Prevalence and Predictors of Household Food Insecurity among Adult/Youth Dyads at the Initiation of the iCook 4-H Two-Year Obesity Prevention Study

Objective: Determine food insecurity prevalence and predictors among adult/youth dyads enrolled in a childhood obesity prevention study (iCook 4-H).Methods: The iCook 4-H intervention was designed for youth (9-10 years old) and their adult main meals preparer to cook, eat, and play together. Although not an inclusion criteria, diverse, low income, and/or rural families were the target during recruitment. At baseline, adults completed surveys on food insecurity, socioeconomic and demographic characteristics and youth anthropometrics were collected with body mass index (BMI) calculated. Descriptive statistics were computed and chi-square analysis was conducted to test differences between potential predictors and food insecurity. Binomial logistic regression was used to assess the relationship between food insecurity and its predictors.Results: Thirty-four percent of households (n=71 of 206) were food insecure. Youth were primarily white (69.9%) and normal weight (58.3%). Adults were also primarily white (74.8%), overweight or obese (67.9%), married (68.9%), not participating in government assistance programs (57.8%), and held no college degree (55.3%). Based on the logistic regression model, households with a non-white youth (OR=13.53; 95% CI=3.33, 55.05), an adult without a college degree (OR=5.62; 95% CI=2.01, 15.73), and government assistance program participation (OR=5.63; 95% CI=2.63, 12.07) were significantly associated with household food insecurity. However, there was no significant association with BMI found (youth p=0.167; adult p=0.179).Conclusion: Consistent with previous findings, household food insecurity status was associated with youth race, adult education, and government assistance program participation. In contrast, no relationship between BMI and food insecurity status was observed in this study, which warrants further investigation

Dissemination Using Infographic Reports Depicting Program Impact of a Community-Based Research Program: eB4CAST in iCook 4-H

Objective: To evaluate barriers to dissemination and implementation and perceptions of the Evidence- Based Forecast Capture, Assemble, Sustain, Timelessness (eB4CAST) dissemination infographic tool as part of iCook 4-H dissemination. Design: Online surveys and phone interviews. Participants: Experts (n = 35) in community research completed the survey; 13 completed the interview. Main Outcomes Measure: Experts’ perceptions of eB4CASTreports used for iCook 4-H dissemination. Analysis: Frequency and thematic analysis. Results: Survey respondents agreed (85%) that the eB4CAST infographic provided a clear understanding of iCook 4-H and relevant information (83%). Statistics included in the infographic were reported as easily understood (66%). Respondents (83%) stated that the infographic would be helpful to share outcomes with stakeholders. Thematic analysis showed that the majority of interviewees agreed that eB4CAST infographics might aid in overcoming barriers to dissemination and implementation including communication and community ownership. Conclusions and Implications: This study provides perceptions from experts regarding the value of using eB4CAST infographics as a tool to disseminate the impact of a community nutrition program

Health Disparities Score Composite of Youth and Parent Dyads from an Obesity Prevention Intervention: iCook 4-H.

iCook 4-H is a lifestyle intervention to improve diet, physical activity and mealtime behavior. Control and treatment dyads (adult primary meal preparer and a 9–10-year-old youth) completed surveys at baseline and 4, 12, and 24 months. A Health Disparity (HD) score composite was developed utilizing a series of 12 questions (maximum score = 12 with a higher score indicating a more severe health disparity). Questions came from the USDA short form U.S. Household Food Security Survey (5), participation in food assistance programs (1), food behavior (2), level of adult education completed (1), marital status (1), and race (1 adult and 1 child). There were 228 dyads (control n = 77; treatment n = 151) enrolled in the iCook 4-H study. Baseline HD scores were 3.00 ± 2.56 among control dyads and 2.97 ± 2.91 among treatment dyads, p = 0.6632. There was a significant decline in the HD score of the treatment group from baseline to 12 months (p = 0.0047) and baseline to 24 months (p = 0.0354). A treatment by 12-month time interaction was found (baseline mean 2.97 ± 2.91 vs. 12-month mean 1.78 ± 2.31; p = 0.0406). This study shows that behavioral change interventions for youth and adults can help improve factors that impact health equity; although, further research is needed to validate this HD score as a measure of health disparities across time

Health Disparities Score Composite of Youth and Parent Dyads from an Obesity Prevention Intervention: iCook 4-H

iCook 4-H is a lifestyle intervention to improve diet, physical activity and mealtime behavior. Control and treatment dyads (adult primary meal preparer and a 9–10-year-old youth) completed surveys at baseline and 4, 12, and 24 months. A Health Disparity (HD) score composite was developed utilizing a series of 12 questions (maximum score = 12 with a higher score indicating a more severe health disparity). Questions came from the USDA short form U.S. Household Food Security Survey (5), participation in food assistance programs (1), food behavior (2), level of adult education completed (1), marital status (1), and race (1 adult and 1 child). There were 228 dyads (control n = 77; treatment n = 151) enrolled in the iCook 4-H study. Baseline HD scores were 3.00 ± 2.56 among control dyads and 2.97 ± 2.91 among treatment dyads, p = 0.6632. There was a significant decline in the HD score of the treatment group from baseline to 12 months (p = 0.0047) and baseline to 24 months (p = 0.0354). A treatment by 12-month time interaction was found (baseline mean 2.97 ± 2.91 vs. 12-month mean 1.78 ± 2.31; p = 0.0406). This study shows that behavioral change interventions for youth and adults can help improve factors that impact health equity; although, further research is needed to validate this HD score as a measure of health disparities across time

Teens Implementing a Childhood Obesity Prevention Program in the Community: Feasibility and Perceptions of a Partnership with HSTA and iCook 4-H.

High school student researchers and teen leaders from the Health Science Technology Academy (HSTA), under the supervision of HSTA teachers, led a childhood obesity prevention (COP) program (iCook 4-H). The objective was to evaluate the feasibility and perceptions of having teen leaders implement a COP program for dyads of youth (9⁻10 years old) and their primary adult food preparer. Behavior change and perceptions were assessed through surveys and open-ended interviews. Across eight HSTA organizations, 43 teen leaders participated in teaching the iCook 4-H program to 24 dyads. Increased frequency of culinary skills, physical activity and mealtime behavior were reported by youth. Almost all adults (93%) reported that their youth had learned kitchen skills and that the program provided youth-adult quality time and developed culinary skills. Youth echoed adult perceptions with additional themes of food safety and physical activity. HSTA teen leaders perceived the program to be successful and reported the training they received to implement the program was adequate 98% of the time. HSTA teachers found the program to be beneficial for HSTA students in improving leadership, confidence and responsibility. iCook 4-H was feasible to be disseminated through teen leaders in the HSTA program. This teen-led approach could serve as a model for youth health-related programming

Teens Implementing a Childhood Obesity Prevention Program in the Community: Feasibility and Perceptions of a Partnership with HSTA and iCook 4-H

High school student researchers and teen leaders from the Health Science Technology Academy (HSTA), under the supervision of HSTA teachers, led a childhood obesity prevention (COP) program (iCook 4-H). The objective was to evaluate the feasibility and perceptions of having teen leaders implement a COP program for dyads of youth (9–10 years old) and their primary adult food preparer. Behavior change and perceptions were assessed through surveys and open-ended interviews. Across eight HSTA organizations, 43 teen leaders participated in teaching the iCook 4-H program to 24 dyads. Increased frequency of culinary skills, physical activity and mealtime behavior were reported by youth. Almost all adults (93%) reported that their youth had learned kitchen skills and that the program provided youth-adult quality time and developed culinary skills. Youth echoed adult perceptions with additional themes of food safety and physical activity. HSTA teen leaders perceived the program to be successful and reported the training they received to implement the program was adequate 98% of the time. HSTA teachers found the program to be beneficial for HSTA students in improving leadership, confidence and responsibility. iCook 4-H was feasible to be disseminated through teen leaders in the HSTA program. This teen-led approach could serve as a model for youth health-related programming

An Impact Mapping Method to Generate Robust Qualitative Evaluation of Community-Based Research Programs for Youth and Adults

Ripple Effect Mapping (REM) is an evaluation approach that has traditionally been used in community settings to visually map the impact of programming and community interventions. This manuscript utilizes the Community Capitals Framework (CCF) to inform REM and to better highlight the changes and impact between various levels of a community, following a childhood obesity prevention intervention. The addition of in-depth qualitative analyses makes this approach particularly useful for the evaluation of interventions with a research–community partnership focus. The objective of this study was to describe a CCF-informed REM approach with detailed protocol, training, and application to the community-based, childhood obesity prevention intervention, iCook 4-H, which targeted youth and adult pairs. This protocol includes the steps required to prepare for REM sessions of, ideally, six youth and adult pairs, one facilitator, and one or two evaluators/note takers. REM sessions typically begin with an icebreaker and appreciative inquiry activities that inform the REM mapping process that follows. In-depth qualitative analysis of the notes and map images captured during REM sessions ensure the rigor required for research-related interventions. Researchers, community members, and participants can use CCF-informed REM collectively as a robust evaluation tool to demonstrate, through visual mapping, the positive effects of community-partnered research programs

Ripple Effect Mapping Outcomes of a Childhood Obesity Prevention Program From Youth and Adult Dyads Using a Qualitative Approach: iCook 4-H

Objective: To describe the impact of the iCook 4-H intervention study based on data gathered through ripple effect mapping focus groups through an explorative approach. Design: Youth–adult dyads responded about ways in which iCook had affected the individual, family, and community. Three questions were asked: (1) What were people doing differently as a result of iCook? (2) Who benefited from iCook and how? (3) Were there changes in the way community groups and institutions did things as a result of iCook?Setting: Ripple effect mapping sessions took place across 5 states (Maine, Nebraska, South Dakota, Tennessee, and West Virginia). Participants: Seventy dyad participants (n = 35 youth, n = 35 adults) from the iCook 4-H intervention. Main Outcome Measure: Three core themes of iCook 4-H were assessed: cooking, eating, and playing together. Analysis: Direct content analysis and word frequencies were used. Results: Seven categories emerged: improved health, increased community involvement, increased knowledge, increased communication, changed motivation, financial mindfulness, and increased appreciation for family. An overarching theme that was determined was that learning new skills together through trying new things (cooking, eating, and playing) leads to positive individual family and community change. Conclusions and Implications: Ripple effect mapping was effective in determining the perceived impact of iCook 4-H on oneself, family, and community

Perceptions of Crop Consultants and Crop Producers on Grazing Corn Residue in Nebraska

We conducted a survey to evaluate factors influencing consultant recommendations on grazing and producer grazing practices in Nebraska. Producers who did not graze cited soil compaction, inconvenience (lack of watering and fencing), and lack of access to livestock as major reasons for not grazing. Producers who allowed grazing and consultants who recommended grazing were more likely than those who did not favor grazing to perceive that grazing increased subsequent grain yields. Most consultants and producers reported making decisions on the basis of their personal observations. Findings from the survey can be used for enhanced Extension dissemination and research activities regarding grazing of residues

Quality of Life Associated with Physical Activity but not Sedentary Time in Youth

Purpose: It has been reported that youth who engaged in more screen time had lower quality of life scores compared to those that were more physically active. Furthermore, increased sedentary behavior increases health risks particularly the risk for obesity. A cross-sectional analysis was completed to examine the relationship between healthrelated quality-of-life (HRQOL) and accelerometer-measured sedentary time (ST) and physical activity (PA) in 9-10-yearold youth who were recruited for the family-based, childhood obesity intervention, iCook 4-H. It was hypothesized that objectively measured ST would be negatively correlated and PA would be positively correlated with HRQOL.Methods: A subset of participants (n=118) wore Actigraph GT3X+ accelerometers for 7 days and completed the Pediatric Quality of Life survey (PedsQLTM, version 4.0) to assess HRQOL. Mean daily minutes of accelerometermeasured ST (547 ± 60) and PA including light-intensity (LPA=240 ± 49), moderate-intensity (MPA=35 ± 11), vigorous-intensity (VPA=17 ± 9), and moderate-to vigorousintensity (MVPA=52 ± 19) were evaluated during waking hours. Multiple linear regressions were used to assess relationship between ST and PA intensities with HRQOL. Statistical significance was set at p ≤ 0.05.Results: There were no significant associations between ST or LPA with HRQOL. MPA, VPA and MVPA were positively associated with multiple HRQOL domains.Conclusion: The lack of relationship between objectively measured ST and LPA with the total HRQOL score and subscales merits further investigation. The findings of the current study support the need for lifestyle interventions that engage families in behavior that increases MVPA