Progress 04/01/23 to 03/31/24
Outputs
Target Audience:During the reporting period of April 1, 2023, to March 31, 2024, our efforts focused on retaining research participants for Aim 1, recruiting and implementing the Delivering Health Toolkit in food pantries for Aim 2, and expanding student access and participation in the education module for Aim 3. The project's final enrollment was in February 2023 and the intervention and data collection concluded in June 2023. During the reporting period, participants actively received the intervention food boxes and education materials. . All follow up data collection was completed in June 2023. The team enrolled 101 participants. Ninety-seven participants (96%) received the full intervention of 12 weeks of home-delivered T2D-appropriate food boxes that included type 2 diabetes education materials both printed and via text messaged video links. Of the 101 participants enrolled, 69 post-intervention data collections were completed marking an overall retention rate of 68.3% for the study. For Aim 2, the target audience was pantries and faith leaders in the Northwest Arkansas region. The team shared the Delivering Health Toolkit and training opportunity with the Arkansas Department of Health Office of Faith-Based Outreach partner network and the UAMS Translational Research Institute Faith Network. During these meetings, the Delivering Health Toolkit and resources were distributed. During this reporting period, the team also worked with the Northwest Arkansas Food Bank and provided Delivering Health training to 15 charitable food system partner organizations. The team also provided another Delivering Health training with information about how to screen for diabetes, provide client education, and build tailored food boxes. Physical and digital materials were shared with the participating pantry and the NWA Food Bank, including presentation slides, the Diabetes Pantry Toolkit, and information on accessing Delivering Health and diabetes self-management resources online. The target audiences for Aim 3 are medical, pharmacy, nursing, and other health professional students at the University of Arkansas for Medical Sciences. During the April 1, 2023, through March 31, 2024, reporting period, 118 medicine, pharmacy, physical therapy, public health, and nursing students completed the IPE Competence Workshop: Food Insecurity. The learning module included content on screening patients for food insecurity and how to assess and manage patients experiencing food insecurity and the cycle of food insecurity and chronic disease, with emphasizing the impact of food insecurity on people with diabetes. Changes/Problems:No changes or problems occurred during the reporting period. What opportunities for training and professional development has the project provided?The team meets weekly on the project to review program activities, data, and continuous quality improvement opportunities. The team provided quarterly updates to the stakeholder advisory group. These updates are emailed to the community representatives, who have experience working with food-insecure communities. How have the results been disseminated to communities of interest?Krista Langston, the project PI, and Bonnie Faitak, the project director, presented a status update and poster presentation on the project during the Society for Nutrition Education and Behavior conference in July 2023. What do you plan to do during the next reporting period to accomplish the goals?1. Implement and evaluate an intervention using home delivery of T2D-appropriate food boxes that include plain language adapted education materials aimed at improving the diet quality, physical activity, and health outcomes of low-income food-insecure people with T2D. Evaluate and analyze data from enrollment, intervention, and post-intervention data collection. Disseminate results to the public, participating food pantries, and participants. 2. Implement, disseminate, and evaluate extension materials--including a toolkit and curriculum--to engage food pantries in supporting the health of their clients with T2D. Focus on developing a 12-part newsletter to distribute to food banks, food pantries, and the University of Arkansas System Division of Agriculture Cooperative Extension agents that can be a lasting resource for organizations serving food-insecure individuals with T2D. 3. Implement and evaluate an education module to improve graduate medical, nursing, and pharmacy students' readiness to support the health of food-insecure individuals at risk for T2D and other diet-sensitive chronic diseases. Continue to offer IPE modules to medicine, pharmacy, physical therapy, public health, and nursing students.
Impacts
What was accomplished under these goals?
1. Implement and evaluate an intervention using home-delivery of T2D-appropriate food boxes that include plain language adapted education materials to improve diet quality, physical activity, and health outcomes of low-income food-insecure people with T2D. The intervention was completed on 06/15/2023, when the team finished the final post-intervention data collection. The team successfully enrolled 101 participants. Twelve weeks of food boxes, which included education materials, were delivered to 97 participants in Northwest Arkansas. Four participants were unenrolled due to moving out of the geographical area or inability to complete the program. Of the 101 participants enrolled, 69 post-intervention data collections were completed. 2. Implement, disseminate, and evaluate extension materials--including a toolkit and curriculum--to engage food pantries in supporting the health of their clients with T2D. The team successfully presented 16 food pantries with the Delivering Health Toolkit and provided resources, training, and technical assistance to the food bank and food pantry representatives. The team successfully presented the Delivering Health project to two faith-based organizations: the Arkansas Department of Health Office of Faith-Based Outreach partner network and the UAMS Translational Research Institute Faith Network. The team began developing a 12-part newsletter to distribute to food banks, food pantries, and the University of Arkansas System Division of Agriculture Cooperative Extension agents. 3. Implement and evaluate an education module to improve graduate medical, nursing, and pharmacy students' readiness to support the health of food-insecure individuals at risk for T2D and other diet-sensitive chronic diseases. The IPE Competence Workshop: Food Insecurity was presented to 118 medicine, pharmacy, physical therapy, public health, and nursing students.
Publications
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Progress 04/01/22 to 03/31/23
Outputs
Target Audience:During the reporting period of April 1, 2022 through March 31, 2023, our efforts focused on the recruitment and retention of research participants for Aim 1, recruitment and implementation of the Delivering Health Toolkit in food pantries for Aim 2, and expanding student access and participation in the education module for Aim 3. For Aim 1, the team recruited 55 research participants from 3 of food pantries. The team offered free health screenings to clients utilizing the food pantry. They provided screenings to 199 clients. From the 199 health screening patients, 66 clients with HbA1c of greater than or equal to 7 were invited to participate in the research study and 57 consented to enroll. Two participants were deemed ineligible, one because of medical reasons and another because of relocation out of the research area. Eleven participants chose Spanish as their preferred language for intervention materials, 15 chose Marshallese, and the remaining 29 chose English. Eighteen participants in the study are male and thirty-seven are female. Cohorts three and four included a total of 36 participants, and 35 of them received a full dose of the 12-week food delivery and diabetes self management education materials. One participant relocated and did not notify study staff until deliveries were almost complete. Cohort 5 delivery began after the present reporting period and will be reported upon next year. The target audiences for Aim 2 were food pantries in North Central, food pantries in Northeast Arkansas, and University of Arkansas System Division of Agriculture Cooperative Extension agents. The team reached out to the Food Bank of North Central Arkansas and the Food Bank of Northeast Arkansas to present the toolkit in early summer 2022 and set up training opportunities with their member food pantries. In August, the Food Bank of North Central Arkansas invited one of the team members to present the Delivering Health toolkit training virtually. During that training there were 26 agencies represented. In September, the Food Bank of Northeast Arkansas invited the team to present the Delivering Health toolkit in person over two days to 48 agencies across their member network. Of pantries that responded to the training evaluation survey, feedback was overall positive. About 88% agreed or strongly agreed that the training prepared them to make changes to improve client health, 85% agreed or strongly agreed that the training helped them feel confident in their ability to help their clients improve their health, and 88% would recommend the training to others. Surveys were administered to training participants both pre-training and at three months post-training. Twenty-one organizations completed both surveys and were matched for analysis. Across all training activities, most pantries reported implementing few training-related operational changes in the three months between the pre- and post-surveys. However, about half of the pantries reported increased implementation of diabetes related components, including changes to better support clients with diabetes and to increase staff knowledge to serve clients with diabetes. This finding is consistent with responses left in open text items and suggests that the training was effective in assisting pantries to better support clients with diabetes. In open response items to the training evaluation survey, most respondents shared that they found the training informative and helpful. Some pantries reported they wanted to implement more training components, but there were real world constraints that the training did not fully consider. Pantries reported they are limited in space, money, volunteers, and available foods. Some pantries reported they felt they were doing well serving their clients considering these restraints. Several also stated they wanted to implement more of what they learned in the training, but could not at this time. A few pantries indicated they wanted more information on how to procure healthy foods. The team also trained 51 University of Arkansas System Division of Agriculture Cooperative Extension agents at their annual conference about the Delivering Health Diabetes-Friendly Pantry toolkit. Sixteen of the agents completed a survey about the training and all agreed or strongly agreed that they learned something they could apply to their work. Thirteen of the agents reported that they believed pantry staff would be receptive to the materials and training. The target audiences for Aim 3 are medical, pharmacy, nursing, and other health professional students at the University of Arkansas for Medical Sciences. During the April 1, 2022 through March 31, 2023 reporting period, 24 medical, pharmacy, and nursing students completed the "A Place at the Table" exposure bridge training module, which focuses on increasing future healthcare providers' knowledge of diet-related risks for food insecure individuals. Changes/Problems: One change in approach for the program was how pantries were recruited and trained for Aim 2. The UAMS team was able to identify more partner pantries after meeting with regional food banks and offered training during annual agency meetings. Food banks looked forward to the nutrition training as a supplement to their required annual safety trainings. This approach of group training allowed UAMS to train more pantries in regions across the state. Having support from the food banks was helpful because they can also encourage pantries to make healthy changes in their operations. Weather was a challenge during cohort 5 enrollment. The team had to reschedule 3 recruitment and enrollment events due to winter weather which caused the partner pantry and university to close. Despite this challenge, the team was able to enroll 22 participants in cohort 5, for a total of 101 total study participants. What opportunities for training and professional development has the project provided?The team provided quarterly updates to the stakeholder advisory group meetings comprised of community stakeholders who work with the food insecure population in Northwest Arkansas via email and two virtual meetings. The group provides regular feedback on the progress and plans for future program implementation. One co-investigator meeting was held to receive input and guidance on the research design, future plans, and findings to date. Two University of Arkansas nursing students supported data collection for health screenings as part of recruitment of the second cohort of Aim 1 study participants. A UAMS medical student and nursing professor participated in data collection for health screenings as a part of recruitment of cohorts 3-5 of the Aim 1 study. How have the results been disseminated to communities of interest?Long CR. Overview of the White House Conference on Hunger, Nutrition, and Health and Food as Medicine. No Kid Hungry Campaign Arkansas Stakeholder Meeting (Virtual); November 2022. Long CR. Debrief panel on the White House Conference on Hunger, Nutrition, & Health. University of Arkansas School of Law LL.M. Program in Agricultural and Food Law & the Food Law Student Network (Virtual); October 2022. Long CR. Community-engaged diabetes research in Arkansas: a focus on food insecurity. 2022 Arkansas Diabetes Update Symposium (Virtual); June 2022. What do you plan to do during the next reporting period to accomplish the goals?1. Implement and evaluate an intervention using home-delivery of T2D-appropriate food boxes that include plain language adapted education materials aimed at improving diet quality, physical activity, and health outcomes of low-income food insecure people with T2D. - Complete Aim 1 activities with 24 Cohort 5 participants including grocery delivery, educational handouts and videos, dietary recalls, and post-intervention data collection. - Begin data analysis of NDSR dietary recalls of participants in cohorts 1-5 of the Aim 1 study. - Begin data analysis of pre and post intervention health screening data including HbA1c. 2. Implement, disseminate, and evaluate extension materials--including a toolkit and curriculum--to engage food pantries in supporting the health of their clients with T2D. - Identify and partner with 2-3 additional pantries to implement the Delivering Health Diabetes Friendly Pantry Toolkit. - Focus on dissemination efforts to distribute the materials to more food pantries and faith based communities. 3. Implement and evaluate an education module to improve graduate medical, nursing, and pharmacy students' readiness to support the health of food insecure individuals at risk for T2D and other diet-sensitive chronic diseases. - Identify host platform for "Improving Health through Food Insecurity Assessment and Intervention" training module for continuing education credits for healthcare professionals.
Impacts
What was accomplished under these goals?
1. Implement and evaluate an intervention using home-delivery of T2D-appropriate food boxes that include plain language adapted education materials aimed at improving diet quality, physical activity, and health outcomes of low-income food insecure people with T2D. The team successfully recruited and enrolled 55 research participants, of which 54 received the full dose of intervention including the 12 weeks of food boxes and educational handouts and videos. The team launched recruitment for the third, fourth, and fifth cohorts of the Aim 1 study at three new food pantries. The team provided 199 health screenings to community members interested in joining Aim 1. 2. Implement, disseminate, and evaluate extension materials--including a toolkit and curriculum--to engage food pantries in supporting the health of their clients with T2D. The team successfully trained 76 pantries with the Delivering Health Diabetes-Friendly Pantry toolkit. The team successfully trained 51 University of Arkansas System Division of Agriculture Cooperative Extension agents about the Delivering Health Diabetes-Friendly Pantry toolkit. 3. Implement and evaluate an education module to improve graduate medical, nursing, and pharmacy students' readiness to support the health of food insecure individuals at risk for T2D and other diet-sensitive chronic diseases. The team successfully developed a CE on food insecurity for practicing medical professionals in the state of Arkansas. The module is called "Improving health through food insecurity assessment and intervention". In February, 24 students completed the Exposure Bridge interprofessional education activity "A Place at the Table."
Publications
- Type:
Journal Articles
Status:
Awaiting Publication
Year Published:
2023
Citation:
Short E, Gannon MA, Bounds K, Faitak B, Martin P, Moore S, Shannon D, Selig JP, English ES, Felix HC, Haggard-Duff L, Mejia-Otero J, McElfish PA, Long CR. An Integrated Approach to Address Diabetes in the Context of Food Insecurity: Delivering Health Study Protocol. Submitted to: Contemporary Clinical Trials Communications
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Progress 04/01/21 to 03/31/22
Outputs
Target Audience:During the reporting period of April 1, 2021 through March 31, 2022, our efforts have focused on the recruitment and retention of research participants for Aim 1, recruitment and implementation of the Delivering Health Toolkit in food pantries for Aim 2, and expanding student access and participation in the education module for Aim 3. The team recruited 24 research participants from a food pantry over 2 weeks during August and September 2021. The team offered free health screenings to clients utilizing the food pantry and provided screenings to 56 clients. From the 56 health screening patients, 24 clients with HbA1c of greater than or equal to 7 were invited to participate in the research study. One participant moved out of the geographic area and was unable to complete the intervention and one participant did not receive 7 weeks of food boxes because they moved and did not notify the research team. Ultimately, 22 of the 24 enrolled participants received the full 12-week intervention, including the 12 weeks of food boxes and educational handouts and videos. Seven of the participants chose Spanish as their preferred language for intervention materials, 10 chose Marshallese, and the remaining seven chose English. Recruitment activities for the next cohort of study participants for Aim 1 are happening in March and April 2022. The target audience for Aim 2 was food pantries located in Benton and Washington Counties. The team reached out to three pantries and two piloted the Delivering Health toolkit. The team trained six food pantry volunteers at one pantry and three at the other to learn about the intersection of food insecurity and type 2 diabetes, implementing client choice systems, nudging healthy foods, stocking the pantry with healthy foods, and developing a written nutrition policy. To understand the impact of the Delivering Health toolkit and training, at Pantry 1, the team conducted 20 of client surveys and 1 volunteer survey at pre intervention. At post intervention the team conducted 13 client surveys and 1 volunteer survey. At Pantry 2, the team conducted 13 client surveys and 1 volunteer surveys at pre intervention and 15 client surveys and 1 volunteer survey at post intervention of the Delivering Health toolkit training. The team used bag audits and pre and post intervention surveys at the 2 pilot pantries to analyze and refine the Delivering Health toolkit. The team worked with the University of Arkansas System Division of Agriculture Cooperative Extension to present the program during the organization's monthly statewide agent meeting in December 2021. Fifty Cooperative Extension Agents participated in the meeting, and 20 submitted interest forms to complete the Delivering Health Diabetes-Friendly Pantry Train-the-Trainer series. Fourteen have completed the full series, which will enable them to train pantries in their communities to provide education materials and resources for their clients with diabetes. In March 2022, the Northwest Arkansas Food Bank invited a team representative to present on the Delivering Health program during their Annual Agency meeting. Ten food pantry representatives attended the meeting, and four submitted interest forms to learn more about implementing the Delivering Health program at their food pantries. The team will reach out to all of the interested pantries to offer Delivering Health Toolkit training beginning in April 2022. The team will also have an opportunity to present to food pantry representatives during a meeting of agencies from the North Central Arkansas Food Bank in late March 2022. The target audience for Aim 3 are medical, pharmacy, nursing, and other health professional students at the University of Arkansas for Medical Sciences. During the April 1, 2021 through March 31, 2022 reporting period, 99 medical, pharmacy, and nursing students have completed the three training module, which focuses on increasing future healthcare providers' knowledge of diet-related risks for food insecure individuals. Changes/Problems:Due to the COVID-19 pandemic surge in late 2021 and early 2022 there were challenges in research participant retention during post intervention data collection. There has been some hesitancy among food pantries to adopt full client choice models because of the ongoing COVID-19 pandemic. Supply chain issues in the food system made it challenging to procure some of the food box grocery items. The grocer was able to identify replacements for the items, but in some cases it was difficult to ensure each participant received the same exact food each week. The research team noted each substitution that occurred. Because the research study's first cohort's delivery and data collection spanned both the fall and winter holidays, there was a loss to follow up for 2 participants due to travel outside of the country. Participants who utilize food pantries can in some cases lack regular and consistent access to technology, which created challenges for our team to reach them on their primary and secondary phone numbers. For the upcoming second cohort of the Aim 1 research study, the recruitment and research team modified the recruitment and enrollment process to emphasize the importance of updating contact information and communicating with the team about relocations and contact changes. The team continues to provide adapted intervention options to pantries in order to successfully implement the Delivering Health Diabetes-Friendly Pantry toolkit. The team has continued to update the timeline and activities to ensure successful implementation of the project. What opportunities for training and professional development has the project provided?Our team hosts quarterly stakeholder advisory group meetings comprised of community stakeholders who work with the food insecure population in Northwest Arkansas. The group provides regular feedback on the progress and plans for future program implementation. Co-investigator meetings have been held twice to receive input and guidance on the research design, future plans, and findings to date. Safety Monitoring Committee meetings have been held twice to create a safety assessment matrix, appoint lead medical monitors, and assess case by case questions about Aim 1 study eligibility. Two University of Arkansas nursing students supported data collection for health screenings as part of recruitment of the second cohort of Aim 1 study participants. How have the results been disseminated to communities of interest?Dissemination efforts have included7 presentations to the following audiences: Long CR. How do food and physical activity policies affect our health? Diet, Food, Exercise and Nutrition During Social Distancing Series; University of Arkansas Center For Human Nutrition seminar (Virtual); April 2021. English, ES. Research and Programming to Improve Diet Quality and Access to Healthy Foods. New York Institute of Technology, College of Osteopathic Medicine. Population Health class (Virtual). April 30, 2021. Long CR, English ES. Community-based chronic disease prevention through healthy food access: an invitation to collaborate. Arkansas Children's Nutrition Center, Arkansas Children's Research Institute (Virtual); October 2021. Long CR, English ES. Fireside chat: food insecurity and the business community. community hARvest, Young Professionals of the Urban League of Arkansas; Bentonville, AR; October 2021. Long CR. How do food and physical activity policies affect our health? Exploring Topics in Food Science course (guest lecture), Department of Food Science, University of Arkansas; Fayetteville, AR (Virtual); December 2021. Long CR. Engaging communities in diabetes research in Arkansas. Research Symposium, Arkansas Colleges of Health Education; Fort Smith, AR (Virtual); February 2022. English ES, Long CR. Listening session: future of the charitable food system. Northwest Arkansas Food Bank 2022 Annual Agency Meeting; Springdale, AR; March 2022. What do you plan to do during the next reporting period to accomplish the goals?1. Implement and evaluate an intervention using home-delivery of T2D-appropriate food boxes that include plain language adapted education materials aimed at improving diet quality, physical activity, and health outcomes of low-income food insecure people with T2D. Identify 2-3 recruitment sites with the goal of recruiting an additional 50-77 participants for the Aim 1 research study during April 1, 2022- March 31, 2023. Analyze preliminary results from the first recruitment cohort to focus on quality improvement of home delivery T2D- appropriate food boxes. 2. Implement, disseminate, and evaluate extension materials--including a toolkit and curriculum--to engage food pantries in supporting the health of their clients with T2D. Present Delivering Health Diabetes-Friendly Pantry to a total of 3 food banks across Arkansas to increase recruitment of food pantry implementation sites. Provide regular training and technical assistance to Extension Agents to implement the Delivering Health Diabetes-Friendly Pantry. Continue to evaluate the outcomes of the Delivering Health Diabetes-Friendly Pantry strategies with pantry and Extension Agent surveys. Work towards recruiting and implementing the Delivering Health Diabetes-Friendly Pantry in 73 additional pantries across Arkansas. 3. Implement and evaluate an education module to improve graduate medical, nursing, and pharmacy students' readiness to support the health of food insecure individuals at risk for T2D and other diet-sensitive chronic diseases. Implement and revise Food Insecurity online "Learn On Demand" continuing education module for physicians, nurses, pharmacists, physician assistants, occupational therapists, physical therapists, and physicians assistants. Continue to offer and evaluate inter professional education module to graduate medical, nursing, pharmacy and other health professional students.
Impacts
What was accomplished under these goals?
1. Implement and evaluate an intervention using home-delivery of T2D-appropriate food boxes that include plain language adapted education materials aimed at improving diet quality, physical activity, and health outcomes of low-income food insecure people with T2D. Adaptation of the Diabetes Self-Management Education (DSME) curriculum to people experiencing low-incomes, food insecurity, and T2D was completed. The adapted curriculum was divided into a total of 12 educational handouts, each available in English, Spanish, and Marshallese for a total of 36 educational handouts. Twelve adapted Diabetes Self-Management Education (DSME) educational videos were produced in English, Spanish, and Marshallese in both long and short forms, for a total of 72 videos. A website with the published handouts and videos in English, Spanish, and Marshallese was published for pantries to access and a separate website available to research participants was published. The team successfully recruited and enrolled 24 research participants, of which 22 received the full dose of intervention including the 12 weeks of food boxes and educational handouts and videos. The team launched recruitment for the second cohort of Aim 1 study participants at a food pantry located in a different geographic area of Northwest Arkansas. 2. Implement, disseminate, and evaluate extension materials--including a toolkit and curriculum--to engage food pantries in supporting the health of their clients with T2D. The Delivering Health Diabetes-Friendly Pantry toolkit was successfully implemented in two pantries. Outcomes included an increase in the percentage of Healthy Eating Research Nutrition Guidelines for the Choose Often category of the Charitable Food System (HER) from 25% to 67% in pantry 1 and 39% to 50% in pantry 2. Successfully trained 14 Extension agents to implement the Delivering Health Diabetes-Friendly Pantry toolkit. The team has developed a statewide approach to implementing the Delivering Health Diabetes-Friendly Pantry toolkit and has two food bank sponsored opportunities to directly offer training to pantries in March 2022. 3. Implement and evaluate an education module to improve graduate medical, nursing, and pharmacy students' readiness to support the health of food insecure individuals at risk for T2D and other diet-sensitive chronic diseases. In February 2022, 14 healthcare students participated in a Nutrition and Lifestyle Consultation Simulation as part of the Aim 3 education module. The post assessments reflect that nine students agreed or strongly agreed that the simulation session was helpful in their personal development for weight bias and food insecurity principles. Ten students reported they agreed or strongly agreed that they felt more comfortable in their ability to assess for food insecurity than they did prior to this activity. Eleven of the students reported they agreed or strongly agreed that they intend to incorporate food insecurity related research and practice into their career. In April 2021, 85 students completed Quadruple Aim Competence Workshop post assessment as part of the Aim 3 education module. 92.86% of students agreed or strongly agreed with this statement "reflect on your intention to include food insecurity related research and practice as a focus of your clinical, academic, and/or scientific career." One student shared "The workshop also made me think about how I can actively address food insecurity within my public health discipline (epidemiology)."
Publications
- Type:
Journal Articles
Status:
Submitted
Year Published:
2022
Citation:
Haggard-Duff L; Neill K, Gannon M, McElfish PA, English E, Teigen A, Long CR. Interprofessional education workshop to teach food insecurity assessment and intervention. Submitted to Journal of Interprofessional Education and Practice.
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Progress 04/01/20 to 03/31/21
Outputs
Target Audience:During the reporting period of April 1, 2020 throughMarch 31, 2021, our efforts have focused on the development and pilot of an interprofessional educational module through food insecurity needs related to T2D and other chronic diseases. The evaluation team has received 17 evaluations from the pilot modules. These evaluations will provide valuable insight into opportunities for adjustment and improvement.The educational module will continue to be used to train graduate medical, nursing, pharmacy, and other health professional students. Changes/Problems:Due to the COVID-19 pandemic, some of theactivity timelineshave been altered, but the content of the project aims and anticipated outcomes have not. The team will continue to adapt the activity timelineto ensure successful implementation of the project. What opportunities for training and professional development has the project provided?Our team hosted a stakeholderadvisory group meeting comprised of community stakeholders who work with the food insecure population on a regular basis. This stakeholder advisory group meeting provided the opportunity for project staff and the advisory group to learn from each other, receive updates about the project implementation to date, and provide feedback about future project plans. How have the results been disseminated to communities of interest?Dissemination efforts have been limited by the pandemic. We have made three online presentations describing the project to three audiences: A seminar for researchers at the University of Arkansas for Medical Sciences' Center for Health Services Research. A seminar for researchers at Center for Neuroscience and Cell Biology, University of Coimbra, Portugal A panel discussion for Medical Humanities undergraduate students at Harding University, Searcy, Arkansas In addition, information was disseminated to the general public across Arkansas in a May 25, 2020, statewide newspaper story in the Arkansas Democrat-Gazette titled "Grant to aid study on Type 2 diabetes." What do you plan to do during the next reporting period to accomplish the goals? Implement and evaluate an intervention using home-delivery of T2D-appropriate food boxes that include plain language adapted education materials aimed at improving diet quality, physical activity, and health outcomes of low-income food insecure people withT2D. The production team will finalize all 36 DSME supplemental videos during the early summer of 2021. Recruitment of 100 participants is anticipated to begin in October 2021. COVID-19 continues to be the rate limiting step for launching recruitment and enrollingparticipants for the intervention. Implement, disseminate, and evaluate extension materials--including a toolkit and curriculum--to engage food pantries in supporting the health of their clients with T2D. Pilot the Healthy Pantry Toolkit with two client choice pantries in northwest Arkansas. After the pilot, we will revise curriculum and toolkits based on initial implementation and evaluation findings. Revised curriculum and toolkits will be translated into Spanish and Marshallese. Our team will continue to implement and evaluate the revised curriculum and toolkit in 75 food pantries across Arkansas. Our team will train extension staff, who will assist in training pantries within their regions of the state. Implement and evaluate and education module to improve graduate medical, nursing, and pharmacy students' readiness to support the health of food insecure individuals at risk for T2D and other diet-sensitive chronic diseases. Evaluate and revise IPE modules with feedback from stakeholders. Train UAMS educators, extension professionals, and food pantry staff to deliver the revised module. Deploy and evaluate the IPE module to reach medicine, nursing, pharmacy, and other health care professional graduate students.
Impacts
What was accomplished under these goals?
Implement and evaluate an intervention using home-delivery of T2D-appropriate food boxes that include plain language adapted education materials aimed at improving diet quality, physical activity, and health outcomes of low-income food insecure people withT2D. The adaptationof Diabetes Self-Management Education (DSME) curriculum was completed by a registered nurse and a registered dietitian. The curriculum consists of 12 lessons, which include an educational handout and a video for each week. The curriculum has been adapted and translated in three languages: English, Spanish, and Marshallese. All videos scripts (36 videos total) have been scripted and translated. The English version videos are currently in production, with an anticipated due date of May 30, 2021. Our team has designed weekly food boxes, containing ~9,000 calories of food, to be home delivered to each participant. The food boxes follow the American Diabetes Association Create Your Plate method and include food that largely reflects Feeding America's Foods to Encourage framework. In addition to the healthy ingredients, each box will containeducational handouts to support the weekly lesson, healthy recipes, and shopping lists. Our research evaluation team has drafted the data collection instruments that will be utilized for pre-intervention and post-intervention. Study measures include demographic, socioeconomic, HbA1c, diet quality and fruit and vegetable consumption, physical activity, BMI, T2D self-management behaviors,T2D self-efficacy, and food insecurity. Implement, disseminate, and evaluate extension materials--including a toolkit and curriculum--to engage food pantries in supporting the health of their clients with T2D. Our team has developed a Healthy Food Pantry toolkit for extension professionals to use while engagingfood pantries to improve the nutritional quality of food they distribute and their clients to consume. The toolkit will facilitate implementation of three practices: 1) adopting nutrition guidelines that guide pantry operations, 2) using standardized food bank purchasing lists and donor education efforts focused on healthy foods, and 3) providing clients choice over foods they bring home and nudging them toward healthier food choices. The toolkit will be piloted in two local food pantries during the summer of 2021. Due to the pandemic, our timeline for piloting the Healthy Food Pantry toolkit has been delayed. Implement and evaluate aneducation module to improve graduate medical, nursing, and pharmacy students' readiness to support the health of food insecure individuals at risk for T2D and other diet-sensitive chronic diseases. With the direction of Dr. Christopher Long, Dr. Lauren Haggard-Duff defined learning objectives and developed an interprofessional learning module based on evidence-based practices and standards. The module was piloted with graduate students in medicine, nursing, pharmacy, and other health professions. The module was organized around the SEARCH mnemonic of steps health care professionals can take to address food insecurity and chronic disease. Three separate IPE modules/activities, which include an exposure bridge activity and a simulation activity, have been created and approved through the UAMS IPE office. The pilot of the IPE modules was completed during spring 2021. Our evaluation team will begin conducting interviews with students and educators to capture their suggestions for improvement.
Publications
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