- Email: [email protected]
Changing Health of Children Using HEAL, a School Based Intervention
TUESDAY, OCTOBER 21
Poster Session: Wellness and Public Health Changing Health of Children Using HEAL, a School Based Intervention Author(s): C.L. Schoerner1, A.C. Grisham1, B.A. Spear1, D. Dunnaway2, D. Hester1, C. Swaid3; 1Pediatrics, Univ. of Alabama at Birmingham, Birmingham, AL, 2 Samford Univ., Birmingham, AL, 3HEAL, Birmingham, AL Learning Outcome: After this presentation, the attendee should be able to Identify at least 3 measures that can show if school based programs are effective. Background: 35% of Alabama’s youth are overweight or obese. African American (AA) and Hispanic children have higher rates of obesity. Healthy Eating Active Living (HEAL)Ó is a school based PE curriculum that combines nutrition and physical activity (PA) designed to improve the health of children. This purpose of this study was to evaluate HEAL’s use in schools with high minority populations to determine if there were improvements in health indicators. Methods: Children were assessed pre/post school year for: %BMI, nutrition and PA knowledge and behavior (validated questionnaires). Fitness was assessed utilizing the PACER test. Paired T-tests were used to compare pre/ post intervention. Results: 174 children, ages 10-11, from 3 elementary schools participated in this study (62.5% AA, 4.6% Hispanic). 45.4% were overweight/obese which is 15% higher than state average. Significant differences (p<.05) were seen from pre to post intervention including: PACER laps increased from 22.56 to 29.71; total knowledge increased from 9.73 to 13.3; nutrition knowledge increased from 8.51 to 10.74; behavior changes showed decreases in fast food consumption from 1.39x/wk. to 1.14x/wk. and increases in family meals from 3.05/wk. to 3.87/wk. Using BMI%tiles, 20% of obese children dropped to overweight, 29% of overweight dropped to normal weight, with none increasing to obesity category. Conclusions: Results show that schools with high minority populations can benefit by utilizing the HEAL comprehensive PE curriculum that incorporated both PA and nutrition. Children reduced BMI%tiles, improved fitness, increased knowledge and changed behavior thereby setting them on a course for improved overall health.
Control Your Diabetes for Life Program: Helping Rural Residents Participate in Diabetes Education through Multiple Formats Author(s): L. Franzen-Castle1, D. Schroeder2, D. Willcox3, S. Petersen3, T. Nelson3, M. Kamm4; 1Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 2 University of Nebraska-Lincoln Extension, West Point, NE, 3Franciscan Care Services, West Point, NE, 4Educational Media, University of Nebraska-Lincoln, Lincoln, NE Learning Outcome: Participants will be able to identify strategies to provide education to and evaluate outcomes of rural residents engaged in community programing as well as ways to utilize different expertise in a team teaching approach. Many diabetic, rural residents have limited resources and access to education, making selfmanagement and participating in education difficult. Control Your Diabetes for Life program, led by the University of Nebraska-Lincoln (UNL) in coordination with Franciscan Care Service, is offered 1-3 times a year in various locations not previously offering classes for persons with diabetes in Nebraska. In 2011-2012, programing was disseminated through distance education, DVD presentations, broadcast on Nebraska Educational TV, and web video streamed (2,870 webpage hits). End-of-session surveys (post-pre format) with group setting participants (n¼505) showed significant changes (p<0.05) in knowledge and behavior for diabetes self-management. Group setting participants were randomly selected to complete a one-year follow-up survey, with a 43% response rate (n¼105). Responses were separated by diabetic status (non-diabetic [14%], pre-diabetic [12%] and diabetic [73%]) with significant differences detected. By separating the data by diabetic status, a more accurate depiction of long-term impacts was elucidated because some questions were not applicable to non- and pre-diabetic participants. Across categories, significant improvements were reported for physical activity (65%), practicing a healthier lifestyle (78%), and changing family recipes to match dietary plans (57%). Approximately 90% were female, 63% were 60-79 years old, and 98% were white. Thirty-six counties were reached. Sixty-six percent reported sharing program information with others. Programing helped participants establish and utilize diabetes self-management techniques and improve blood glucose control. This program reached over 750 people through DVD presentations, group education, TV broadcast, and webpage postings. Calculated savings in medical costs for participants equates to $674,100. Funding Disclosure: Internal funds from the University of Nebraska-Lincoln
Funding Disclosure: None A Process Model: Development of a Pilot Assessment of Fruit and Vegetable Intake in SNAP-Ed Populations
Effectiveness and Feasibility of Healthy Menu Changes for Non-Trainee Military Dining Facilities
Author(s): M. Scott1, S.R. Cullen1, M. LaFleche1, C. Kokinakis1, J. Kerver2, M. Subramain1; 1Michigan Fitness Foundation, Lansing, MI, 2Michigan State University, East Lansing, MI
Author(s): B. Belanger, J. Kwon; Department of Hospitality Management and Dietetics, Kansas State Univ., Manhattan, KS
Learning Outcome: At the end of this presentation participants will be able to identify the steps to collaboratively develop a pilot impact evaluation framework with multiple stakeholders needs addressed. Practitioners and educators must provide evidence of the impact of their nutrition education interventions. Therefore evaluation and assessment is an important component to enhance the communication of outcomes and impacts to any programs stakeholders and aids in providing evidence of effective and efficient use of funds, whether they be public or private. The United States Department of Agriculture’s (USDA’s) Supplemental Nutrition Assistance Program (SNAP) provides publicly funded nutrition assistance benefits to eligible low-income households so they can have access to an adequate diet. The Michigan Fitness Foundation (MFF) facilitates the implementation of Michigan’s SNAP Education (SNAP-Ed) programs and evaluations. A team of 20 Michigan SNAP-Ed program evaluators and key program informants convened to select indicators and develop protocols for data collection to assess the collaborative impact of statewide nutrition education programs. The collaborative team broke out into three workgroups; 1) survey administration, communication, and technical assistance; 2) survey sampling and statistical analysis; 3) nutrition assessment. Assessment tools utilized in this framework included n¼3,816 nine-item dietary assessment components of the National Youth Risk Behavior Survey by the Centers for Disease Control and Prevention along with n¼5,928 ten-item surveys developed by the National Cancer Institute for adults. The framework of the pilot evaluation project, based on recommendations from these work groups and collaborative meetings, will be presented. Sharing this framework with conference attendees will provide insight into action for how nutrition educators and practitioners can work collaboratively with stakeholders and partners to develop a process to show collective impact for their initiatives.
Learning Outcome: To recognize factors that affect non-trainee soldiers’ reported and actual food choice and consumption behaviors. The purpose of this study was to evaluate the impact implementing the Initial Military Training (IMT) menu standards, which are more nutritionally adequate than those used in non-trainee dining facilities (DFAC), had on food selection, nutrient intake, and satisfaction of soldiers in a non-trainee status. Participants were recruited during lunch periods before and three weeks after the menu standard changes. Direct observations, digital photography, and plate waste methods were used to assess soldiers’ food selection and consumption, along with a survey assessing customer satisfaction. Food selection and consumption were evaluated using the Army’s Go for Green Nutrition Labeling Program and the Military Dietary Reference Intakes (MDRI). Descriptive statistics and independent sample t-tests were used to summarize and compare the data. A total of 172 and 140 soldiers participated before and after menu changes, respectively. Before, soldiers consumed 886 kcals (38.6% from total fat and 11.2% from saturated fat) and 1784 mg of sodium. After the menu change, all figures improved (705 kcals, 31% of kcals from total and 9% from saturated fat, and 1339 mg of sodium) (p<0.01). The percentage of healthier food selections mirrored food served at the DFAC and improved after the intervention (p<0.001). No differences were observed in overall satisfaction and meal acceptability after the intervention, and “food appeal” ratings actually improved. Our findings suggest implementing the IMT menu standards in non-trainee Army DFACs is feasible and has the potential to improve the overall healthfulness of soldiers’ food selection and consumption. Funding Disclosure: This study was funded by the Retired Army Medical Specialist Corps Association (RAMSCA)
Funding Disclosure: USDA, State of Michigan, Michigan Fitness Foundation
A-78
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
September 2014 Suppl 2—Abstracts Volume 114 Number 9
Poster Session: Wellness and Public Health Changing Health of Children Using HEAL, a School Based Intervention Author(s): C.L. Schoerner1, A.C. Grisham1, B.A. Spear1, D. Dunnaway2, D. Hester1, C. Swaid3; 1Pediatrics, Univ. of Alabama at Birmingham, Birmingham, AL, 2 Samford Univ., Birmingham, AL, 3HEAL, Birmingham, AL Learning Outcome: After this presentation, the attendee should be able to Identify at least 3 measures that can show if school based programs are effective. Background: 35% of Alabama’s youth are overweight or obese. African American (AA) and Hispanic children have higher rates of obesity. Healthy Eating Active Living (HEAL)Ó is a school based PE curriculum that combines nutrition and physical activity (PA) designed to improve the health of children. This purpose of this study was to evaluate HEAL’s use in schools with high minority populations to determine if there were improvements in health indicators. Methods: Children were assessed pre/post school year for: %BMI, nutrition and PA knowledge and behavior (validated questionnaires). Fitness was assessed utilizing the PACER test. Paired T-tests were used to compare pre/ post intervention. Results: 174 children, ages 10-11, from 3 elementary schools participated in this study (62.5% AA, 4.6% Hispanic). 45.4% were overweight/obese which is 15% higher than state average. Significant differences (p<.05) were seen from pre to post intervention including: PACER laps increased from 22.56 to 29.71; total knowledge increased from 9.73 to 13.3; nutrition knowledge increased from 8.51 to 10.74; behavior changes showed decreases in fast food consumption from 1.39x/wk. to 1.14x/wk. and increases in family meals from 3.05/wk. to 3.87/wk. Using BMI%tiles, 20% of obese children dropped to overweight, 29% of overweight dropped to normal weight, with none increasing to obesity category. Conclusions: Results show that schools with high minority populations can benefit by utilizing the HEAL comprehensive PE curriculum that incorporated both PA and nutrition. Children reduced BMI%tiles, improved fitness, increased knowledge and changed behavior thereby setting them on a course for improved overall health.
Control Your Diabetes for Life Program: Helping Rural Residents Participate in Diabetes Education through Multiple Formats Author(s): L. Franzen-Castle1, D. Schroeder2, D. Willcox3, S. Petersen3, T. Nelson3, M. Kamm4; 1Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 2 University of Nebraska-Lincoln Extension, West Point, NE, 3Franciscan Care Services, West Point, NE, 4Educational Media, University of Nebraska-Lincoln, Lincoln, NE Learning Outcome: Participants will be able to identify strategies to provide education to and evaluate outcomes of rural residents engaged in community programing as well as ways to utilize different expertise in a team teaching approach. Many diabetic, rural residents have limited resources and access to education, making selfmanagement and participating in education difficult. Control Your Diabetes for Life program, led by the University of Nebraska-Lincoln (UNL) in coordination with Franciscan Care Service, is offered 1-3 times a year in various locations not previously offering classes for persons with diabetes in Nebraska. In 2011-2012, programing was disseminated through distance education, DVD presentations, broadcast on Nebraska Educational TV, and web video streamed (2,870 webpage hits). End-of-session surveys (post-pre format) with group setting participants (n¼505) showed significant changes (p<0.05) in knowledge and behavior for diabetes self-management. Group setting participants were randomly selected to complete a one-year follow-up survey, with a 43% response rate (n¼105). Responses were separated by diabetic status (non-diabetic [14%], pre-diabetic [12%] and diabetic [73%]) with significant differences detected. By separating the data by diabetic status, a more accurate depiction of long-term impacts was elucidated because some questions were not applicable to non- and pre-diabetic participants. Across categories, significant improvements were reported for physical activity (65%), practicing a healthier lifestyle (78%), and changing family recipes to match dietary plans (57%). Approximately 90% were female, 63% were 60-79 years old, and 98% were white. Thirty-six counties were reached. Sixty-six percent reported sharing program information with others. Programing helped participants establish and utilize diabetes self-management techniques and improve blood glucose control. This program reached over 750 people through DVD presentations, group education, TV broadcast, and webpage postings. Calculated savings in medical costs for participants equates to $674,100. Funding Disclosure: Internal funds from the University of Nebraska-Lincoln
Funding Disclosure: None A Process Model: Development of a Pilot Assessment of Fruit and Vegetable Intake in SNAP-Ed Populations
Effectiveness and Feasibility of Healthy Menu Changes for Non-Trainee Military Dining Facilities
Author(s): M. Scott1, S.R. Cullen1, M. LaFleche1, C. Kokinakis1, J. Kerver2, M. Subramain1; 1Michigan Fitness Foundation, Lansing, MI, 2Michigan State University, East Lansing, MI
Author(s): B. Belanger, J. Kwon; Department of Hospitality Management and Dietetics, Kansas State Univ., Manhattan, KS
Learning Outcome: At the end of this presentation participants will be able to identify the steps to collaboratively develop a pilot impact evaluation framework with multiple stakeholders needs addressed. Practitioners and educators must provide evidence of the impact of their nutrition education interventions. Therefore evaluation and assessment is an important component to enhance the communication of outcomes and impacts to any programs stakeholders and aids in providing evidence of effective and efficient use of funds, whether they be public or private. The United States Department of Agriculture’s (USDA’s) Supplemental Nutrition Assistance Program (SNAP) provides publicly funded nutrition assistance benefits to eligible low-income households so they can have access to an adequate diet. The Michigan Fitness Foundation (MFF) facilitates the implementation of Michigan’s SNAP Education (SNAP-Ed) programs and evaluations. A team of 20 Michigan SNAP-Ed program evaluators and key program informants convened to select indicators and develop protocols for data collection to assess the collaborative impact of statewide nutrition education programs. The collaborative team broke out into three workgroups; 1) survey administration, communication, and technical assistance; 2) survey sampling and statistical analysis; 3) nutrition assessment. Assessment tools utilized in this framework included n¼3,816 nine-item dietary assessment components of the National Youth Risk Behavior Survey by the Centers for Disease Control and Prevention along with n¼5,928 ten-item surveys developed by the National Cancer Institute for adults. The framework of the pilot evaluation project, based on recommendations from these work groups and collaborative meetings, will be presented. Sharing this framework with conference attendees will provide insight into action for how nutrition educators and practitioners can work collaboratively with stakeholders and partners to develop a process to show collective impact for their initiatives.
Learning Outcome: To recognize factors that affect non-trainee soldiers’ reported and actual food choice and consumption behaviors. The purpose of this study was to evaluate the impact implementing the Initial Military Training (IMT) menu standards, which are more nutritionally adequate than those used in non-trainee dining facilities (DFAC), had on food selection, nutrient intake, and satisfaction of soldiers in a non-trainee status. Participants were recruited during lunch periods before and three weeks after the menu standard changes. Direct observations, digital photography, and plate waste methods were used to assess soldiers’ food selection and consumption, along with a survey assessing customer satisfaction. Food selection and consumption were evaluated using the Army’s Go for Green Nutrition Labeling Program and the Military Dietary Reference Intakes (MDRI). Descriptive statistics and independent sample t-tests were used to summarize and compare the data. A total of 172 and 140 soldiers participated before and after menu changes, respectively. Before, soldiers consumed 886 kcals (38.6% from total fat and 11.2% from saturated fat) and 1784 mg of sodium. After the menu change, all figures improved (705 kcals, 31% of kcals from total and 9% from saturated fat, and 1339 mg of sodium) (p<0.01). The percentage of healthier food selections mirrored food served at the DFAC and improved after the intervention (p<0.001). No differences were observed in overall satisfaction and meal acceptability after the intervention, and “food appeal” ratings actually improved. Our findings suggest implementing the IMT menu standards in non-trainee Army DFACs is feasible and has the potential to improve the overall healthfulness of soldiers’ food selection and consumption. Funding Disclosure: This study was funded by the Retired Army Medical Specialist Corps Association (RAMSCA)
Funding Disclosure: USDA, State of Michigan, Michigan Fitness Foundation
A-78
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
September 2014 Suppl 2—Abstracts Volume 114 Number 9