Assessing the Potential of Increasing Promotoras in Extension: Hispanic Balanced Living with Diabetes

A sustainable Extension model for promoting health and managing lifestyle-related chronic diseases in Hispanic populations would help mitigate health disparities in Hispanic communities. Hispanic Balanced Living with Diabetes (HBLD) is a type 2 diabetes lifestyle management program that we tested in Virginia. Through postintervention focus group discussions, we assessed barriers faced by Hispanics when accessing health care services, satisfaction with HBLD, and feasibility of training members of the Hispanic community to become promotoras, individuals who help facilitate adoption of healthful behaviors. Incorporating native Spanish speakers as educators and promotoras will ensure culturally relevant delivery of lifestyle modification programs, accurate communication of information, and development of trust with participants

The Farmacy Garden: A Model Program for Expanding Services to Low-Income Families

Fruit and vegetable prescription, or FVRx, programs present an opportunity for expanding and promoting gardening projects, which are a mainstay of Extension programming. The Farmacy Garden, a collaboration of multiple local partners, provides a point of access for learning about and obtaining fresh fruits and vegetables and represents an integrated programming approach for increasing food security for low-income families. The garden serves as a living laboratory—a community venue for agricultural workshops and nutrition education and a space to pilot test additional programming. The Farmacy Garden is a replicable model for Extension professionals interested in leveraging local resources to expand programming and services

Dietary Modulation of Inflammation-Induced Colorectal Cancer through PPARγ

Mounting evidence suggests that the risk of developing colorectal cancer (CRC) is dramatically increased for patients with chronic inflammatory diseases. For instance, patients with Crohn's Disease (CD) or Ulcerative Colitis (UC) have a 12–20% increased risk for developing CRC. Preventive strategies utilizing nontoxic natural compounds that modulate immune responses could be successful in the suppression of inflammation-driven colorectal cancer in high-risk groups. The increase of peroxisome proliferator-activated receptor-γ (PPAR-γ) expression and its transcriptional activity has been identified as a target for anti-inflammatory efforts, and the suppression of inflammation-driven colon cancer. PPARγ down-modulates inflammation and elicits antiproliferative and proapoptotic actions in epithelial cells. All of which may decrease the risk for inflammation-induced CRC. This review will focus on the use of orally active, naturally occurring chemopreventive approaches against inflammation-induced CRC that target PPARγ and therefore down-modulate inflammation

Assessing the SNAP Consumer Environment at Farmers Markets

The SNAP at Farmers Market Environmental Assessment was developed as a tool for market managers to examine SNAP participant accessibility for redeeming SNAP benefits at farmers markets. By completing the SNAP at Farmers Market Environmental Assessment, the tool can serve as a guide for providing practical next steps for market improvement. Extension practitioners and researchers, including SNAP-Ed staff, can use the assessment tool to support policy, systems, and environment change efforts that promote access to local, high-quality foods by SNAP consumers, the redemption of SNAP benefits, and potentially increased sales at farmers markets

Cooperative Extension’s Capacity to Address Food Insecurity by Supporting Food Recovery Organizations

Virginia Cooperative Extension (VCE) educators are uniquely positioned to support the food recovery organizations (FROs) which address hunger-related needs resulting from food insecurity. Based on an online survey to measure how VCE educators have engaged with FROs and their experiences, respondents who previously supported FROs did so across multiple programming areas, and those who had not indicated an interest while also experiencing barriers. Respondents also reported the need for context- and audience-specific resources particular to the spectrum of food recovery. Addressing barriers and resource needs through a transdisciplinary eXtension Food Recovery Community of Practice may support educators in doing this work

Low-Income Mothers\u27 Perceptions of Barriers to Using Farmers Markets: A SNAP-Ed Initiative to Understand Access Points to Local Foods

The study reported here describes a Virginia Family Nutrition Program\u27s target population\u27s perceptions of barriers to using a farmers market to access local foods. Mothers from a rural county photographed their shopping experience. Using a photo elicitation process to develop themes related to food access, the mothers identified barriers to shopping at farmers markets. The results can provide guidance to agents, program assistants, and farmers market coordinators on promoting use of farmers markets by low-income populations. The development of experiential learning opportunities to overcome barriers is critical if farmers markets are encouraged as an avenue for promoting healthy eating

Developing a conceptual framework for the relationship between food security status and mental health among low-income mothers

IntroductionBuilding household resiliency is one strategy that may help insulate households from the effects of food system volatility that contributes to in food insecurity. A stronger understanding of the relationship between food security and mental health is needed to identify potential factors for intervention to improve household resiliency to food system stressors. Because mothers often make household food decisions, they are an important population for building household resiliency. The purpose of this study was to develop and test a conceptual framework for the relationship between food security and mental health for low-income mothers and to identify potential targets for intervention.MethodsA conceptual framework was developed based on the existing literature on mental health and food security, as well as factors that impact both constructs. This framework was tested by a path analysis using data from a 2021 cross-sectional survey of low-income Virginia mothers that used validated scales to assess food security status, indicators of mental and physical health, food coping strategies, and social support.Results and discussionThe initial model was systematically adapted to develop the final retained model. The retained model did not include a direct effect of food security on mental health, but highlighted two significant mediators of the relationship, food coping strategies and social support. While the effect of social support was not practically significant, the effects of food coping strategies as a mediator from food security to perceived stress and life satisfaction were small (β = 0.21, 0.14, respectively; p < 0.001). The retained model provides a framework for understanding the relationship between food security and mental health and highlights potential targets for intervention. Notably, reducing the need for mothers to utilize food coping strategies should be targeted on multiple levels to reduce the impact on mental health and ultimately improve resiliency to future food system shocks

Supplemental Nutrition Assistance Program (SNAP)-authorized retailers received a low score using the Business Impact Assessment for Obesity and population-level nutrition (BIA-Obesity) tool

Background: The Supplemental Nutrition Assistance Program (SNAP) supports Americans with lower income to purchase dietary products at authorized retailers. This research aimed to evaluate SNAP-authorized retailers’ public commitments in support of nutrition security and to examine differences between traditional grocers and nontraditional (e.g., convenience, drug, dollar) SNAP-authorized retailers’ public commitments. Methods: Prominent United States (U.S.) SNAP-authorized retailers nationally and in two U.S. states (California and Virginia) were identified based on number of store locations (n = 61). Public information available in grey literature were reviewed and scored using the Business Impact Assessment for Obesity and population-level nutrition (BIA-Obesity) tool. SNAP-authorized retailers were classified as traditional (e.g., grocery) or nontraditional (e.g., non-grocery) retailers. Total BIA-Obesity from 0 to 615, representing low to optimal support) and category scores were calculated for corporate strategy, relationships with external organizations, product formulation, nutrition labeling, product and brand promotion, and product accessibility. Descriptive statistics were used to describe BIA-Obesity scores overall and by category. Mann–Whitney U was used to test for potential differences in median BIA-Obesity total scores between traditional and nontraditional SNAP-authorized retailers (a priori, p \u3c 0.05). Results: Average total BIA-Obesity scores for SNAP-authorized retailers ranged from 0 to 112 (16.5 ± 23.3). Total BIA-Obesity scores for traditional SNAP-authorized retailers (32.7 ± 33.6; median 25) were higher than nontraditional SNAP-authorized retailer scores (11.2 ± 16; median 5) (p = 0.008). For BIA-Obesity categories, average scores were highest for the category relationships with external organizations (8.3 ± 10.3) and lowest for promotion practices (0.6 ± 2.1). Conclusions: Results of this research underscore a dearth of available evidence and substantial opportunity for improvement regarding SNAP-authorized retailer strategies to support nutrition security among Americans with lower income

Supplemental Nutrition Assistance Program (SNAP)-Authorized Grocery, Convenience, Dollar, and Restaurant or Delivery Service Settings Are Associated With Increased Obesity Prevalence in Virginia

Purpose: United States Department of Agriculture Supplemental Nutrition Assistance Program (SNAP) participants use SNAP-authorized stores for dietary purchases. Relationships between obesity prevalence and access to grocery and varied nontraditional (eg, dollar, drug, and convenience) SNAP settings are underexplored. This research aimed to determine the association of a full range of SNAP-authorized stores with obesity prevalence in Virginia. Design: The SNAP Retailer Locator was used to cross-sectionally identify authorized stores, and county health ranking information was applied based on store location. Setting: Virginia, United States. Sample: The SNAP-authorized stores, classified among store categories: grocery or supermarket; drug; mass merchandiser; supercenter; convenience; dollar; club; other; nonfood store; farmers markets; and independent grocery stores. Measures: County-level obesity prevalence with income and rurality as potential confounders. Analysis: Multiple linear regression was used to determine associations between county-level adult obesity prevalence and available SNAP-authorized store formats ( P \u3c .05 a priori). Results: Store format was a predictor of obesity prevalence in Virginia in simple and adjusted models ( R 2 = 0.035, P \u3c .0001 and R 2 = 0.434, P \u3c .0001, respectively). Grocery store or supermarket access was associated with obesity. The SNAP-authorized convenience, dollar, and nonfood stores were associated with a 0.3, 0.5, and 1.3 increase in county obesity prevalence, respectively ( P \u3c .05). Conclusions: Research, practice, and health policy approaches to improve grocery, convenience, dollar, and restaurant or delivery service settings may favorably influence community obesity prevalence in Virginia

Progress Evaluation for the Restaurant Industry Assessed by a Voluntary Marketing-Mix and Choice-Architecture Framework That Offers Strategies to Nudge American Customers toward Healthy Food Environments, 2006–2017

Consumption of restaurant food and beverage products high in fat, sugar and sodium contribute to obesity and non-communicable diseases. We evaluated restaurant-sector progress to promote healthy food environments for Americans. We conducted a desk review of seven electronic databases (January 2006–January 2017) to examine restaurant strategies used to promote healthful options in the United States (U.S.). Evidence selection (n = 84) was guided by the LEAD principles (i.e., locate, evaluate, and assemble evidence to inform decisions) and verified by data and investigator triangulation. A marketing-mix and choice-architecture framework was used to examine eight voluntary strategies (i.e., place, profile, portion, pricing, promotion, healthy default picks, priming or prompting and proximity) to evaluate progress (i.e., no, limited, some or extensive) toward 12 performance metrics based on available published evidence. The U.S. restaurant sector has made limited progress to use pricing, profile (reformulation), healthy default picks (choices), promotion (responsible marketing) and priming and prompting (information and labeling); and some progress to reduce portions. No evidence was available to assess progress for place (ambience) and proximity (positioning) to promote healthy choices during the 10-year review period. Chain and non-chain restaurants can apply comprehensive marketing-mix and nudge strategies to promote healthy food environments for customers