SUMMER HARVEST ADVENTURE: A GARDEN-BASED OBESITY PREVENTION PROGRAM FOR CHILDREN RESIDING IN LOW-RESOURCE COMMUNITIES

• Sponsoring Institution: National Institute of Food and Agriculture
• Project Status: COMPLETE
• Funding Source: AFRI COMPETITIVE GRANT
• Reporting Frequency: Annual
• Accession No.: 1011966
• Grant No.: 2017-68001-26353
• Cumulative Award Amt.: $978,383.00
• Proposal No.: 2016-11075
• Project Start Date: Apr 1, 2017
• Project End Date: Mar 31, 2023
• Grant Year: 2017
• Program Code: [A2111]- Childhood Obesity Prevention: Extension Interventions to Prevent Childhood Obesity

Recipient Organization
OHIO STATE UNIVERSITY
PLANT BIOTECHNOLOGY CENTER
COLUMBUS,OH 43210

Performing Department
HRS - Health & Rehab Sciences

Non Technical Summary
Thisnovel proposal is in direct response to the AFRI Childhood Obesity Prevention Challenge Area aligning with the USDA Strategic Plan. The long-term goal of our enhanced Team Nutrition-based intervention, "Summer Harvest Adventure," is to promote obesity prevention strategies (improve diet, physical activity) and help fill the summer meal gap for children, ages 8-11 years, residing in low-resource communities. The healthcare cost of every obese child in the U.S. over a lifetime is $19,000 more than his/her normal-weight counterpart. These financial costs are in addition to the devastating emotional, physical, and medical consequences of obesity. While modest progress has been made, childhood obesity remains a significant health issue, especially in disparate populations and during the summer months, when millions of children lose access to school-based feeding programs and suffer gaps in meals that contribute to an obesogenic environment. To counter these trends, we will implement and test the efficacy of the "Great Harvest Adventure," modified from an existing USDA Team Nutrition curriculum for youth called the "Great Garden Detective Adventure."Ourobjective is to conduct a randomized controlled trial to test the efficacy of a comprehensive garden-based behavioral, social, and environmental intervention forvulnerablechildren (ages 8-11 years). Our summer-based intervention enhances the USDA classroom-based curriculum and includes: 1) remote and group coaching using a focused motivational interviewing approach; 2) weekly fruit, vegetable, and herb harvesting to increase summer food access; and 3) group education for children and their families in a social setting. Our integrated and innovative program fully embraces the three components of the agricultural knowledge system (extension, education, and research), all contributing to the achievement of the following Program Area Priorities: 1) develop an efficacious behavioral, social, and environmental intervention to increase dietary intakes of fruits and vegetables; 2) increase physical activity in children; and 3) increase the number of parents, caregivers, educators, practitioners, and researchers who receive training to address the complex problem of childhood obesity.

Animal Health Component

65%

Research Effort Categories

Basic

25%

Applied

65%

Developmental

10%

Classification

Knowledge Area (KA)	Subject of Investigation (SOI)	Field of Science (FOS)	Percent
703	6099	3020	100%

Knowledge Area
703 - Nutrition Education and Behavior;

Subject Of Investigation
6099 - People and communities, general/other;

Field Of Science
3020 - Education;

Keywords

childhood obesity prevention

family functioning

garden

motivational interviewing

Goals / Objectives
Thegoal of this innovative project is to conduct a randomized controlled trial to test the efficacy of a comprehensive garden-based behavioral, social, and environmental intervention for children (ages 8-11 years) residing in low-resource communities.Our summer-based intervention enhances the USDA classroom-based curriculum and includes: 1) remote and group coaching using a focused motivational interviewing approach; 2) weekly fruit, vegetable, and herb harvesting to increase summer food access; and 3) group education for children and their families in a social setting.We will conduct a 2-arm RCT designed to determine the efficacy of a multifaceted obesity prevention and lifestyle (diet and physical activity) intervention in low-resource children and parent/adult caregiver (PAC) called "Summer Harvest Adventure." A total of 240 children (ages 8-11 years) will be randomized to the garden-based intervention (SHA) or an enhanced control group (MSP). Assessments for both groups will be collected at orientation held one week prior to the intervention (week 0), and immediately following the completion of the intervention (week 10) by trained personnel that are blinded to participants' treatment arm assignment.Our fully integrated project embraces all 3 functions of the agricultural knowledge system including research, education, and extension. Specific project objectives aim:1. To examine the efficacy of SHA on change in fruit and vegetable intake from baseline (week 0) to the posttest (week 10) in low-resource children aged 8-11 years.· Hypothesis 1: SHA youths will have greater increases in skin carotenoids from baseline to posttest compared to MSP.2. To examine the efficacy of SHA on body composition, physical activity patterns, and obesity-related indices of health after the 10-week intervention.· Hypothesis 2: SHA youths will demonstrate greater improvements in body composition, physical activity, and indices of health post-intervention compared to MSP.3. To examine the efficacy of SHA on child-parent/adult caregiver interactions and the mechanisms of change by which these group differences arise.· Hypothesis 3: SHA youths will demonstrate greater improvements in child-PAC interactions as measured by Expressed Emotion, compared to MSP.· Hypothesis 4: Child-PAC interactions will mediate the improvement in fruit and vegetable intake in SHA compared to the MSP group after controlling for baseline scores.

Project Methods
Study Population and Enrollment. Youth will be assented and parents consented 1 week prior to the launch of the 10-week program. A web-based randomization and registration process will be designed for the verification of inclusion/exclusion criteria and then randomization of eligible participants. Summer Harvest Adventure (Comprehensive Intervention Group). SHA is a multi-component approach designed to facilitate positive behavior change and promote obesity prevention strategies for families (increase fruit and vegetable intake and physical activity). SHA participants will also receive: 1) weekly remote motivational interviewing coaching (described below); 2) fruit, vegetable, and herb harvesting (in 2-hour blocks); 3) group education classes based on GDA Team Nutrition and promoting MyPlate guidelines; and 4) healthy food preparation and taste-testing.Study orientation (week 0). At orientation and after blinded baseline data collection, families randomized to the SHA will receive a FitBit Charge wearable fitness tracker. Participants will be provided verbal and written instructions on how to wear the activity monitor and directions for accessing and synching to a secure web portal. For participants without ready access to Wi-Fi, we will capture weekly quantitative measures and synch data at the garden in a semiprivate area. In addition, SHA participants will receive a schedule of future classes and harvests and will meet their MIC.Group Education. Ten group sessions are scheduled for 60 minutes each and will be held at the classroom adjacent to the garden and will include both child and parent/adult caregiver (PAC) in the lessons. All classes will be led by Cooperative Extension educators trained in group motivational interviewing. Each class will end with healthy food preparation and taste-testings using available garden produce. Specific dietary and physical activity components of the intervention phase will be consistent with the MyPlate guidelines for children and include: 1) increasing fruits and vegetables; 2) improving whole grain intake; 3) increasing water intake and limiting sugar-sweetened and high-fat beverages; 4) selecting lean proteins; 5) limiting sweets; and 6) incorporating 60 minutes of physical activity per day. Trained dietetic interns and interdisciplinary service-learning students will be available during all harvests to provide additional assistance and support to families.Produce Harvesting. For this study, a bountiful harvest of fruits, vegetables, and herbs will be available for 10 weeks. SHA families will each be given a large cloth garden bag and encouraged to harvest a bountiful selection of crops. This produce, for home use, will help fill the summer meal gap for low-resource families and expose them to a wide variety of produce each week.Remote Motivational Interviewing Coaching (MIC). Motivational interviewing (MI) is a client-centered method for enhancing intrinsic motivation to promote positive health behavior by exploring and resolving ambivalence. Our MIC training is novel in that it will specifically target MI strategies for obesity prevention for low-resource families with children ages 8-11 years. In addition, our MI training will employ precise approaches to encourage child-PAC interactions. Our MICs will promote the following modifiable behaviors: 1) improving dietary and physical activity patterns; 2) increasing daily meals and snack structures; 3) reducing screen time; and 4) monitoring behaviors to improve adherence.My Summer Plate (Enhanced Control Group). We propose a conservative test of our intervention by comparing SHA to the enhanced control group, MSP. At orientation and after blinded baseline data collection, families randomized to the MSP group will receive a FitBit Flex wearable fitness tracker, instructions for use, and obtain an educational packet with MyPlate handouts. This packet will also be available online. The control participants will receive the same assessment frequency as intervention participants. We will capture quantitative measures and sync data at the two scheduled data collection visits. Data Collection Procedures. All data will be collected in a central Research Electronic Data Capture (REDCap) database housed at OSU. Initial data entry will be performed by members of the research team at each institution through remote access to this database. We will perform central training of all research staff on procedures for study enrollment and data collection. We will subsequently perform data quality checks and review these at each subsequent meeting (phone and in-person) of the field staff.Study Measures.USDA SNAP-Ed surveys will be completed by both child and PAC. The adult survey requests demographics, basic health behaviors, self-efficacy, and lifestyle goals. The youth behavior survey for children (grades 3-5) collects diet and physical activity information.Physical Activity Patterns will be assessed using FitBits,wearable devices thatmonitor steps/day and activity minutes. These devices will sync data wirelessly into our secure web portal. Trained research associateswill collect pre- and post- clinical measuresof height and weight. BMI will be calculated using weight (kg) divided by the square of height (m). BMI-for-age percentile growth charts will be used to measure the size and growth patterns of children in the study. Waist circumference (WC) will be measured with a precision of 0.1 cm per CDC guidelines for children. Skin carotenoids, a marker of produce intake, will be measured using Pharmanex NuSkin Biophotonic Scanner (model S3) using the standardized and validated protocol. Attendance at all harvests, group education, and scheduledhealth coachingencounters will be tracked electronically. Participants will receive an attendance card with a unique QR identifier. Analysis of Primary Hypothesis. The two groups will be compared on all variables at baseline to determine if statistically significant differences are present using two-sample t-tests or chi-square tests, depending on whether the variable is continuous or categorical. If statistically significant differences are found on baseline measures, they will be examined as covariates in statistical models of interest in an exploratory fashion. Importantly, only the pre-specified covariates of baseline outcome variable, minority status, baseline BMI-z, and cohort status will be included in the primary and secondary analyses. Analysis of our Secondary Hypotheses. The same approach and statistical models employed for our primary hypothesis will be used for our secondary hypotheses. The main difference between the precise models used will be (a) the specific outcome variable and (b) the time point, posttest or follow-up, employed to form the change score for the hypothesis of interest.Analysis of Hypotheses 3 & 4. For Hypothesis 3, the same approach and statistical models employed for our primary and secondary hypotheses will be used with the main differences being the outcome variable will be Expressed Emotion. For Hypothesis 4, we will employ a longitudinal mediation model. We will use Mplus 7.31 to statistically test the mediator of interest on the outcome of interest. This test will have important ramifications for future refinement and development of the SHA intervention by allowing us to focus upon the most salient mechanisms of change that ultimately lead to better outcomes within our target population.

Progress 04/01/17 to 03/31/23

Outputs
Target Audience:The goal of this project was to conduct a randomized controlled trial to test the efficacy of a comprehensive gardenbased behavioral, social, and environmental intervention for children (ages 8-11 years) residing in low-resourcecommunities. Prior to COVID-19, we successfully recruited, enrolled, and retained our target number of participants in years 1 & 2. These preliminary data and subset analyses are impressive but not yet completed due to COVID-related research and staffing interruptions. In Year 2, we secured additional (extramural) funding to extend our study to fully integrate caregivers into our intervention and to also collect (optional) biospecimens (stool, urine, and hair) for future analysis. We have biobanked most of the specimens and analyzed a subset (n=10 dyads). These results are impressive; thus, we are anxious to continue these analyses. More details of the subset analysis are listed below under "Dissemination of Results." Our year 3 intervention (originally scheduled for summer 2020) was not permitted given mandatory university shut down on all human subjects' research. During this time, we maintained our staffing in hopes of a delayed start and focused on refining our study manuals (curricula, coaching training, educational materials, handouts, data collection info, webpage, etc). We also submitted COVID-friendly IRB amendments to allow for remote consenting if needed. We deferred our last intervention year until 2021, but the impact of COVID (Delta variant) significantly impacted our recruitment given parents were reluctant to allow their children to participate in our intervention without being vaccinated. Despite these challenges, we were able to successfully recruit 47 youth/caregiver dyads (n=94) in 2021. We completed a COVID-friendly and modified intervention and collected additional biospecimens. With impressive preliminary data, we feel it is critical to complete the dissemination component of our project that was delayed due to COVID. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?The opportunities for training and professional development throughout this trial have been extensive. In addition to training students and interns in reserach, they were exposed to numerous educational opportunities, and networking. Our students have actively engaged in all facets of the trial - from the clinic to the community. Junior investigators have also been mentored throughout this trial and obtained preliminary data for future trials. All research team members have been exposed to the role of Extension and the impact of garden-based research. How have the results been disseminated to communities of interest?We continue to share ongoing 'lessons learned' with extension specialists, researchers, students, collaborators, and stakeholders. In addition, we have refined and updated our curricula, website, and remote training sessions, so they are ready for final dissemination. What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? Prior to COVID-19, we successfully recruited, enrolled, and retained our target number of participants in years 1 & 2. These preliminary data and subset analyses are impressive but not yet completed due to COVID-related research and staffing interruptions. In Year 2, we secured additional (extramural) funding to extend our study to fully integrate caregivers into our intervention and to also collect (optional) biospecimens (stool, urine, and hair) for future analysis. We have biobanked most of the specimens and analyzed a subset (n=10 dyads). These results are impressive; thus, we are anxious to continue these analyses. More details of the subset analysis are listed below under "Dissemination of Results." Our year 3 intervention (originally scheduled for summer 2020) was not permitted given mandatory university shut down on all human subjects' research. During this time, we maintained our staffing in hopes of a delayed start and focused on refining our study manuals (curricula, coaching training, educational materials, handouts, data collection info, webpage, etc). We also submitted COVID-friendly IRB amendments to allow for remote consenting if needed. We deferred our last intervention year until 2021, but the impact of COVID (Delta variant) significantly impacted our recruitment given parents were reluctant to allow their children to participate in our intervention without being vaccinated. Despite these challenges, we were able to successfully recruit 47 youth/caregiver dyads (n=94) in 2021. We completed a COVID-friendly and modified intervention and collected additional biospecimens. With impressive preliminary data, we feel it is critical to complete the dissemination component of our project that was delayed due to COVID. These activities are listed below in detail. In our 1-year extension, we completed our goals: • Professional Development: The eXtension Design-a-thon is no longer in operation. Nonetheless, we have embarked on successful dissemination of study results. Ourbest practices continue to beshared via webinars, online resource sharing portals, and national efforts to increase both local and national impact. • Ripple Effect Mapping (REM): We identified a graduate student that has completed the IRB for conducting REM as her thesis project. We plan to complete the REM in 2024. Wewill provide a complete programmatic impact evaluation that engages program and community stakeholders to map retrospectively and visually a "performance story" resulting from a program. • Website Development and Ongoing Maintenance: A website has been developed and continues to be maintained throughoutto capture, chronicle, and document study outputs and education. Our website has been updated and our final curriculum guides and garden resources are provided in online and print-ready pdf formats. This website is a valuable resource for practitioners and those delivering summer garden-based programming. • Expansion and Promotion of Land Grant Resources: We continue to expand and export best practices for summer garden-based interventions for childhood obesity prevention on a national scale. • USDA National Pre-Conference Workshop: Motivational interviewing (MI) is a paradigm shift for most educators and practitioners, especially those trained in a passive or prescriptive style of communication. Although some educators receive modest MI training, our MI training will focus exclusively on MI for families residing in low-resource communities and aimed at reinforcing obesity prevention strategies and improving child-parent/adult caregiver interactions in remote and group settings. We orginally proposed anational pre-conference SNEB workshop to train educators, students, and dietitians on our MI training program. The intent of this pre-conference would be to provide professional development training for Cooperative Extension educators, students, and dietitians in MIC training in group (1/2 day session) and remote settings (1/2 day session). Since the USDA Obesity Prevention Programs no longer are required to present at SNEB, we have published MI materials while determining the most impactful method of disseminating this information. • Dissemination of Results: Our team continues to disseminate key findings at national conferences and in peer-review publicationsin high-impact journals. As mentioned, we also continue to build our website for national distribution of the curricula. • Conduct subset analysis of all data. We have convened biostatisticians and biospecimen experts that continue to analyze the remainder of our data. Additonal publications are in process.

Publications

Progress 04/01/21 to 03/31/22

Outputs
Target Audience:Our year 3 intervention (originally scheduled for summer 2020) was not permitted given mandatory university shut down on all human subjects' research. During this time, we maintained our staffing in hopes of a delayed start and focused on refining our study manuals (curricula, coaching training, educational materials, handouts, data collection info, webpage, etc). We also submitted COVID-friendly IRB amendments to allow for remote consenting if needed. We deferred our last intervention year until 2021, but the impact of COVID (Delta variant) significantly impacted our recruitment given parents were reluctant to allow their children to participate in our intervention without being vaccinated. Despite these challenges, we were able to successfully recruit 47 youth/caregiver dyads (n=94) in 2021. We completed a COVID-friendly and modified intervention and collected additional biospecimens. With impressive preliminary data, we feel it is critical to complete the dissemination component of our project that was delayed due to COVID. These activities are listed below in detail. Changes/Problems:The COVID-19 pandemic was, by far, our most challenging obstacle given the University restrictions and impact on study enrollment. The no-cost extension should afford us the opportunity to complete our research goals. What opportunities for training and professional development has the project provided?Our professional training and development continued, remotely, during year 3 and 4 despite the COVID research restrictions. Extension personnel and dietetic & nutrition students and interns were involved in website updates, document revisions, curriculum development, clinic preparation, online recipe creation, and related prep work for the research restrictions to be lifted. In addition, our motivational interviewer trainer continued remote training, competency checks, and booster sessions as scheduled. A new course, titled Service-Learning Opportunities in Vulnerable Communities Course (HRS 2300, 3 credits) was successfully developed and launched in Year 1. Again, COVID forced this class to be discontinued until our students can return to community sites for their service-learning. How have the results been disseminated to communities of interest?We have shared ongoing 'lessons learned' with extension specialists and are in discussions about adapting the framework to a remote platform in rural communities. In addition, we have refined our curricula, website, and remote training sessions so they are ready for review and final dissemination. As detailed below, this grant has resulted in 2peer-reviewed publications, 4 national peer-reviewed published abstracts, 4 national posters, 6 presentations, and provided the data for 2 doctoral dissertations. In addition, we have 2 other manuscripts in preparation. Doctoral Students: Doctoral Student Ashlea Braun: Development, Implementation, and Evaluation of an Integrated Remote Motivational Interviewing Intervention from a Registered Dietitian for Behavior Modification. Health and Rehabilitation Sciences Dual Master of Science / Doctor of Philosophy Program, The Ohio State University, Columbus, Ohio. Graduated 2020, recruited by Oklahoma State (tenure track faculty). Doctoral Student Nicole Stigall-Weikle: Combining Non-invasive Diagnostics to Identify and Modify Cardiovascular Disease in Vulnerable Children. Health and Rehabilitation Sciences Dual Master of Science / Doctor of Philosophy Program, The Ohio State University, Columbus, Ohio. Doctoral Candidate. Anticipated graduation 2022. What do you plan to do during the next reporting period to accomplish the goals?A no-cost extension was granted in 2021, so we can complete ouroriginal Year 5 goals: Professional Development: Complete the eXtension Design-a-thon which will convene 8-10 national experts (selected by eXtension) to participate in concept mapping specific to the project. Results from previous eXtension design studios have resulted in widespread dissemination of best practices that were shared via webinars, online resource sharing portals, and national marketing efforts to increase both local and national impact. Ripple Effect Mapping (REM): We have identified a graduate student that is interested in conducting REM as her thesis project. REM will provide a complete programmatic impact evaluation that engages program and community stakeholders to map retrospectively and visually a "performance story" resulting from a program. Website Development and Ongoing Maintenance: A website has been developed and maintained throughout the project to capture, chronicle, and document the intervention. This website needs updated in the extension year with final curriculum guides and garden resources in online and print-ready pdf formats. We anticipate this website will be a valuable resource for practitioners and those delivering summer programs. Expansion and Promotion of Land Grant Resources: With USDA collaboration, we plan to expand and export best practices for summer garden-based interventions for childhood obesity prevention on a national scale. Capitalizing on state lands and land grant resources to combat childhood obesity, especially targeting disparate populations, would have great potential and significant reach. USDA National Pre-Conference Workshop: Motivational interviewing (MI) is a paradigm shift for most educators and practitioners, especially those trained in a passive or prescriptive style of communication. Although some educators receive modest MI training, our MI training will focus exclusively on MI for families residing in low-resource communities and aimed at reinforcing obesity prevention strategies and improving child-parent/adult caregiver interactions in remote and group settings. In an extension year, we are proposing a national pre-conference workshop to train educators, students, and dietitians on our MI training program. The intent of this pre-conference would be to provide professional development training for Cooperative Extension educators, students, and dietitians in MIC training in group (1/2 day session) and remote settings (1/2 day session). Dissemination of Results: Travel to 2 national conferences and publication fees to disseminate study results, continue to publish results in high-impact journals, and continue to build our website for national distribution of the curricula (once approved by USDA and eXtension). Conduct subset analysis of all data. This includes surveys, biometrics, and biospecimens. Our preliminary results are quite impressive and warrant further and more complex bioinformatics and analyses.

Impacts
What was accomplished under these goals? Prior to COVID-19, we successfully recruited, enrolled, and retained our target number of participants in years 1 & 2. These preliminary data and subset analyses are impressive but not yet completed due to COVID-related research and staffing interruptions. In Year 2, we secured additional (extramural) funding to extend our study to fully integrate caregivers into our intervention and to also collect (optional) biospecimens (stool, urine, and hair) for future analysis. We have biobanked most of the specimens and analyzed a subset (n=10 dyads). These results are impressive; thus, we are anxious to continue these analyses. More details of the subset analysis are listed below under "Dissemination of Results." Our year 3 intervention (originally scheduled for summer 2020) was not permitted given mandatory university shut down on all human subjects' research. During this time, we maintained our staffing in hopes of a delayed start and focused on refining our study manuals (curricula, coaching training, educational materials, handouts, data collection info, webpage, etc). We also submitted COVID-friendly IRB amendments to allow for remote consenting if needed. We deferred our last intervention year until 2021, but the impact of COVID (Delta variant) significantly impacted our recruitment given parents were reluctant to allow their children to participate in our intervention without being vaccinated. Despite these challenges, we were able to successfully recruit 47 youth/caregiver dyads (n=94) in 2021. We completed a COVID-friendly and modified intervention and collected additional biospecimens. With impressive preliminary data, we feel it is critical to complete the dissemination component of our project that was delayed due to COVID. These activities are listed below in detail. In fall, 2021, we submitted a no-cost extension request that was approved. We have revised our study timeline and aims to successfully compelete this project.

Publications

• Type: Other Status: Published Year Published: 2019 Citation: " Adams I, Braun A, Hill E, Al-Muhanna K, Stigall N, Lobb J, Rausch J, Portner, Evans K, Spees C. Garden-Based Intervention for Youth Improves Dietary and Physical Activity Patterns, Quality of Life, Family Relationships, and Indices of Health. J Nutr Ed Behav. 2019; 51:S20-21.
• Type: Other Status: Published Year Published: 2018 Citation: Spees CK, Lobb J, Portner J, Braun A, Adams I. Summer Harvest Adventure: A garden-based obesity prevention program for children residing in low-resource communities. J Nutr Ed Behav. 2018; 50:S121.
• Type: Other Status: Published Year Published: 2017 Citation: Laubert J, Braun A, Adams I, Bebo P, Ludy MJ, Spees CK. Growing Healthy Kids: Feasibility of a Garden-Based Nutrition Education Intervention for Low-Resource Families. J Nutr Ed Behav. 2017; 49:S67.
• Type: Other Status: Published Year Published: 2021 Citation: Loman B, Hill E, Bailey M, Zhu J, Khalsa AS, Kelleher K, Spees CK. A high-fiber diet intervention improves diet quality and is related to blood pressure and bacteriome composition in caregiver-child dyads. Curr Dev Nutr. Jun 2021;5(Suppl 2):1168. https://academic.oup.com/cdn/article/5/Supplement_2/1168/6293372. https://mediasite.osu.edu/Mediasite/Play/14b2d8bf4c0f4d21b9594a7a3efc5e441d.
• Type: Journal Articles Status: Published Year Published: 2021 Citation: Chen L, Sun X, Singh A, Bailey M, Kelleher K, Spees C, Zhu J. Accurate and reliable quantitation of short chain fatty acids from human feces by ultra high-performance liquid chromatography-high resolution mass spectrometry (UPLC-HRMS). Journal of Pharmaceutical and Biomedical Analysis, Volume 200, 5 June 2021, 114066. https://www.sciencedirect.com/science/article/abs/pii/S0731708521001771.
• Type: Conference Papers and Presentations Status: Published Year Published: 2020 Citation: " Stigall N, Evans K Spees CK. Using Sonography to Measure Abdominal Adiposity in the Pediatric Population: A Possible Screening Mechanism for Cardiovascular Disease Risk. Hybrid Oral Abstract Presentation and Didactic Talk at: The 2020 AIUM (Annual Integrative Ultrasound Meeting); New York, NY, United States. March 2020.
• Type: Conference Papers and Presentations Status: Published Year Published: 2021 Citation: Braun A, Xu M, Weaver L, Pratt K, Darragh A, Spees C. Use of motivational interviewing to target parent/adult caregiver behavior in pediatric obesity prevention. Poster presentation at: Winter Conference Live 2020, The Nutrition Society; Virtual Event. July 2021
• Type: Other Status: Published Year Published: 2018 Citation: Graves AB. Ohio State garden offers nutrition for body, spirit. Ohio Farm Bureau, Together with Farmers. https://ofbf.org/2018/09/26/hope-grows/. September 2018.
• Type: Websites Status: Other Year Published: 2020 Citation: https://go.osu.edu/sha

Progress 04/01/20 to 03/31/21

Outputs
Target Audience:The target audience for this study was 240 low resource children ages 8-11 years over the 3-year intervention. We have successfully recruited and enrolled our target for years 1 & 2. We were preparing to enroll for year 3 in March of 2020 when our university froze all clinical research due to COVID-19. Hence, we were unable to complete a summer intervention in 2020. If all things go well and the vaccine roll-out succeeds, we plan to run our year 3 intervention in 2021. Changes/Problems:By far, COVID-19 and its impact on clinical research has proven to be the largest challenge since study initation. We are very concerned about meeting our grant requirements within the original time frame. We are actively preparing for year 3 and hope we will be granted permisson to proceed with this cliical trialby our institution. Another challenge has been receiving our data analysisin a timely fashion given turnover of the stats team. What opportunities for training and professional development has the project provided?Our professional training continued during our 3rd year despite the forced COVID research deferral. Extension personnel and dietetic & nutrition students were involved in website updates, document revisions, curriculum development, clinic preparation, recipe creation, and related prep work for 2021. In addition, our motivational interviewer trainer continued remote training, compentency checks, and booster sessions as scheduled. How have the results been disseminated to communities of interest?Although the study was powered for 3 years, we have only completed 2 years given the COVID research shut downs. Once we finish our final intervention year, as planned, we will disseminate all results. We have, however, shared 'lessons learned' with extension specialists and are in discussions about adapting the framework to a remote platform in rural communities. In addition, we have refined our curricula, website, and remote training sessions so they are ready for review and dissemination. What do you plan to do during the next reporting period to accomplish the goals?Our goal for the next reporting period is to complete year 3 of our intervention, so we can fully evaluate the impact of the intervention on low-resource families. COVID and subsequent trial delays have significantly impacted our original study timeline. With the slow vaccine roll out and advent of new COVID variants, we are receiving mixed messages from our institution on future clinical trials. This has resulted in staffing issues and concerns about recruitment in 2021.

Impacts
What was accomplished under these goals? We have successfully recruited, enrolled, and retained our target number of participants in years 1 & 2. In Year 2, we secured additional (extramural) funding to extend our reach to the caregivers as well. We plan to continue evaluating the impact of the intervention on the caregivers in Year 3. Year 3 was impacted by COVID-19 and all clinical labs at our institution were closed. During this time, we focused on refining our manuals (curricula, coaching training, educational materials, handouts, data collection info, webpage, etc). Our preliminary data is very strong and supports our study hypotheses.

Publications

Progress 04/01/19 to 03/31/20

Outputs
Target Audience:240 low resource children (ages 8-11 years) Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?Professional development includes service-learning for students of many disciplines, remote motivational interviewing training for leaders and educators. How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals?Complete year 3 of the intervention, analyze data and publish results.

Impacts
What was accomplished under these goals? Year 1 & 2 of the 3-year intervention have been successfully completed. Preliminary data suggests the program is feasible, acceptible, and efficacious.

Publications

• Type: Other Status: Published Year Published: 2019 Citation: Adams I, Braun A, Hill E, Al-Muhanna K, Stigall N, Lobb J, Rausch J, Portner, Evans K, Spees C. NP23 Garden-Based Intervention for Youth Improves Dietary and Physical Activity Patterns, Quality of Life, Family Relationships, and Indices of Health. J Nutr Ed Behav. 2019:51;S20-21.
• Type: Conference Papers and Presentations Status: Published Year Published: 2018 Citation: Spees CK, Lobb J, Portner J, Braun A, Adams I. Summer Harvest Adventure: A garden-based obesity prevention program for children residing in low-resource communities. J Nutr Ed Behav. 2018:50;S121.

Progress 04/01/18 to 03/31/19

Outputs
Target Audience:240low resource children (ages 8-11 years) Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?Remote motivational interviewing sessions continue with boosters sessions and competency checks. Approximately 25-30 undergraduate and graduate students are involved in service learning during clinic visits and the intervention each year. In addition, several graduate and PhD studentsare assisting with data collection and analysis. How have the results been disseminated to communities of interest?We have not yet disseminated results to communities of interest given the study is powered for 3 years. What do you plan to do during the next reporting period to accomplish the goals?Year 2 of the 3-year intervention begins June 5, 2019. We will continue with our proposed plan.

Impacts
What was accomplished under these goals? Year 1 goals for recruitment and enrollment were met. The Y1 status was disseminated on a poster at the SNEB national meeting and abstract published in JNEB.Y1 results have been submitted to SNEB and a manuscript is in preperation. Y2 recruitment and enrollment goals have been met and the intervention begins June 5, 2019.

Publications

• Type: Journal Articles Status: Accepted Year Published: 2018 Citation: Spees CK, Lobb J, Portner J, Braun A, Adams I. Summer Harvest Adventure: A garden-based obesity prevention program for children residing in low-resource communities. J Nutr Ed Behav. 2018:50;S121
• Type: Journal Articles Status: Submitted Year Published: 2019 Citation: Adams I, Lobb J, Rausch J, Portner J, Braun A, Hill E, Al-Muhanna K, Spees CK. "Garden-Based Program for Youth Improves Dietary and Physical Activity Patterns, Quality Of Life, Family Relationships, and Indices of Health." J Nutr Ed Behav.

Progress 04/01/17 to 03/31/18

Outputs
Target Audience:A total of 240 children (ages 8-11 years) over a 3-year period. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?Key research personnel have completed CITI training and COI. 2 personnel are engaging in motivational interviewing training that contributes to their professional development. How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals?The 3-year intervention phase begins in April 2018. Enrollment and recruitment will begin in spring and intervention begins in June.

Impacts
What was accomplished under these goals? Timelines and deadlines have been met for year 1. Recruitment and enrollment beginning in year 2 as planned.

Publications