Objectives There are no published data on which children are at risk for not engaging in programming during the summer window of risk. The objective of this study was to compare the demographic characteristics of children who do (“attenders”) and do not (“non-attenders”) participate in summer programming. Methods Project SWEAT was a prospective observational study of pre-K through 5th grade children residing in low-income, urban neighborhoods. Caregivers were texted weekly during the summer (10 weeks) by the research team to gather information on their child's attendance in programming. Text messages stated, “Hello from Project SWEAT! How many days this week did [Child Name] attend a summer program? Please respond with a number from 0–5, where 0 – no days, 2 – 2 days, etc.” Attenders were defined as having attended ≥1 day of programming during the summer and non-attenders as 0 days. Chi-square was conducted to determine differences in demographic characteristics according to attender status. Results Attendance data were collected from 88.50% of the study sample (n = 100 out of 113). Mean age was 7.03 ± 0.23 years; 52.00% (n = 52), 70.10% (n = 68), and 80.00% (n = 80) were female, low-income, and Black, respectively. Almost one-third (32.99%, n = 32) were classified as overweight (19.59%, n = 19) or obese (13.40%, n = 13) at baseline. Fifty-one % (n = 51) of study participants were classified as attenders, and 49.00% (n = 49) were non-attenders. Mean attendance was 10.40 ± 1.43 days. Attenders were more likely to be male (62.75% [n = 32] vs. 37.25% [n = 19], P < 0.01). Conclusions Children who are female are significantly less likely to attend summer programming than male participants. Given that summertime is a window of risk for child health (e.g., inappropriate weight gain) and food security, further research needs to be conducted to understand who and why certain children are attending summer programming. Funding Sources USDA North Central Nutrition Education Center for Excellence.
Objectives To examine the nutrition and physical activity (PA) environment of urban USDA Summer Food Service Program (SFSP) sites. Methods The current study was part of a larger observational trial – Project SWEAT (Summer Weight and Environmental Assessment Trial) – investigating the determinants of unhealthy summer weight gain in children residing in low-income urban zip codes. All SFSP sites located in Project SWEAT neighborhoods were recruited. The nutrition and PA environment was assessed via the field-tested 83-item Site Environmental Assessment Form. Nutrition environment characteristics included, but were not limited to, presence of water fountain(s) [yes/no] and vending machines [healthy, unhealthy, or mixed options). PA environment characteristics included, but were not limited to, presence of indoor gym, indoor/outdoor basketball court, nearby parks, outdoor playground equipment, and sports equipment [yes/no]. PA behaviors from the perspective of the site directors was also assessed (6-point Likert Scale; 0 = Never, 5 = Daily). Summary statistics were calculated. Results Twenty-eight SFSP sites were identified and 20 completed (71% response rate). Nutrition environment characteristics: 90% (n = 18) of sites had water fountains and 40% (n = 8) had either snack or beverage vending machines or both. 100% of sites that had snack vending (n = 5 of 8) and 80% of sites that had beverage vending (n = 7 of 8) had mixed options. PA environment: 90% (n = 18) had at least one PA environmental characteristic; 39% (n = 7), 67% (n = 12), and 94% (n = 17) had swimming pool, playground equipment, and a basketball hoop, respectively. 70% (n14) of site directors encouraged children to go outside (70%, n = 14) and praised PA (80%, n = 16) 5–6 times per week. Child daily participation in moderate PA was reported by 85% (n = 17) of site directors. Conclusions Results demonstrate that urban SFSP sites have healthy snacks and beverages and PA areas available to participants; thus, the SFSP has potential to play a role in protecting at-risk children from unhealthy weight gain during the summer. Funding Sources USDA North Central Nutrition Education Center for Excellence.
Objectives Assess the impact of an 8-week Head Start family meals intervention (Simple Suppers) on participating caregiver's weight status and health outcomes. Methods This is a single arm pre- to post-test study. The intervention is occurring during the 2019–20 school year (fall, winter, and spring sessions) at 3 Head Start sites. Caregiver outcomes include: BMI (kg/m2), waist circumference (cm), blood pressure (mm Hg), and mental health measures (depression (Patient Health Questionnaire-9 (PHQ-9)), perceived stress (Perceived Stress Scale (PSS)), and anxiety (Generalized Anxiety Disorder-7 (GAD-7))). Regression models factoring in attendance will be used to examine pre- to post-test changes. Results Nineteen caregivers completed data collection for the fall session. 55.6% of families were low-income and 21.1% had low/very low food security. Mean (SD) caregiver age was 37.6 (12.1) yr, 94.7% were female, and 84.2% were non-Hispanic Black. There were no significant changes in BMI, blood pressure, waist circumference, depression, or perceived stress from pre- to post-test according to attendance level, however anxiety significantly decreased with increasing attendance (P < 0.05). Data collection for the remaining sessions will be completed in spring 2020. Conclusions This study can be expected to have a positive impact by understanding the role of healthy family mealtime routines in caregiver's physical and mental health among racial minorities residing in low-income households. Funding Sources USDA NIFA.
Individuals from racial minority backgrounds, especially those with low income, are at increased risk for obesity. Family meals positively impact child nutritional health; however, there is limited evidence examining the impact on caregivers, particularly racial minority and income-restricted individuals. The objective of this intervention study was to determine the effect of Simple Suppers, a 10 week family meals program, on caregiver diet and nutrition outcomes. Intervention versus waitlist control participants were compared from baseline (T0) to post-intervention (T1). In addition, intervention participants were assessed at a 10 week follow-up time point (T2). This study was a two-group quasi-experimental intervention trial. Lessons (10 total) were delivered on a weekly basis for 90 min. Data were collected from intervention and waitlist control participants at T0 and T1, and intervention participants at T2. After baseline (T0) data collection, families enrolled in the immediate upcoming session of Simple Suppers (intervention group) or waited for 10 weeks (waitlist control group) to begin the program. Participants were caregivers of children ages 4–10 years. This study was conducted in a faith-based community center for underserved families in Columbus, Ohio. Primary outcomes were: diet quality assessed by Healthy Eating Index (HEI) total and component scores, and total energy intake (kcal/day); body mass index (BMI) (kg/m2), waist circumference (cm), systolic and diastolic blood pressure (BP) (mmHG); and self-efficacy for having healthy meals and menu planning (both scalar). The impact of the intervention (T0:T1) was assessed using generalized mixed-effects linear regression models. Maintenance of change in study outcomes among intervention participants (T1:T2) was examined with paired t-tests. 109 caregivers enrolled in this study. The retention rate at T1 was 90% (i.e., 98 participants). 56 of 68 intervention participants completed T2, resulting in a retention rate of 82%. Almost all (99%) were female, 61% were Black, and 50% were between 31 and 40 years old. In total, 40% had low income and 37% had low or very low food security. At T1, intervention vs. waitlist controls had a lower daily energy intake (p = 0.04), but an HEI-2010 component score for fatty acids (adequacy) that was lower indicating a lower dietary intake of fatty acids (p = 0.02), and a component score for empty calories (moderation) that was significantly lower indicating a higher intake of empty calorie foods (p = 0.03). At T1, intervention vs. waitlist controls also had a lower BMI (p < 0.001) and systolic BP (p = 0.04), and higher self-efficacy (p = 0.03). There were no group differences in other outcomes. At T2, intervention participants maintained the changes in daily energy intake, BMI, systolic BP, and self-efficacy that improved during the intervention period. There was no change (improvement) in the component score for fatty acids; however, the component score for empty calories significantly improved (p = 0.02). Engagement in the Simple Suppers program led to improvements in caregivers’ daily caloric intake, weight status, systolic blood pressure, and self-efficacy for family meals. Future research should further explore the dietary and nutritional health benefits of family meals among caregivers at the highest risk for obesity.
Objectives Simple Suppers is a 10-week evidence-based intervention (EBI) designed to improve family mealtime routines and child weight status among racially diverse elementary-age children from low-income households. Results from a previous trial demonstrated effectiveness, thereby warranting a scale-out study to reach other child populations (i.e., preschool-age children). In the current study, Southside Simple Suppers Scale-Up (S4), we propose a hybrid type 2 effectiveness-implementation trial, which has a dual focus on effectiveness and implementation outcomes. This type of trial will allow facilitation of the research translation process to develop effective solutions to promote the health of preschool-age children. Methods S4 is occurring during the 2019–20 school year (fall, winter, spring) at 3 Head Start sites (school readiness program for low-income children). Effectiveness outcomes (child food preparation skills, family meal routines) are collected at pre- and post-programming via direct measure and survey. Child food preparation skills are rated on 4-point Likert scale (strongly disagree to strongly agree). Family mealtime routines (i.e., eating meals together, TV on while eating) are reported by number of days per week. Implementation outcomes (adoption, fidelity, fiscal efficiency) are collected throughout programming. Adoption is assessed by weekly attendance. Fidelity is assessed with a program-specific checklist and videotaping. Fiscal efficiency is evaluated by assessing cost of programming per family. Results Nineteen caregivers completed data collection for the fall session. 55.6% families were low-income. Mean(SD) caregiver age was 37.6(12.1) yr, 94.7% were female, 84.2% were Black, and mean(SD) BMI was 35.3(11.2) kg/m2. Mean(SD) child age was 3.4(0.5) yr, 47.6% were female, and mean (SD) BMI z-score was 1.16(1.38). Child food preparation skills significantly increased from pre- to post-test (P < 0.05); there were no significant changes in family mealtime routines. Programming was delivered as intended 78% of the time and mean cost of weekly programming was $8.63 per family. Programming and data collection will be complete in spring 2020. Conclusions Results from this novel hybrid effectiveness-implementation trial will inform the future scale-up of the EBI Simple Suppers program in Head Start. Funding Sources USDA NIFA.
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