Source: UNIVERSITY OF TENNESSEE submitted to
"GET FRUVED:" A PEER-LED, TRAIN-THE-TRAINER SOCIAL MARKETING INTERVENTION TO INCREASE FRUIT AND VEGETABLE INTAKE AND PREVENT CHILDHOOD OBESI
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
EXTENDED
Funding Source
Reporting Frequency
Annual
Accession No.
1002314
Grant No.
2014-67001-21851
Project No.
TENW-2013-04389
Proposal No.
2014-07144
Multistate No.
(N/A)
Program Code
A2101
Project Start Date
Aug 1, 2014
Project End Date
Jul 31, 2020
Grant Year
2014
Project Director
Colby, S.
Recipient Organization
UNIVERSITY OF TENNESSEE
2621 MORGAN CIR
KNOXVILLE,TN 37996-4540
Performing Department
Nutrition
Non Technical Summary
Our project is a Pretest-Posttest, Control Group Trial using a nested cohort design with three conditions (intense intervention, diffuse intervention and control) in college and high school campus settings. Using the CBPR model, state steering committees composed of research faculty, Extension faculty and staff, university faculty and staff, and older adolescents will guide the study development and implementation.This project is an integrated approach combining research (process, formative, and outcome assessments incorporated into a theory based intervention design), education (the development and instruction of a multi-state, undergraduate health promotion course), and Extension (the development and testing of a 4-H health promotion program for students in college and high school 4-H groups led by Extension and 4-H faculty and staff).College freshman student partners and formalization of research agreements with public school partners will occur in the fall of year 01. In the spring of year 01, freshman student partners will enroll in an undergraduate course, become collegiate 4-H members, and plan a social marketing campaign. The developed social marketing campaign will be implemented on college campuses by the collegiate 4-H team in year 02. In year 03, the collegiate 4-H team will mentor a team of high school 4-H students in the development and implementation of the social marketing campaign in high school settings. In years 04 and 05, the program will be disseminated to 4 additional college and high school 4-H student team partners.
Animal Health Component
0%
Research Effort Categories
Basic
0%
Applied
100%
Developmental
0%
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
70360991010100%
Goals / Objectives
The objective of this project is to test the effectiveness of a peer-led, train-the-trainer, social marketing intervention to positively impact the weight of older adolescents.The 9 month interactive, social marketing environmental intervention will aid older adolescents in effectively managing weight through increasing healthfulness of diet, increased physical activity, and improved stress management behavior as compared to a control group.
Project Methods
In the fall of year 01, 30 college freshman students will be recruited from general/survey nutrition courses at each of the four intervention universities to participate in a special undergraduate spring course. Thirty freshman students will also be recruited from general/survey nutrition courses at each of the four control universities. Researchers at the intervention schools will also work with nutrition students to identify and develop partnerships with student organizations. Researchers and student partners will also work with local high schools and school boards to formalize research agreements and relationships. In the spring of year 01, as a part of a newly developed undergraduate course, 30 freshman students from each intervention university will join their collegiate 4-H program. The course will cover principles of social marketing for health behavior change. Throughout the course, the collegiate 4-H students will develop and plan a social marketing campaign. Following a peer-led approach, the 4-H students will also partner with and be mentored by upper-level nutrition students and student organizations in the development and planning of the campaign.The collegiate 4-H students recruited to participate in the course and implementation phases of the project and those from the control schools will be assessed using physical measurements, online questionnaires, and accelerometers at the beginning of spring year 01, end of spring year 01.In year 02, the now sophomore collegiate 4-H students in the intense intervention group will work with student partners to implement the developed social marketing campaign. Extension faculty and staff will partner with the collegiate 4-H student teams to educate and give advice on the content of health promotion messages. Collegiate 4-H students will also assess the healthiness of their campus environments and advocate for changes to the physical and food environment.In year 02, a random sample of 331 freshmen, 18-19 year old, determined by screening to be at increased health risk (increased BMI and waist circumference, low intakes of fruits and vegetables, high levels of stress, and low levels of physical activity) will be recruited from each of the eight universities (four intervention and four control). Physical measurements; online questionnaires; sales data from dining halls/cafeterias and vending services; recreational facility usage data; assessments of the physical environment; and a subsample of accelerometer measures will be collected early fall and late spring. The 30 collegiate 4-H students and the same 30 students from the control schools recruited in year 01 will be reassessed using the same physical measurements, online questionnaires, and accelerometers at the beginning of fall year 02, end of spring year 02.In year 03, two high schools in each of the four intervention University states will be recruited to participate in the research process and will be randomized to control and intervention. Following the train-the-trainer model, teams of now junior collegiate 4-H students will now mentor teams of 20 high school 4-H students at each of the intervention sites in the development and implementation of the Fruved campaign in the high school environment.In year 03, a random sample of 331 freshman high school students will be recruited from the intervention high schools and a random sample of 331 freshman high school students from the control high schools in each of the four intervention University town areas. Physical measurements; and online questionnaires; sales data from dining halls/cafeterias and vending services; relevant portions of the Healthy Campus Audit; recreational facility usage data; and a subsample of accelerometer measures will be collected early fall and late spring. The 4-H high school students recruited to participate in the design and implementation phases of the project will be assessed using physical measurements, online questionnaires, and accelerometers early fall/late spring in year 03. The sustainability of observed changes at the individual and environmental college level will be assessed by conducting follow-up assessments year 03.In year 04, to continue to assess the sustainability of observed changes at the individual and environmental high school level will be assessed by conducting follow-up assessments. Additionally materials will be developed allowing this peer-led, train-the-trainer, interactive social marketing approach promoting health behavior to be further disseminated to other college and high school environments. Four additional college and high school pairs will be recruited to participate in the dissemination phase. In year 05 the collegiate 4-H students will work with high school 4-H students to develop and implement the project in high schools. The high school 4-H student group will complete the modified project assessments. In year 05, the results and materials developed in this project will be further disseminated through publications and presentations.Advocacy for Environmental ChangeBased on outcomes from the Healthy Campus Audit, 4-Hstudents will work with researchers and steering committees concurrently with the social marketing campaign implementation to develop strategies for environmental changes that support the goals and priorities of the student participants. The longitudinal design assessing individual behavior and environment change proposed in this study will allow for the evaluation of these time-dependent environmental changes.Evaluation Measures Overview: The primary outcome measure will be body weight. Secondary outcome measures include physical activity, dietary quality, fruit and vegetable intake, anthropometric measurements (waist, hip, waist to hip ratios, and neck circumference), eating competence, quality of life, behavior changeability, stress, and sleep assessment. In addition, sales data of food on the school campus and recreational facility usage data will be assessed, and perceived and actual food, physical activity, and health promotion environments will be assessed.Data AnalysisPRIMARY OUTCOME ANALYSES Since we are using more than two time intervals in the design, we will be using General Linear Modeling to analyze for changes in physical assessments, specifically a mixed-model Analysis of variance and covariance (ANCOVA) if the group-specific slopes are homogeneous. In this approach the General Linear Model with regression adjustment for covariates at the individual level is used to determine adjusted group means. Appropriate covariates can be added to the analysis as necessary based on the results of preliminary analyses (institution, target population, gender, ethnicity, etc.). Should statistical assumptions be seriously violated, appropriate transformations will be used. If assumptions are met, regression adjustments for covariates will be performed. In the next stage, those identified means would be analyzed with the General Linear Model to determine intervention effects (with or without adjustments for covariates) at the group level. If the group-specific slopes are not homogeneous then a random-coefficients analysis will be conducted. Taking advantage of regression adjustments for covariance and over-time correlation in the repeated measure will help reduce the impact of ICC.SECONDARY OUTCOMES ANALYSES A wide range of analyses will be employed to analyze the influence of the intervention on secondary outcomes, including multivariate analyses of variance (MANOVA), ANOVAs, and logistic regression. Significant ANOVAs will be followed up with tests of simple and main effects as appropriate. The intervention group-by-occasions interaction test will assess the impact of the intervention in the treatment group relative to the control group across time on the secondary outcome measures.

Progress 08/01/18 to 07/31/19

Outputs
Target Audience:The project reaches older adolescents in college and high school settings. High school students, in grades 9-12, represent a population experiencing increasing rates of unwanted weight gain. There is currently a lack of effective interventions for this target population. In year 05, 2,184 high school students were assessed as a part of this project. Students (n= 447) in college and university settings who are now seniors and who originally participated in the project as freshmen were reassessed in spring of year 05 (Wave I participants). Changes/Problems:The non-technical summary in the pdf form does not include approved changes to the project over time. The updated non-technical summary is: This program is a non-diet approach to weight management for older adolescents. A non-diet approach does not promote following a special diet to manage weight; instead, it promotes healthy behavior associated with weight management. A non-diet approach is especially important with youth and older adolescent populations so as to avoid impairment in emotional well-being associated with body dissatisfaction. Healthy weight status will be achieved by improving dietary intake patterns (increasing intakes of fruits and vegetables, decreasing food high in saturated fats and added sugars), increasing physical activity, and improving stress management. The focus on these three elements (diet, physical activity, and stress) was chosen based on priorities for intervention identified by student partners in previous CBPR research projects conducted by this multi-state research team. These foci are similar to professionally developed current recommendations for obesity prevention (>5 fruits/vegetables, <2 hours of screen time, >1 hour of physical activity, and no sugar-sweetened beverages)44 but also include the target population priority of stress management. Fall of year 01 was devoted to the recruitment of student partners (intense intervention group) and the development of partnerships. In the spring of year 01, recruitment of student partners were enrolled in two newly developed undergraduate courses across four intervention state partners, became collegiate 4-H members, planned a social marketing campaign and/or learned to be peer mentors or student researchers. In year 02, first year college students were recruited, peer mentors were matched with a group of first year students, and the developed social marketing campaign was piloted tested on four college campuses (diffuse intervention) by the collegiate 4-H teams. In year 02, the toolkit with 24-weeks of intervention was also refined. In year 03, the collegiate 4-H team (intense intervention group) used the refined tool kit to pilot and feasibility test the intervention on four college campuses. In year 03, the assessment process for high school 4-H students (intense intervention group) was piloted tested and college students worked with the high school students on adapting the toolkit for use in the implementation of the social marketing campaign in high school settings (diffuse intervention). In year 04, the pilot and feasibility tested college intervention was tested with a randomized control trial design with 30 intervention and 29 control university partners. The adapted high school toolkit was pilot and feasibility tested in three intervention and two control high school settings. In year 05, the high school intervention was tested with a randomized control trial design with 7 intervention and 7 control high schools (and an additional 2 interventions in non-traditional high schools and control in 1 non-traditional high school) in one district's high schools. What opportunities for training and professional development has the project provided?About 50 students, staff, and faculty have been trained as a part of the Fruved project in year 05. Training opportunities included: All new partners/investigators were trained on human and behavioral science research using the Collaborative Institutional Training Initiative (CITI Program) and in Working with Minors regulations. Students working at high school RCT sites completed online training to conduct environmental audits. Student researchers continued to be trained on both research, program development, and intervention implementation focused on health promotion. Student researchers continued to be trained in survey development, anthropometric measurements (height, weight, circumferences, using accelerometers to assess physical activity, and blood pressure measurements), data entry, and data analysis. Student researchers continued to be trained to use objective measures to assess the healthfulness of the environment (dining, vending, stores, recreational resources, and policies). Students and faculty researchers continued to be trained on a variety of technological platforms including zoom, wikispaces, Google drive, iStock, social media sites, Qualtrics, and a variety of statistical packages. Students and faculty researchers continued to be trained on using social media platforms (Face Book, Twitter, Instagram) to promote health messages. Student researchers continued to be trained on research presentation and dissemination in abstracts preparation, poster presentation, oral presentation, panel presentation, and manuscript development. How have the results been disseminated to communities of interest?Dissemination occurred in year 05 by the publication of 12 new journal articles and presentations at national conferences, including the American Society of Nutrition and the Society for Nutrition Education and Behavior. In total, 18 journal articles have been published, 18 are currently submitted for review, and over 100 national conference presentations have been made since the beginning of this project. What do you plan to do during the next reporting period to accomplish the goals?We plan to request a no-cost time extenstion to complete several tasks related to the goals of the project: Continue data analysis Continue manuscript development Further dissemination of the college toolkit Further refinement and dissemination of the high school toolkit Testing of the feasibility, acceptability, and effectiveness of dissemination of the high school toolkit in an additional 7 high schools Assessment of the project's sustainability in the 9 intervention schools from the year 05 RCT study

Impacts
What was accomplished under these goals? College Participant Assessments- In the spring of year 05, 447 students (Wave I) from six of the original eight partner colleges completed the same assessment protocols that were used in years 02-04 of this project. Wave I diffuse intervention assessments included anthropometric measurements (weight, height, waist, hip, waist-to-hip ratios, and neck circumference), physical activity, dietary quality, fruit and vegetable intake, body image, substance abuse, gardening, cooking, meal planning, food choice, food security, sustainable transportation, green eating, art, stress, sleep assessment, body composition and facial recognition, sexual orientation, breastfeeding, minority and diversity, health disparities, personality, gender issues, social media usage, and eating disorders. A carotenoid scanner was used with participants at four sites to provide an additional objective measure of fruit and vegetable consumption. Wellness reports- The automated digital system was developed to electronically create and distribute "Wellness Reports" to all students in the high school and college follow up intervention group (Waves I). The "Wellness Reports" were provided to participants at the intervention sites via email and provided feedback on the student's fruit and vegetable intake, sleep, physical activity, and stress management skills in relation to the averages on their campus and national recommendations. High School Environmental Assessments- Environments at the 9 intervention and 8 control high schools were assessed in the fall of year 05. sHEI Development and Validation- a short form of the Healthy Eating Index (sHEI) was developed and tested at the college and high school level with 50 college participants in the summer of year 05 and 50 high school participants in the spring of year 05.The HEI measures diet quality without considering quantity to assess how well one's diet aligns with the US 2015-2020 Dietary Guidelines for Americans which promotes making nutritious food choices from a variety of food sources and can be used to evaluate nutrition interventions or monitor changes in dietary patterns. The original HEI is lengthy and takes quite a bit of time to complete. Therefore, thepurpose of thissurvey is to shorten the time by condensing questions while still providing an accurate score reflecting dietary intake. For validation ofthe shortened HEI (sHEI)each participant completed three days of 24-hour dietary recalls, anthropometric measures, and four different versions of the sHEI to determine which version would calculate the most accurate score in relation to the dietary intake. Participants were also assessed with the carotenoid scanner for an additional, objective measure of fruit and vegetable intake. High School Intervention- The student researchers implemented the social marketing and environmental change intervention as part of the intervention testing at the 9 intervention high schools in year 05. College students who were trained by college faculty mentored high school students in the assessment of the high school students' food environment. Graduate student researchers mentored undergraduate college students to train them in assessments and implementing the intervention. They met weekly with high school students and talked about the project, identified issues and priorities for the high school environment, and implemented the modified College Fruved implementation toolkit in the High School environment. High school students, mentored by college students, presented the survey and environmental assessment outputs at an interactive health fair ("Fruvapalooza: A Health and Wellness Event", which was held on the campus of the University of Tennessee) to peers, family, school faculty/staff/administration, and community key stakeholders. High school students mentored by college students completed health promotion activities and social marketing projects and advocated for changes in environments and policies related to diet, physical activity, and stress management. To facilitate opportunities for high school student involvement at times when college student mentors could not be present, "Champion Teachers" were identified at the intervention high schools. These teachers enabled and encouraged students to complete projects and helped the college students navigate rules and regulations at each high school. High School Student Assessment Survey- 2,184 high school students have taken the Health and Wellness Survey and received Wellness Reports. Follow up surveys are currently being conducted along with efforts to obtain parental permission to use survey data. Plate Waste study- unique to year 05 of the project, a plate waste pre post study was conducted to provide another measure of potential differences in the dietary choices of students at intervention and control schools. The graduate students worked with the PI to develop protocols and trained undergraduate college students and some high school students to help with separation and measurement of food items. Cafeteria staff were integral to the success of the project, and assisted with logistics and collection of school data.

Publications

  • Type: Journal Articles Status: Published Year Published: 2018 Citation: Charlier CM, Barr ML, Colby SE, Green GW, Olfert MD. Correlations of Androgen Deficiency in Aging Males (ADAM) with Stress and Sleep in Young Adult Males. Healthcare 2018, 6, 121.
  • Type: Journal Articles Status: Published Year Published: 2018 Citation: Horacek TM, Dede Yildirim E, Kattelmann K, Byrd-Bredbenner C, Brown O, Colby S, Greene G, Hoerr SL, Kidd T, Koenings M, Morrell J, Olfert MD, Phillips B, Shelnutt K, White A. Multilevel Structure Equation Model of Students Dietary Intentions/Behaviors, BMI and the Healthfulness of Convenience Stores. Nutrients 2018, 10(11), 1569.
  • Type: Journal Articles Status: Published Year Published: 2018 Citation: Villaro MJ, Colby SE, Riggsbee K, Zhou W, Byrd-Bredbenner C, Olfert MD, Barnett TE, Horacek T, Sowers M, Mathews AE. Food choice priorities change over time and predict dietary intake at the end of the first year of college among students in the U.S. Nutrients 2018, 10(9), 1296
  • Type: Journal Articles Status: Awaiting Publication Year Published: 2018 Citation: El Zein A, Shelnutt K, Colby S, Vilaro M, Zhou W, Greene G, Olfert MD, Riggsbee K, Morrell JS, Mathews A. The Silent Struggle: Prevalence and Correlates of Food Insecurity among College Freshmen Attending Eight Universities in the United States. BMC PH 2018
  • Type: Journal Articles Status: Published Year Published: 2018 Citation: Barr ML, Colby SE, Riggsbee K, Leischner K, Mathews AE, Vilaro M, Kattelmann KK, Olfert MD. Health Behaviors of Student Community Partners after Designing and Implementing a Healthy Lifestyle Intervention. Behav Sci 2018, 8, 99.
  • Type: Journal Articles Status: Published Year Published: 2018 Citation: Famodu OA, Barr ML, Colby SE, Zhou W, Holaskova I, Leary MP*, Byrd-Bredbenner C, Mathews AE, Olfert MD. Neck Circumference Positively Relates to Cardiovascular Risk Factors in College Students. J. Environ. Res. Public Health2018, 15(7), 1480.
  • Type: Journal Articles Status: Published Year Published: 2018 Citation: Barr ML, Guo G, Colby SE, Olfert MD. Detecting Body Mass Index from a Facial Photograph in Lifestyle Intervention. Technologies 2018, 6(3), 83.
  • Type: Journal Articles Status: Published Year Published: 2018 Citation: Olfert MD, Charlier CM, Famodu OA, Barr ML, Zhou W, Mathews AE, Colby SE. Self-report vs. Measured Height, Weight and BMI in Young Adults. Int. J. Environ. Res. Public Health2018, 15(10), 2216.
  • Type: Journal Articles Status: Published Year Published: 2018 Citation: Famodu OA, Barr ML, Hol�skov� I, Zhou W, Morrell JS, Colby SE, Olfert MD. Shortening of the Pittsburgh Sleep Quality Index Survey Using Factor Analysis. Sleep Disorders 2018. Vol 2018, Article ID 9643937.
  • Type: Journal Articles Status: Published Year Published: 2018 Citation: Olfert MD, Barr ML, Riggsbee K, Kattelmann KK, Leischner K, Mathews AE, Vilaro M, Colby SE. A Community Based Participatory Approach to Training Young Adults to Design and Implement a Social Marketing Framed Lifestyle Intervention on their College Campus.Education Sciences 2018. Educ Sci 2018, 8(3), 150.
  • Type: Journal Articles Status: Under Review Year Published: 2019 Citation: Olfert MD, Barr ML*, Riggsbee K, Kattelmann KK, Leischner K, Mathews AE, Vilaro M, Colby SE. Recruiting Young Adult Interventionists for a Community-Based Participatory Research Behavior Change Intervention. Methods and Protocols.
  • Type: Journal Articles Status: Under Review Year Published: 2019 Citation: Olfert MD, Barr ML*, Riggsbee K, Kattelmann KK, Leischner K, Mathews AE, Vilaro M, Colby SE. A Community Based Participatory Approach to Training Young Adults to Design and Implement a Social Marketing Framed Lifestyle Intervention on their College Campus. iJMR
  • Type: Journal Articles Status: Under Review Year Published: 2019 Citation: Barr ML*, Colby SE, Riggsbee K, Leischner K, Mathews AE, Vilaro M, Kattelmann KK, Olfert MD. Health Behaviors of Student Community Partners after Designing and Implementing a Healthy Lifestyle Intervention on College Campuses. Public Health Nutrition
  • Type: Journal Articles Status: Under Review Year Published: 2019 Citation: Kattelmann KK, Hofer EJ, Merfeld CM, Meendering JR, Olfert MD, White JA, Hagedorn RL, Solby SE, Meade RL, Franzen-Castle L, Aguirre TA, Mathews DR, Moyer JC, White AA. Quality of Life Associated with Physical Activity But Not with Sedentary Time in Youth. Pediatric Exercise Science.
  • Type: Journal Articles Status: Under Review Year Published: 2019 Citation: Olfert MD, Barr ML*, Mathews AE, Horacek TM, Riggsbee K, Zhou W, Colby SE. To be a Vegetarian or not in College: the Health, Lifestyle, and Environmental Characteristics. Nutrition Practice and Research.
  • Type: Journal Articles Status: Under Review Year Published: 2019 Citation: Riggsbee K, Spence M, Steeves EA, Moret L, Olfert MD, Wiggins S, Vilaro M, Colby S. I eat whatever I see before I run out the door: A Qualitative Study to Understand Adolescent Food Environments and Food Choices. Appetite.
  • Type: Journal Articles Status: Under Review Year Published: 2019 Citation: Sowers M, Colby SE, Kavanagh K, Steeves EA, Zhou W, Hagedorn RL*, Olfert MD. Description and Comparison of Contents, Traffic, and Consumer Demographics of Vending Machines on a College Campus. Appetite.
  • Type: Journal Articles Status: Under Review Year Published: 2019 Citation: Horacek TM, Dede Yildirim E, Kattelmann K, Byrd-Bredbenner C, Brown O, Colby S, Greene G, Hoerr S, Kidd T, Koenings MM, Morrell J, Olfert MD, Shelnutt K, White A, Phillips B. Healthfulness of convenience stores mediated by college students meal intentions and energy from fat intake predicts their body mass index. Appetite.
  • Type: Journal Articles Status: Under Review Year Published: 2019 Citation: El Zein A, Shelnutt K, Colby S, Vilaro M, Zhou W, Greene G, Olfert MD, Riggsbee K, Morrell JS, Mathews A. The Silent Struggle: Prevalence and Correlates of Food Insecurity among College Freshmen Attending Eight Universities in the United States. BMC PH.
  • Type: Journal Articles Status: Under Review Year Published: 2019 Citation: Casteneda G, Colby SE, Barnett TE, Olfert MD, Wenjun Z, Leite WL, El Zein A, Mathews AE. Examining the Effect of Weight Conscious Drinking on Binge Drinking Frequency among College Freshmen. Jrnl of American College Health.
  • Type: Journal Articles Status: Under Review Year Published: 2019 Citation: Colby SE, Olfert MD, Kattelmann KK, Mathews A, Kidd T, Brown O, White A, Horacek T, Riggsbee K, Glover J, Faulk M, Green G, Byrd-Bredbenner C, Morrell J, Franzen-Castle L, Shelnutt KP. How we got Fruved! Protocols developed for a peer-led, train-the-trainer social marketing intervention to increase fruit and vegetable intake and prevent childhood obesity. JNEB.
  • Type: Journal Articles Status: Under Review Year Published: 2019 Citation: Zhou W, Yang W, Olfert MD, Mathews A, Kattelmann K, Colby S. Using Integer Programming to Match University Freshmen to Peer Mentors. Technology.
  • Type: Journal Articles Status: Under Review Year Published: 2019 Citation: Colby SE, Kattelmann KK, Zhou W, Byrd-Bredbenner C, White AA, Greene GW, Hoerr SL, Kidd T, Horacek TM, Phillips BW, Koenings MM, Brown ON, Olfert MD, Morrell JS, Shellnutt KP. Characteristics and behaviors associated with weight among college students: a cross-sectional study. Jrnl of Nutr & Behav


Progress 08/01/17 to 07/31/18

Outputs
Target Audience:The project reaches older adolescents in high school settings. These students, in grades 9-12, represent a population experiencing increasing rates of unwanted weight gain. There is currently a lack of effective interventions for this target population. In year 04, 2286 high school students were assessed as a part of this project. In year 05, this number will be increased as the intervention for high school students will be expanded to reach additional high school locations. Changes/Problems:Because not all RCT colleges elected to participate in the high school RCT, and concerns of selection bias inherent in using only the schools interested in participating, the RCT high school work will be conducted in one school district with all schools randomly assigned to intervention or control. This is a stronger research design and does not decrease the sample size, scope of work, or anticipated outcomes of the project. What opportunities for training and professional development has the project provided?Over 100 students, staff, and faculty have been trained as a part of the Fruved project in year 04. Training opportunities included: All new partners were trained on human and behavioral science research using the Collaborative Institutional Training Initiative (CITI Program). Students and faculty at the RCT sites completed online training to conduct environmental audits. Student researchers continued to be trained on both research, program development, and intervention implementation focused on health promotion. Student researchers continued to be trained in survey development, anthropometric measurements (height, weight, circumferences, using accelerometers to assess physical activity, and blood pressure measurements), data entry, and data analysis. Interrater reliability, at a 0.80 level of agreement, was reached for all student researchers. Student researchers continue to be trained to use objective measures to assess the healthfulness of the environment (dining, vending, stores, recreational resources, and policies). Students and faculty researchers continued to be trained on a variety of technological platforms including zoom, wikispaces, pictochart, Vimeo, google drive, iStock, social media sites, qualtrics, and a variety of statistical packages. Students and faculty researchers continued to be trained on using social media platforms to promote health messages. Student researchers continued to be trained on research presentation and dissemination in abstracts preparation, poster presentation, oral presentation, panel presentation, and manuscript development. How have the results been disseminated to communities of interest?Dissemination occurred in year 04 by the publication of 7 journal article and the presentation of 12 national conference presentations including at the American Society of Nutrition, Food and Nutrition Convention and Expo, and the Society for Nutrition Education and Behavior. In total, 9 journal articles and 98 national conference presentations related to this project have been made since beginning this project. What do you plan to do during the next reporting period to accomplish the goals? High School Intervention Randomized Control Trial- The intervention will be implemented at 7 intervention high schools. Seven high schools will serve as control sites. High School Participant Assessments- At least 100 students from each of the 14 schools (7 intervention and 7 control sites) will complete the surveys assessing self-reported height, weight, physical activity, fruit and vegetable intake, hours of sleep, and stress management in the fall and spring of year 05. High School Environmental Assessments- High school campus environments will be assessed in the fall of year 05 following the same proceedures used in the campus environment assessments in the previous years. High School Intervention- After-school groups of high school students will work with faculty, student researchers, and Extension professionals from their local College to modify and implement the Fruved intervention on high school campuses. Recruited high school students will become members of 4-H if not already a part of the 4-H program. They will also be introduced to the Fruved project through visits to the college campus where they will have the opportunity to observe the intervention implementation at the college level. Wellness reports- The "Wellness Reports" will be automatically provided via email to high school participants at the intervention sites in fall and spring. The "Wellness Reports" will provided feedback on the student's fruit and vegetable intake, sleep, physical activity, and stress management skills in relation to the averages on their campus and to national recommendations.

Impacts
What was accomplished under these goals? College Participant Assessments- In the fall of year 04, 8215 students (Wave III) from the 59 RCT colleges completed the same assessment protocols that were used in year 03 of this project and 1377 of those (Wave III) were reassessed in the spring of year 04. In the spring of year 04, 316 from year 02 (Wave I group) were reassessed; and 283 from year 03 (Wave II group) were reassessed. Wave I diffuse intervention assessments included anthropometric measurements (weight, height, waist, hip, waist-to-hip ratios, and neck circumference), physical activity, dietary quality, fruit and vegetable intake, body image, substance abuse, gardening, cooking, meal planning, food choice, food security, sustainable transportation, green eating, art, stress, sleep assessment, body composition and facial recognition, sexual orientation, breastfeeding, minority and diversity, health disparities, personality, gender issues, social media usage, and eating disorders. Wave II and Wave II assessments were limited to self-reported height, weight, physical activity, fruit and vegetable intake, hours of sleep, and stress management. Wellness reports- The automated digital system was developed to electronically create and distribute "Wellness Reports" to all students in the intervention group in Waves II and III who took surveys in year 04. The "Wellness Reports" were provided to participants at the intervention sites via email and provided feedback on the student's fruit and vegetable intake, sleep, physical activity, and stress management skills in relation to the averages on their campus and national recommendations. All students in the RCT schools also received their "Wellness Reports" in the spring of 2018. College Environmental Assessments- Environments at the 30 intervention and 29 control universities were assessed in the fall of year 04. College Tool Development and Validation- Manuscripts were published describing tools used to assess secondary outcomes that had been developed and validated in years 02-03 included: gardening, food choice, and green eating. The manuscripts and presentations related to the development and validation of sustainable transportation and cooking and meal planning will be completed in year 05. College Intervention Testing- The student researchers implemented the 24-topic area social marketing and environmental change intervention as part of the intervention testing at the 30 intervention colleges in year 04. Fidelity assessments were completed at three time points during the year. High School Pilot and Feasibility Testing Recruitment-High school students at the three intervention schools were recruited to be a part of the Fruved team and to take surveys through flyers, word-of-mouth, classroom teacher announcements, emails, and tabling events. High School Pilot and Feasibility Testing Participant Assessments- Surveys were completed with 2286 high school students from the 3 intervention and 2 control schools. Surveys assessed self-reported height, weight, physical activity, dietary quality, fruit and vegetable intake, body image, gardening, cooking, meal planning, food choice, food security, food safety, stress, social media use, and sleep assessment. Height and weights were collected from 692 to be used to validated the use of self-reported heights and weights. Accelerometer data were collected from 209 to be used to validate the use of self-reported physical activity. High School Pilot and Feasibility Testing Environmental Assessments- High school environments for the 3 intervention and 2 control schools were assessed by teams of college students. High school students at the intervention sites participated in the process. High School Intervention Pilot and Feasibility Testing- Researchers, Extension, and student partners worked with 3 high schools to pilot and feasibility test the intervention. Each school tested a slightly different approach to applying the train-the-trainer model. In one, college students who were trained by college faculty mentored teams of high school students in the assessment of the high school students' food environment. The researchers, Extension professionals, college student researchers, and SMEI students met with the recruited high school students and talked about the project weekly, identified issues and priorities for the high school environment, and implemented the modified College Fruved implementation toolkit in the High School environment. High school students, mentored by college students, presented the survey and environmental assessment outputs at interactive health fairs to peers, family, school faculty/staff/administration, and community key stakeholders. High school students mentored by college students conducted health promotion activities and social marketing throughout the school year and advocated for changes in environments and policies related to diet, physical activity, and stress management. In the second, college students were present for and supported health promotion activities and posted results from the surveys and environmental assessments around campus. In the third, the researchers and college student researchers met with the high school students and their advisor and provided instruction on the project. The high school student advisor and high school students then identified issues and priorities for the high school environment and implemented the modified College Fruved implementation toolkit in the High School environment. High School RCT Recruitment- In one school district where the high school intervention was pilot and feasibility tested in one school, the 14 remaining schools in that school district have been contacted and invited to participate in the testing of the high school intervention in the 2018-2019 school year (year 05 of the project). Schools have been randomly assigned to intervention (n=7) and control (n=7). RCT Preparation- An interactive, password protected website was developed to support High School RCT activities.

Publications

  • Type: Conference Papers and Presentations Status: Submitted Year Published: 2018 Citation: Riggsbee K, Colby S, Kidd T, Brown O, White A, Horacek T, Olfert M, Mathews A, Kattelmann K, Shelnutt K, Franzen-Castle L, Greene G, Morrell J, Sowers M, Zhou W, Allison C, Barr M, Mosby T, Vilaro M, Wangcheng Yan W. Development and Pilot Testing of A Community Based Participatory Research Obesity Prevention Program on College Campuses. Submitted to Society for Nutrition Education Minneapolis July 2018.
  • Type: Conference Papers and Presentations Status: Submitted Year Published: 2018 Citation: Colby SE, Mathews A, Olfert MD, Kattelmann K, Kidd T, White A, Horacek T, Morrell J, Franzen-Castle L, Greene G, Byrd-Bredbenner C, Zhou W, Brown O, Shelnutt K. A Social Marketing and Environmental Change Intervention: Get Fruved Years 01-04. Submitted to Society for Nutrition Education and Behavior Annual Meeting Minnesota, MN, July 2018.
  • Type: Conference Papers and Presentations Status: Submitted Year Published: 2018 Citation: Allison C, Riggsbee K, Olfert M, Horacek T, ColbyS, Current initiatives to shape healthfulness of college campuses. Submitted to American Public Health Association November 2018.
  • Type: Conference Papers and Presentations Status: Submitted Year Published: 2018 Citation: Riggsbee K, Riggsbee J, Vilaro M, Spence M, Anderson Steeves, E, Zhou, W, Olfert M, Franzen-Castle L, HoracekT, Colby S. Utilizing Story-Mapping to Better Understand and Explore Adolescent Food Environments. Submitted to American Public Health Association November 2018.
  • Type: Journal Articles Status: Published Year Published: 2017 Citation: El Zein A, Shelnutt K, Colby S, Olfert M, Kattelmann K, Brown O, Kidd T, Horacek T, White A, Zhou W, Vilaro M, Greene G, Morell J, Riggsbee K, & Mathews A. Sociodemographic Predictors and Correlates of Food Insecurity among College First Year Students. J Academy of Nut and Diet 2016;117(10): A146 http://dx.doi.org/10.1016/j.jand.2017.08.102
  • Type: Journal Articles Status: Published Year Published: 2017 Citation: Simon M and Horacek T. Intuitive Eating Practices and Attitudes of Registered Dietitian Nutritionists J Academy of Nut and Diet 2016;117(10): A131 DOI: http://dx.doi.org/10.1016/j.jand.2017.08.046
  • Type: Conference Papers and Presentations Status: Published Year Published: 2018 Citation: Balderson A, Lewis A, Udahagora M, Sankavaram K, Bahadur R. Student Life: Assessment of Lifestyle Factors Among College Students. Presented at March 19th 2018 for The Maryland Academy of Nutrition and Dietetics (MAND) Poster Award of Excellence at the MAND Annual Meeting.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2018 Citation: Pavone L, Slattery E, Lewis A, Udahagora M, Sankavaram K, Bahadur R Food Security and Health Behaviors Among College Students. Presented at March 19th 2018 for The Maryland Academy of Nutrition and Dietetics (MAND) Poster Award of Excellence at the MAND Annual Meeting.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Staub DJ, Loso JL, Colee J, Colby S, Zhou W, Vilaro M, Kattelman K, Olfert MD, Franzen-Castle L, Mathews AE. A Retrospective Study of Gardening Experience and Fruit and Vegetable Consumption at the End of the First College Year. FNCE, Academy of Nutrition and Dietetics Annual Meeting, October 21-24, 2017, Chicago, IL.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Gordon S, Almudaihim A, Shelnutt K, Vilaro M, Colby S, Mathews A. The Impact of Family Structure on Perceived Social Support for Health Behaviors of Incoming College Freshmen. Food and Nutrition Conference and Exhibition (FNCE), Annual Conference, Chicago IL, October 22, 2017.
  • Type: Journal Articles Status: Published Year Published: 2018 Citation: Horacek TM, Yildirim ED, Simon MB, Byrd-Bredbenner C, White AA, Shelnutt KP, Olfert MD, Morrell J, Mathews A, Kidd, Kidd T, Kattelmann K , Franzen-Castle L, Colby S, Brown O. Development and Validation of the Full Restaurant Evaluation Supporting a Healthy (FRESH) Dining Environment Audit. J Hunger Environ Nutr. 2018
  • Type: Journal Articles Status: Published Year Published: 2017 Citation: Colby S, Zhou W, Sowers M, Shelnutt K, Olfert M, Morrell J, Koenings M, Kidd T, Horacek T, Greene G, Brown O, White A, Hoerr S, Byrd-Bredbenner C, Kattelmann K. Development of a Questionnaire to Assess College Students' Perceptions of the Healthfulness of the Campus Environment. Am J Health Behav 2017; 41(6):701-709 � DOI: 10.5993/AJHB.41.6.4
  • Type: Journal Articles Status: Published Year Published: 2017 Citation: Colby S, Zhou W, Sowers M, Shelnutt K, Olfert M, Morrell J, Koenings M, Kidd T, Horacek T, Greene G, Brown O, White A, Hoerr S, Byrd-Bredbenner C, Kattelmann K. College Students' Health Behavior Clusters: Differences by Sex. Am J Health Behav 2017;41(4):378-389 https://doi.org/10.5993/AJHB.41.4.2
  • Type: Journal Articles Status: Under Review Year Published: 2018 Citation: Hanson AJ, Kattelmann K, McCormack LA, Zhou W, Brown ON, Horacek TM, Shelnutt KP, Kidd T, Opoku-Acheampong A, Franzen-Castle LD, Olfert MD, Colby SE. An Evaluation of the Relationship between Cooking and Wellness Behaviors in College Students. (In review).
  • Type: Journal Articles Status: Published Year Published: 2018 Citation: Leischner K, Arneson McCormack L, Britt B, Heiberger G, Kattelmann K. The Healthfulness of Entr�es and Students Purchases in a University Campus Dining Environment. Healthcare 2018, 6(2), 28; doi:10.3390/healthcare6020028
  • Type: Journal Articles Status: Published Year Published: 2017 Citation: Loso Ju, Staub D, Colby SE, Olfert MD, Kattelmann K, Vilaro Mp, Colee J, Zhou W, Franzen-Castle L, Mathews AE. Gardening Experience is associated with Increased Fruit and Vegetable Intake among First-Year College Students: A Cross-sectional Examination. Journal of the Academy of Nutrition and Dietetics. Accepted, September 10, 2017.
  • Type: Journal Articles Status: Published Year Published: 2017 Citation: Vilaro Mp, Colby SE, Zhou W, Barnett TE, Byrd-Bredbenner C, Olfert MD, Riggsbee Kg, Mathews AE. Development and Testing of the Food Choice Priorities Survey (FCPS): Assessing the importance of multiple factors on young adults' food choices. Evaluation & the Health Professions. 2017 Dec 40(4): 425-449. DOI: 10.1177/0163278717735872
  • Type: Conference Papers and Presentations Status: Submitted Year Published: 2018 Citation: Sriram KA, Barr ML, Colby SE, Mathews AE, Riggsbee K, Horacek T, Mosby T, Zhou W, Olfert MD Vegetarian College Student Lifestyle and Environmental Choices. Submitted to American Society of Nutrition Boston, MA June 2018.


Progress 08/01/16 to 07/31/17

Outputs
Target Audience:The college environment makes college freshmen an especially optimal target of intervention. Research indicates that the more diffused an intervention is in all facets of an individual's life and environment, the more successful the intervention will be in changing behavior. By targeting college freshmen, the campaign will be especially effective in reaching multiple and comprehensive elements of the participants' social and physical environments. The freshmen on these campuses live in dorms, spend most of their time in the campus physical environment, and eat in University dining facilities. This allows the intervention to saturate all elements of the students' lives. In years 01-03 of this project, thousands of students were reached. The project also reaches older adolescents in high school settings. These students, in grades 9-12, represent a population still experiencing increasing rates of unwanted weight gain. There is currently a lack of effective interventions for this target population. In year 03, 237 high school students were assessed as a part of this project. In year 04, this number will be greatly increased as the initial intervention for high school students will be expanded to reach six additional high school locations. Changes/Problems:There was a deviation in the timeline but it did not result in a reduction in the scope of work initially proposed.The changes expanded on the initial proposed strategies and will result in additional research outcomes. The dissemination phase of the project to the college population planned for Year 04 was adjusted to provide for a large-scale randomized control trial of the developed and pilot tested intervention to reach 45 intervention and 45 control schools instead of 4 intervention and 4 control schools. To prepare for these year 04 activities, efforts were required in year 03 that included recruitment of the 90 new university partners, developing additional program dissemination materials, conducting multiple informational webinars with new partners, and disseminate of intervention toolkits. What opportunities for training and professional development has the project provided?Over 70 students, staff, and faculty have been trained as a part of the Fruved project in year 03. Training opportunities included: All new partners were trained on human and behavioral science research using the Collaborative Institutional Training Initiative (CITI Program). Student researchers continued to be trained on both research, program development, and intervention implementation focused on health promotion. Student researchers continued to be trained in survey development, anthropometric measurements (height, weight, circumferences, using accelerometers to assess physical activity, and blood pressure measurements), data entry, and data analysis. Interrater reliability, at a 0.80 level of agreement, was reached for all student researchers. Student researchers continue to be trained to use objective measures to assess the healthfulness of the environment (dining, vending, stores, recreational resources, and policies). Students and faculty researchers continued to be trained on a variety of technological platforms including zoom, wikispaces, pictochart, Vimeo, google drive, iStock, social media sites, qualtrics, and a variety of statistical packages. Students and faculty researchers continued to be trained on using social media platforms to promote health messages. Student researchers continued to be trained on research presentation and dissemination in abstracts preparation, poster presentation, oral presentation, panel presentation, and manuscript development. How have the results been disseminated to communities of interest?Dissemination occurred in year 03 by the publication of one journal article and the presentation of 44 national conference presentations including at the American Society of Nutrition, Food and Nutrition Convention and Expo, and the Society for Nutrition Education and Behavior. 10 oral presentations have been made to university administration and high school partners at state level meetings. What do you plan to do during the next reporting period to accomplish the goals?1.College Intervention Randomized Control Trial- The intervention will be implemented at 45 intervention universities. Forty-five universities will serve as control sites. 2.College Participant Assessments- At least 50 students from each of the 90 universities (45 intervention and 45 control sites) will complete the surveys assessing self-reported height, weight, physical activity, fruit and vegetable intake, hours of sleep, and stress management in the fall and spring of year 04. 3.Colllege Environmental Assessments- College campus environments will be reassessed in the spring of year 04 following the same proceedures used in the campus environment assessments in the previous years. 4.Recruitment in High Schools - All high school students will be recuited to participate in surveys and all high school students at intervention high schools will be invited to participate in the Fruved program via flyer, word-of-mouth, classroom teacher, and tabling events. 5.High School Participant Assessments- All high school students in the six high schools (three intervention and three control) will be invited to take a survey that assesses self-reported heights, weights, fruit and vegetable intake, physical activity, sleep, and stress management skills in the fall and spring of year 04. An additional 600 students will complete objective anthropometric assessments and wear accelerometers. 6.High School Environmental Assessments- The environments of six high school campuses (three intervention and three control) will be assessed in the fall and spring of year 04. 7.High School Intervention- Classes and after school groups of high school students will work with faculty, student researchers, and Extension professionals from their local College to modify and implement the Fruved intervention on high school campuses. Recruited high school students will become members of 4-H if not already a part of the 4-H program. They will also be introduced to the Fruved project through visits to the college campus where they will have the opportunity to observe the intervention implementation at the college level. 8. Wellness report cards- The "Wellness Report Cards" will be automatically provided via email to participants (college and high school) at the intervention sites. The "Wellness Report Cards" will provided feedback on the student's fruit and vegetable intake, sleep, physical activity, and stress management skills in relation to the averages on their campus and to national recommendations.

Impacts
What was accomplished under these goals? Recruited Incoming Freshmen- All new incoming first-year students (approximately 32,000 incoming students; considered Wave II diffuse intervention participants) at the four intervention and four control schools were invited to participate in a survey. The survey was not limited to freshmen but freshmen were targeted through recruitment efforts. Recruitment was conducted through email, flyers, word-of-mouth, and tabling events. College Participant Assessments- 119 of the Intense Intervention Group were assessed using the same assessment protocols that were used in the first year of this project in the fall of year 03 and 88 were reassessed in the spring of year 03. In the Wave I diffuse Intervention group there were two subgroups, those screened as being "at risk" for unwanted weight gain and those with "lower risk" of unwanted weight gain. 628 of the "at risk" Wave I diffuse intervention (freshmen from year 02) were reassessed in the fall and 447 reassessed again in the spring. Intense Intervention and Wave I diffuse intervention assessments included anthropometric measurements (weight, height, waist, hip, waist-to-hip ratios, and neck circumference), physical activity, dietary quality, fruit and vegetable intake, body image, substance abuse, gardening, cooking, meal planning, food choice, food security, food safety, sustainable transportation, green eating, art, stress, and sleep assessment. Additional research questions are being investigated with the Intense Intervention and Wave I diffuse intervention data using survey assessments on the following topics: body composition and facial recognition, sexual orientation, breastfeeding, minority and diversity, health disparities, personality, gender issues, social media usage, and eating disorders. 328 of the "lower risk" of unwanted weight gain were reassessed in spring of year 03. 1314 new freshmen (Wave II diffuse intervention participants) were assessed in the fall of year 03 and 247 reassessed in the spring of year 03. Those assessments were limited to self-reported height, weight, physical activity, fruit and vegetable intake, hours of sleep, and stress management. Wellness report cards- An automated digital system was developed to electronically create and distribute "Wellness Report Cards" to all students who took surveys in year 03. The "Wellness Report Cards" were provided to participants at the intervention sites via email and provided feedback on the student's fruit and vegetable intake, sleep, physical activity, and stress management skills in relation to the averages on their campus and national recommendations. College Environmental Assessments- Environments at the four intervention and four control universities were reassessed in the spring of year 03. College Tool Development and Validation- Tools used to assess secondary outcomes were further developed and validated include: gardening, cooking, meal planning, food choice, food safety, sustainable transportation, and green eating. Development and validation of these tools began in year 02 and were completed in year 03. The manuscripts and presentations related to this process will be continued to be worked on in year 04. College Implement intervention- The student researchers implemented the 24-topic area social marketing and environmental change intervention as part of the pilot and feasibility testing in year 03. The toolkit and planned intervention components continued to be adjusted in a reflexive and on-going basis using a CBPR approach. The faculty researchers and Extension professionals partnered with the students throughout the intervention process to educate and give advice on the content of health promotion messages. Fruved student organizations functioned to bring together other health-related student organizations on campus and university health-related programs to provide a platform for collaboration and marketing of health-related events on campus. High School Recruitment-High school students were recruited to be a part of the Fruved team and to take surveys through flyers, word-of-mouth, classroom teacher announcements, emails, and tabling events. High School Participant Assessments- Surveys were completed with 237 high school students. Surveys assessed self-reported height, weight, physical activity, dietary quality, fruit and vegetable intake, body image, gardening, cooking, meal planning, food choice, food security, food safety, stress, social media use, and sleep assessment. High School Environmental Assessments- One high school environment was assessed by teams of college students in mentorship with high school students. High School Intervention Development- Researchers, Extension, and student partners worked with local high schools and school boards to formalize research agreements and relationships. All process were pilot tested in one high school. Following the train-the-trainer model, the college SMEI and student researchers mentored a team of high school students (the high school intense intervention group) in the assessment of the high school students' food environment. Recruited high school students had their health-related behavior assessed. The researchers, Extension professionals, college student researchers, and SMEI students met with the recruited high school students and talked about the project, identified issues and priorities for the high school environment, and began to modify the College Fruved implementation toolkit for the High School environment. RCT Recruitment- A request for applications was sent out nationally through listservs and emails. Ninety applications were received. RCT Preparation- Over 12 webinars were conducted to begin to train the 90 university partners in preparing for year 04 program activities. An intervention and control toolkit was finalized and distributed. An interactive, password protected website was developed to support RCT activities.

Publications

  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Hanson A, Kattelmann K, Mathews A, Olfert M, Barr M, Brown O, Horacek T, Kidd T, White A, Violette G, Colby S. An Evaluation of the Relationship between College Students Cooking Skills, Frequency, and Self-Efficacy and Fruit and Vegetable Intake and Body Mass Index: GetFRUVED Study. SNEB Annual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Hanson A, Kattelmann K, Mathews A, Olfert M, Brown O, Horacek T, Kidd T, White A, Colby S. An Evaluation of the Relationship between Physical Activity, Cooking, Dietary Behaviors and Wellness Indicators: GetFRUVED Study. SNEB Annual Meeting, Washington, DC. July 30, 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Hicks D, Kattelmann K. Development of a Quantitative Measure of Community Readiness for Change for Health and Wellness. Society for Nutrition Education and Behavior Annual Conference. Washington, DC. July 20-24, 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Horacek T, Dede Yildirim E, White, A, Shelnutt K, Riggsbee K, Olfert M, Morrell J, Kidd T, Kattelmann K, Franzen-Castle L, Bryd-Bredbenner C, Brown O. G. Greene. Convenience Store SHELF (Supportive Healthy Environment for Life-promoting Food) Audit Differences between College Campuses. FNCE Annual Meeting Boston, MA October 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Laitner MH, Mathews A., Colby S,Olfert MD,Kattelmann K.,Brown O, Kidd T, Horacek T, White A., Zhou W, Greene G, Riggsbee K, Morell J, Shelnutt K. Prevalence of Food Insecurity and Associated Health Behaviors among College Freshmen. FNCE Annual Meeting, Boston, MA October 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: LiPuma C, Horacek T. College Students Meal Management and Fast Food Ordering Behaviors. SNEB Annual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Loso J, Staub D, Colby S, Zhou W, Olfert MD, Kattelmann K, Vilaro M , Brown O, Kidd T, Horacek T, White A, Franzen-Castle L. , Mathews A. Childhood and Current Gardening is Associated with Increased Fruit and Vegetable Intake among College-Aged Students Participating in the Get Fruved Study. FNCE Annual Meeting, Boston, MA October 2016
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Mckee S, Engel M, Gordon S, Vilaro MJ, Mathews AE. Peer Mentorship: An evaluation of one component of the Get Fruved Health Intervention study. Presented at University of Florida, College of Public Health and Health Professions, Public Health Day. April 7, 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Morris AM, Barr ML, Famodu OA, Colby SE, Zhou W, Hagedorn RL, Clark RL, Riggsbee K, Olfert MD. Wellness Characteristics of College Freshmen at West Virginia University. Experimental Biology FASEB  American Society of Nutrition Annual Meeting, Abstract #8131. Chicago, Illinois. April 22-26. 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Olfert IM, Mathews AT, Famodu OA, Olfert MD, Cuff CF, Murray PJ, Haughey NJ, Colby SE, McFadden JW. Team Science Approach Helps to Identify how Fruit and Vegetable Consumption Improves Metabolic Health: A Fruvedomic Pilot Study. NISBRE. Washington DC, July 26-28, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Olfert MD, FAmodu OA, Clark RL, Holaskova I, Murray PJ, Waander T, Molina C, Morrell JS. Development of an At Risk for Metabolic Syndrome Score. Society for Nutrition Education and Behavior Annual Conference. Washington, DC. July 20-24, 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Powell KD, Colby SE, Olfert MD, Zhou W, Spence ML, Springer CM, Kavanagh KF. Associations between breastfeeding intention and accurate body size estimation among female college students. Experimental Biology (EB), American Society of Nutrition (ASN) Chicago, Illinois. 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Riggsbee KA, Colby SE, Sowers MF, Mathews A, Olfert MD, Barr ML, Kattelmann K, Kidd T, Horacek T, Brown O, White A. Social Media and Dietary Patterns among College Students. SNEB Annual Meeting San Diego, CA July 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Simon M, Kattelmann K, Mathews A, Franzen Castle L, Greene G, White A, Brown O, Olfert M, Byrd-Bredbenner C, Morrell J, Horacek,T. Developing a Tool to Measure Workplace and University Wellness and Obesity-Prevention Policies, Opportunities, Initiatives and Notable Topics: The POINTS Audit. FNCE Annual Meeting Boston, MA October 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Sowers MF, Colby S, Riggsbee K, Greene G, Pickett M, Olfert M, Shelnutt K, Brown O, Horacek T, Kidd T, Kattelmann K, White A, Franzen-Castle L, Zhou W, Yan W, Byrd- Bredbenner C. Development and Validity of a College Environmental Perceptions Survey (CEPS). (October 2016). American Public Health Association Annual Meeting, Denver, CO.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Sowers MF, Colby S, Anderson Steeves E, Kavanagh KF, Zhou W, Odoi A. Frequency of Vending Machine Usage as a Predictor of Weight Status Among College Students. Submitted poster presentation at The Academy of Nutrition and Dietetics Food and Nutrition Conference and Expo. October 21-24, 2017. Chicago, IL.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Sowers MF, Colby S, Anderson Steeves B, Kavanaugh K, Zhou W, Olfert M, Hagedorn R. Description and Comparison of Contents, Traffic, and Consumer Demographics of Vending Machines on a College Campus. Poster presentation at Society for Nutrition Education and Behavior Annual Meeting. July 20-23, 2017. Washington, D.C.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Sowers MF, Colby S, Allison C, Zhou W. Development and Validation of a B.E.A.N. Survey for College Students. Poster presentation at Experimental Biology. April 22-26, 2017. Chicago, IL.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Sowers MF, Colby SE, Yan W, Zhou W, Olfert MD, Barr ML, Mathew A, Vilaro M, Kattelmann KK, Leischner K, Kidd T, Brown O, Horacek T, White A, Williams J. A Comparison of Peer Mentors' and Mentees' Health Behaviors: The GetFruved Study. Poster presentation at Society for Nutrition Education and Behavior Annual Meeting. July 30  August 3, 2016. San Diego, CA.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Sowers, M.F., Colby, S., Anderson Steeves, E., Kavanagh, K.F., Zhou, W., Olfert, M., Hagedorn, R. Description of Content, Sales, and Consumer Demographics of Vending Machines on a College Campus. Society for Nutrition Education and Behavior Annual Conference. Washington, DC. July 20-24, 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Vilaro M, Riggsbee K, Zhou W, Colby S, Byrd-Bredbenner C, Olfert M, Barnett T, Kidd T, Mathews A. Development and Testing of the Food Choice Priorities Survey for College Students. (October 2016). The Food and Nutrition Conference and Expo, Boston, MA.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Vilaro M, Mathews A, Barnett T, Byrd-Bredbenner C, Zhou W, Riggsbee K, Olfert M, Horacek T, Sowers M, Colby S. Food choice priorities predict fruit and vegetable intake among college freshmen enrolled in the Get Fruved study. To be presented at the American Public Health Association (APHA) Annual Meeting & Expo, Atlanta, GA. November 4-8, 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Wattick RA; Barr ML; Hagedorn RL; Shelnutt K; Mathews A; Colby SE; Olfert MD. Appalachian Young Adults Food Security and Tobacco Use. Society for Nutrition Education and Behavior Annual Conference. Washington, DC. July 20-24, 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Wangcheng Yan, Wenjun Zhou, Sarah Colby, Kendra Kattelmann, Anne Mathews, Melissa D. Olfert. The GetFruved Project Uses Integer Programming to Match Freshmen to Peer Mentors. INFORMS. Nashville TN, November 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: White J, Olfert MD, Brown O, Colby S, Horacek T, Kattelmann K, Kidd T, Shelnutt K, White A, Greene G. Campus Environment Perceptions Impact Fruit and Vegetable Intake and Vigorous Physical Activity in College Students. SNEB Annual Meeting, San Diego, CA. July 30, 2016.
  • Type: Journal Articles Status: Published Year Published: 2017 Citation: Mathews AT, Famodu OA, Olfert MD, Murray PJ, Cuff CF, Downes MT, Haughey NJ, Colby SE, Chantler PD, Olfert IM, McFadden JW. Efficacy of nutritional interventions to circulating ceramides in young adults: FRUVEDomic pilot study. Physiol Rep, 5(11), 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Allison, C., Wiggins, S., Yan, W., Zhou, W., Olfert, M.D., Kattelmann, K., Mathews, A., Brown, O., Kidd, T., Horacek, T., White, A., Colby, S. Gender Differences in Use of Social Media for Health-related Information. Experimental Biology FASEB  American Society of Nutrition Annual Meeting. Chicago, Illinois. April 22-26, 2017. Abstract # 9351.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Barr, ML, Charlier CM, Mathews A, Kattelmann K, Colby S, Olfert MD. , Self-Reported Young Adult Male Androgen Deficiency Correlation with Stress and Sleep. Society for Nutrition Education and Behavior Annual Conference. Washington, DC. July 20-24, 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Barr ML, Olfert, MD, Mathew A, Riggsbee K, Kattlelmann KK, Leischner K, Colby SE. Training College Students to Create a Health Promotion Intervention for Freshman: Get Fruved Study. SNEB Anuual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Barr ML, Olfert MD, Mathews A, Riggsbee K, Leischner K, Kattelmann KK, Colby S. Intervention Planning and Baseline Characteristics of College Students Trained to Implement Wellness on Campus: GetFRUVED Study. SNEB Annual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Barr ML, Mathews A, Kattelmann K, Colby s, Olfert M. West Virginia University Health Promotion Program: GetFruved. WV Rural Health Conference, Logan, WV. October 19, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Barr ML, Charlier CM, Colby SE, Greene G, Bryd-Bredbenner C, Olfert MD. Young Adult Males and Regional Appalachian Differences in Dietary Patterns across U.S. Universities. Experimental Biology FASEB  American Society of Nutrition Annual Meeting, Abstract #7801. Chicago, Illinois. April 22-26. 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Barr ML, Famodu OA, Gou G, Colby SE, Olfert MD. Facial Imagery BMI Algorithm correlates with Normal and Overweight Measured BMI. Experimental Biology FASEB  American Society of Nutrition Annual Meeting, Abstract #7895. Chicago, Illinois. April 22-26. 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Burke M, White A, Greene G, Colby S. Green Eating and Health Behavior in College Students. FNCE Annual Meeting, Boston, MA, October 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Clark RL, Famodu OA, Morrill A, Warner C, Ruseski J, Murray PJ, Colby SE, Olfert MD. Cost Increase to Follow USDA MyPlate Diet in College Aged Students. Society for Nutrition Education and Behavior Annual Conference. Washington, DC. July 20-24, 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Colby SE, Zhou W, Mathews A, Kattelmann K, Olfert MD, Brown O, Kidd T, White A, Horacek T. A Social Marketing and Environmental Change Intervention: Get Fruved Years 01-02. SNEB Annual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Elzein A, Shelnutt K, Colby S, Olfert M, Kattelmann K, Brown O, Kidd T, Horacek T, White A, Zhou W, Greene G, Riggsbee K, Morrell J, Mathews A. The Prevalence of Food Insecurity and Its Association with Health and Academic Outcomes among College Freshmen. (December 2016). American Society for Nutrition  Advances and Controversies in Clinical Nutrition. Orlando, FL.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Elzein A, Mathews A, Colby S, Byrd-Bredbenner C, Riggsbee K, Zhou W, Olfert M, Barnett, T, Hansen A, Brown O, Kidd T, Horacek T, Violette G, Vilaro M. Food Choice Priorities of College Freshmen and Variation by Demographic Characteristics: Get Fruved Study. (October 2016). The Food and Nutrition Conference and Expo, Boston, MA.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Famodu OA, Olfert MD, Holaskova I, Barr ML, Zhou W, Morrell J, Colby SE. Shortening Pittsburgh Sleep Quality Index Survey Using Factor Analysis. SNEB Annual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Famodu OA, Cuff C, Cockburn A, Olfert IM, McFadden JW, Downes ME, Murray PJ, Holaskova I, Barr ML, Colby SE, Morrell J, Olfert MD. Nutrition Intervention to Profile Microbiome and Behaviors in Young Adults at Risk for Metabolic Syndrome: FRUVEDomic Pilot Study. SNEB Annual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Famodu OA, Barr ML, Colby SE, Zhou W, Bryd-Bredbenner C, Mathews AE, Olfert MD. Associations Between Neck Circumferences and Measures of Health in Young Adults. Experimental Biology FASEB  American Society of Nutrition Annual Meeting, Abstract #7928. Chicago, Illinois. April 22-26. 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Famodu OA, Charlier CM, Barr ML, Colby SE, Zhou W, Mathews AE, Olfert MD. Self-reported vs. Measured Height and Weight in Young Adults.Experimental Biology FASEB  American Society of Nutrition Annual Meeting, Abstract #7969. Chicago, Illinois. April 22-26. 2017.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Famodu OA, Infante AM, Cuff CC, Holaskova I, Olfert MI, Downes MT, Murray PJ, McFadden JW, Colby SE, Morrell J,Olfert MD. Microbiome Impact from a Nutrition Intervention in Young Adults: FRUVEDomics Pilot Study. Experimental Biology FASEB  American Society of Nutrition Annual Meeting, Abstract #8205. Chicago, Illinois. April 22-26. 2017.


Progress 08/01/15 to 07/31/16

Outputs
Target Audience:The college environment makes college freshmen an especially optimal target of intervention. Research indicates that the more diffused an intervention is in all facets of an individual's life and environment, the more successful the intervention will be in changing behavior. By targeting college freshmen, the campaign will be especially effective in reaching multiple and comprehensive elements of the participants' social and physical environments. The freshmen on these campuses live in dorms, spend most of their time in the campus physical environment, and eat in University dining facilities. This allows the intervention to saturate all elements of the students' lives. In year 01 of this project, to develop the foundation needed for the train-the-trainer approach planned for implementation in year 02, a variety of college student majors and students in different years of study were reached. The inclusion criteria for the freshmen recruited for assessment in this study include: being an 18 or 19 year old incoming first-year student at increased health risk (as defined by this study as having low intakes of fruits and/or vegetables) and one of the following additional factors: first generation college student, lower income background, overweight or obese, minority status, or history of parental overweight or obesity. Changes/Problems:There was a deviation in the timeline but it did not result in a reduction in the scope of work initially proposed. It was originally planned: Year 02- test the intervention in the college population Year 03- test the intervention in the high school population Year 04- disseminate to the college population Year 05- disseminate to the high school population Based on feedback from student partners and primary investigators, it was decided that the work in year 02 in the college population was gaining momentum and the research design would benefit from considering the work in year 02 to be pilot. It was believed that this would strengthen the quality and consistency of the delivery of the intervention if it were delivered in year 03.This also allows for the refined toolkit to be tested as a completed product. What opportunities for training and professional development has the project provided?Over 90 student, faculty, and Extension partners have been trained as a part of the Fruved project in year 02. Training opportunities included: 1. All new partners were trained on human and behavioral science research using the Collaborative Institutional Training Initiative (CITI Program). 2. Student researchers and SMEI students continued to be trained on both research, program development, and intervention implementation focused on health promotion. 3. Student researchers were trained in survey development, anthropometric measurements (height, weight, circumferences, using accelerometers to assess physical activity, and blood pressure measurements), data entry, and data analysis. Interrater reliability, at a 0.80 level of agreement, was reached for all student researchers. 4. Student researchers and SMEI students were trained to use objective measures to assess the healthfulness of the environment (dining, vending, stores, recreational resources, and policies). 5. Student, faculty researcher, and Extension partners received training on a variety of technological platforms including ASA 24, zoom, wikispaces, pictochart, Vimeo, groupme, google drive, iStock, social media sites, qualtrics, and a variety of statistical packages. 6. Students, faculty researchers and Extension professionals received training on using social media platforms to promote health messages. 7. Student researchers were trained and had experiences on research presentations in abstracts, poster presentations, oral presentations, and panel presentations. How have the results been disseminated to communities of interest?Dissemination occurred in year 02 with 17 national presentations including at the American Society of Nutrition, American Physiologic Society, Food and Nutrition Conference and Expo, and the Society for Nutrition Education and Behavior. Three oral presentations have been made to university administration partners at state level meetings. What do you plan to do during the next reporting period to accomplish the goals?1. Peer mentors New peer mentors will be recruited, enrolled, and trained in a university course on mentoring in fall of 2016. Those newly trained peer mentors will be matched with newly entering first year students for the 2016-2017 school year. 2. Implement intervention the SMEI students and student researchers will implement the refined social marketing campaign. 3. Assessments In fall of year 03, all newly entering first year college students (diffuse intervention and control) will be invited to take a modified survey that assesses self-reported heights, weights, fruit and vegetable intake, physical activity, sleep, and stress management skills. Assessments with the freshmen assessed in year 02 (now sophomores) will be repeated in the spring of year 03. Intense intervention students (SMEI and Peer mentors) will also be reassessed in the spring of year 03. College campus environments will be reassessed in the spring of year 03 following the same proceedures used in the campus environment assessments in the spring of year 01. 4. Wellness report cards The Wellness Report Cards will be provided to participants at the intervention sites that provided feedback on their fruit and vegetable intake, sleep, physical activity, and stress management skills in relation to the averages on their campus and to national recommendations. 5. Recruitment in High Schools Researchers, Extension, and student partners will continue to work with local high schools and school boards to formalize research agreements and relationships. All processes will be pilot tested in one high school. Following the train-the-trainer model, the college SMEI and student researchers will mentor a team of high school 4-H students (the high school intense intervention group) in the assessment of the high school students' food environment. Recruited high school students will have their health and health behavior assessed. Recruited high school students will become members of 4-H if not already a part of the 4-H program and will be introduced to the Fruved project through visits to the college campus where they will have the opportunity to observe the intervention implementation at the college level. The researchers, Extension professionals, college student researchers, and SMEI students will meet with the recruited high school students to talk more about the project, identify issues and priorities for the high school environment, and modify the Fruved implementation toolkit for the High School environment.

Impacts
What was accomplished under these goals? 1. Peer mentors A peer matching algorithm was developed and tested. The 564 at-risk first-year students from the intervention schools were matched using the newly developed matching algorithm with peer mentors in groups of 1-6 mentees per mentor. Peer mentors met with their mentees throughout the year in a variety of settings and reported the frequency and quality of interactions through monthly logs. To isolate the impact that having a peer mentor had on health-related outcomes, the behavior changes from pre to post of at-risk first-year students from intervention schools that were not assigned a peer mentor will be statistically compared to those that were matched to peer mentors. Additional analysis of the peer mentor logs will be conducted to examine a dosage effect by comparing pre to post behavior changes between those more intensely involved with their mentors and those with less intense interactions. 2. Implement intervention the SMEI students and student researchers implemented the 24-week social marketing campaign toolkit. The toolkit and planned intervention components were adjusted in a reflexive and continuous basis with a student driven Social Marketing Committee and researchers. Adjustments and refinements were based on continuous feedback from student partners. The Fruved campaign included five costumed characters (Banana, Bean, Carrots, Grapes, and Tomato). Characters interacted with students on campus in freshmen residence halls, dining halls/cafeterias, and highly trafficked public areas. Photos and videos of interactions were taken and put on social media sites including Facebook, Twitter, Instagram, SnapChat, and YouTube. Weekly activities were focused on a range of health-related topics, all under the overarching areas of diet, physical activity, and stress management. Specific week's topics included: MyPlate, yoga, cardiovascular exercises, music, time management, dance, meditation, fiber, flexibility, portions, strength, positivity, sleep, friendships, substance abuse, body image, trying something new, hydration, savor the flavor, and step counting. The faculty researchers and Extension professionals partnered with the collegiate 4-H student teams throughout the intervention process to educate and give advice on the content of health promotion messages. The need emerged for Fruved student organizations to be established that functioned to bring together all other health-related student organizations on campus and university health-related programs to provide a platform for collaboration and communication. 3. Town Hall Meetings- Student groups held Town Hall Meetings to engage the general student population in identifying priorities and developing plans for advocacy for environmental change. 4. Recruited Incoming Freshmen- To evaluate the impact of the intervention, all incoming first-year students (approximately 32,000 incoming students) at the four intervention and four control schools had been invited to participate in a screening process to see if they were eligible to be assessed. Recruitment began in year 01 and was completed in the beginning of year 02. To be eligible, incoming first-year students needed to be at increased health risk as defined by this study as low intakes of fruits and/or vegetables and one of the following additional factors: first generation college student, from a lower income background, overweight or obese, minority status, or history of parental overweight or obesity. 5,743 students took the eligibility screener. 2,885 were considered eligible. 5. Assessments- 1,076 of the Intense Intervention Group were assessed using the same assessment protocols that were used in the first year of this project. The primary outcome measure is body weight. Secondary outcome measures include physical activity, dietary quality, fruit and vegetable intake, anthropometric measurements (waist, hip, waist-to-hip ratios, and neck circumference), body image, substance abuse, gardening, cooking, meal planning, food choice, food security, food safety, sustainable transportation, green eating, art, stress, and sleep assessment. Additional research questions will be investigated using survey assessments on the following topics: body composition and facial recognition, sexual orientation, breastfeeding, minority and diversity, health disparities, personality, gender issues, social media usage, and eating disorders. In addition, sales data of food on the school campus (from dining halls/cafeterias and vending machines) and recreational facility usage data will be assessed, and perceived and actual food, physical activity, and health promotion environments will be assessed. Some tools used to assess secondary outcomes were developed and validated and include: gardening, cooking, meal planning, food choice, food safety, sustainable transportation, and green eating. Development and validation of these tools will continue into year 03 since the statistical analysis and publications related to these newly developed tools have not been completed. 859 first year students that were considered ineligible based on initial screener responses were reassessed at the end of year 02. This will be used to verify that those considered most at risk did actually gain the most weight. This will also allow us to test the impact of the intervention on those considered less "at-risk." Environmental assessment protocols were further validated and refined. 6. Wellness report cards- These were provided to participants at the intervention sites and provided feedback on their fruit and vegetable intake, sleep, physical activity, and stress management skills in relation to the averages on their campus and to national recommendations. 7. Recruitment in High Schools Researchers, Extension, and student partners identified potential high school partners. Two high schools in each of the four intervention university states were randomized to control and intervention. High schools in each state were matched by size and community composition and geographically separated to prevent potential exposure to the campaign. Researchers approached and received approval from the local high schools' principals and began to discuss protocols that will be submitted to the local school boards to formalize research agreements and relationships.

Publications

  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Allison C, Riggsbee K, Spurgeon S, Crouter S, Zhou W, Matthews A, Olfert MD, Kattelmann K, Kidd T, Horacek T, Brown O, White A, Colby S. The Impact of Art and Culture on Health Behaviors in College Students. Exhibition of Undergraduate Research and Creative Achievement, The University of Tennessee. April 2016.
  • Type: Conference Papers and Presentations Status: Submitted Year Published: 2016 Citation: Hanson A, Kattelmann K, Mathews A, Olfert M, Barr M, Brown O, Horacek T, Kidd T, White A, Violette G, Colby S. An Evaluation of the Relationship between College Students Cooking Skills, Frequency, and Self-Efficacy and Fruit and Vegetable Intake and Body Mass Index: GetFRUVED Study. SNEB Annual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Allison C, Faulk M, Colby Sarah. Development and Validation of a Survey about Beans for College Populations. The National Conference on Undergraduate Research, Asheville, NC. April 2016.
  • Type: Conference Papers and Presentations Status: Submitted Year Published: 2016 Citation: Hamm C, Northcutt A, Riggsbee KA, Crouter S, Zhou, W, Colby SE. College Students and Risk of Developing Type 2 Diabetes. Exhibition of Undergraduate Research and Creative Achievement, Knoxville, TN April 2016.
  • Type: Conference Papers and Presentations Status: Submitted Year Published: 2016 Citation: Riggsbee KA, Colby SE, Sowers MF, Mathews A, Olfert MD, Barr ML, Kattelmann K, Kidd T, Horacek T, Brown O, White A. Social Media and Dietary Patterns among College Students. SNEB Annual Meeting San Diego, CA July 2016.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2016 Citation: White J, Olfert MD, Brown O, Colby S, Horacek T, Kattelmann K, Kidd T, Shelnutt K, White A, Greene G. Campus Environment Perceptions Impact Fruit and Vegetable Intake and Vigorous Physical Activity in College Students. SNEB Annual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2016 Citation: Colby SE, Zhou W, Mathews A, Kattelmann K, Olfert MD, Brown O, Kidd T, White A, Horacek T. A Social Marketing and Environmental Change Intervention: Get Fruved Years 01-02. SNEB Annual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Submitted Year Published: 2016 Citation: Opoku-Acheampong A, Kidd T, Miller, C, Colby S. Exploring Healthy Behaviors and Chronic Diseases Risk Factors among College Students. SNEB Annual Meeting, San Diego, CA. July 30 - August 2, 2016.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2016 Citation: LiPuma C, Horacek T. College Students Meal Management and Fast Food Ordering Behaviors (SU data only). SNEB Annual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2016 Citation: Barr ML, Olfert MD, Mathews A, Riggsbee K, Leischner K, Kattelmann KK, Colby S. Intervention Planning and Baseline Characteristics of College Students Trained to Implement Wellness on Campus: GetFRUVED Study. SNEB Annual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2016 Citation: Famodu OA, Olfert MD, Holaskova I, Barr ML, Zhou W, Morrell J, Colby SE. Shortening Pittsburgh Sleep Quality Index Survey Using Factor Analysis. SNEB Annual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2016 Citation: Famodu OA, Cuff C, Cockburn A, Olfert IM, McFadden JW, Downes ME, Murray PJ, Holaskova I, Barr ML, Colby SE, Morrell J, Olfert MD. Nutrition Intervention to Profile Microbiome and Behaviors in Young Adults at Risk for Metabolic Syndrome: FRUVEDomic Pilot Study. SNEB Annual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Submitted Year Published: 2016 Citation: Sowers, MF, Colby SE, Yan W, Zhou W, Olfert MD, Barr ML, Mathew A, Vilaro M, Kattelmann KK, Leischner K, Kidd T, Brown O, Horacek T, White A, Williams J, A Comparison of Peer Mentors' and Mentees' Health Behaviors: Get Fruved Study. SNEB Anuual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Submitted Year Published: 2016 Citation: Barr ML, Olfert, MD, Mathew A, Riggsbee K, Kattlelmann KK, Leischner K, Colby SE. Training College Students to Create a Health Promotion Intervention for Freshman: Get Fruved Study. SNEB Annual Meeting, San Diego, CA. July 30, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Colby S, Zhou W, Yan W, Dahlman S,Olfert M, Barr M, Kattelmann K, Creager K, Mathews A,Vilaro A, Brown O, Kidd T, Horacek T, White A. Peer Mentoring to Prevent Obesity in First Year College Students: Get Fruved Study. Experimental Biology (EB), American Society of Nutrition (ASN), San Diego, CA. April 2-6, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Barr ML, Olfert MD, Zhou W, Riggsbee K, Mathews AEW, Vilaro M, Kattelmann KK, Leischner K, Crouter S, Morrell JS, Thompson D, White A, Horacek T, Kidd T, Brown O, Colby SE. Fruit and Vegetable Consumption and Physical Activity in Young Adults: Get Fruved Study. Experimental Biology (EB), American Society of Nutrition (ASN), San Diego, CA. April 2-6, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2015 Citation: Barr ML, White JA, Famodu OA, Olfert MD. 'Get Fruved: Overview, recruitment and training in West Virginia for a peer-led, social marketing campaign aimed at increasing healthier lifestyles on college campuses. Appalachian Translational Research Network (ATRN). Charleston, WV. October 14-16, 2015. (Travel award $200)
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Barr ML, Olfert MD, Zhou W, Riggsbee K, Mathews AEW, Vilaro M, Kattelmann KK, Hanson A, White A, Horacek T, Kidd T, Brown O, Colby SE. Recruitment Strategies Implemented Across a Four-State Lifestyle Intervention: Get Fruved Study. Experimental Biology (EB), American Society of Nutrition (ASN), San Diego, CA. April 2-6, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Olfert MD, Barr ML, Zhou W, Riggsbee K, Mathews AEW, Vilaro M, Kattelmann K, Hanson A, Spurgeon S, Morrell JS, Franzen-Castle L, Byrd-Bredbenner C, White A, Horacek T, Kidd T, Brown O, Colby SE. Sleep and Stress Level of College Students Developing a Health Promotion Intervention: Get Fruved Study. Experimental Biology (EB), American Society of Nutrition (ASN), San Diego, CA. April 2-6, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Famodu OA, Cuff CF, Cockburn A, Downes MT, Murray PJ, McFadden JW, Colby SE, Morrell JS, Olfert IM, Olfert MD. Impact of Free-Living Nutrition Intervention on Microbiome in College Students at Risk for Disease: Fruvedomic Pilot Study. Experimental Biology (EB), American Society of Nutrition (ASN), San Diego, CA. April 2-6, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Morris AA, Barr ML, Famodu OA, Olfert MD. Thematic Analysis of Feedback from Student Researchers conducting a Healthy Campus Environmental Audit. Undergraduate Research Day at the Capitol (URDC), Charleston, WV, Feb. 25, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Bowyer D, Barr ML, Olfert MD. Identifying Effectiveness of Twitter at West Virginia University when Targeting a Large Audience. Undergraduate Research Day at the Capitol (URDC), Charleston, WV, Feb. 25, 2016.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2015 Citation: Famodu OA, Olfert IM, Murray PJ, Downes MT, McFadden JW, Cuff CF, Cockburn A, Olfert MD. Nutrition Intervention to Profile Metabolic, Microbiome and Vascular Health in Young Adults at Risk for Disease: FRUVEDomic Pilot Study, IDeA Conference (NIH CTSI), Biloxi, MS, 2015. Nov. 11-13, 2015. (Oral Presentation award $500)
  • Type: Conference Papers and Presentations Status: Published Year Published: 2015 Citation: Barr ML, White JA, Famodu OA, Olfert MD. 'Get Fruved Healthy Campus Environmental Audit: Evaluating the Healthfulness of the Built and Food Environments on College Campuses. Appalachian Translational Research Network (ATRN). Charleston, WV. October 14-16, 2015. (Travel award $200)
  • Type: Conference Papers and Presentations Status: Published Year Published: 2015 Citation: Famodu OA, Olfert IM, Murray PJ, McFadden JW, Cuff CF, Chantler P, Holaskova I, Olfert MD. Designing a Nutrition Intervention to Impact Metabolic, Microbiome and Vascular Health in Young Adults at Risk for Disease: FRUVEDomic Pilot. Appalachian Translational Research Network (ATRN). Charleston, WV. October 14-16, 2015. (Travel award $200)


Progress 08/01/14 to 07/31/15

Outputs
Target Audience:The college environment makes college freshmen an especially optimal target of intervention. Research indicates that the more diffused an intervention is in all facets of an individual's life and environment, the more successful the intervention will be in changing behavior. By targeting college freshmen, the campaign will be especially effective in reaching multiple and comprehensive elements of the participants' social and physical environments. The freshmen on these campuses live in dorms, spend most of their time in the campus physical environment, and eat in University dining facilities. This allows the intervention to saturate all elements of the students' lives. In year 01 of this project, to develop the foundation needed for the train-the-trainer approach planned for implementation in year 02, a variety of college student majors and students in different years of study were reached. The inclusion criteria for the freshmen recruited for assessment in this study include: being a 18 or 19 year old incoming first-year student at increased health risk (as defined by this study as having low intakes of fruits and/or vegetables) and one of the following additional factors: first generation college student, lower income background, overweight or obese, minority status, or history of parental overweight or obesity. Changes/Problems:To assess the impact of the peer mentoring element within the Fruved intervention, an additional subsample of 200 participants will be recruited and assessed (via survey only) in year 02. To accomidate for this additional assessment cost, the sample size for the diffuse group has been reduced to 225. Using a sample size of 225 in our diffuse group has been determined through statistical power analysis to be adequate to address the outcome measures for this project. What opportunities for training and professional development has the project provided?Over 670 student, faculty, and Extension partners have been trained as a part of the Fruved project in year 01. Training opportunities included: All partners were trained on human and behavioral science research using the Collaborative Institutional Training Initiative (CITI Program). Student researchers and SMEI students were trained on both research and program development focused on health promotion. Topic areas included: barriers to and facilitators of individual healthy behavior, environmental influences on behavior, behavior change theory, principles of social marketing to promote healthy behavior change, and policy and advocacy issues. Student researchers were trained in survey development, dietary assessment methodology, anthropometric measurements (height, weight, circumferences, using accelerometers to assess physical activity, and blood pressure measurements. Interrater reliability, at a 0.80 level of agreement, was reached for all student researchers. Student researchers and SMEI students also participated in multiple leadership training opportunities including a national collegiate 4-H leadership conference and the 4-H essential elements training. Peer mentors were trained in 14 different elements of wellness and how to be effective peer mentors to promote health with college freshmen populations. Student researchers and SMEI students were trained to use objective measures to assess the healthfulness of the environment (dining, vending, stores, recreational resources, and policies). Student, faculty researcher, and Extension partners received training on a variety of technological platforms including ASA 24, zoom, wikispaces, pictochart, Vimeo, groupme, google drive, iStock, social media sites, qualtrics, and a variety of statistical packages. Students, faculty researchers and Extension professionals received training on using social media platforms to promote health messages. How have the results been disseminated to communities of interest?Dissemination occurred in year 01 by the presentation of four national presentations at the Society for Nutrition Education and Behavior 2015 and one international presentation. Twelve oral presentations have been made to university administration partners at state level meetings. What do you plan to do during the next reporting period to accomplish the goals? Peer mentors The 225 at-risk first-year students from the intervention schools will be matched with peer mentors in groups of 2-5 mentees per mentor. Peer mentors will meet with their mentees throughout the year and bring them to different intervention events. To isolate the impact that having a peer mentor has on health-related outcomes, another 50 or more at-risk first-year students (extended diffuse intervention group) from intervention schools will not be assigned a peer mentor and will also be assessed at the beginning of the school year for health and health behaviors. Implement intervention the SMEI students and student researchers will implement the developed 9-month social marketing campaign. The Fruved campaign will center around five costumed characters (Banana, Bean, Carrots, Grapes, and Tomato). Each character will represent a "team." Characters will interact with students on campus in freshmen residence halls, dining halls/cafeterias and highly trafficked public areas. Photos and videos of interactions will be taken and put on the Fruved website, Facebook, Twitter, Instagram, SnapChat, and YouTube. The Fruved website will link participants to previously developed and tested online education modules (Project YEAH, NRI grant, Kattelmann K, PI). Online educational modules (focused on healthy diet patterns, physical activity, and stress management) will also be available as a mobile app. Student participants from the general freshmen population will be asked to set weekly health goals related to diet, physical activity, and stress management throughout the campaign and will receive email and/or text messages with goal-specific written and video health promotion messages. Weekly activities will be focused on a range of health-related topics, all under the overarching areas of diet, physical activity, and stress management. Specific week's topics will including: MyPlate, yoga, cardiovascular exercises, music, time management, dance, meditation, fiber, flexibility, portions, strength, positivity, sleep, friendships, substance abuse, body image, trying something new, hydration, savor the flavor, and step counting. The faculty researchers and Extension professionals will partner with the collegiate 4-H student teams throughout the intervention process to educate and give advice on the content of health promotion messages. Based on outcomes from the Healthy Campus Audit from year 01, student partners will work with researchers and Extension professionals concurrently with the social marketing campaign implementation to develop strategies for environmental changes that support the goals and priorities of the student participants. Environmental changes that may occur during this intervention include: increased availability of low-cost nutrient dense foods, improved biking and walking paths, changes in types of foods available in vending machines and dining halls/cafeterias, nutrient information provided at point of purchase in dining halls/cafeterias, and increased signage promoting water fountain and stair usage. "Town hall meetings" will be held on intervention campuses throughout year 02 to connect students and university policy makers and facilitate discussions essential to effectively change environments. Assessments In fall of year 02, 1800 "at-risk" first year college students (diffuse intervention and control) will be assessed. Assessments with the same 1,800 students will be repeated in the spring of year 02. Intense intervention students (SMEI and Peer mentors) will also be reassessed in the spring of year 02. Extended diffuse intervention group (at-risk first year students not matched with peer mentors) from intervention schools will also be assessed at the beginning and end of year 02 using the same survey procedures as used with other assessments but without the in-person anthropometric measurements. College campus environments will be reassessed in the fall of year 02 following the same proceedures described in the campus environment assessments described in year 01. Recruitment in High Schools Researchers, Extension, and student partners will work with local high schools (including student organizations, school food service, Parent Teacher Associations, school wellness committees, teachers, and administration) and school boards to formalize research agreements and relationships. Two high schools in each of the four intervention university states will be randomized to control and intervention. High schools in each state will be matched by size and community composition and geographically separated to prevent potential exposure to the campaign. Following the train-the-trainer model, the college SMEI and student researchers will be mentoring teams of high school 4-H students (the high school intense intervention group) at each of the intervention sites in the development and implementation of the Fruved campaign in the high school environment. In spring of year 02, high school students will be recruited to be a part of the Fruved project at both the intervention and control high schools. All recruited high school students will have their health and health behavior assessed. Recruited high school students from the intervention sites will become members of 4-H if not already a part of the 4-H program and will be introduced to the Fruved project through visits to the college campus where they will have the opportunity to observe the intervention implementation at the college level. In the summer of year 02, researchers, Extension professionals, student researchers, and SMEI students will meet with the recruited high school students from the intervention high schools for a summit to learn more about the project, identify issues and priorities for the high school environment, and modify the Fruved implementation toolkit for the High School environment.

Impacts
What was accomplished under these goals? Partnership Building During the fall of year 01 researchers and Extension professionals at the intervention universities worked with student researchers to identify and develop partnerships with other students, faculty researchers, university staff, student organizations and campus programs. Students (n=565) were recruited from each of the four intervention universities to be in the intense intervention group. Students in the intense intervention group are in one of three roles within the project: student researchers, peer mentors, or SMEI students. Peer Mentoring Course The peer mentors took an online course (16 weeks) developed for this project that taught them how to be effective peer mentors. As a part of that course, those peer mentors' health and health behavior were assessed at the beginning and end of the semester. Social Marketing and Environment Intervention Course (SMEI) The SMEI students became collegiate 4-H partners and took a hybrid course on Social Marketing and Environmental Intervention course (16 weeks) in which they partnered with researchers, student researchers, and Extension professionals and identified student priorities, assessed campus environments, and developed a social marketing and environmental intervention campaign. SMEI students came together in person at a Fruved Summit in April of year 01 with student researchers, faculty researchers, and Extension professionals to discuss, share, and refine intervention plans (n=120). National committees of student partners were developed and worked together over the summer of year 01 to further develop and refine intervention details. Assessments The Intense Intervention Group will be assessed using the same assessment protocols that will be used in the remaining four years of this project. The primary outcome measure will be body weight. Secondary outcome measures include physical activity, dietary quality, fruit and vegetable intake, anthropometric measurements (waist, hip, waist-to-hip ratios, and neck circumference), body image, substance abuse, gardening, cooking, meal planning, food choice, food security, food safety, sustainable transportation, green eating, art, stress, and sleep assessment. Additional research questions will be investigated using survey assessments on the following topics: body composition and facial recognition, sexual orientation, breastfeeding, minority and diversity, health disparities, personality, gender issues, social media usage, and eating disorders. In addition, sales data of food on the school campus (from dining halls/cafeterias and vending machines) and recreational facility usage data will be assessed, and perceived and actual food, physical activity, and health promotion environments will be assessed. Some tools used to assess secondary outcomes are currently being developed and validated include: gardening, cooking, meal planning, food choice, food safety, sustainable transportation, and green eating. Recruited Incoming Freshmen To evaluate the impact of the intervention, all incoming first-year students (approximately 32,000 incoming students) at the four intervention and four control schools have been invited to participate in a screening process to see if they are eligible to be assessed. To be eligible, incoming first-year students will need to be at increased health risk as defined by this study as low intakes of fruits and/or vegetables and one of the following additional factors include: first generation college student, from a lower income background, overweight or obese, minority status, or history of parental overweight or obesity. As of 7/30/15, 1,178 students have taken the eligibility screener. Screening will be continued into year 02 of the grant. A goal of 225 at-risk, first-year students (diffuse intervention group) will be recruited at each of the four intervention and four control universities or a total of 1,800 total (900 intervention and 900 control participants).

Publications

  • Type: Conference Papers and Presentations Status: Published Year Published: 2015 Citation: Colby S, Olfert M, Mathews A, Kattelmann K, Kidd T, Brown O, White A, Horacek T, Greene G, Byrd-Bredbenner C, Shelnutt K. "Get Fruved:" A peer-led, train-the-trainer social marketing intervention to increase fruit and vegetable intake and prevent childhood obesity. SNEB, Pittsburgh, PA. July 25-28, 2015.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2015 Citation: Colby S, Vilaro M, Glover J, Barr M, Riggsbee K, Dahlman S. Get Fruved! Building an Innovative Intervention Using Students Creativity and Passion. SNEB, Pittsburgh, PA. July 25-28, 2015.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2015 Citation: Mullin M, Dede Y, Kelly E, Brown O, Byrd-Bredbenner C, Frazen-Castle L, Greene G, Kattelmann K, Koenings M, Kidd T, Morrell J, Olfert M, Riggsbee K, Shelnutt K, White A, Horacek T. A Simple Convenience Store SHELF (Supportive Healthy Environment for Life-promoting Food) Audit. SNEB, Pittsburgh, PA. July 25-28, 2015.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2015 Citation: Horacek T, Dede Yildirim E, Mullin M, Matthews M, Franzen Castle L, Koenings MM, Shelnutt K White A. Full Restaurant Evaluation Supporting a Healthy (FRESH) Dining Environment Audit. ISBNPA, Scotland. June 3-6, 2015.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2015 Citation: Mathews A and Shelnutt K. Get Fruved! National Collegiate 4-H conference  Gainesville, FL, March 13-14 2015.