Sociodemographic factors associated with attendance to Brighter Bites, a school-based food co-op nutrition intervention for low-income families

Participants: The analytic sample included 6,796 participants from five of the six cities in which Brighter Bites was implemented (Houston, Austin, Dallas, Washington, D.C., and Southwest Florida). Main Outcome Measures: Predictor variables included child’s grade, gender, race/ethnicity, parent employment, and government assistance utilization. Outcome variable was a binary measure of attendance: 1=attendance at or above the threshold or 0=attendance below the threshold, where the threshold was operationalized as attending 75% of the distributions. Analysis: A multi-level logistic regression and bivariate analysis were completed to measure the association between attendance and predictor variables. Results: Results show, compared to Hispanics, Whites were 39% and African Americans 53% less likely to attend at the threshold. Also, families who received SNAP benefits were 33% less likely to attend and families with homemakers had 1.68 greater odds of attending. Conclusions and Implications Identifying predictors of program attendance can inform future equitable implementation and dissemination strategies. Findings indicate race/ethnicity, parent employment and receipt of certain government assistance have significant associations with attending Brighter Bites

Dietary Behaviours During Covid-19 among Households at Risk For Food insecurity

The objective of the present study was to examine associations between variables of COVID-19-related concerns and changes in fruit and vegetable (FV) consumption among a sample of participants from the Brighter Bites program at risk for food insecurity. Cross-sectional data were collected during April-June 2020 using a rapid-response survey to understand social needs, COVID-19-related concerns and diet-related behaviours among families with children participating in Brighter Bites

A Cluster-Randomized Controlled Trial to assess the Impact of a Nutrition intervention On Dietary Behaviors among Early Care and Education Providers: the Create Healthy Futures Study

Create Healthy Futures is a self-paced, web-based intervention on improving healthy eating behaviors among Early Care and Education (ECE) providers. We examined the impact of web-based Create Healthy Futures on diet quality measured by the Alternative Healthy Eating Index (AHEI) 2010, dietary behaviors, and related psychosocial and environmental factors among ECE providers. A cluster randomized controlled trial (CRCT) was implemented with baseline surveys administered from October 2019-January 2020, intervention implementation from April-May 2020, and post-intervention from May 2020-August 2020. Centered-based ECE programs under the Pennsylvania Head Start Association (n = 12) were recruited and randomized to intervention (n = 5) or comparison (n = 7) groups. A total of 186 ECE providers completed the post-intervention surveys (retention rate: 86.1%). At baseline, 31.5% of ECE providers were food insecure. Pre-to-post intervention demonstrated no significant within-or-between-group changes in the AHEI-2010 diet quality scores. ECE providers in the intervention group reported a significant decrease from baseline to post-intervention in the number of days eating out (aMD = -0.8, CI:-1.6, -0.1

Social Determinants of Health-Related Needs During Covid-19 among Low-income Households With Children

INTRODUCTION: Little is known about the social needs of low-income households with children during the coronavirus-2019 (COVID-19) pandemic. Our objective was to conduct a cross-sectional quantitative and qualitative descriptive analysis of a rapid-response survey among low-income households with children on social needs, COVID-19-related concerns, and diet-related behaviors. METHODS: We distributed an electronic survey in April 2020 to 16,435 families in 4 geographic areas, and 1,048 responded. The survey asked families enrolled in a coordinated school-based nutrition program about their social needs, COVID-19-related concerns, food insecurity, and diet-related behaviors during the pandemic. An open-ended question asked about their greatest concern. We calculated descriptive statistics stratified by location and race/ethnicity. We used thematic analysis and an inductive approach to examine the open-ended comments. RESULTS: More than 80% of survey respondents were familiar with COVID-19 and were concerned about infection. Overall, 76.3% reported concerns about financial stability, 42.5% about employment, 69.4% about food availability, 31.0% about housing stability, and 35.9% about health care access. Overall, 93.5% of respondents reported being food insecure, a 22-percentage-point increase since fall 2019. Also, 41.4% reported a decrease in fruit and vegetable intake because of COVID-19. Frequency of grocery shopping decreased and food pantry usage increased. Qualitative assessment identified 4 main themes: 1) fear of contracting COVID-19, 2) disruption of employment status, 3) financial hardship, and 4) exacerbated food insecurity. CONCLUSION: Our study highlights the compounding effect of the COVID-19 pandemic on households with children across the spectrum of social needs

Design For a Cluster Randomized Controlled Trial to Evaluate the Effects of the Catch Healthy Smiles School-Based oral Health Promotion intervention among Elementary School Children

BACKGROUND: The top two oral diseases (tooth decay and gum disease) are preventable, yet dental caries is the most common childhood disease with 68% of children entering kindergarten having tooth decay. CATCH Healthy Smiles is a coordinated school health program to prevent cavities for students in kindergarten, 1st, and 2nd grade, and is based on the framework of Coordinated Approach to Child Health (CATCH), an evidence-based coordinated school health program. CATCH has undergone several cluster-randomized controlled trials (CRCT) demonstrating sustainable long-term effectiveness in incorporating the factors surrounding children, in improving eating and physical activity behaviors, and reductions in obesity prevalence among low-income, ethnically diverse children. The aim of this paper is to describe the design of the CATCH Healthy Smiles CRCT to determine the effectiveness of an oral health school-based behavioral intervention in reducing incidence of dental caries among children. METHODS: In this CRCT, 30 schools serving low-income, ethnically-diverse children in greater Houston area are recruited and randomized into intervention and comparison groups. From which, 1020 kindergarten children (n = 510 children from 15 schools for each group) will be recruited and followed through 2nd grade. The intervention consists of four components (classroom curriculum, toothbrushing routine, family outreach, and schoolwide coordinated activities) will be implemented for three years in the intervention schools, whereas the control schools will be offered free trainings and materials to implement a sun safety curriculum in the meantime. Outcome evaluation will be conducted at four time points throughout the study period, each consists of three components: dental assessment, child anthropometric measures, and parent survey. The dental assessment will use International Caries Detection and Assessment System (ICDAS) to measures the primary outcome of this study: incidence of dental caries in primary teeth as measured at the tooth surface level (dfs). The parent self-report survey measures secondary outcomes of this study, such as oral health related behavioral and psychosocial factors. A modified crude caries increment (mCCI) will be used to calculate the primary outcome of the CATCH Healthy Smiles CRCT, and a two-tailed test of the null hypothesis will be conducted to evaluate the intervention effect, while considering between- and within-cluster variances through computing the weighted-average of the mCCI ratios by cluster. CONCLUSION: If found to be effective, a platform for scalability, sustainability and dissemination of CATCH already exists, and opens a new line of research in school oral health. CLINICAL TRIALS IDENTIFIER: At ClinicalTrials.gov - NCT04632667

Fruit and Vegetable intake and Home Nutrition Environment among Low-income Minority Households With Elementary-Aged Children

Racial/ethnic and socioeconomic differences were shown to have an influence on child fruit and vegetable intake. This study examined the associations between parent and child fruit and vegetable intake and the home nutrition environment among Hispanic/Latino and African American families. Through a cross-sectional study design, self-reported surveys

Food Insecurity and Health-Related Concerns among Elementary Schoolteachers During the Covid-19 Pandemic

INTRODUCTION: US school systems underwent major upheaval, including closures, implementation of virtual and/or hybrid learning, and stringent infection mitigation protocols, during the initial phase of the COVID-19 pandemic. We aimed to examine the association between food insecurity and perceived health, perceived stress, and social determinants of health concerns among elementary schoolteachers serving predominantly low-income children during the COVID-19 pandemic. METHODS: Brighter Bites, a nonprofit organization that weekly distributes fresh fruits and vegetables and nutrition education materials to more than 300 schools serving racial and ethnic minority populations with low income, conducts annual surveys of participating teachers to help determine subsequent efforts to support schools and families during the school year. We analyzed self-reported data collected electronically by the Brighter Bites teachers survey in 76 elementary schools during summer 2020. We used generalized linear mixed models to measure the association between food insecurity and health-related concerns. RESULTS: Of 862 teachers who responded to the survey, 685 answered the 2 questions about food insecurity status; of these, 199 (29.1%) reported experiencing food insecurity. Food insecurity was positively associated with poor perceived general health, greater perceived stress, concerns about various social determinants of health, and changes in fruit and vegetable consumption during the COVID-19 pandemic. CONCLUSION: Our study demonstrated the high prevalence of food insecurity and highlights its associated factors among elementary schoolteachers during the COVID-19 pandemic. It calls attention to the high correlation of various concerns among elementary schoolteachers during the COVID-19 pandemic. Further intervention and policy efforts are needed to relieve food insecurity-related concerns and enhance well-being among teachers

Conceptual understanding of screen media parenting: report of a working group

Screen media (television, computers, and videogames) use has been linked to multiple child outcomes, including obesity. Parents can be an important influence on children\u27s screen use. There has been an increase in the number of instruments available to assess parenting in feeding and physical activity contexts, however few measures are available to assess parenting practices regarding children\u27s screen media use. A working group of screen media and parenting researchers convened at the preconference workshop to the 2012 International Society for Behavioral Nutrition and Physical Activity (ISBNPA) annual meeting, “Parenting Measurement: Current Status and Consensus Reports,” to identify and prioritize issues in assessing screen media parenting practices. The group identified that screen media use can pose different risks for children, depending on their age and developmental stage, across physiologic, psychosocial, and development outcomes. With that in mind, a conceptual framework of how parents may influence their child\u27s screen-viewing behaviors was proposed to include the screen media content, context of viewing, and amount viewed. A research agenda was proposed to prioritize a validation of the framework and enhance the ability of researchers to best assess parenting influences across the three domains of content, context and amount of children\u27s screen media use

Increasing moderate-to-vigorous physical activity among preschool children during school hours

Introduction: Evidence suggests that preschoolers do not spend much time engaging in physical activity, especially moderate-to-vigorous Physical Activity (MVPA), and invest more time in sedentary activities. This study aims to examine the effectiveness of the Physical Education component of a theory-based intervention program, the CATCH (Coordinated Approach To Child Health) Early Childhood, measured by preschoolers\u27 % time engaged in MVPA at preschool, and describe the measurement tools and procedures used in the process evaluation of the Physical Education (PE) component of CEC. Method: 440 preschoolers aged 3 to 5 years enrolled in the 6 Harris County Department of Education (HCDE) Head Start centers for the 2009-20 10 school year and their parents participated in this study. Preschoolers\u27 physical activity level was measured by ActiGraph GT3X accelerometers and the System for Observing Fitness Instruction Time-Preschool (SOFIT-P). Differences in percent time spent in different levels of physical activity (PA) were examined by using the Mann-Whitney U test and Analysis of Covariance (ANCOVA). The process evaluation gathered information from classroom teachers in the 3 intervention centers and from trained program staff during center visits. Descriptive analysis was conducted to present the result from this process evaluation. Result(s): More than half of the participating parents and preschoolers were Hispanic, and approximately 40% of the preschoolers were overweight or obese at baseline. Increase in mean percent time spent in moderate-to-vigorous physical activities was observed to be more apparent among preschoolers in the intervention group measured both by accelerometer and SOFIT-P (not statistically significant). Indoor vigorous activity increased significantly between pretest and posttest among preschoolers in the intervention group (p=0.049). For the process evaluation, trained program staff had 46 visits to the three intervention centers during implementation; 46% of which visits observed CEC PE lessons conducted indoors at carpeted areas with only a music player needed; 95.6% observed high teacher participation in the activities (most or all of the time); 91.3% observed children being often encouraged to be physically active; 88.9% observed half or more of the class engaged in PA for at least 80% of the time. Conclusion: The results of this study showed that a multicomponent physical activity program in lower-income preschools favorably increased physical activities among low-income children attending Head Start preschools. Moreover, process evaluation showed that CEC PE program was delivered with high level of reach and fidelity, which conformed to the design of CEC PE

Ethnic Differences in the Home Food Environment and Parental Food Practices Among Families of Low-Income Hispanic and African-American Preschoolers

Abstract available at publisher's website.http://dx.doi.org/10.1007/s10903-012-9575-