Lessons Learned Recruiting Comparison Elementary Schools for Impact Evaluation of SNAP-Ed Interventions

To determine the effectiveness of Supplemental Nutrition Assistance Program- Education (SNAP-Ed) nutrition and physical activity programming in elementary schools, it is necessary to recruit socioeconomically similar comparison schools not receiving SNAP-Ed programming. We developed a flexible recruitment strategy to tailor our approach to each individual school district and site. Here we discuss the lessons learned during the 10-month recruitment period, including early outreach, emphasizing participation benefits, leveraging and building relationships, and visiting sites

Using coupons to encourage healthier child snack purchases in corner stores: results from the CHOMPS study

ObjectivesTo examine youths’ (ages 6–15 years) autonomous snack purchases in corner stores and pilot use of coupons to encourage more healthful snack purchases.MethodsThis pilot study involved four corner stores proximal to K-8 schools in Massachusetts. Kids-only coupons of varying discounts were provided in store and paired with simple visual and verbal economic and health messages. Observational data about youths’ autonomous snack purchases was recorded pre- and post-intervention. Outcomes of interest were snack item, price, and nutrient content. Comparisons of purchase characteristics and nutritional content across intervention conditions were made using Chi-squared and t-tests.ResultsAcross all stores, 2,973 purchase observations were recorded totaling approximately $6,000. Researchers estimated that about 55% of shoppers were 10–12 years old. Modest coupon usage (2.2% of purchases) was noted. However, candy purchases decreased, and the percentage of purchase events that included at least one healthier food item more than doubled, regardless of coupon use. Improvements in the nutritional content of snacks were also observed.ConclusionKids-only coupons have the potential to assist with shifting autonomous snack purchase behavior in outside of school settings

Schools provided healthy meals even during COVID

COVID-related school closures had a big impact on millions of children nationwide, many of whom rely on schools for healthy meals. An online survey of 3,297 fourth- and fifth-grade students in 67 California school sstudied the dietary habits of schoolchildren during the pandemic. The results showed that students who ate one or two school meals a day had significantly higher intakes of vegetables, whole fruits, and 100% fruit juice, compared to students who did not eat school meals. Specifically, students who ate one school meal a day ate more beans and orange vegetables, while those who ate two school meals a day consumed a wider variety of vegetables, including beans and orange vegetables. However, children who ate one school meal a day drank more fruit drinks and flavored milks than those who did not eat school meals. Further, students who ate two school meals consumed more fruit drinks, flavored milks, and sports and energy drinks than those who did not eat school meals. Our findings suggest that, while school meals were an important source of fruits and vegetables during the pandemic, more needs to be done to reduce consumption of sugary drinks

Perceived Produce Availability and Child Fruit and Vegetable Intake: The Healthy Communities Study

Children eat more fruits and vegetables when more are available at home, but less is known about how the neighborhood food environment relates to children’s diet and weight outcomes. The goal of this study was to determine whether parental perception of the food environment (neighborhood and home) is associated with children’s fruit and vegetable (F&V) intake and weight outcomes, and to assess differences by household food security status and household income. Cross-sectional data from the 2013–2015 U.S. Healthy Communities Study included 5138 children, aged 4 to 15 years old, from 130 U.S. communities. Neighborhood and home food environments were assessed with parent-reported, perceived F&V availability scores. Associations were tested with multi-level linear regression models. Parents’ perception of produce availability was associated with household F&V availability ratings (β = 0.09 points, p < 0.001). Household F&V availability was associated with child F&V intake (β = 0.32 cups/day or 25.6 g/day, p < 0.001). A higher child F&V intake was associated with a lower child BMI z-score (β = −0.05, p = 0.002). Weaker relationships were seen for children living in food insecure or low-income households. Optimizing neighborhood and home access to F&V may help children improve diet quality, but may not be as effective for children living in food insecure or low-income households

Perceived Produce Availability and Child Fruit and Vegetable Intake: The Healthy Communities Study.

Children eat more fruits and vegetables when more are available at home, but less is known about how the neighborhood food environment relates to children's diet and weight outcomes. The goal of this study was to determine whether parental perception of the food environment (neighborhood and home) is associated with children's fruit and vegetable (F&V) intake and weight outcomes, and to assess differences by household food security status and household income. Cross-sectional data from the 2013-2015 U.S. Healthy Communities Study included 5138 children, aged 4 to 15 years old, from 130 U.S. communities. Neighborhood and home food environments were assessed with parent-reported, perceived F&V availability scores. Associations were tested with multi-level linear regression models. Parents' perception of produce availability was associated with household F&V availability ratings (β = 0.09 points, p < 0.001). Household F&V availability was associated with child F&V intake (β = 0.32 cups/day or 25.6 g/day, p < 0.001). A higher child F&V intake was associated with a lower child BMI z-score (β = -0.05, p = 0.002). Weaker relationships were seen for children living in food insecure or low-income households. Optimizing neighborhood and home access to F&V may help children improve diet quality, but may not be as effective for children living in food insecure or low-income households

Development of an online curriculum for California early care and education providers on healthy beverages

BackgroundChildren's consumption of sugar-sweetened beverages is associated with obesity, diabetes, and dental decay. California's Healthy Beverages in Child Care Act (AB 2084) requires all licensed child care centers and family child care homes to comply with healthy beverages standards, however many licensed providers in California are unaware of the law and few are fully compliant with the law's requirements. The aim of the current project is to describe the development of a self-paced online training on best practices and implementation of AB 2084 in English and Spanish for family child care home and child care center providers; and to evaluate the feasibility, defined as being accessible, acceptable, and satisfactory to providers, of this new online course.MethodsThe project was broken into two main stages: (1) development of the online course; and (2) evaluation of the final online course. The first stage was completed in five phases: (1) identify relevant course content and develop narration script; (2) conduct in-person focus groups with child care providers to review and edit the content; (3) adapt course content and translate for Spanish-speaking providers; (4) build the online course and resources; and (5) pilot online course and evaluate accessibility. The second stage, evaluation of the acceptability and satisfaction of the final course was rated on a Likert scale from 1 to 4; the evaluation was completed as part of a larger randomized control trial with 43 child care providers. The course features four key requirements of AB 2084 as the main sections of the course (milk, sweetened beverages, juice, and water), plus background information about beverages and children's health, special topics including caring for children with special needs, family engagement, written policies, and child engagement.ResultsThe child care providers who completed the evaluation found the online training was easily understandable (median(Q1,Q3,IQR) = 4 (4,4,0)), included new information (3 (1, 3, 4)), provided useful resources (4(4,4,0)), and was rated with high overall satisfaction (3 (1, 3, 4)).ConclusionOnline training in English and Spanish designed for child care providers is a feasible medium to deliver important health messages to child care providers in an accessible, acceptable, and satisfactory manner

Prenatal Exposure to Autism-Specific Maternal Autoantibodies Alters Proliferation of Cortical Neural Precursor Cells, Enlarges Brain, and Increases Neuronal Size in Adult Animals.

Autism spectrum disorders (ASDs) affect up to 1 in 68 children. Autism-specific autoantibodies directed against fetal brain proteins have been found exclusively in a subpopulation of mothers whose children were diagnosed with ASD or maternal autoantibody-related autism. We tested the impact of autoantibodies on brain development in mice by transferring human antigen-specific IgG directly into the cerebral ventricles of embryonic mice during cortical neurogenesis. We show that autoantibodies recognize radial glial cells during development. We also show that prenatal exposure to autism-specific maternal autoantibodies increased stem cell proliferation in the subventricular zone (SVZ) of the embryonic neocortex, increased adult brain size and weight, and increased the size of adult cortical neurons. We propose that prenatal exposure to autism-specific maternal autoantibodies directly affects radial glial cell development and presents a viable pathologic mechanism for the maternal autoantibody-related prenatal ASD risk factor

Household Food Insecurity is Associated with Higher Adiposity among US Schoolchildren Ages 10-15 Years: The Healthy Communities Study.

BackgroundLimited research exists on the relationship between food insecurity and children's adiposity and diet and how it varies by demographic characteristics in the United States.ObjectiveThe aim of this study was to assess the relationship between household food insecurity and child adiposity-related outcomes, measured as BMI (kg/m2) z score (BMI-z), weight status, and waist circumference, and diet outcomes, and examined if the associations differ by age, sex, and race/ethnicity.MethodsData collected in 2013-2015 from 5138 US schoolchildren ages 4-15 y from 130 communities in the cross-sectional Healthy Communities Study were analyzed. Household food insecurity was self-reported using a validated 2-item screener. Dietary intake was assessed using the 26-item National Cancer Institute's Dietary Screener Questionnaire, and dietary behaviors were assessed using a household survey. Data were analyzed using multilevel statistical models, including tests for interaction by age, sex, and race/ethnicity.ResultsChildren from food-insecure households had higher BMI-z (β: 0.14; 95% CI: 0.06, 0.21), waist circumference (β: 0.91 cm; 95% CI: 0.18, 1.63), odds of being overweight or obese (OR: 1.17; 95% CI: 1.02, 1.34), consumed more sugar from sugar-sweetened beverages (β: 1.44 g/d; 95% CI: 0.35, 2.54), and less frequently ate breakfast (β: -0.28 d/wk; 95% CI: -0.39, -0.17) and dinner with family (β: -0.22 d/wk; 95% CI: -0.37, -0.06) compared to children from food-secure households. When examined by age groups (4-9 and 10-15 y), significant relationships were observed only for older children. There were no significant interactions by sex or race/ethnicity.ConclusionsHousehold food insecurity was associated with higher child adiposity-related outcomes and several nutrition behaviors, particularly among older children, 10-15 y old