies implemented in Hollandale, MS. Milestone a) Evaluate nutrition intervention strategies in place in Hollandale, MS. Milestone b) Develop measures to evaluate the impact of the CBPR/CPPE processes on the community of Hollandale, MS. Milestone c) Monitor the effects of other activities within Hollandale on the nutrition intervention. Milestone d) Utilize appropriate qualitative and quantitative statistical techniques to evaluate objectives and test hypotheses of the interventions in Hollandale, MS. Milestone e) The participation of the Hollandale NIRI (community group) in the analytical process will be documented. Milestone f) A data monitoring and evaluation system will be in place
for continuous monitoring of data collection and quality of processes used. Milestone g) Manuscripts describing the status of interventions in Hollandale, MS, with regards to process and outcome variables will be completed by MSU EXT scientists and submitted to peer reviewed journals for publication. Milestone h) MSU EXT will participate in the convening of a national Delta NIRI symposia for scientific and lay communities on CBPR/CPPE, and nutrition intervention strategies for at-risk populations in rural communities. Year 2008 Objective 4. Initiate the process of adapting the successful nutrition intervention strategies from Hollandale, MS, to other Lower Mississippi Delta communities. Milestone a) At least one additional community in MS will be targeted and recruited for community-based nutrition intervention research to duplicate the successful strategies and interventions. Milestone b) Manuscripts describing the research process and intervention outcomes will be prepared by MSU
EXT scientists and submitted to peer reviewed journals for publication. Milestone c) MSU EXT will participate in the convening of a Delta NIRI national symposia for scientific and lay communities on CBPR, CPPE, and nutrition intervention strategies in rural communities. 4a List the single most significant research accomplishment during FY 2006. This accomplishment is aligned with National Program 107 Human Nutrition: Component 7. Health Promoting Intervention Strategies for Targeted Populations. Action Plan Problem Statements: Identify, implement and test nutrition and physical activity interventions in low- income communities. The development of the Hollandale NIRI walking trail led to the initial stage of a nutrition and physical activity intervention, "Hollandale NIRI Fit for Life Steps," for the community of Hollandale. This intervention consisted of trained volunteers and coaches from the community to lead walking groups, followed by the implementation of walking groups and
monthly educational and motivational sessions intended to impact behavioral factors that have been shown to influence health. "Hollandale NIRI Fit for Life Steps" is being implemented in three phases: 1) training of coaches, including coaches' recruitment of walking group participants; 2) participant enrollment and walking group intervention activities, lasting 6 months; and 3) follow-up on coaches and participants, at 12 months from participant enrollment, with phase one completed and currently at month 4 of phase two. The potential impact of these accomplishments will lead to healthier lifestyles of Hollandale residents, reducing the prevalence of diabetes, hypertension, and other chronic health diseases, as well as serving as a model for implementing successful interventions in other like communities. 4b List other significant research accomplishment(s), if any. As of January 2006, Hollandale NIRI established an office to expand and implement community-based efforts to further
address the community's needs as related to nutrition and capacity building. Mississippi State University Cooperative Extension (MSU EXT) has served as Community Coordinator of this office. MSU EXT has provided several programs that had a direct impact on the community and includes residents that are not participating in the "Hollandale NIRI Fit for Life Steps" Research Intervention. These include the following: Summer Youth Soccer Nutrition Education, Summer Youth Intern Program, Community-Wide Health Fairs, Breast Cancer Awareness Program and the rise of public awareness. Summer Youth Soccer Nutrition Education, Summer Youth Intern Program, and the participation in Community-Wide Health Fairs directly concentrate on food choices, health problems and behavioral and lifestyle factors. The impact of these programs include raising the awareness with publicity and diversity within the Hollandale community, serving as foundation for future interventions; and provided recruitment of
community participants for the research activities. 5. Describe the major accomplishments to date and their predicted or actual impact. Mississippi State University Cooperative Extension has provided a Community Coordinator as the lead staff person for coordinating all research activities in the community for Hollandale NIRI. MSU EXT has taken leadership for implementing nutrition education projects as part of the research for Hollandale NIRI Fit for Life Steps. 6. What science and/or technologies have been transferred and to whom? When is the science and/or technology likely to become available to the end- user (industry, farmer, other scientists)? What are the constraints, if known, to the adoption and durability of the technology products? In the Hollandale NIRI Summer Youth Intern Program, students completed training on Workforce Preparedness under the direction of MSU EXT. In these workshops students used training computers from MSU EXT. Students developed a resume and used
PowerPoint to prepare presentations. 7. List your most important publications in the popular press and presentations to organizations and articles written about your work. (NOTE: List your peer reviewed publications below). Delta Democrat Times, Greenville, MS. Completion of the 12 Month followup of the Fit For Life Steps Study. May 23, 2006. WABG Television Station. Discuss the Soccer and Will Try Research Study in the Hollandale NIRI Community. June 2006.
Impacts
(N/A)
Publications
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Progress 10/01/04 to 09/30/05
Outputs
1. What major problem or issue is being resolved and how are you resolving it (summarize project aims and objectives)? How serious is the problem? What does it matter? The Lower Mississippi Delta (LMD) area of Arkansas, Louisiana, and Mississippi is characterized by high rates of poverty, low education attainment, and food insecurity. There is a high prevalence of hypertension, diabetes, obesity, anemia, and heart disease, all of which are influenced by nutrition. We are attempting to resolve these problems through the efforts of the Lower Mississippi Delta Nutrition Intervention Research Initiative (Delta NIRI). The Delta NIRI Consortium consists of the original partners: scientists from Alcorn State University, Alcorn State, MS (ASU); Arkansas Children's Hospital Research Institute, Little Rock, AR (ACHRI); Pennington Biomedical Research Center, Baton Rouge, LA (PBRC); Southern University and A&M College, Baton Rouge, LA (SU); The University of Arkansas at Pine
Bluff, Pine Bluff, AR (UAPB); The University of Southern Mississippi, Hattiesburg, MS (USM); and the Agricultural Research Service (ARS) of USDA, Little Rock, AR. The Delta NIRI Consortium also now includes representatives from the Arkansas, Louisiana, and Mississippi Cooperative Extension Service; the College of Public Health of the University of Arkansas for Medical Sciences, Little Rock, AR; a private researcher, Jackson, MS; and members from the Delta communities of Marvell, AR; Hollandale, MS; and Franklin Parish, LA. The ARS has initiated agreements with other scientists with needed expertise for specific research requirements. For example, the Children's Nutrition Research Center (CNRC) in Houston is collaborating with a Baylor College of Medicine scientist that has nutrition epidemiology skills, and the Human Nutrition Research Center on Aging (HNRCA) at Tufts University in Boston is providing expertise on the development of an original adult food frequency questionnaire.
These scientists, Extension, and community members participate fully in the Delta NIRI Consortium. The Consortium is diverse in its composition: including minorities, many research disciplines (nutrition, food science, family economics, sociology, medicine, community development, community grass root, agriculture, etc.), and a variety of professionals (nutritionists, pediatricians, nurses, food scientists, sociologists, agriculture economists, etc.). This diversity is necessary because of the complexity of the food concerns, poverty, isolation, and low educational attainment in parts of the Delta region. The Delta NIRI Consortium is evaluating the nutritional health in the LMD, to identify nutritionally responsive problems, and to design and evaluate interventions using a community participatory research model. Use of this model will promote capacity-building and sustainability at the community level. Lessons learned about successful intervention approaches will be disseminated in
order to facilitate implementation on a larger scale in similar areas of the United States. Rates of rural poverty and nutrition-related chronic diseases in the LMD are among the Nation's highest. Arkansas, Mississippi, and Louisiana traditionally rank at or near the bottom in health rankings of the United States and continue to worsen compared with other states. Food insecurity, adult and child obesity, and high blood pressure and diabetes among adults are higher in each of these states than for the national average. The area is underserved by food and nutrition and other health professionals, thus the burden of food-related health problems is carried by minority, low-income, and educationally disadvantaged individuals and families in the Delta communities. The presence of these problems severely limits the quality of life, productivity, and the future of this rural, at-risk population, while propelling them into the high-user category for nutrition assistance programs and high-cost
health care and treatment of nutrition-related disease. The Lower Mississippi Delta Nutrition Intervention Research Initiative falls under the National Program 107 - Human Nutrition, and addresses established performance goals through developing and transferring effective nutrition intervention strategies. 2. List the milestones (indicators of progress) from your Project Plan. Year 2005 Develop nutrition interventions in the Hollandale Community, through community-based participatory research (CBPR): 1) Establish Community Groups and Research Teams. 2) Identify community-specific nutritional problems/concerns. 3) Identify community resources/environmental conditions. Year 2006 Design the nutrition intervention research for the Hollandale Community, using Comprehensive Participatory Planning and Evaluation (CPPE): 1) Evaluate proposed intervention strategies. 2) Develop community-specific research plans/protocols. 3) Modify and develop new data collection instruments. 3a List the
milestones that were scheduled to be addressed in FY 2005. For each milestone, indicate the status: fully met, substantially met, or not met. If not met, why. 1. Establish Community Groups and Research Teams. Milestone Fully Met 2. Identify community-specific nutritional problems/concerns. Milestone Substantially Met 3. Identify community resources/environmental conditions. Milestone Substantially Met 3b List the milestones that you expect to address over the next 3 years (FY 2006, 2007, and 2008). What do you expect to accomplish, year by year, over the next 3 years under each milestone? Year 2006: Develop nutrition interventions in Hollandale, MS, through community- based participatory research (CBPR): 1) Establish Community Groups and Research Teams. Accomplish: Community Groups and Research Teams will be established to identify intervention strategies to improve food choices through food selection and meal preparation; healthy weight through food selection and physical
activity; and food security through food availability and food selection. 2) Identify community-specific nutritional problems/concerns. Accomplish: Community-specific nutritional problems will be successfully identified through community meetings that encompass the community-based participatory process, focus groups, and the comprehensive community planning and evaluation process. 3) Identify community resources/environmental conditions. Accomplish: To further develop intervention strategies, community readiness levels will be determined and strategies will be enhanced. 4a What was the single most significant accomplishment this past year? Hollandale NIRI Fit for Life Steps A nutritional and physical activity intervention is needed in the Hollandale, Mississippi, community to alleviate the chronic health concerns that exist in this rural community. The development of the Hollandale NIRI walking trail led to the initial stage of a nutrition and physical activity intervention,
"Hollandale NIRI Fit for Life Steps" for the community of Hollandale. Through the efforts of the Mississippi State Cooperative Extension and other partners, supported by the Lower Mississippi Delta NIRI, an intervention was developed and consists of trained volunteers and coaches that lead walking groups. Additionally monthly educational and motivational sessions are being engaged to impact the volunteers' behavior, with emphasis on influencing their health. The impact of these accomplishments will lead to healthier lifestyles of Hollandale residents, reducing the prevalence of diabetes, hypertension, and other chronic health diseases, as well as serving as a model for implementing successful interventions in other like communities. 5. Describe the major accomplishments over the life of the project, including their predicted or actual impact. The Hollandale community has been organized into a functional organization known as the "Hollandale NIRI." The Hollandale NIRI maintains
elected officers of chair, co-chair, and secretary, and has approximately 25 active members who meet monthly to address nutritional health issues and to plan sustainable nutrition intervention. The Hollandale NIRI has established bylaws that are used as a guide for organizational operation. The customers include the entire Hollandale community. Interventions, community outreach and public awareness will serve as a continuum for health issues that are prominent in this area as related to nutrition and for approaches to a healthier community. The Hollandale NIRI has established an administrative and program office in the Hollandale community, and uses a Cooperative Extension Community Coordinator as the lead staff person. All accomplishments made under this project are fully consistent with relevant milestones listed in the Project Plan, and with the relevant research components as defined in the National Program 107 Action Plans performance goals through developing and transferring
effective nutrition intervention strategies. Accomplishments under this project contribute to the achievement of ARS Strategic Plan Goal 4, Objective 1, Performance Measure 1, in that project accomplishments contribute substantially to attainment of the Agency FY 2007 target of executing and reporting nutritional interventions.
Impacts
(N/A)
Publications
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Progress 10/01/03 to 09/30/04
Outputs
1. What major problem or issue is being resolved and how are you resolving it (summarize project aims and objectives)? How serious is the problem? What does it matter? The Lower Mississippi Delta (LMD) area of Arkansas, Louisiana, and Mississippi is characterized by high rates of poverty, low education attainment, and food insecurity. There is a high prevalence of hypertension, diabetes, obesity, anemia, and heart disease, all of which are influenced by nutrition. We are attempting to resolve these problems through the efforts of the Lower Mississippi Delta Nutrition Intervention Research Initiative (Delta NIRI). The Delta NIRI Consortium consists of the original partners: scientists from Alcorn State University, Alcorn State, MS (ASU); Arkansas Children's Hospital Research Institute, Little Rock, AR (ACHRI); Pennington Biomedical Research Center, Baton Rouge, LA (PBRC); Southern University and A&M College, Baton Rouge, LA (SU); The University of Arkansas at Pine
Bluff, Pine Bluff, AR (UAPB); The University of Southern Mississippi, Hattiesburg, MS (USM); and the Agricultural Research Service (ARS) of USDA, Little Rock, AR. The Delta NIRI Consortium also now includes representatives from the Arkansas, Louisiana, and Mississippi Cooperative Extension Service; the College of Public Health of the University of Arkansas for Medical Sciences, Little Rock, AR; a private researcher, Jackson, MS; and members from the Delta communities of Marvell, AR; Hollandale, MS; and Franklin Parish, LA. The ARS has initiated agreements with other scientists with needed expertise for specific research requirements. For example, the Children's Nutrition Research Center (CNRC) in Houston is collaborating with a Baylor College of Medicine scientist that has nutrition epidemiology skills, and the Human Nutrition Research Center on Aging (HNRCA) at Tufts University in Boston is providing expertise on the development of an original adult food frequency questionnaire.
These scientists, Extension, and community members participate fully in the Delta NIRI Consortium. The Consortium is diverse in its composition: including minorities, many research disciplines (nutrition, food science, family economics, sociology, medicine, community development, community grass root, agriculture, etc.), and a variety of professionals (nutritionists, pediatricians, nurses, food scientists, sociologists, agriculture economists, etc.). This diversity is necessary because of the complexity of the food concerns, poverty, isolation, and low educational attainment in parts of the Delta region. The Delta NIRI Consortium is evaluating the nutritional health in the LMD, to identify nutritionally responsive problems, and to design and evaluate interventions using a community participatory research model. Use of this model will promote capacity- building and sustainability at the community level. Lessons learned about successful intervention approaches will be disseminated in
order to facilitate implementation on a larger scale in similar areas of the United States. Rates of rural poverty and nutrition-related chronic diseases in the LMD are among the nation's highest. Arkansas, Mississippi, and Louisiana traditionally rank at or near the bottom in health rankings of the United States and continue to worsen compared with other states. Food insecurity, adult and child obesity, and high blood pressure and diabetes among adults are higher in each of these states than for the National average. The area is underserved by food and nutrition and other health professionals, thus the burden of food-related health problems is carried by minority, low-income, and educationally disadvantaged individuals and families in the Delta communities. The presence of these problems severely limits the quality of life, productivity, and the future of this rural, at-risk population, while propelling them into the high-user category for nutrition assistance programs and
high-cost health care and treatment of nutrition-related disease. The Lower Mississippi Delta Nutrition Intervention Research Initiative falls under the National Program 107 - Human Nutrition, and addresses established performance goal 3.1.2 through developing and transferring effective nutrition intervention strategies. 2. List the milestones (indicators of progress) from your Project Plan. Year 1 (2004) Establish a cooperative partnership with Hollandale NIRI consortium partners. Support Hollandale NIRI in coordinating, assisting, designing and organizing community participatory based nutritional interventions in Hollandale, MS. Year 2 (2005) Develop nutrition interventions in Hollandale, MS, through community- based participatory research (CBPR): 1) Establish Community Groups and Research Teams. 2) Identify community-specific nutritional problems/concerns. 3) Identify community resources/environmental conditions. Design the nutrition intervention research for Hollandale, MS,
using Comprehensive Participatory Planning and Evaluation (CPPE): 1) Evaluate proposed intervention strategies. 2) Develop community specific research plans/protocols. 3) Modify and develop new data collection instruments. Implement and evaluate nutrition intervention strategies in Hollandale, MS: 1) Complete training on data collection/intervention strategies. 2) Pre-test data collection instruments/procedures. 3) Complete operational plan/research protocol. 4) Implement community-specific nutrition interventions. 3. Milestones: A. List the milestones that were scheduled to be addressed in FY 2004. How many milestones did you fully or substantially meet in FY 2004 and indicate which ones were not fully or substantially met, briefly explain why not, and your plans to do so. Establish a cooperative partnership with Hollandale NIRI consortium partners. This objective has been fully met. Support Hollandale NIRI in coordinating, assisting, designing, and organizing community
participatory based nutritional interventions in Hollandale, MS. This objective has been substantially met. B. List the milestones that you expect to address over the next 3 years (FY 2005, 2006, & 2007). What do you expect to accomplish, year by year, over the next 3 years under each milestone? Year 2005 Develop nutrition interventions in Hollandale, MS, through community- based participatory research (CBPR): 1) Establish Community Groups and Research Teams. Community Groups and Research Teams will be established to identify intervention strategies to improve food choices through food selection and meal preparation; healthy weight through food selection and physical activity; and food security through food availability and food selection. 2) Identify community-specific nutritional problems/concerns. Community-specific nutritional problems will be successfully identified through community meetings that encompass the community based participatory process, focus groups, and the
comprehensive community planning and evaluation process. 3) Identify community resources/environmental conditions. To further develop intervention strategies, community readiness levels will be determined and strategies will be enhanced. Design the nutrition intervention research for Hollandale, MS, using Comprehensive Participatory Planning and Evaluation (CPPE): 1) Evaluate proposed intervention strategies. Proposed intervention strategies will be evaluated that is needed to address key health issues. 2) Develop community specific research plans/protocols. Manual of Operations will be finalized and training programs will be administered to outline the research plans and protocols. 3) Modify and develop new data collection instruments. Data collection instruments will be modified to tailor to the needs of the Lower Mississippi Delta NIRI research and minimize collection errors. Implement and evaluate nutrition intervention strategies in Hollandale, MS: 1) Complete training on
data collection/intervention strategies. Community liaisons, community NIRI members, Delta NIRI partners, students, and other individuals involved with the Delta NIRI will be trained using guidance from the manual of operations, to prepare for the implementation of the nutrition/physical activity interventions in the community. 2) Pre-test data collection instruments/procedures. The pretest data collection will be completed. 3) Complete operational plan/research protocol. The Manual of Operations will be finalized in each community group. 4) Implement community-specific nutrition interventions. Community interventions will be initiated in each community. 4. What were the most significant accomplishments this past year? A. Single most significant accomplishment during FY 2004: An individual was hired to serve as the Hollandale NIRI Community Coordinator and took a lead in establishing a functionally operative Hollandale NIRI worksite in Hollandale, MS. This accomplishment is
important since the Lower Mississippi Delta NIRI becomes a permanent fixture in the Hollandale community through the Hollandale NIRI. The Mississippi Cooperative Extension, in collaboration with the Lower Mississippi Delta NIRI and Delta NIRI cooperators (Alcorn State University and University of Southern Mississippi), employed a Hollandale NIRI Community Coordinator to oversee Hollandale NIRI operations and nutritional projects. The potential impact of these accomplishments will lead to healthier lifestyles of Hollandale residents, reducing the prevalence of diabetes, hypertension, and other chronic health diseases, as well as serving as a model for implementing successful interventions in other like communities. B. Other significant accomplishment(s), if any. Hollandale NIRI has collaborated with the City of Hollandale and local businesses to develop a community walking trail to promote increased physical activity by community residents. This accomplishment is important as it
serves as a means of capacity building within the community to conduct nutritional and physical activity research interventions. The Hollandale NIRI, in collaboration with the Lower Mississippi Delta NIRI researchers and Delta NIRI cooperators (Alcorn State University, University of Southern Mississippi, and the Mississippi Cooperative Extension) developed the Hollandale Community Walking Track to support Delta NIRI interventions. The walking trail activities are integrated with nutrition strategies that support the Hollandale NIRI anticipated goals/outcomes of improved healthy weight, food choices, and household food security for the Hollandale community residents. C. Significant activities that support special target populations. None 5. Describe the major accomplishments over the life of the project, including their predicted or actual impact. The Hollandale community has been organized into a functional organization known as the "Hollandale NIRI." The Hollandale NIRI maintains
elected officers of chair, co-chair, and secretary, and has approximately 25 active members who meet monthly to address nutritional health issues and to plan sustainable nutrition intervention. The Hollandale NIRI has established By-Laws that are used as a guide for operation. The Hollandale NIRI has established an administrative and program office in the Hollandale community, and uses a Cooperative Extension Community Coordinator as the lead staff person.
Impacts
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Publications
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