Progress 09/01/13 to 08/31/15
Outputs
Target Audience:The project research team will include four paid internships (two each for two academic years) for Tennessee State University (TSU) freshman or sophomore undergraduates. Students will received comprehensive research methodology training in development of the research tool, data collection, data analysis and manuscript preparation, which will contribute to skills building in completing class assignments. Experiential learning in data collection and outreach in an underserved population further provided students with ability to understand how to utilize research results for effective programs and innovations in Extension and Agricultural sciences. Additionally, the project educated and assisted low-income African American and White families in the Women, Infants, Children's Supplemental Food Program (WIC) with children ages 2-4 years old in purchasing a more balanced diet for their families. Changes/Problems:Methods Change Assisting Parents to Purchase (APP) for Children's Health grant team met monthly beginning in August 2014, when data collection began, and continued until the target number achieved and follow-up visits completed. In November 2014 it was determined that we needed to find an additional recruitment source due the large number of disconnects on the proposed recruitment list drawn from the 2012 CHEW Nutrition Survey of WIC families. The Nashville Metro Action Commission offered to give our research team access to nutrition classes taught at Head Start schools to recruit WIC participant families. A recruitment protocol amendment was requested and approved by TSU IRB committee before project team members attended nutrition classes at four different Head Start Centers and recruited additional WIC families needed to test the developed food purchasing guides. A total of 52 WIC families with young children 2-5 years old were interviewed with height and weight measurements taken at baseline and taught how to use the purchasing and packaging guides in combination to make a well-balanced and nutrition list of foods to buy. What opportunities for training and professional development has the project provided?Training on research lit review processstudents trained in retrieving and reviewing peer-reviewed articles and summaries written and turned in to PI. PI provided feedback to students as to content and how to improve both writing and determining if methods of research were effective. Students were trained to use the USDA website to look up information in both the main website on serving sizes and on SuperTracker for food group servings to educate students to understand and participant in the development of the purchasing and packaging guides and thus increase comprehension of study methods and terminology. Further, when food purchasing and packaging guides developed, students used these guides to make food shopping list for a mother and a child, each using different age groups and calorie requirements thus giving them first-hand knowledge of the benefits and possible drawbacks of using these for the WIC participants. Undergraduate students were trained in the interviewing and weight/height measurement process as well as assisting the Extension Nutrition Educator and the Co-PI Nursing faculty in the interviewing of the study participants. Additionally, students were trained to assist interviewers with calling to schedule interview appointments and to make a follow-up call after each interview to determine if participants had any questions about how to use the guides. This gave the students experiential training in community outreach both in face-to-face contact and by phone. Students were met with individually each week and attended (as class schedules permitted) the monthly project team meetings to assess what they were learning and to answer any questions they had about community-based research. When data collection lessened, students were given assignments to find, have approved by PI, and summarize journal articles that reported on similar obesity prevention implementation and to analyze the methods of these projects. PI reviewed the submitted article summaries and then met with each student individually to discuss the students' progress in understanding appropriate social science research methods. How have the results been disseminated to communities of interest?Presentation on findings scheduled for the 2015 CHEW Conference in November with audience expected of 200 researchers, public health personnel, faculty, community non-profit stakeholders, community members and students. Manuscript planned to submit for publication in January 2016. Purchasing guides and packaging guide sent to NIFA Nutrition Program Leaders and phone meeting scheduled with SUPER-TRACKER oversight to discuss possibly adding ability to produce food purchasing guides from site so that nutrition and public health counselors and general public nationwide have access. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
APP grant team met weekly for one-two hours since beginning of October 2013 until June 2014. The content of these meetings included the methods and content for both the development of the food purchasing and packaging guides and the students (one in Ag Sciences and on in Biology, both in the College of Agriculture, Human and Natural Sciences) attended the staff meetings and participated in the creation of the food guides, the sampling frame, creation of questionnaires, and the request for IRB approval. The students attended these meetings whenever their class schedules permitted. Additionally in these meetings, any minor changes in the Recruitment techniques, Consent form and Questionnaire for the project were decided and then new IRB amendment request was completed and IRB approval obtained. Referral to meeting notes post meetings resulted in the development of the WIC-approved food purchasing guides using the USDA SuperTracker daily food group needs multiplied by seven for the week's shopping for the WIC mothers according to calorie needs and which one to give participants will be determined by BMI status with measurements taken during the baseline interview process. The children's food purchasing guides were developed using same USDA SuperTracker food group methods and calorie allocation dependent on age group and on activity level (i.e., less than 30 minutes, 30-60 minutes, and more than 60 minutes per day) for 3-5 year olds, which will be determined by asking the parent at the baseline interview. Based on these SuperTracker divisions, 13 separate purchasing guides with appropriate food group serving needs per week were developed. Please see outputs section for details of these. To be used in conjunction with the food group weekly servings needed (i.e., the food purchasing guides) a separate packaging guide was developed in order to further assist the WIC participant in making a balanced weekly food shopping list. The packaging guide provides information on the WIC approved items and how many servings are contained in packages or cartons, etc. most commonly found in the grocery and that are in accord with their amounts approved on WIC vouchers to purchase for the standard package for non-pregnant mothers and standard food vouchers (both cash and regular) for both mothers and children. The recruited 52 WIC participant families with 2-5 year old tested the purchasing guides for one month and 45 of those families consented to follow-up with 7 families either refusing to do follow-up interview or had disconnected phones. Ethnic composition of the sample was 66% non-Hispanic Black, 11.3% non-Hispanic White and the remaining were other ethnicities including Hispanics and Egyptians. A large majority of the sample were married (60.4%) with about equal numbers having a high school education or less (45.2%) versus those who had college and beyond (52.8%). The majority of the primary shoppers interviewed were employed (58.4%) with 9.4% being unemployed, 13.2% being disabled and 17% being a homemaker. Almost half (48.1%) of participant families used Head Start for child care with another 13.5% using other day care centers, 17.3% using a babysitter and 21.2% not using any child care. The mean number of children in participant families receiving WIC vouchers was 1.27 with the mean number of children and adults shopped for is 4.04 and mean age of child interviewed was 3.7 years old. Figured from height and weight measurements taken on the initial interview, an overwhelming majority of mothers in participant families were obese (67.3%) with 21.2% being overweight and 11.5% being considered normal. This is over twice the rate reported in 2014 where 32% of female TN population was classed as Obese (Trust for America's Health and Robert Wood Johnson Foundation. The State of Obesity 2015 [PDF]. Washington, D.C.: 2015, http://stateofobesity.org/states/tn/). BMI percentiles for the children were the opposite with 55.7% being underweight or normal and 28.3% considered overweight and a disturbing 15.1% considered obese with a BMI percentile greater than or equal to the 95th. This compares with 14.2% obesity among low-income 2-4 year olds in 2011 in Tennessee (http://stateofobesity.org/states/tn/). Analysis was then completed comparing the baseline and follow-up data on the 45 families using paired sample t-tests. Statistically significant results were found for the following: 1) "reading nutrition labels from 26.7% to 53.3% (p<.002); "know how much of each food group my family needs" from 55.8% to 82.2% (p<.003); decrease in those reporting buying whole milk from 15.6% to 11.1% (p<.05) and "never had sodas last week" from 60% to 66.7% was marginally significant (p<.063). Additionally, substantial but not statistically significant positive results were found for the following: 1) "Find grocery shopping stressful" decreased from 31.1% to 26.7%; 2)"Make a list before going shopping" increased from 60% to 71.1%; 3) positive answer to "never having snack chips in last week" increased from 8.9% to 20.0%; and 4) those who reported "never having ice cream in last week" went from 44% to 49%. Mean numbers per day of the following decreased significantly (p values ranged from .003 to .025): saturated fat grams; added teaspoons of sugar/syrup; meat, poultry ounce equivalent; fruit juice cup equivalent; dairy cup equivalent (collected and analyzed using the Block Kids Food Screener 2007-Last Week, Food Frequency Questionnaire). Questions asked on the one-month follow-up only regarding use of purchasing guides revealed nearly every primary shopper interviewed (95.6%) thought "the purchasing guides were helpful" and 86.7% said yes to "would consider using the purchasing guides regularly. Before undergraduatestudent traineesleft after spring semester in May 2015, PI asked each to write a summary of what they had learned since being a part of the APP team. In that summary, each student did give multiple examples of what they had learned and how it would help them in their continued success in chosen STEM disciplines. Both students were enrolled as juniors for fall semester 2015 in STEM disciplines. Student Training: A five-session introductory Statistical Package for Social Science interactive workshop was conducted for students and led by the data manager of "Assisting Parents to Purchase for Health" grant. The workshop was conducted from Oct 29th- Dec 3rd2013 with each student having a laptop computer to create datasets, modify variables and conduct data analysis in session and then assignments were given and completed outside of sessions and reviewed at the next workshop. Topics covered included: SPSS Workshop Outline Preferences Viewer SPSS Data SPSS Output Labels Charts SPSS Pivot Tables File Locations Syntax Editor File Window Edit Window View Window Data Window Define Variable Properties Sort Cases Sort Variables Merge Files Aggregate Data Select Cases Transform Window Compute Variable Recode Variable Analyze Window Descriptive Statistics Frequencies Descriptives Crosstabs Tables Means Graphs Window Utilities Window Additional on student training in professional research techniques in "training & professional development." ?
Publications
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Progress 09/01/13 to 08/31/14
Outputs
Target Audience: As of September 20, 2014, we have baseline interviewed seven Women, Infant, Children's (WIC) participant mothers and have one-month follow-up interviewed four of them after they had tested our purchasing and packaging guides developed by the grant staff. Changes/Problems: We have previously reported to our Program Officer that we had a change in Co-PI to Dr. Pamela Ark, Assoicate Professor of Nursing at Tennessee State University due to Dr. Yuan Zhou leaving TSU and unable to continue as Co-PI in her current position. What opportunities for training and professional development has the project provided? Motivational Interviewing techniques training and Statisical Package for Social Science software workshops conducted for the staff and students on this project. How have the results been disseminated to communities of interest?
Nothing Reported
What do you plan to do during the next reporting period to accomplish the goals? Complete data collection and testing of the purchasing guides and packaging guide with 50 WIC participant mothers of young children 2-5 years old. Address recruiting issues of changed or disconnected phone numbers of list of 150 WIC participants and if impossilbe to get target number, then conduct recruiting at WIC approved grocers. Enter and analyze the interview data. Prepare and submit a manuscript using project results. Prepare the final report of the results.
Impacts
What was accomplished under these goals?
APP grant team met weekly for one-two hours since beginning of October 2013 until June 2014. The content of these meetings included the methods and content for both the development of the food purchasing and packaging guides and the training for the two TSU undergraduate STEM students (one in Ag Sciences and on in Biology, both in the College of Agriculture, Human and Natural Sciences). The students attended these meetings whenever their class schedules permitted. Additionally in these meetings, any minor changes in the Recruitment techniques, Consent form and Questionnaire for the project were decided and then new IRB amendment request was completed and IRB approval obtained. Referral to meeting notes post meetings resulted in the development of the WIC-approved food purchasing guides using the USDA SuperTracker daily food group needs multiplied by seven for the week’s shopping for the WIC mothers according to calorie needs and which one to give participants will be determined by BMI status with measurements taken during the baseline interview process. The children’s food purchasing guides were developed using same USDA SuperTracker food group methods and calorie allocation dependent on age group and on activity level (i.e., less than 30 minutes, 30-60 minutes, and more than 60 minutes per day) for 3-5 year olds, which will be determined by asking the parent at the baseline interview. Based on these SuperTracker divisions, 13 separate purchasing guides with appropriate food group serving needs per week were developed. Please see outputs section for details of these. To be used in conjunction with the food group weekly servings needed (i.e., the food purchasing guides) a separate packaging guide was developed in order to further assist the WIC participant in making a balanced weekly food shopping list. The packaging guide provides information on the WIC approved items and how many servings are contained in packages or cartons, etc. most commonly found in the grocery and that are in accord with their amounts approved on WIC vouchers to purchase for the standard package for non-pregnant mothers and standard food vouchers (both cash and regular) for both mothers and children. APP grant team meeting monthly beginning in August 2014 when data collection began to test food purchasing and packaging guides that will continue until target number achieved and follow-up visits completed. At the end of first fiscal year of grant (i. e., September 20), seven baseline and four follow-up interviews completed. Student Training: A five-session introductory Statistical Package for Social Science interactive workshop was conducted for students and led by the data manager of “Assisting Parents to Purchase for Health” grant. The workshop was conducted from Oct 29th – Dec 3rd 2013 with each student having a laptop computer to create datasets, modify variables and conduct data analysis in session and then assignments were given and completed outside of sessions and reviewed at the next workshop. Students trained in retrieving and reviewing peer-reviewed articles and summaries written and turned in to PI. PI provided feedback to students as to content and how to improve both writing and determining if methods of research were effective. Further, students were trained to use the USDA website to look up information in both the main website on serving sizes and on SuperTracker for food group servings to educate students to understand and participant in the development of the purchasing and packaging guides and thus increase comprehension of study methods and terminology. Further, when food purchasing and packaging guides developed, students used these guides to make food shopping list for a mother and a child, each using different age groups and calorie requirements thus giving them first-hand knowledge of the benefits and possible drawbacks of using these for the WIC participants. Undergraduate students were trained in the interviewing and weight/height measurement process as are assisting the Extension Nutrition Educator and the Co-PI Nursing faculty in the interviewing of the study participants. This first-hand participation in the data collection process will give them valuable insight in community outreach and social science research. Also, students are being trained after data collected in data integrity and data entry. Further, students will do phone follow-up with participants to offer to assist participants with any questions or issues in using the guides, which will enable students to understand appropriate research communication techniques with active study participants.
Publications
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