- Email: [email protected]
P54 Outcome Evaluation of the University of Tennessee Extension Farmers’ Market Fresh Nutrition Education Program
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Poster Abstracts
Journal of Nutrition Education and Behavior Volume 51, Number 7S, 2019
P52 (continued) Study Design, Settings, Participants: This study was conducted in three senior living centers in Indiana with one site set as the control. Subjects for this study were male and female individuals who were ≥ 60 y old. Implementation of the pilot-tested, PSCE nutrition education curricula was utilized. Six lessons were administered over six weeks immediately following the senior congregant lunch. Knowledge and intent to change eating behavior tests were administered after the lesson plan, and at the conclusion of the intervention. Results: Sixty two participants (49% male/female) with a mean age range of 70-79 y completed the study, and 63% indicated they had at least one chronic condition. Wilcoxon Signed Rank indicated a significant improvement in nutrition knowledge of participants who completed the post intervention test (z = -2.56, P = .01). One-way ANOVA indicated that after the grains lesson plan, the intervention participants (N = 32) intent to change behavior as reported in “I will eat ≥ 3 oz of grain/d next month” was significant, P = .05. Conclusion: There was a significant improvement in knowledge change. Intent to change behavior was significant after the grains intervention, but not after the other five lessons. Some seniors indicated older age > 85 y was a barrier to change since they “made it that far.” Designing interventions for seniors needs to be age specific targeting younger seniors for behavior change. Funding: Ball State University.
P53 Awareness and Perceptions of Maine SNAP-Ed Among Maine SNAP Recipients Brent Walker, MS, RD, [email protected], Altarum, 4 Milk St, Ste 303, Portland, ME 04101; Rebecca Hofer, MPH, Altarum; Brenda Wolford, MS, RD, Altarum; Patricia Dushuttle, MA, State of Maine−DHHS Office for Family Independence Background: Contracted by the State of Maine—DHHS Office for Family Independence (OFI), Altarum has served as the external evaluator for Maine Supplemental Nutrition Assistance Program-Education (SNAP-Ed) since 2013. Objective: Assess awareness, perceived value, and barriers to accessing Maine SNAP-Ed direct education classes among Maine SNAP recipients. Study Design, Settings, Participants: Altarum conducted a cross-sectional telephone survey using a list of adult Maine SNAP recipients provided by the State of Maine−DHHS OFI. Measurable Outcome/Analysis: Respondents were asked about awareness, perceived value, and barriers to participation in Maine SNAP-Ed direct education classes. Results were weighted to reflect characteristics of Maine SNAP recipients. Descriptive statistics and 95% confidence intervals were calculated to identify significant differences between groups. Results: Approximately half of Maine SNAP recipients (49%) were aware of Maine SNAP-Ed. Many SNAP recipients (45%) learned about SNAP-Ed classes through other
assistance programs (e.g., WIC). A majority (61%) recognized one or more of Maine SNAP-Ed’s direct education classes by name. Only 7% of SNAP recipients had taken a Maine SNAP-Ed direct education class. However, most SNAP recipients (72%) were “somewhat” or “very interested” in learning how to eat healthy. Those who had taken a Maine SNAP-Ed class reported that the program helped them plan healthy meals for themselves and their family (96%), try a new recipe (91%), and think about making healthier food choices (91%). Barriers to participation mentioned by those who had not taken a Maine SNAP-Ed class included: being unaware that nutrition education classes were offered (52%), difficulty with the locations (43%), disbelieving classes would change behaviors (40%), and being too busy (35%). Approximately 4 in 10 who had not participated (41%) were uninterested in taking a nutrition education class. Conclusion: The majority of Maine SNAP recipients were aware of SNAP-Ed and interested in learning to eat healthy. Maine SNAP-Ed may be able to increase program participation by addressing identified barriers. Funding: SNAP-Ed.
P54 Outcome Evaluation of the University of Tennessee Extension Farmers’ Market Fresh Nutrition Education Program Brent Walker, MS, RD, [email protected], Altarum, 4 Milk St, Ste 303, Portland, ME 04101; Margaret Wilkin, MPH, Altarum; Brenda Wolford, MS, RD, Altarum; Molly Carmody, MA, Altarum; Karen L. Franck, PhD, The University of Tennessee Extension; Christopher T. Sneed, PhD, The University of Tennessee Extension Background: In 2015, University of Tennessee Extension (UT Extension) piloted the nutrition education program Farmers’ Market Fresh (FMF) with a primary objective of encouraging fruit/vegetable (FV) consumption by limited-resource families through purchases at farmers’ markets. FMF is funded by the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) and has since been expanded to over 30 markets statewide. Objective: To measure the effectiveness of FMF among limited-resource families. Study Design, Settings, Participants: Altarum conducted an outcome evaluation to assess exposure, changes in attitudes and behavior, and demographics. Adults were surveyed at SNAP-Ed eligible farmers’ markets with FMF (intervention) and without FMF (comparison) in July and August 2018. Measurable Outcome/Analysis: Descriptive statistics described the sample and outcome variables. Confidence intervals estimated associations between FMF and outcomes. Multivariate logistic regression models were conducted to determine the impact of FMF on outcomes, controlling for demographic characteristics. Results: A total of 382 surveys were completed; 211 intervention and 171 comparison. Intervention respondents Continued on page S57
Journal of Nutrition Education and Behavior Volume 51, Number 7S, 2019 P54 (continued) were two and a half times as likely as comparison to receive information on healthy eating and nutrition, almost three times as likely to learn about purchasing fresh FV on a budget, and 2.4 times as likely to learn about selecting a variety of FV. Intervention respondents were significantly more likely than comparison to report being very confident in their ability to purchase fresh FV on a budget (69% versus 50%) and to select a variety of fresh FV (82% versus 68%). Respondents attending the market at least once per week were more likely than those attending less than once per week to report increased FV consumption. Intervention respondents with minor children in the household were significantly more likely than those without children to report trying a new FV (74% versus 52%) and trying a new recipe (74% versus 46%). Conclusion: FMF was successful in reaching farmers’ market shoppers and increasing confidence and behaviors related to healthy eating. Funding: SNAP-Ed.
P55 Behavior-Specific Nutrition Education Intervention Improves Fruit and Vegetable Preference Among Elementary School Children Sanjoy Saha, MS, [email protected], Department of Nutritional Sciences, Texas Tech University, 1301 Akron Ave, College of Human Sciences, Lubbock, TX 79409; Wilna Oldewage-Theron, PhD, RD, Department of Nutritional Sciences, Texas Tech University Objective: To assess the effectiveness of a nutrition education intervention (NEI) to enhance fruit and vegetable (FV) preference among elementary school children. Use of Theory or Research: A six-week NEI informed by the social cognitive theory. Lessons as well as activities were focused on promoting preference of FV. Target Audience: In total, 115 children in 3rd to 5th grade from four elementary schools (where at least 40% of the children were eligible to obtain free lunch) in the South Plains of Texas participated in this study. Program Description: The study was designed with pre- and post-intervention measurements. Class-based nutrition education (25 minutes once a week), and cooking demonstration sessions (20 minutes once a week) for children, and weekly nutrition handout to parents were implemented. Evaluation Methods: A Likert-scale questionnaire (downward) with 10 fruit and 10 vegetable items were administered during both pre- and post-intervention surveys. The participants were also asked during pre- and post-intervention surveys about three foods they would like to buy/eat more if they had money. Data analysis was carried out with using IBM SPSS Statistics (version 23, Chicago IL), and to assess changes in FV preference, Wilcoxon signed-rank test (paired test) was used. Results: Preliminary results show that 51.3% were girls, and 37.4% were African American/Black (Non-Hispanic). Participants had higher preference for fruits than vegetables during both pre- and post-intervention surveys.
Poster Abstracts
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Preference for fruits (from 17.04 § 6.00 to 14.43 § 4.45, lower score indicates higher preference), and vegetables (from 26.73 § 6.62 to 23.71 § 7.88, lower score indicates higher preference) improved significantly (P < .05) after the NEI. A significant number of participants (from 62.6% to 88.7%) indicated they would buy/eat at least one fruit or vegetable item/day if they had money, after the intervention (P < .05). Conclusion: A multicomponent based NEI that incorporates behavior-specific nutrition lessons, and hands-on experience, can improve FV preference among children. Funding: Texas Tech University.
P56 Changes in Healthy Eating and Physical Activity Behaviors of Low-Income Adult Georgians Participating in Supplemental Nutrition Assistance Program Education (SNAP-Ed) Jung Sun Lee, PhD, RDN, [email protected], University of Georgia, 280 Dawson Hall, Department of Foods and Nutrition, Athens, GA 30602; Edda Cotto-Rivera, MPH, CHES, University of Georgia; Laurel Sanville, MS, RD, LD, University of Georgia; Joanna Akin, MPH, University of Georgia; Vibha Bhargava, PhD, University of Georgia Objective: To examine the impact of Food Talk: Better U (FTBU), the University of Georgia SNAP-Ed’s new healthy weight management program on healthy eating, food resource management, and physical activity behaviors in a sample of low-income Georgians. Use of Theory or Research: Social cognitive theory and expanded health belief model. Target Audience: SNAP-Ed eligible Georgian adults with children Program Description: FTBU was developed based on a comprehensive formative evaluation. FTBU is a series of four 90-minute lessons taught by paraprofessionals focusing on portion control, goal setting, limiting added sugar, small healthy shifts, and problem-solving strategies. Each lesson includes a sharing session, didactic lesson, physical activity (PA), cooking demonstration and tasting, and goal setting. Evaluation Methods: Outcome evaluation of the program used pre- and post-self-administered questionnaire, 24-hour dietary recalls, and self-reported and measured weight. Outcome measures included Medium Term behavior change indicators (MT1, 2, and 3) from the SNAP-Ed Evaluation Framework and other validated measures. McNemar tests were used to examine changes in reported healthy behaviors between pre- and post-test. Results: A total of 454 low-income Georgians participated in FTBU in FY 2018 (mean age 52.6 § 17.1 years, 74.4% females, 47.6% Black, 68.3% overweight/obese). Overall, participants reported engaging in more healthy behaviors after the intervention. The percent of participants who reported eating more than one fruit (MT1c) and vegetable (MT1d) per day significantly increased after the intervention. Most food resource management indicaContinued on page S58
Poster Abstracts
Journal of Nutrition Education and Behavior Volume 51, Number 7S, 2019
P52 (continued) Study Design, Settings, Participants: This study was conducted in three senior living centers in Indiana with one site set as the control. Subjects for this study were male and female individuals who were ≥ 60 y old. Implementation of the pilot-tested, PSCE nutrition education curricula was utilized. Six lessons were administered over six weeks immediately following the senior congregant lunch. Knowledge and intent to change eating behavior tests were administered after the lesson plan, and at the conclusion of the intervention. Results: Sixty two participants (49% male/female) with a mean age range of 70-79 y completed the study, and 63% indicated they had at least one chronic condition. Wilcoxon Signed Rank indicated a significant improvement in nutrition knowledge of participants who completed the post intervention test (z = -2.56, P = .01). One-way ANOVA indicated that after the grains lesson plan, the intervention participants (N = 32) intent to change behavior as reported in “I will eat ≥ 3 oz of grain/d next month” was significant, P = .05. Conclusion: There was a significant improvement in knowledge change. Intent to change behavior was significant after the grains intervention, but not after the other five lessons. Some seniors indicated older age > 85 y was a barrier to change since they “made it that far.” Designing interventions for seniors needs to be age specific targeting younger seniors for behavior change. Funding: Ball State University.
P53 Awareness and Perceptions of Maine SNAP-Ed Among Maine SNAP Recipients Brent Walker, MS, RD, [email protected], Altarum, 4 Milk St, Ste 303, Portland, ME 04101; Rebecca Hofer, MPH, Altarum; Brenda Wolford, MS, RD, Altarum; Patricia Dushuttle, MA, State of Maine−DHHS Office for Family Independence Background: Contracted by the State of Maine—DHHS Office for Family Independence (OFI), Altarum has served as the external evaluator for Maine Supplemental Nutrition Assistance Program-Education (SNAP-Ed) since 2013. Objective: Assess awareness, perceived value, and barriers to accessing Maine SNAP-Ed direct education classes among Maine SNAP recipients. Study Design, Settings, Participants: Altarum conducted a cross-sectional telephone survey using a list of adult Maine SNAP recipients provided by the State of Maine−DHHS OFI. Measurable Outcome/Analysis: Respondents were asked about awareness, perceived value, and barriers to participation in Maine SNAP-Ed direct education classes. Results were weighted to reflect characteristics of Maine SNAP recipients. Descriptive statistics and 95% confidence intervals were calculated to identify significant differences between groups. Results: Approximately half of Maine SNAP recipients (49%) were aware of Maine SNAP-Ed. Many SNAP recipients (45%) learned about SNAP-Ed classes through other
assistance programs (e.g., WIC). A majority (61%) recognized one or more of Maine SNAP-Ed’s direct education classes by name. Only 7% of SNAP recipients had taken a Maine SNAP-Ed direct education class. However, most SNAP recipients (72%) were “somewhat” or “very interested” in learning how to eat healthy. Those who had taken a Maine SNAP-Ed class reported that the program helped them plan healthy meals for themselves and their family (96%), try a new recipe (91%), and think about making healthier food choices (91%). Barriers to participation mentioned by those who had not taken a Maine SNAP-Ed class included: being unaware that nutrition education classes were offered (52%), difficulty with the locations (43%), disbelieving classes would change behaviors (40%), and being too busy (35%). Approximately 4 in 10 who had not participated (41%) were uninterested in taking a nutrition education class. Conclusion: The majority of Maine SNAP recipients were aware of SNAP-Ed and interested in learning to eat healthy. Maine SNAP-Ed may be able to increase program participation by addressing identified barriers. Funding: SNAP-Ed.
P54 Outcome Evaluation of the University of Tennessee Extension Farmers’ Market Fresh Nutrition Education Program Brent Walker, MS, RD, [email protected], Altarum, 4 Milk St, Ste 303, Portland, ME 04101; Margaret Wilkin, MPH, Altarum; Brenda Wolford, MS, RD, Altarum; Molly Carmody, MA, Altarum; Karen L. Franck, PhD, The University of Tennessee Extension; Christopher T. Sneed, PhD, The University of Tennessee Extension Background: In 2015, University of Tennessee Extension (UT Extension) piloted the nutrition education program Farmers’ Market Fresh (FMF) with a primary objective of encouraging fruit/vegetable (FV) consumption by limited-resource families through purchases at farmers’ markets. FMF is funded by the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) and has since been expanded to over 30 markets statewide. Objective: To measure the effectiveness of FMF among limited-resource families. Study Design, Settings, Participants: Altarum conducted an outcome evaluation to assess exposure, changes in attitudes and behavior, and demographics. Adults were surveyed at SNAP-Ed eligible farmers’ markets with FMF (intervention) and without FMF (comparison) in July and August 2018. Measurable Outcome/Analysis: Descriptive statistics described the sample and outcome variables. Confidence intervals estimated associations between FMF and outcomes. Multivariate logistic regression models were conducted to determine the impact of FMF on outcomes, controlling for demographic characteristics. Results: A total of 382 surveys were completed; 211 intervention and 171 comparison. Intervention respondents Continued on page S57
Journal of Nutrition Education and Behavior Volume 51, Number 7S, 2019 P54 (continued) were two and a half times as likely as comparison to receive information on healthy eating and nutrition, almost three times as likely to learn about purchasing fresh FV on a budget, and 2.4 times as likely to learn about selecting a variety of FV. Intervention respondents were significantly more likely than comparison to report being very confident in their ability to purchase fresh FV on a budget (69% versus 50%) and to select a variety of fresh FV (82% versus 68%). Respondents attending the market at least once per week were more likely than those attending less than once per week to report increased FV consumption. Intervention respondents with minor children in the household were significantly more likely than those without children to report trying a new FV (74% versus 52%) and trying a new recipe (74% versus 46%). Conclusion: FMF was successful in reaching farmers’ market shoppers and increasing confidence and behaviors related to healthy eating. Funding: SNAP-Ed.
P55 Behavior-Specific Nutrition Education Intervention Improves Fruit and Vegetable Preference Among Elementary School Children Sanjoy Saha, MS, [email protected], Department of Nutritional Sciences, Texas Tech University, 1301 Akron Ave, College of Human Sciences, Lubbock, TX 79409; Wilna Oldewage-Theron, PhD, RD, Department of Nutritional Sciences, Texas Tech University Objective: To assess the effectiveness of a nutrition education intervention (NEI) to enhance fruit and vegetable (FV) preference among elementary school children. Use of Theory or Research: A six-week NEI informed by the social cognitive theory. Lessons as well as activities were focused on promoting preference of FV. Target Audience: In total, 115 children in 3rd to 5th grade from four elementary schools (where at least 40% of the children were eligible to obtain free lunch) in the South Plains of Texas participated in this study. Program Description: The study was designed with pre- and post-intervention measurements. Class-based nutrition education (25 minutes once a week), and cooking demonstration sessions (20 minutes once a week) for children, and weekly nutrition handout to parents were implemented. Evaluation Methods: A Likert-scale questionnaire (downward) with 10 fruit and 10 vegetable items were administered during both pre- and post-intervention surveys. The participants were also asked during pre- and post-intervention surveys about three foods they would like to buy/eat more if they had money. Data analysis was carried out with using IBM SPSS Statistics (version 23, Chicago IL), and to assess changes in FV preference, Wilcoxon signed-rank test (paired test) was used. Results: Preliminary results show that 51.3% were girls, and 37.4% were African American/Black (Non-Hispanic). Participants had higher preference for fruits than vegetables during both pre- and post-intervention surveys.
Poster Abstracts
S57
Preference for fruits (from 17.04 § 6.00 to 14.43 § 4.45, lower score indicates higher preference), and vegetables (from 26.73 § 6.62 to 23.71 § 7.88, lower score indicates higher preference) improved significantly (P < .05) after the NEI. A significant number of participants (from 62.6% to 88.7%) indicated they would buy/eat at least one fruit or vegetable item/day if they had money, after the intervention (P < .05). Conclusion: A multicomponent based NEI that incorporates behavior-specific nutrition lessons, and hands-on experience, can improve FV preference among children. Funding: Texas Tech University.
P56 Changes in Healthy Eating and Physical Activity Behaviors of Low-Income Adult Georgians Participating in Supplemental Nutrition Assistance Program Education (SNAP-Ed) Jung Sun Lee, PhD, RDN, [email protected], University of Georgia, 280 Dawson Hall, Department of Foods and Nutrition, Athens, GA 30602; Edda Cotto-Rivera, MPH, CHES, University of Georgia; Laurel Sanville, MS, RD, LD, University of Georgia; Joanna Akin, MPH, University of Georgia; Vibha Bhargava, PhD, University of Georgia Objective: To examine the impact of Food Talk: Better U (FTBU), the University of Georgia SNAP-Ed’s new healthy weight management program on healthy eating, food resource management, and physical activity behaviors in a sample of low-income Georgians. Use of Theory or Research: Social cognitive theory and expanded health belief model. Target Audience: SNAP-Ed eligible Georgian adults with children Program Description: FTBU was developed based on a comprehensive formative evaluation. FTBU is a series of four 90-minute lessons taught by paraprofessionals focusing on portion control, goal setting, limiting added sugar, small healthy shifts, and problem-solving strategies. Each lesson includes a sharing session, didactic lesson, physical activity (PA), cooking demonstration and tasting, and goal setting. Evaluation Methods: Outcome evaluation of the program used pre- and post-self-administered questionnaire, 24-hour dietary recalls, and self-reported and measured weight. Outcome measures included Medium Term behavior change indicators (MT1, 2, and 3) from the SNAP-Ed Evaluation Framework and other validated measures. McNemar tests were used to examine changes in reported healthy behaviors between pre- and post-test. Results: A total of 454 low-income Georgians participated in FTBU in FY 2018 (mean age 52.6 § 17.1 years, 74.4% females, 47.6% Black, 68.3% overweight/obese). Overall, participants reported engaging in more healthy behaviors after the intervention. The percent of participants who reported eating more than one fruit (MT1c) and vegetable (MT1d) per day significantly increased after the intervention. Most food resource management indicaContinued on page S58