Source: CALIFORNIA STATE UNIVERSITY LONG BEACH FOUNDATION submitted to NRP
HARVESTING HEALTHY HABITS IN LONG BEACH: A NUTRITION AND GARDENING INTERVENTION TO PREVENT CHRONIC DISEASES AMONG UNDERSERVED POPULATIONS
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
ACTIVE
Funding Source
Reporting Frequency
Annual
Accession No.
1029793
Grant No.
2023-69015-39407
Cumulative Award Amt.
$969,826.00
Proposal No.
2022-08676
Multistate No.
(N/A)
Project Start Date
Jan 15, 2023
Project End Date
Jan 14, 2027
Grant Year
2023
Program Code
[A1344]- Diet, Nutrition and the Prevention of Chronic Disease
Recipient Organization
CALIFORNIA STATE UNIVERSITY LONG BEACH FOUNDATION
6300 E STATE UNIVERSITY DR STE 332
LONG BEACH,CA 90815-4670
Performing Department
(N/A)
Non Technical Summary
The Harvesting Healthy Habits in Long Beach project aims to improve eating patterns to prevent chronic diseases and increase food access among underserved ethnic/minority children and their families through a nutrition and gardening intervention. The project has five goals: 1) Education - Increase the pool of qualified health and nutrition professionals to enter the workforce to prevent chronic diseases among underserved communities; 2) Extension - Engage community and university stakeholders in the design, testing, and implementation of the intervention and the design of student training activities to ensure relevance to the priority populations; 3) Research - Evaluate the effectiveness of the intervention in improving eating patterns among underserved children in grades 3 to 5; 4) Extension - Strengthen underserved communities through engagement of research participant's families in intervention activities; and 5) Extension- Improve food security and nutritional health outcomes for participants and their families. Project goals will be carried out through a collaboration between a university-based research center and a community-based garden with all activities informed by a community advisory board of stakeholders and community members. The proposed intervention will be developed based on prior research and the Social Cognitive Theory of behavior change. Research and extension activities will result in increased knowledge, self-efficacy, and skills to improve eating habits among underserved children and their families. Through education activities, underrepresented students will gain valuable training and experience to enter the workforce or graduate school. Results, best practices, and lessons learned will be disseminated to community members, researchers, and universities to promote replication.
Animal Health Component
100%
Research Effort Categories
Basic
0%
Applied
100%
Developmental
0%
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
70360201010100%
Goals / Objectives
The proposed Harvesting Healthy Habits in Long Beach: A Nutrition and Gardening Intervention to Prevent Chronic Diseases among Underserved Populations is an integrated project aiming to improve eating patterns to prevent chronic diseases and increase food access among underserved low-income and racial/ ethnic minority children and their families.Goal 1 (Education): Increase the pool of qualified health and nutrition professionals to enter the workforce to prevent and address chronic conditions among underserved communities.Objective1. Recruit, select, and engage a total of six (6) graduate and twelve (12) undergraduate students in a comprehensive research training and experiential learning fellowship.Objective 2. Train fellows in community-engaged research, health promotion, intervention implementation, and evaluation.Objective 3. Support fellows with mentorship, career guidance, and professional development.Objective4. Engage fellows in hands-on community engaged research, nutrition and gardening health promotion, and data collection and evaluation.Goal 2 (Extension): Engage community and university stakeholders in the design, testing, and implementation of the intervention and the design of student training activities to ensure relevance to the priority populations.Objective5. Engage a Community Advisory Board to provide guidance and direction for the content and delivery of the intervention.Objective 6. Engage 24-30 community stakeholders in a focus group of 8-10 participants to inform the design and implementation of the Harvesting Healthy Habits intervention.Goal 3 (Research): Evaluate the effectiveness of the Harvesting Healthy Habits intervention in increasing healthy lifestyles among underserved children in grades 3 to 5.Objective7. Enroll 144 underserved children in 3rd to 5th grade and a parent/caregiver to participate in the Harvesting Healthy Habits intervention.Objective8. Assess improvements in knowledge, attitudes, and skills related to healthy eating patterns (e.g., benefits of eating fruits, vegetables, breakfast) among children and their parent/caregiver.Objective 9. Assess improvements in eating patterns (e.g., increases in fruit and vegetable intake and breakfast, and decreases in refined sugar) among children and their parent/caregiver from pre-to-post intervention, and post-to-follow-up.Objective10. Assess increases in awareness and knowledge related to the importance of healthy eating patterns for children among parents/caregivers.Objective11. Assess changes in parental influence on children's eating patterns (e.g., serving sizes, food selection).Goal 4 (Extension): Strengthen underserved communities through engagement of research participant's families in Harvesting Healthy Habits intervention activities.Objective12. Engage 432 non-research participants in the Harvesting Healthy Habits intervention.Goal 5 (Extension): Improve food security and nutritional health outcomes for underserved families in the Harvesting Healthy Habits intervention.Objective13. Provide at least 144 families access to existing food distribution opportunities.Objective14. Provide at least 144 families referrals to enrollment assistance into federally funded nutrition programs
Project Methods
Education methods:Student Training and Mentorship:Selected fellows will attend an initial orientation and training followed by monthly trainings throughout the fellowship (8 total monthly trainings per year). Fellows will have the unique opportunity to receive interdisciplinary training and experience in the fields of nutrition sciences, health education, gardening, and child development. Fellows will be involved in the development and piloting phase of the Harvesting Healthy Habits intervention and will have the opportunity to learn from the input of community stakeholders. Fellows will also be involved in recruitment efforts, implementation of the intervention, data collection and management, and evaluation. Students will meet regularly with the PI and Co-I at CSULB to receive the support needed to ensure academic progress, retention, and successful graduation. Each fellow will receive guidance and mentorship to develop an abstract and poster to present at a conference. Fellows will receive a research stipend to support their studies and conference travel funding opportunities to expand their exposure to the field.Evaluation of Education Activities:Evaluation of education activities will involve the tracking and achievement of Outcomes 1-4. Data will be collected using tracking forms and online questionnaires (via Qualtrics) 44 an online survey platform that can be accessed via smart phone devices). Process evaluation will be applied to assess project milestones related to education including: 1) timely recruitment and selection of students each year, 2) implementation of the orientation and training, as well as the monthly trainings in research methods, professional development workshops, and mentorship each yearResearch Methods:Formative Research:Three focus groups will be implemented to engage community stakeholders and the priority populationin the planning and design of theintervention. One group will consist of the CAB members. An existing group of committed stakeholders has been formed as part of a CAB that informs community-based engagement at the CSULB Center. The second focus group will 11 consist of the priority population, children in 3rd to 5th grade; and the third group will consist of parents/caregivers of children in 3rd to 5th grade. Focus groups will consist of 8-10 participants and will be moderated by the PI or Co-I using a moderator's guide with questions related to topics selected for the intervention. The findings from activities related to stakeholder engagement (Goal 2, Objectives 5 - 6), are expected to inform and prioritize intervention content, assist in highlighting potential barriers and enabling factors specific to the priority population, and provide further guidance on logisticsImplementation phase:Research Study Design: The Harvesting Healthy Habits intervention will use a onegroup study design with repeated measures (pre, post, and 3-month follow-up) to test the efficacy of intervention content in improving nutrition and health lifestyle outcomes of 144 underserved children in grades 3 to 5 and their parent/caregiver. One hundred seventy-four (174) youth and a parent/caregiver will be recruited for the research component. Expecting 20% attrition, a minimum of 144 child participants are expected to complete the intervention along with a parent/caregiver and will be included in the evaluation analysis. Children and a parent/caregiver will engage in the Harvesting Healthy Habits intervention informed by community stakeholders, previous studies and the Social Cognitive Theory (SCT).The Harvesting Healthy Habits intervention is a child-focused, family-based intervention to promote changes at the individual and interpersonal (parents/caregivers) levels through interactive sessions. Children in grades 3 to 5 (approximately 8-11 years of age) will participate in four, 2-hour group sessions to be implemented within a one-month timeframe.Each session will include three components: 1) nutrition education and learning activities, 2) hands-on gardening, and 3) a hands-on food demonstration. The parent/caregiver will participate in two, 2- hour sessions (1 & 4) for some activities with their children and in separate groups based on content to be covered.Evaluation of Research Activities:Evaluation of research activities will involve the tracking and achievement of Outcomes 7-12 listed in Table 3. 144 underserved children and a parent/caregiver and will be evaluated by process evaluation measures including: 1) timely recruitment and enrollment of participants based on project timeline, 2) retention in the intervention, and 3) completion of sessions. The process measures will help to ensure the project is on schedule and on track for successful completion. Measures used for the evaluation of research outcomes in knowledge, attitudes, intent, skills, and behavior related to healthy eating patterns (e.g., benefits of eating fruits, vegetables, breakfast, risk of consuming sweetened sugar beverages) will assess pre-post and follow-up changes among child and caregiver participants. Questionnaires will include validated measures (i.e., Youth Nutrition and Physical Activity Survey; Nutrition Knowledge and Food Intake) as well as questions developed using topic-specific item.Data Analysis, and Interpretation Procedures: A mixed methods approach will be employed to address the multiple components for the development, implementation, and evaluation of the Harvesting Healthy Habits intervention. Process Evaluation. Will provide a record of activity and give immediate feedback on: 1) the study design and implementation of the intervention (research and extension outcomes); 2) the recruitment of student fellows and implementation of the experiential learning fellowship 17 (education); and 3) the implementation of food distribution and enrollment activities.Summative Evaluation:To assess the effectiveness of the research and education components, the PI will conduct quantitative analyses on data collected from pre, post, and 3- month follow-up surveys for children and caregiver participants; and from pre, post, and 1-year follow-up surveys for student fellows. Quantitative descriptive and inferential analyses will be conducted using SPSS. 52 Analyses to assess pre-post changes for evaluation of the intervention and the experiential learning fellowship will include paired-samples t-tests for continuous data and chi-square tests for differences in dichotomous data. Furthermore, repeated-measures ANOVA will be used to assess changes across multiple time points. Statistical significance for all statistical analyses will be set at p < .05.Extension:Engagement of Research Participant's Families:Siblings and other family members of the research participants will be invited to participate in the Harvesting Healthy Habits intervention. They will not participate in the research component of the study and therefore will not complete data collection, but will benefit from nutrition knowledge, gardening knowledge and skills, and making new and easy recipes with produce grown in the garden. We anticipate 2-3 additional family members from each household will participate for a total of approximately 432 participants in the extension activitiesImproving Food Security Outcomes among Underserved Families:The proposed project aims to improve food access among participating families via two activities: 1) availability of monthly food distributions at the AtDE community garden through a partnership with the Foodbank of Southern California; and 2) connecting families to CalFresh (SNAP) and the Supplemental Nutrition Program for Women, Infants, and Children's (WIC) by providing information about eligibility and enrollment assistance available in Long Beach.Evaluation of Extension Activities:Evaluation of the extension activities will involve the tracking and achievement of Outcomes 5-6 and 12-14.

Progress 01/15/24 to 01/14/25

Outputs
Target Audience:Research: Underserved children in 3rd to 5th grade and a parent/caregiver living in the city of Long Beach. Extension: Family members of research participants or community members ineligible to be research participants. Education: Undergraduate and graduate students at California State University Long Beach who meet the following criteria: 1) declared major in nutrition, health science, kinesiology or other health related major; 2) minimum 3.0 GPA 3) junior or senior standing for undergraduates, enrolled in a Master's degree program for graduate students; and 4) preference given to students from traditionally underrepresented groups such as first-generation educated (parents/legal guardians cannot hold a bachelor's degree from a U.S. University or College), students with financial need, members of racial/ethnic minority groups, and students with disabilities. Changes/Problems: Due to alate award notice, the project start was delayed. This delay resulted in a revised participant recruitment timeline. Participant cohorts have been smaller than expected. We anticipated larger groups of 6 however, due to other obligations/time conflicts cohorts have included an average of 3 families. This change has affected our ability to stay on track to reach our research participant numbers in order to meet our goal by the end of the grant. We anticipate the need for a no cost extension to allow us to reach 144 research participants. There is also a growing concern of changes that may affect our ability to reach underserved populations. There is also a concern of fear in the community in participating in programs, which has increased barriers to recruitment. We have added additoinal recruitment activities and will prioritize outreach in the next grant period. What opportunities for training and professional development has the project provided?Cohort 1 students continued to receive professional development through the mentored process of developing a research abstract and poster. Students presented their poster at the CSULB Week of Research, Scholarly, and Creative Activity (RSCA) Symposium. Cohort 2 students were provided with an orientation and onboarding, in addition to an intensive one-week training to further prepare them to engage in experiential learning through the implementation of various aspects of the research intervention. Through their participation, students have gained an understanding of the research process, specifically, community-based participatory research as it relates to nutrition and chronic disease prevention, responsible and ethical conduct of research, and hands-on research experience with guidance from the PI and Co-I. Additionally, students receive professional development workshops with support in the following areas: preparing and planning for graduate school, resume and CV, goal-setting, and professional etiquette, and leadership and team work. Students also engage in structured mentorship meetings with the Co-I every 2 months, and ongoing unstructured mentorship from the PI, Co-I and Research Coordinator that provide them additional support for their academic, professional, and personal goals.? 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? Goal 1: Applications for the third and last cohort of six students will open mid-March. Applications are due April 10th. Interviews and final selections will be complete by April 30th. Students will begin their training and experiential learning experience on June 2, 2025. Training and mentorship will be provided as it has been done with the first two cohorts. Goal 2: N/A Goal 3: Ongoing recruitment, intervention sessions, and data collection will take place with research participants. Intervention sessions have been scheduled through June 30th, 2025. We are currently working on a schedule for July - December 2025. We anticipate the need for a no cost extension given the late start of the project. Goal 4: Community participants will continue to be invited to attend interventions sessions in order to benefit from the information provided. Goal 5: Families who participate in the intervention will continue to receive a flyer that details information on all the food pantries available in the City of Long Beach.

Impacts
What was accomplished under these goals? Goal 1: During the reporting period, a second cohort of 4 undergraduate and 2 graduate students (OBJ. 1) were recruited, selected and trained. Students received training in community-engaged research, health promotion, intervention implementation, and evaluation (OBJ. 2); in addition to ongoing mentoring, career guidance, and professional development workshops (OBJ. 3). Students have received hands on experiential learning by engaging in community-based research, nutrition and gardening health promotion, and data collection and evaluation (OBJ. 4). The second cohort of students will continue to receive training, mentorship, and hands-on experiential learning through the end of their fellowship in June 2025. In total, 7 undergraduate and 5 graduate students have been recruited and trained since the inception of the grant. Goal 2: Goal was met during the last project period. We consulted and received guidance from the Community Advisory Board on intervention implementation (OBJ. 5). Feedback and guidance were incorporated into final versions of the curriculum. Thirteen community members were engaged in a focus group to inform the design and implementation of the intervention (OBJ. 6). Participants consisted of adults and children from the priority population. Feedback was incorporated into the intervention design. Goal 3: Implementation phase of the intervention started in September 2023. During this project period, 15 cohorts of participants received the intervention resulting in reaching forty-four (44) underserved children in grades 3 - 5 and their parents/caregivers (OBJ. 7). An average of 3 families participate per cohort. Cumulatively, 54 children in grades 3 - 5 and their parents/caregivers were reached by the intervention. Knowledge, attitudes, and skills related to healthy eating are assessed via pre-, post-, and 3-month follow up surveys (OBJ. 8). Preliminary results from pre- and post-survey data indicate improvement in healthy eating knowledge scores among children from pre (M=4.85, SD=1.5) to post (M=5.67, SD=1.7), t(53) = 3.74, p = <.001. Similar results were found among adults from pre (M=5.74, SD=1.3) to post (M=6.35, SD=1.25), t(43) = 3.55. p = <.001. Nutrition label literacy skills were measured with four items asking participants to respond to questions given a nutrition label. Scores improved among children from pre (M=1.96, SD=1.45) to post (M=2.93, SD=1.01), t(53) = 5.56, p =<.001. Increased positive perceptions and attitudes of fruits and vegetables were observed among children at post (M=3.39, SD=.46), compared to pre (M=3.16, SD=.65), t(53) = 2.61, p =.012. For example, child participants increased in agreement with the statements, "I try to eat lots of vegetables" and "Eating fruits and vegetables everyday keeps me healthy." Similarly, positive changes in children's perception in their ability to do certain things such as washing and preparing fruits and vegetables, saying no to unhealthy foods from friends, and reading a food label was observed from pre (M=3.04, SD=.68) to post (M=3.32, SD=.53), t(53) = 3.25, p =.002. Preliminary data on eating patterns (OBJ. 9) among children did not result in significant changes in fruit, vegetable, breakfast, and sugar-sweetened beverage consumption from pre-to-post. However, seperateanalysisdemonstrated a significant increase in daily servings of green vegetables from pre-to-post, t(51) = 2.02, p=.049, for children. Similar trends were found among adult participants. Parental awareness and knowledge related to the importance of healthy eating patterns for children (OBJ. 10) was assessed with the Children's Eating Behavior Questionnaire comprised of 3 subscales (food responsiveness, slowness of eating, and satiety responsiveness), which correspond to three styles of eating behavior studies have found to be repeatedly associated with higher weight in children. Preliminary results with our small sample indicate no significant changes. Assessment of parental influence on children's eating patterns (OBJ. 11) was assessed using the Parenting strategies for Eating and Activities Scale (PEAS) comprised of 5 subscales (monitoring, limit-setting, discipline, permission, and concern). Significant changes were observed from pre-to-post for permission(p=<.05) and monitoring (p=<.01), suggesting parents increased monitoring of fruit and vegetable consumption with their children, and their children were more likely to ask for permission to consume snacks and sugar-sweetened beverages post intervention. Additionally, parenting practices related to vegetables were assessed using 31-items divided into 6 subscales (effective responsiveness, effective structure, effective non-directive control, ineffective responsiveness, ineffective structure, ad ineffective control). Preliminary results do not demonstrate significant statistical changes from pre-to-post. Its possible participants need more time to incorporate changes, therefore, changes from pre-to-3 month follow up will be assessed. Data collection with families is ongoing as intervention sessions are scheduled. Goal 4: One hundred (100) non-research participants engaged in the Harvesting Healthy Habits intervention (obj. 12) during this reporting period. Guests ofresearch participants includesiblings, cousins, and a second parent/caregivers. To date, 126 community participants were reached. Goal 5: Families who participate in the intervention are provided with a flyer that details information on all the food pantries available in the City of Long Beach. This allows families to receive support as needed with different options based on location and time. Families are also informedabout the locations in the city that offer free enrollment assistance for SNAP and WIC. During the reporting period 44 families were provided with the information on food pantries and locations that provide enrollment assistance to federally funded nutrition programs.

Publications


    Progress 01/15/23 to 01/14/24

    Outputs
    Target Audience:Research: Underserved children in 3rd to 5th grade and a parent/caregiver living in the city of Long Beach. Extension: Family members of research participants or community members ineligible to be research participants. Education: Undergraduate and graduate students at California State University Long Beach who meet the following criteria: 1) declared major in nutrition, health science, kinesiology or other health related major; 2) minimum 3.0 GPA 3) junior or senior standing for undergraduates, enrolled in a Master's degree program for graduate students; and 4) preference given to students from traditionally underrepresented groups such as first-generation educated (parents/legal guardians cannot hold a bachelor's degree from a U.S. University or College), students with financial need, members of racial/ethnic minority groups, and students with disabilities. Changes/Problems:The late award notice, pushed back our initial recruitment timeline for students and research participants. While extensive efforts were made to get the project up and running promptly after award notice, the research timeline had to be revised to account for time lost. The subaward with Adventures to Dreams Enrichment community garden had to be terminated after multiple attempts to resolve issues surrounding availability of garden space for intervention activities and spending of grant funding. The termination has not impacted the project's ability to move the intervention activities forward. We are currently communicating with other community gardens in the area for potential collaboration and have taken on garden responsibilities to prevent delays.. What opportunities for training and professional development has the project provided?Students were provided with an orientation and onboarding, in addition to an intensive one-week training to further prepare them to engage in experiential learning through the implementation of various aspects of the research intervention. Through their participation, students have gained an understanding of the research process, specifically, community-based participatory research as it relates to nutrition and chronic disease prevention, responsible and ethical conduct of research, and hands-on research experience with guidance from the PI and Co-I. Students also engage in structured mentorship meetings with the Co-I every 3 months, and ongoing unstructured mentorship from the PI, Co-I and Research Coordinator. Additionally, mentorship from PI and Co-I and professional development workshops provided students with support in the following areas: preparing and planning for graduate school, resume and CV, goal-setting, and professional etiquette, and leadership and team work. 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?Goal 1: We are currently recruiting for the second cohort of students. Applications are due April 10th. Interviews and final selections will be complete by April 30th. Students will begin their training and experiential learning experience on June 3rd, 2024. Training and mentorship will be provided as it has been done with the first cohort. Goal 2:Completed year 1. Goal 3: Ongoing recruitment, intervention sessions, and data collection will take place with research participants. Intervention sessions have been scheduled through June 30th, 2024. We are currently working on a schedule for July - December 2024. Goal 4: Community participants will continue to be invited to attend interventions sessions in order to benefit from the information provided. Goal 5: Families who participate in the intervention will continue to receive a flyer that details information on all the food pantries available in the City of Long Beach.

    Impacts
    What was accomplished under these goals? Goal 1: The first cohort of 3 undergraduate and 3 graduate students (Obj. 1) were recruited, selected and trained. Students received training in community-engaged research, health promotion, intervention implementation, and evaluation (obj. 2); in addition to ongoing mentoring, career guidance, and professional development workshops (obj. 3). Students have received hands on experiential learning by engaging in community-based research, nutrition and gardening health promotion, and data collection and evaluation (obj. 4). Students will continue to receive training, mentorship, and hands-on experiential learning through the end of their fellowship in June 2024. Goal 2: We consulted and received guidance from the Community Advisory Board on intervention implementation (obj. 5). Feedback and guidance were incorporated into final versions of the curriculum. Thirteen community members were engaged in a focus group to inform the design and implementation of the intervention (obj. 6). Participants consisted of adults and children from the priority population. Feedback was incorporated into the intervention design. Goal 3: Implementation phase of the intervention began in September 2023. Two concurrent cohorts of participants took place in order to catch up to the timeline. Ten (10) underserved children in grades 3 - 5 and their parents/caregivers were reached in the first year (obj. 7). Improvements in knowledge, attitudes, skills, and eating patterns (obj. 8 - 11) are still in progress and will be analyzed as sample size increases. Data collection with families is ongoing as intervention sessions are scheduled. Goal 4: Ten non-research participants have engaged in the Harvesting Healthy Habits intervention. Guests from research participants includes siblings of the child and adult spouse. Goal 5: Families who participate in the intervention are provided with a flyer that details information on all the food pantries available in the City of Long Beach. This allows families to receive support as needed with different options based on location and time. Families are also told about the locations in the city that offer free enrollment assistance for SNAP and WIC.

    Publications