Source: UNIV OF HAWAII submitted to NRP
CHILDRENS HEALTHY LIVING NETWORK (CHLN) IN THE U.S. AFFILIATED PACIFIC REGION
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
COMPLETE
Funding Source
HATCH
Reporting Frequency
Annual
Accession No.
1011781
Grant No.
(N/A)
Cumulative Award Amt.
(N/A)
Proposal No.
(N/A)
Multistate No.
W-1194
Project Start Date
Dec 5, 2016
Project End Date
Sep 30, 2021
Grant Year
(N/A)
Program Code
[(N/A)]- (N/A)
Recipient Organization
UNIV OF HAWAII
3190 MAILE WAY
HONOLULU,HI 96822
Performing Department
Human Nutrition, Food & Animal Sciences
Non Technical Summary
The Children's Healthy Living Program for Remote Underserved Minority Populations in the Pacific Region (CHL) is a partnership among remote Pacific states and other jurisdictions of the US: Alaska, American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Federated States of Micronesia (FSM), Hawai'i, Republic of Palau, and the Republic of the Marshall Islands (RMI). All jurisdictions have US Land Grant Colleges. CHL is a partnership among land grant colleges and public health partners that share a purpose to build capacity to address health issues through research, training and outreach. Partnership among land grants, components of land grants, and public health and other partners that affect policies, systems and environments that affect health is explicitly called for in the recent USDA Healthy Food Systems, Healthy People (2016) call to action, and the USDA Cooperative Extension Framework for Health and Wellness (Braun et al. 2014). The goal of the CHL Program collaboration among Pacific Region states/jurisdictions was to build social/cultural, physical/built, and political/economic environments that will promote active play and intake of healthy food to prevent young child obesity in the Pacific Region. To do this, CHL engages the community, and focuses on capacity building and sustainable environmental change. This multistate project will support and extend the CHL network, training, intervention activities and research programs initiated through CHL. CHL evolved from past collaborations among its participants. The largest collaboration was from a USDA NIFA CAP grant (Grant number 2011-68001-30335), and most recent was the Child Health Assessment of the Pacific (CHAP) USDA NIFA ELI fellowship grant (Grant number 2016-67032-24989). The resulting CHL grant solidified a management structure, developed PSE-oriented multi-level intervention research, built capacity and course work in PSE-oriented work to prevent child obesity, gathered data that filled the gap of missing nutrition surveillance systems in the region, and continues to use those systems to develop understanding through peer reviewed research and publication and to inform programs and policies relevant to the underserved population of the Pacific, not served by NHANES. Since NHANES does not sample the Pacific region, nor present data on Native Hawaiian, Native Alaskan or Pacific Islander race/ethnic groups, measured data on obesity, dietary intake and physical activity are not available without CHL, and are critical to guide programs and policies. Further, since Pacific foods are not identified in these surveys, they will not be analyzed by national labs for nutritional properties, to guide nutrition guidance and programs in the region. CHL conducted a meta-analysis of available research and agency data of the child obesity problem in the Pacific and showed the overweight plus obesity level to be 21% at 2y to 39% at 8y (Novotny et al. 2015). Obesity prevalence went from 10% and age 2y to 23% at 8y. CHL gathered data on 51 communities in 11 jurisdictions on over 5,000 children, their households, and their communities. 27 of these communities in 5 jurisdictions were involved in a multilevel community randomized controlled trial (Wilkens et al 2014) and the other 25 communities collected the same data in a one-time prevalence survey. Data include acanthosis nigricans screening, weight, height and waist circumference assessment, 2 randomly selected days of 6,453 food and activity logs (food records and physical activity logs) from 2-8yo children throughout the region, community environment assessments (store, park, church, walkability and food and utility cost assessments), data which will be evaluated to help fill the void in data for policy and program planning, and which will provide a foundation from which ongoing monitoring systems will be developed and sustained. Further, CHL has developed a community based intervention program (Braun et al. 2014, Fialkowski et al. 2013, Wilken et al 2013) and is disseminating it and continuing to serve as a data hub and a facilitator of coalition building and training in the community (Fialkowski et al 2015). The CHL work was conducted through a community engaged process (Fialkowski et al 2013) that involved development of Local Advisory Committees (LAC's) in each jurisdiction, that included all sectors and provide groups identified that might influence child health. These LAC's meet at least annually and evolved into community and jurisdiction level coalitions that organized and sustained key efforts. CHL was recognized as a backbone organization that facilitates the work and provides a key evaluation and training role that we aim to sustain with this multistate project; this role suited to the land grant mission of facilitation of community work (extension), evaluation (research) and training (instruction). The CHL Network will extend the work of two other multistate projects (W2005 and W2003) that are related to child obesity by focusing on the Pacific Region and the policy, systems and environmental approaches to obesity prevention and support of child health and wellness.
Animal Health Component
50%
Research Effort Categories
Basic
25%
Applied
50%
Developmental
25%
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
7036099302050%
7246020101050%
Knowledge Area
703 - Nutrition Education and Behavior; 724 - Healthy Lifestyle;

Subject Of Investigation
6020 - The family and its members; 6099 - People and communities, general/other;

Field Of Science
3020 - Education; 1010 - Nutrition and metabolism;
Goals / Objectives
Adapt and disseminate CHL child obesity policy, systems and environmentally focused multi-level prevention training and social marketing materials for the Pacific region. Facilitate use of CHL data, findings related to child obesity and its multilevel (policy, system, and environmental) determinants. Build and sustain a child health and nutrition monitoring system in the Pacific.
Project Methods
The multistate project will use existing core CHL infrastructure (Coordinating Center, Data Center, Training Center) and guidelines (Data Use, Publication, Core Values) to share data, tools, training and intervention materials among Pacific jurisdictions. The CHL infrastructure includes data coordination, training in child obesity prevention, and leadership on obesity measurement and standardization (Li et al 2015, Fialkowski et al. 2015, Novotny et al. 2013).The CHLN will have available data from the CHL prevalence and intervention studies, tools used to collect those data (accelerometers, stadiometers, scales, measuring tapes, Pacific Tracker diet and activity software), training material developed (Pacific Food Guide, CHL Summer Institute), and CHL intervention materials (Role Model Training Guide, Master Gardening and Food Preservation Materials). Materials not covered by privacy rules (HIPAA and IRB) will be publically available, mostly through the CHL website (www.chl-pacific.org).These resources, data, and collaborations will form the basis of new grant proposals, training programs, extension and outreach activities and capacity building within each jurisdiction.

Progress 12/05/16 to 09/30/21

Outputs
Target Audience:The Children's Healthy Living Network targets children and their families as well as communities with a focus on Native Hawaiian and other Pacific indigenous populations. In addition CHLN targets students and professionals in the region wishing to receive training in nutrition and child health. Changes/Problems:COVID19 has impacted our students in CHLD (made it more difficult for them to succeed). It has also delayed research in complementary foods. Thankfully our familiarity with delivering online training has not prevented our ability to continue to provide training and education through the CHL Summer Institute or prevent the production of Open Educational Resources. What opportunities for training and professional development has the project provided? CHLD Program has 5 Native Hawaiian students working to complete a baccalaureate degree in dietetics that is enhanced with an evidenced-based child obesity prevention online curriculum, mentoring, a learning environment that incorporates Hawaiian values and service learning in the community. 101 students and professionalscompleted online courses related to child obesity prevention through the CHL Summer Institute. Led the instructor orientation for five instructors teaching for the CHL Summer Institute in 2021 How have the results been disseminated to communities of interest?The resources available through the training program (courses and textbook) are available online. What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? Co-PD for the CHL Food Systems Grant, USDA NIFA 2021-68012-35899, to identify and test drivers of resiliency in food supply chains for decreasing food waste and increasing food and nutrition security, healthful diets and health among children. Co-I for the CHL Center of Excellence (CHL Center), USDA NIFA 2018-69001-27551, to serve as a center for child obesity prevention in the Pacific through training, research, and extension/outreach. Co-I for Hawaii with the Partners in Excellence for Leadership in MCH Nutrition grant, US DHHS 5T79MC00013-28-00, to develop an MCH OER Co-I for Hawaii with the Western Region Public Health Training Center grant, US DHHS 6UB6HP31687-01-02 subcontract, to support development of child obesity prevention training through internships and online training modules. Director of the Children's Healthy Living Dietetics Scholars Program (CHLD), USDA Multicultural Scholars Program 2018-38413-28140 to support Native Hawaiian dietetic students Enrolled participants in a study to investigate complementary foods of infants on Oahu supported by an infrastructure award from Ola HAWAII (NIHMD #2U54MD007601-31) Leading the update of version 2e of the free open educational resource textbook titled: "Human Nutrition" to be released in 2022 Leading development of a Lifespan Nutrition OER Textbook Offered 6 online course for the CHL Summer Institute in 2021

Publications

  • Type: Journal Articles Status: Published Year Published: 2021 Citation: Yamanaka, A.B.*, Davis, J.D., Wilkens, L.R., Hurwitz, E.L., Fialkowski, M.K., Deenik, J., Leon Guerrero, R.T., and Novotny, R. 2021. Determination of Child Waist Circumference Cut-Points for Metabolic Risk based on Acanthosis nigricans, the Childrens Healthy Living Program. Prev Chronic Dis. 2021; 18;E64.
  • Type: Book Chapters Status: Awaiting Publication Year Published: 2021 Citation: Held, S., McCormick, A., Simonds, V., Braun, K.L., Burhansstipanov, L., Haozous, E., Rangel, V., Chung-Do, J.J., Ho-Lastimosa, I., Novotny, R., and Fialkowski Revilla, M.K. 2021. Using Community-based Participatory Research to Address Indigenous Health. In: Improving Indigenous Public Health through Community-Engaged Interventions: Stories of Success. In Press.


Progress 10/01/19 to 09/30/20

Outputs
Target Audience:The Children's Healthy Living Network targets children and their families as well as communities with a focus on Native Hawaiian and other Pacific indigenous populations. Changes/Problems:COVID19 has impacted funding available from the CHL Summer Institute which has been supporting this work. After the completion of this fiscal year it is unknown how financial support will be available support project activities. What opportunities for training and professional development has the project provided?CHLD Program has 5 Native Hawaiian students working to complete a baccalaureate degree in dietetics that is enhanced with an evidenced-based child obesity prevention online curriculum, mentoring, a learning environment that incorporates Hawaiian values and service learning in the community. About 150 students and professionals from the US Affiliated Pacific completed online courses related to child obesity prevention through the CHL Summer Institute. How have the results been disseminated to communities of interest?The resources available through the training program (courses and textbook) are available online. What do you plan to do during the next reporting period to accomplish the goals? Offering the CHL Summer Institute courses in 2021. Continuing to support the scholars in the CHL Dietetics Scholars Program. Work with the Western Region Public Health Training Center to develop training modules and internships. Develop the OER textbook for FSHN 370. Submit additional grant proposals related to infant nutrition.

Impacts
What was accomplished under these goals? Co-I for the CHL Center of Excellence (CHL Center), USDA NIFA 2018-69001-27551, to serve as a center for child obesity prevention in the Pacific through training, research, and extension/outreach. Co-I for Hawaii with the Western Region Public Health Training Center grant, US DHHS 6UB6HP31687-01-02 subcontract, to support development of child obesity prevention training through internships and online training modules. Director of the Children's Healthy Living Dietetics Scholars Program (CHLD), USDA Multicultural Scholars Program 2018-38413-28140 to support Native Hawaiian dietetic students. Infrastructure award from Ola HAWAII to investigate first foods of infants on Oahu. Served as Chair of W1194 Training subgroup. Led the update of version 2 of the free open educational resource textbook titled: "Human Nutrition" Leading development of a Lifespan Nutrition OER Textbook. Led the instructor orientation for instructors teaching for the CHL Summer Institute in 2020. Offered 7 online course for the CHL Summer Institute in 2020.

Publications

  • Type: Journal Articles Status: Published Year Published: 2020 Citation: Eicher-Miller, H., Zhu, F., and Fialkowski, M.K. 2020. Nutrition Among Vulnerable Populations. Nutrients. 2020; 12(10):3150.
  • Type: Journal Articles Status: Published Year Published: 2020 Citation: Campbell, S., Chen, J., Boushey, C.J., Eicher-Miller, H., Zhu, F., and Fialkowski, M.K. 2020. Food Security and Diet Quality in Native Hawaiian, Pacific Islander, and Filipino Infants 3 to 12 Months of Age. Nutrients. 12(7): 2120.
  • Type: Books Status: Published Year Published: 2020 Citation: Collaborative Open Education Resource Textbook by faculty and students from the Department of Human Nutrition, Food and Animal Sciences. Human Nutrition: 2020 Edition (Version 2). Available at: http://pressbooks.oer.hawaii.edu/humannutrition2/


Progress 10/01/18 to 09/30/19

Outputs
Target Audience:The Children's Healthy Living Network targets children and their families as well as communities with a focus on Native Hawaiian and other Pacific indigenous populations. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?CHLD Program has 5 Native Hawaiian students working to complete a baccalaureate degree in dietetics that is enhanced with an evidenced-based child obesity prevention online curriculum, mentoring, a learning environment that incorporates Hawaiian values and service learning in the community. Over 130 students and professionals from the US Affiliated Pacific completed online courses related to child obesity prevention through the CHL Summer Institute. How have the results been disseminated to communities of interest? The resources available through the training program (courses and textbook) are available online. Presentations have been given at local and national conferences. What do you plan to do during the next reporting period to accomplish the goals?• Offering the CHL Summer Institute courses in 2020 • Continuing to support the scholars in the CHL Dietetics Scholars Program • Working with the Western Region Public Health Training Center to develop training modules and internships •Archiving the videos, audios and transcripts of the kupuna interviews on scholarspace • Begin work on an OER textbook for FSHN 370

Impacts
What was accomplished under these goals? Co-I for the CHL Center of Excellence (CHL Center), USDA NIFA 2018-69001-27551, to serve as a center for child obesity prevention in the Pacific through training, research, and extension/outreach. Co-I for Hawaii with the Western Region Public Health Training Center grant, US DHHS 6UB6HP31687-01-02 subcontract, to support development of child obesity prevention training through internships and online training modules. Director of the Children's Healthy Living Dietetics Scholars Program (CHLD), USDA Multicultural Scholars Program 2018-38413-28140 to support Native Hawaiian dietetic students Infrastructure award from Ola HAWAII to investigate first foods of infants on Oahu Served final term as Chair of W1194 convening monthly meetings and a third annual meeting in May 2019 to maintain connections between group members and momentum in project activities. Served as Chair of W1194 Training subgroup Led the development of new marketing site for the CHL Summer Institute Leading the update of version 2 of the free open educational resource textbook titled: "Human Nutrition" Led the instructor orientation for instructors teaching for the CHL Summer Institute in 201 Offered five online course for the CHL Summer Institute in 2019 Finalized Video/audio recordings of 13 interviews with kupuna on traditional feeding practices

Publications

  • Type: Journal Articles Status: Published Year Published: 2019 Citation: Fialkowski, M.K., Calabrese, A.*, Tilinghast, B., Titchenal, A., Meinke, W., Banna, J.C., and Draper, J. 2019. Open Educational Resource Textbook Impact on Students in an Introductory Nutrition Course. J Nutr Educ Behav. 2019. doi: 10.1016/j.jneb.2019.08.006.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2019 Citation: Fialkowski, M.K., Fonseca, T.*, Ng-Osorio, J., and Pinto, P.* 2019. Stories of Native Hawaiian Infant Feeding Practices as Told by Kapuna. Fourth Annual Conference on Native American Nutrition, Prior Lake, MN, September 15  18, 2019.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2019 Citation: Esquivel, M., Fialkowski, M.K., Wilkens, L., Boushey, C., LeonGuerrero, R., Coleman, P., Shallcross, L., Fleming, T., Novotny, R. 2019. Childrens Healthy Living Program efforts in the North Pacific to enhance Food Composition and Dietary Data.OCEANIAFOODS Conference, Auckland, NZ, September 3  4, 2019.


Progress 10/01/17 to 09/30/18

Outputs
Target Audience:The Children's Healthy Living Network targets children and their families as well as communities with a focus on Native Hawaiian and other Pacific indigenous populations. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?The Child Health Assessment in the Pacific (CHAP) Undergraduate Summer Fellowship Program provided summer training for undergraduate students working towards degrees in nutrition, nursing, early childhood education, public health and other related degrees. Ten fellows from the University of Guam, Northern Marinas College, the University of Hawaii at Manoa, and Chaminade University completed the program in Summer 2018. The program builds regional capacity in early childhood nutrition and health assessment training, develops and sustains a Pacific network of individuals working to monitor and prevent early childhood obesity, and develop and evaluate a program that will sustain training in early childhood nutrition and health assessment. CHLD Program development is underway to build regional capacity in childhood obesity prevention by increasing the number of Native Hawaiian students to complete a baccalaureate degree in dietetics that is enhanced with an evidenced-based child obesity prevention online curriculum, mentoring, a learning environment that incorporates Hawaiian values and service learning in the community. 126 students and professionals from the US Affiliated Pacific completed online courses related to child obesity prevention through the CHL Summer Institute. How have the results been disseminated to communities of interest?The resources available through the training program (courses and textbook) are available online. Presentations have been given at local and national conferences What do you plan to do during the next reporting period to accomplish the goals?We will be: offering the CHL Summer Institute courses recruiting students for the CHL Dietetics Scholars Program work with the Western Region Public Health Training Center to develop training modules and internships finalizing the remaining videos of the kupuna interviews analyzing the interviews to find themes related to infant feeding practices

Impacts
What was accomplished under these goals? Accomplishments included: Funding of the CHL Center of Excellence (CHL Center), USDA NIFA 2018-69001-27551, to serve as a center for child obesity prevention in the Pacific through training, research, and extension/outreach. Funding from the Western Region Public Health Training Center grant, US DHHS 6UB6HP31687-01-02 subcontract, will support development of child obesity prevention training through internships and online training modules. Funding of the Children's Healthy Living Dietetics Scholars Program (CHLD), USDA Multicultural Scholars Program 2018-38413-28140 to support Native Hawaiian dietetic students Funding from the Ola HAWAII Team-Science Pilot Projects Program (NIH/NIMHD 2U54MD007601-31) to investigate first foods of infants on Oahu Funding from HMSA (CF-021803) to investigate first foods of infants on Oahu Funding from the 4-H National Council Healthy Living Mini Grant Program to promote Healthy Living through Ai Pono in Hawaiian Communities Served as Chair of W1194 convening monthly meetings and a second annual meeting in May 2018 to maintain connections between group members and momentum in project activities. Served as Chair of W1194 Training subgroup Led the development of one additional online course for the CHL Summer Institute and the first edition of the free open educational resource textbook titled: "Human Nutrition" Led the instructor orientation for instructors teaching for the CHL Summer Institute in 2018 Offered three online course for the CHL Summer Institute in 2018 Directed another successful summer training for the Child Health Assessment in the Pacific (CHAP) program training 10 undergraduate students from Saipan, Guam, and Hawaii in child diet and anthropometry assessment Video/audio recorded 13 interviews with kupuna on traditional feeding practices, 6 of those videos have been drafted and sent to the kupuna for verification before finalization Hawaii Co-I for the Western Region Public Health Training Center grant

Publications

  • Type: Book Chapters Status: Published Year Published: 2018 Citation: Novotny, R., Li, R., Wilkens, L., Fialkowski, M., Fleming, T., Coleman, P., Leon Guerrero, R., Bersamin, A., and Deenik, J. 2018. Chapter 3. Economic Influences on Child Growth Status, from the Childrens Healthy Living Program in the US-Affiliated Pacific Region. In: WEALTHY BUT UNHEALTHY: Overweight and Obesity in Asia and the Pacific:Trends, Costs, and Policies for Better Health. Edited by Matthias Helble and Azusa Sato. 2018 Asian Development Bank Institute.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2018 Citation: Novotny, R., Wilkens, L., Nigg, C., Braun, K.L., Butel, J., Areta, A., Fleming, T., Coleman, P., Belyeu-Camacho, T., Greenberg, J., Bersamin, A., LeonGuerrero, R., Barber, L., Fialkowski, M.K., and Davis, J. 2018. Childrens Healthy Living Multilevel Community Randomized Trial Decreased Young Child Overweight, Obesity and Acanthosis Nigricans in the US affiliated Pacific. Oral Presentation (OR21-14) at the meeting of the American Society for Nutrition, Boston, MA.
  • Type: Journal Articles Status: Published Year Published: 2017 Citation: Yonemori, K.M., Ennis, T., Novotny, R., Fialkowski, M.K., Ettienne, R., Wilkens, L.R., Guerrero, R.T.L., Bersamin, A., Coleman, P., Li, F., and Boushey, C. Collecting wrappers, labels, and packages to enhance accuracy of food records among children 2-8 years in the Pacific region: Childrens Healthy Living Program. Journal of Food Composition and Analysis. Volume 64, Part 1, December 2017, Pages 112-118.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2018 Citation: Fialkowski Revilla, M.K., Ng-Osorio, J., Fonseca, T., and Pinto, P. 2018. Hawaiian Breastfeeding. Oral Presentation at the 2018 Global Neonatal Nurses Institute, Honolulu, HI.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2018 Citation: Ng-Osorio, J., Fialkowski Revilla, M.K., Fonseca, T., and Pinto, P. 2018. Na Moolelo o Ko Kakou Kupuna: Native Hawaiian Oral Histories Infants First Foods. Oral Presentation at the 2018 Pikookoo Conference, Honolulu, HI.
  • Type: Journal Articles Status: Under Review Year Published: 2018 Citation: Fialkowski, M.K., Calabrese, A., Dirige, B., Banna, J.C., Yiu, E., Gibson, W.J., Stewart, M., Lin, G., and Novotny, R. 2018. Student Perception of a Placed-Based Online Introductory Nutrition. Journal of Nutrition Education and Behavior. Course for the Pacific.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2018 Citation: Fialkowski, M.K. 2018. Nutrition and Dietetics: Re-envisioning and regenerating the Pathway. P-20 Agricultural Education Panel Presentation at the SAEA 2018 Conference.


Progress 12/05/16 to 09/30/17

Outputs
Target Audience:Overall: Native Hawaiians and Pacific Islanders, children, remote communities, underserved communities • Objective 1. Students, Health Professionals, Head Start, EFNEP, Extension Educators, Health Departments, Public Health Departments, NCD Coalitions, other governmental agencies in the Pacific region (Hawai'i, Guam, CNMI) • Objective 2. Researchers, Students, Policy Makers, Government Agencies, General Public • Objective 3. Head Start, Early Head Start, Department of Education [DOE] Pre-Kindergarten, other early child education centers, Researchers, Students, Health professionals Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?In summer 2017, 5 online courses were offered to 126 students as a part of the CHL Summer Institute. Students were from the contiguous US, Hawaii, Guam, and Saipan. Course topics were introductory nutrition, lifespan nutrition, culture and child health, and assessment field techniques for children. How have the results been disseminated to communities of interest?Dissemination has occurred through the CHL website and the CHL Summer Institute website. The CHL Summer Institute operated a booth at a local conference (Malama Honua) to disseminate learning opportunities available through the CHL Summer Institute. What do you plan to do during the next reporting period to accomplish the goals?1. Articulate the courses available through the CHL Summer Institute at CHLN Multistate partner institutions (e.g., UOG, and NMC) 2. Develop a field experience course for the CHL Summer Institute 3. Get approval for one new CHL Summer Institute course (applied skills in nutrition) 4. Complete the OER textbook pilot study at UHM 5. Finish pre-testing the kupuna interview guide and get IRB approval to recruit and interview kupuna across the state on traditional Native Hawaiian first feeding practices

Impacts
What was accomplished under these goals? The Children's Healthy Living Network (CHLN) multi-state is building and sustaining activities developed in the CHL program. Each of the CHLN subgroups (Monitoring, Training, Research, and Extension and Policy) have a published CHL paper, for reference. Publications and presentations from the CHL program can be found on the CHL web site at www.chl-pacific.org. 1. Continued anthropometric standardization in US Affiliated Pacific Region Multi-state members influencing and promoting PIHOA resolution to continue train and standardize anthropometric measures to improve the quality of data and reporting. Increasing usefulness of the information for decision making related to non-communicable and communicable diseases critical to the region. Northern Marianas College (NMC) is continuing standardization and training in American Samoa, Pohnpei and CNMI Headstart/ECE. Building the system for regional standardization for anthropometric measures for all age groups. Expanding appropriate measures for the various age groups. Draft training and standardization manual for all age groups. Expanding the network of people trained to health leaders in the US Affiliated Region to increase quality of measures. Partnership with PIHOA and Health Depts 2. CHL Center grant submission (USDA-NIFA-AFRI-006346) CHL's goal is to serve as a Center of Excellence to continue to build capacity in a partnership among 11 jurisdictions of the US Affiliated Pacific - to provide training, research and extension/outreach to maintain and extend the CHL network, examine long-term effects of the multilevel CHL intervention and provide access to best practices in policy, systems and environmental approaches for prevention of child obesity. CHL addresses the USDA NIFA priority areas of 1) food safety, nutrition and health 2) agricultural systems and technology and 3) agricultural economics and rural communities. CHL supports long-range improvement in and sustainability of agriculture and food systems in remote underserved (EPSCOR) US jurisdictions of the Pacific Region that are not represented in National Nutrition and Health Monitoring (NHANES). 3. Childrens' Healthy Living Dietetic Scholars (CHLD) grant submission (USDA-NIFA-HEMS-006391) CHLD will address the USDA MSP area of emphasis to increase diversity in the Food and Agricultural workforce by increasing the number of underrepresented Native Hawaiians (NH) receiving baccalaureate degrees in dietetics at the University of Hawai'i at Manoa (UHM). CHLD will facilitate 5 underrepresented NH scholars to complete the baccalaureate degree in dietetics and sit for the Dietetic Registration Examination in 5 years. CHLD's integrated approach will lead to 5 NH dietetic professionals with exceptional place-based child obesity prevention skills that will contribute to a regional effort to promote health and well-being. 4. Open Educational Research grant submission (Spencer Foundation) This project will examine the impact of an open educational resource (OER) introductory nutrition textbook on student learning in an introductory nutrition course offered across the University of Hawai'i (UH) System. Results will inform the integration strategy of the OER textbook currently in development at UHM for all UH System introductory nutrition courses. 5. Receive Hatch/POW Supplemental funding to start October 2017 An integrated research, extension, and instruction project that will be identifying Kanaka Maoli first food feeding practices through in-depth interviews with kupuna from the four counties across the state of Hawai'i. With permission, interviews will be video and audio recorded for archival purposes and turned into instructional videos on first food feeding practices.

Publications