Cooperative Extension as a Partner in Creating Healthy Communities: An Environmental Scan

health and wellness, chronic disease prevention and management, curriculum, Cooperative Extension, Extension, health programming, Health and Wellness Framework, ECOP Action Team

The Role of Cooperative Extension in Chronic Disease Prevention and Management: Perspectives from Professionals in the Field

Chronic diseases are strongly associated with premature death and increased health care costs. Nearly half of American adults report they have one or more chronic health conditions. Cooperative Extension is calling for refocus to refine and align with broader efforts to promote public health by supporting the prevention and management of chronic disease. The success of this refocus is dependent on a shared vision between funding agencies, stakeholders, and Extension. As part of developing this shared vision, the Chronic Disease Health Implementation Team surveyed 152 Extension administrators, faculty, and Extension Agents/Educators to determine their perception of the role of Extension in chronic disease prevention and management in the next century. Respondents answered the open-ended question, “What role should Cooperative Extension have in working to reduce chronic diseases in America for the next 10, 25, and 100 years? Analysis with grounded theory identified three themes. The respondents perceived the role of Extension professionals as educators and collaborators in chronic disease prevention and management who focus on influencing individuals and environments. As educators, Extension should deliver evidence-based programs to communicate, inform, facilitate, and teach. As collaborators, Extension should facilitate and nurture partnerships to effect changes in chronic disease prevention and management

Food Supply Adequacy in the Lower Mississippi Delta

Objective: To assess food supply adequacy within 3 food store types in the Lower Mississippi Delta. Design: Regional food store survey to determine availability and quality of 102 food items in 62 supermarkets, 77 small/medium stores, and 86 convenience stores. Setting: Lower Mississippi Delta region of the United States. Participants: 225 food stores in 18 counties. Main Outcome Measures: Percentage of Thrifty Food Plan (TFP) food items available and quality ratings of 6 food sections across store types. Results: On average, supermarkets carried 96% of the items that compose the TFP. Mean percentage of TFP carried in small/medium stores was 50%. Convenience stores carried 28% of the TFP items. Supermarkets had higher overall quality ratings and quality ratings for fresh and frozen foods compared to small/medium and convenience stores (P \u3c.01). Implications for Research and Practice: Although supermarkets carried a large percentage of items surveyed, the number of supermarkets in this region is limited. Community residents with limited transportation to reach supermarkets may experience limited food supply adequacy. Therefore, community-based nutrition interventions should include partnerships with small/medium food retailers while trying to impact residents\u27 food choices within those stores

Dietary Intake in the Lower Mississippi Delta Region: Results from the Foods of our Delta Study

Objective To collect and evaluate food intake data from a culturally diverse population and compare with national survey data. Design The Foods Of Our Delta Study was a baseline, cross-sectional survey that utilized random-digit dialing methodology to identify the sample. Food intake was obtained from a 24-hour dietary recall administered by computer-assisted telephone interview using the multiple-pass method Subjects/Setting One thousand seven hundred fifty-one adults and 485 children in the Lower Mississippi Delta (Delta) of Louisiana, Arkansas, and Mississippi. Statistical Analyses Peformed Comparisons of subsets within the Delta were made using weighted t tests. Comparisons of the Delta with the overall US population from the US Department of Agriculture Continuing Survey of Food Intakes by Individuals and with the Dietary Reference Intakes were made using independent sample z tests of weighted estimates. Results Energy intake did not differ between the Delta and the US populations. Intakes of protein were lower, fat higher, and certain micronutrients lower in Delta adults than in US adults. Delta adults had a 20% lower intake of, fruits and vegetables than the US adults and generally poorer adherence to recommendations of the Food Guide Pyramid. African American Delta adults generally consumed less-optimal diets than white Delta adults. Delta children had diets similar to children of the Continuing Survey of Food Intakes by Individuals sample population, but lower intakes were noted for vitamins A, C, riboflavin, and B-6, and for calcium and iron. Applications/Conclusions Data such as these will help drive intervention development in this rural region and perhaps set the stage for research in similarly impoverished areas

Food Shopping Perceptions, Behaviors, and Ability to Purchase Healthful Food Items in the Lower Mississippi Delta

Objective: To examine the agreement between perceptions, behaviors, and ability to purchase healthful food in the Lower Mississippi Delta (LMD). Design: A regional food store survey of healthful food options in supermarkets, small/medium stores, and convenience stores. Focus group discussions were conducted on shopping perceptions and behaviors. Setting: Counties in Arkansas, Louisiana, and Mississippi. Participants: Eighty-one LMD residents, 18-60+ years of age. Main Outcome Measure: Perceptions of healthful food and ability to acquire these food items across store types. Analysis: Focus group data were analyzed using thematic coding. Summary food store statistics were weighted, and estimates were constructed using SUDAAN 9. Data triangulation was achieved by comparing focus group findings with food availability data. Results: A majority (\u3e 85%) of supermarkets had selected vegetables, breads, and cereals perceived as healthful, whereas availability was limited in small to medium grocery stores and convenience stores. Skim milk, perceived as healthful, was limited in all store types. Conclusions and Implications: Limited availability and perceived costs of healthful food in the LMD influenced purchasing behaviors. Attitudes and perceptions should be incorporated into intervention development to improve food choices in conjunction with increasing the availability of healthful food in the LMD

A pilot church-based weight loss program for African-American adults using church members as health educators: a comparison of individual and group intervention.

A church setting may provide an effective delivery mechanism for a health and nutrition program. Church members may be trained to conduct a weight control program. Both interventions (individual and group) were effective in inducing weight loss

Perceptions of Community Nutrition and Health Needs in the Lower Mississippi Delta: A Key Informant Approach

Objective: Key informants\u27 perceptions of nutrition and health needs in their southern rural communities were assessed prior to nutrition intervention planning. Design: This cross-sectional survey used in-person interviews. Subjects/Settings: A sample of 490 individuals from 12 professional and lay roles in 8 community sectors in 36 counties in Arkansas, Louisiana, and Mississippi was chosen. Statistical Analyses Performed: Factor analysis was carried out on reported food, nutrition, and health problems and contributing factors. The General Linear Models procedure identified within- and between-subject effects for factors. Tukey\u27s post hoc tests identified differences between sectors and states. Frequencies and weighted rankings were computed for health problems. Results: Key informants rated individual-level factors (food choices, education, willingness to change, health behavior) as more important than community-level factors (food and health care access, resources) with regard to nutrition and health problems and contributors to problems. The number one health problem was hypertension. Implications: Key informants are knowledgeable about nutrition and health problems, contributing factors, and available resources. Individual factors were perceived as more important contributors to nutrition and health problems providing valuable information for planning nutrition interventions