Formative Evaluation of EFNEP Curriculum: Ensuring the Eating Smart • Being Active Curriculum Is Theory Based

The project reported here served to assess a curriculum for EFNEP to ensure theory compliance and content validity. Adherence to Adult Learning Theory and Social Cognitive Theory tenets was determined. A curriculum assessment tool was developed and used by five reviewers to assess initial and revised versions of the curriculum. T-tests for differences in mean responses from initial review to follow-up for each tenet and Cronbach\u27s α for internal consistency of each tenet were conducted. Reviews found that the Eating Smart • Being Active curriculum successfully incorporated tenets of both theories and content remained true to Dietary Guidelines

Healthy babies through infant-centered feeding protocol: an intervention targeting early childhood obesity in vulnerable populations

<p>Abstract</p> <p>Background</p> <p>Poor feeding practices during infancy contribute to obesity risk. As infants transition from human milk and/or formula-based diets to solid foods, these practices interfere with infant feeding self-regulation and healthy growth patterns. Compared with other socioeconomic groups, lower-income mothers are more likely to experience difficulty feeding their infants. This may include misinterpreting feeding cues and using less-than-optimal feeding styles and practices, such as pressuring infants during mealtimes and prematurely introducing solid food and sweetened beverages. The Healthy Babies trial aims to determine the efficacy of a community-based randomized controlled trial of an in-home intervention with economically and educationally disadvantaged mother-infant dyads. The educational intervention is being conducted during the infant's first 6 months of life to promote healthy transition to solids during their first year and is based on the theory of planned behavior.</p> <p>Methods/Design</p> <p>We will describe our study protocol for a multisite randomized control trial being conducted in Colorado and Michigan with an anticipated sample of 372 economically and educationally disadvantaged African American, Hispanic, and Caucasian mothers with infants. Participants are being recruited by county community agency staff. Participants are randomly assigned to the intervention or the control group. The intervention consists of six in-home visits by a trained paraprofessional instructor followed by three reinforcement telephone contacts when the baby is 6, 8, and 10 months old. Main maternal outcomes include a) maternal responsiveness, b) feeding style, and c) feeding practices. Main infant outcome is infant growth pattern. All measures occur at baseline and when the infant is 6 and 12 months old.</p> <p>Discussion</p> <p>If this project is successful, the expected outcomes will address whether the home-based early nutrition education intervention is effective in helping mothers develop healthy infant feeding practices that contribute to improving infant health and development and reducing the risk of early-onset childhood obesity.</p> <p>Trial Registration</p> <p>Current Controlled Trials <a href="http://www.anzctr.org.au/ACTRN126100000415000.aspx">ACTRN126100000415000</a></p

Parent and Household Influences on Calcium Intake Among Early Adolescents

Background: Calcium intake during early adolescence falls short of requirements for maximum bone accretion. Parents and the home food environment potentially influence children’s calcium intakes. This study aimed to quantify parental psychosocial factors (PSF) predicting calcium intakes of Asian, Hispanic, and non-Hispanic white (NHW) early adolescent children from a parental perspective. Methods: This was a cross-sectional study involving the administration of a validated calcium-specific food frequency questionnaire to a convenience sample of children aged 10–13 years and the primary individual responsible for food acquisition in the child’s household. Based on Social Cognitive Theory, parental factors potentially associated with children’s calcium intake were also assessed via parent questionnaires. The total study sample consisted of 633 parent-child pairs (Asian = 110, Hispanic = 239, NHW = 284). Questionnaires were completed at community-based centers/sites. Outcome measures were the association between parent-child calcium (mg), milk (cups/day), and soda (cans/day) intakes and the predictive value of significant parental PSF towards calcium intakes of their children. Sex-adjusted linear regression and multivariate analyses were performed. Results: Calcium intakes of parent-child pairs were positively associated among all ethnic groups (r = 0.296; P \u3c 0.001). Soda intakes were positively associated among Hispanic parent-child pairs only (r = 0.343; P \u3c 0.001). Home availability of calcium-rich foods (CRF), parental rules and expectations for their child’s intake of beverages, and parents’ calcium intake/role modeling were positively associated with children’s calcium intake and overwhelmed all other PSF in multivariate analyses. Significant cultural differences were observed. Parental role modeling was a significant factor among Hispanic dyads only. Multivariate models explained 19–21% of the variance in children’s calcium intakes. Conclusions: Nutrition interventions to improve children’s calcium intakes should focus on parents and provide guidance on improving home availability of CRF and increasing rules and expectations for the consumption of CRF. Among Hispanic families, interventions promoting parental modeling of desired dietary behaviors may be most successful

Parent calcium-rich-food practices/perceptions are associated with calcium intake among parents and their early adolescent children

Objective: The study aimed to (i) segment parents of early adolescents into subgroups according to their Ca-rich-food (CRF) practices and perceptions regarding early adolescent CRF intake and (ii) determine whether Ca intake of parents and early adolescents differed by subgroup. Design: A cross-sectional convenience sample of 509 parents and their early adolescent children completed a questionnaire in 2006–2007 to assess parent CRF practices and perceptions and to estimate parent and child Ca intakes. Setting: Self-administered questionnaires were completed in community settings or homes across nine US states. Subjects: Parents self-reporting as Asian, Hispanic or non-Hispanic White with a child aged 10–13 years were recruited through youth or parent events. Results: Three parent CRF practice/perception segments were identified, including ‘Dedicated-Milk Providers/Drinkers’ (49 %), ‘Water Regulars’ (30 %) and ‘Sweet-Drink-Permissive Parents’ (23 %). Dedicated-Milk Providers/Drinkers were somewhat older and more likely to be non-Hispanic White than other groups. Ca intakes from all food sources, milk/dairy foods and milk only, and milk intakes, were higher among early adolescent children of Dedicated-Milk Providers/Drinkers compared with early adolescents of parents in other segments. Soda pop intakes were highest for early adolescents with parents in the Water Regulars group than other groups. Dedicated-Milk Providers/Drinkers scored higher on culture/tradition, health benefits and ease of use/convenience subscales and lower on a dairy/milk intolerance subscale and were more likely to report eating family dinners daily than parents in the other groups. Conclusions: Parent education programmes should address CRF practices/perceptions tailored to parent group to improve Ca intake of early adolescent children.Keywords: Calcium-rich foods, Parenting practice, Parents, Early adolescent childre

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Needs Assessment Regarding Online Training for Paraprofessionals in the Expanded Food and Nutrition Education Program

We conducted a needs assessment prior to development of an online training for paraprofessionals in the Expanded Food and Nutrition Education Program. Through interviews with Extension professionals and paraprofessionals from three Extension regions, we determined characteristics of paraprofessionals\u27 existing training environments and the paraprofessionals\u27 characteristics as learners. Interviewees supported the development and implementation of an online training and identified benefits related to online training. Paraprofessionals expressed preference for a video-based rather than text-based format and wanted the training to complement not replace face-to-face training. Our findings may be useful in supporting the development of effective online training that meets the needs of other Extension initiatives