W2194: Children's Healthy Living Network (CHLN) in the U.S. Affiliated Pacific Region

(Multistate Research Project)

Status: Active

Project Menu

SAES-422 Reports

Annual/Termination Reports:

[09/09/2022] [02/26/2024] [08/07/2024] [09/24/2025]

Date of Annual Report: 09/09/2022

Report Information

Annual Meeting Dates: 08/08/2022 - 08/12/2022
Period the Report Covers: 08/08/2021 - 08/07/2022

Participants

Melanie Hingle, University of Arizona
Melissa Olfert, West Virginia University
Patricia Coleman, Northern Marianas College
Rachel Novotny, University of Hawaii at Manoa
Jean Butel, University of Hawaii at Manoa
Marie Kainoa Fialkowski Revilla, University of Hawaii at Manoa
Monica Esquivel, University of Hawaii at Manoa
Tanisha Aflague, University of Guam
Leslie Shallcross, University of Alaska Fairbanks
Travis Flemming, American Samoa Community College
Helen Chipman, United States Department of Agriculture- NIFA
Mallory Koenings, United States Department of Agriculture- NIFA

Brief Summary of Minutes

Minutes Attachment:

2022 CHLN Annual Meeting Notes.docx

Accomplishments

Short-Term outcomes: Extension Sub-Group: CHL (chl-pacific.org) website updated with additional CHL-related extension tools (social marketing materials) that promote CHL health behaviors for adoption in community.  Monitoring Sub-Group: Enhanced knowledge on status of food security surveillance methods among EFNEP and other systems across the USAP. Description of status of food security prevalence and situation among EFNEP and other systems across the USAP.  Training Sub-Group: Dissemination of Open Education Resource (OER) nutrition textbook materials and increased knowledge on positive impact of OER materials on student learning outcomes. 5 Native Hawaiian dietetics students supported and provided leadership curriculum.  Outputs Extension Sub-Group: Updated CHL website, Social marketing intervention materials, CHL Image Respository Monitoring Sub-Group: EFNEP food security manuscript- submitted; Inventory of food security data resources across USAP region. Training Sub-Group: OER Textbooks, Curriculum, Publications   Activities Extension Sub-Group:  Update CHL website and add COVID-appropriate materials <ul> <li style="font-weight: 400;">New social media marketing materials</li> <li style="font-weight: 400;">New trainings</li> <li style="font-weight: 400;">Review for ADA compliance</li> <li style="font-weight: 400;">Monitor website traffic/metrics pre and post</li> </ul> Monitoring Sub-Group: Analyze EFNEP food security data <ul> <li style="font-weight: 400;">TA write up instructions to get data exported at each jurisdiction</li> <li style="font-weight: 400;">TA to sent data and code to Melissa</li> <li style="font-weight: 400;">Eileen (HI), Adriene (AK), Margaret (FSM, Pohnpei, Kosrae, Chuuk coordinators travel between islands), Travis/Molly (AS), Patty (NMI), </li> </ul> Draft manuscript Support incorporation into CHL FS model  Publish manuscript Identify new opportunities to get food security questions included on surveys (Head Start, BRFSS, NCD Hybrid Survey) Community Health Centers) Gather food security tools utilized across jurisdictions and programs Training Sub-Group: Maintain Human Nutrition OER textbook Develop Lifespan Nutrition OER textbook Revise introductory nutrition curriculum Support the training of Native Hawaiian undergraduate students in dietetics Offering online classes through the CHL SI Train instructors in online education Develop Maternal and Child Health OER Textbook Publish findings on impact of integrated learning activities in OER Support the training of graduate students in CHL Food Systems   Milestones Extension Sub-Group: <ol> <li style="font-weight: 400;">Request new resources from jurisdictions - COMPLETED</li> <li style="font-weight: 400;">Review existing <a href="https://docs.google.com/spreadsheets/d/1AiKNL24_R7j4neFZgRviGgVIRPBjB1zb/edit#gid=1346937055">resources</a> on website - COMPLETED</li> <li style="font-weight: 400;">Remove antiquated resources - NOT STARTED*</li> <li style="font-weight: 400;">Review new resources for ADA compliance - NOT STARTED*</li> <li style="font-weight: 400;">Post new resources - NOT STARTED*</li> <li style="font-weight: 400;">advertise/market availability of resources -NOT STARTED*</li> </ol> * Due to the CHL website template not being able to be updated, the CHL Wordpress template needs to be changed.  This will change the website pages.  It was decided to wait until the website template has moved to the new template.   Monitoring Sub-Group: 1- send instructions to jurisdictions to download EFNEP data 2- share data with Melissa at WVU 3- Melissa- data analysis 3a -Abstract writing 3b- Abstracts submitted to APHA (6) 4- Manuscript writing 5- Submit Manuscript 6- Identify list food security data sources in retion (who, what, where)   Training Sub-Group: Release OER textbooks (Human Nutrition and Lifespan Nutrition) Launch revised introductory nutrition curriculum Offer at least 3 different courses during the summer through the CHL SI Support the graduation of at least 2 CHLD scholars Matriculate 5 graduate students into the CHL Food Systems training program Complete data analysis on the impacts of OER integrated learning activities

Publications

Book Chapters   Suzanne Held, Alma Knows His Gun McCormick, Vanessa Simonds, Kathryn L. Braun, Linda Burhansstipanov, Emily Haozous, Valerie Rangel, Jane J. Chung-Do, Ilima Ho-Lastimosa, Rachel Novotny, and Marie Kainoa Fialkowski Revilla. Using Community-based Participatory Research to Address Indigenous Health. In: Improving Indigenous Public Health through Community-Engaged Interventions: Stories of Success. University Press of Kentucky. 2022.   Books   Collaborative Open Education Resource Textbook by faculty and students from the Department of Human Nutrition, Food and Animal Sciences. Human Nutrition (Version 2e). Available at: <a href="https://pressbooks.oer.hawaii.edu/humannutrition2e22/" data-saferedirecturl="https://www.google.com/url?q=https://pressbooks.oer.hawaii.edu/humannutrition2e22/&source=gmail&ust=1663102765613000&usg=AOvVaw3HHvwEbC4LYh4OP1hrN_Z-">https://pressbooks.oer.hawaii.edu/humannutrition2e22/</a>   Publications Novotny R, Yamanaka A,  Butel J, Boushey CJ, Dela Cruz R, Aflague T, Coleman, P, Shallcross L, Fleming T, Wilkens LR. Maintenance Outcomes of the Children’s Healthy Living Program on Overweight, Obesity, and Acanthosis Nigricans Among Young Children in the US-Affiliated Pacific Region: A Randomized Clinical Trial. JAMA Netw Open. 2022;5(6):e2214802. doi:10.1001/jamanetworkopen.2022.14802 Dela Cruz R, Wolfe E, Yonemori KM, Fialkowski MK, Wilkens LR, Coleman P, Lameko-Mua S, Johnson E, Gilmatam D, Sigrah C, Shomour M, Remengesau S, Alfred J, Acosta M, Ettienne R, Deenik J, Aflague T, Salazar KA, Novotny R, Boushey CJ. Exploring Foods of the Pacific: Cultural Food Identity in the US Affiliated Pacific Region. Hawaii J Health Soc Welf. 2022. 81(9): 247-252 . Mulville K, Kai J, Kearney JM, Ng-Osorio J, Boushey CJ, Fialkowski MK. A Qualitative Analysis of a Caregivers' Experience of Complementary Feeding in a Population of Native Hawaiian, Other Pacific Islander and Filipino Infants: The Timing of the Introduction of Complementary Foods, and the Role of Transgenerational Experience. Nutrients. 2022;14(16):3268. 2022 Aug 10. doi:10.3390/nu14163268 Fialkowski MK, Sandlin MR, Kai J, Ng-Osorio J, Custodio RC, Odom SK, Boyd JK, Medina C, Takahashi D, Esquivel MK. An Exploratory Mixed Method Cross-sectional Study to Identify Opportunities to Increase Enrollment and Retention of Native Hawaiian Students in an Undergraduate Dietetic Program. J Acad Nutr Diet. 2022 Aug 21:S2212-2672(22)00933-9. doi: 10.1016/j.jand.2022.08.127. Epub ahead of print. PMID: 36002112. Dela Cruz R, Wolfe E, Yonemori KM, Fialkowski MK, Wilkens LR, Coleman P, Lameko-Mua S, Johnson E, Gilmatam D, Sigrah C, Shomour M, Remengesau S, Alfred J, Acosta M, Ettienne R, Deenik J, Aflague TF, Nelson R, Salazar KA, Novotny R, Boushey CJ. Consumption of Traditional Fruits and Vegetables among Children in the US-Affiliated Pacific Region. Curr Dev Nutr. 2022 Jun 16;6(7):nzac101. doi: 10.1093/cdn/nzac101. PMID: 35854938; PMCID: PMC9283104. Joo KA, Fialkowski MK, Esquivel M, Haumea SL. Hawai'i Registered Dietitian Nutritionist 2019-2020 Workforce Assessment. Hawaii J Health Soc Welf. 2022 Apr;81(4 Suppl 2):31-38. PMID: 35495070; PMCID: PMC9036456. Kai J, Chen JJ, Braun KL, Kaholokula JK, Novotny R, Boushey CJ, Fialkowski MK. Associations between Cultural Identity, Household Membership and Diet Quality among Native Hawaiian, Pacific Islander, and Filipino Infants in Hawai'i. Children (Basel). 2022 Jan 2;9(1):48. doi: 10.3390/children9010048. PMID: 35053673; PMCID: PMC8774442. Yamanaka AB, Davis JD, Wilkens LR, Hurwitz EL, Fialkowski MK, Deenik J, Guerrero RT, Novotny R. Peer Reviewed: Determination of Child Waist Circumference Cut Points for Metabolic Risk Based on Acanthosis Nigricans, the Children’s Healthy Living Program. Preventing Chronic Disease. 2021;18.2021;18:210021. DOI:<a href="https://doi.org/10.5888/pcd18.210021">https://doi.org/10.5888/pcd18.210021</a>   Abstracts <div><a href="https://apha2022sessions.hubb.me/AbstractDetail.aspx?id=928268" target="_blank" data-saferedirecturl="https://www.google.com/url?q=https://apha2022sessions.hubb.me/AbstractDetail.aspx?id%3D928268&source=gmail&ust=1663145339590000&usg=AOvVaw2sba8xTat_CmRQiFPkPvN5">Food Insecurity Risk Increases during COVID-19 Pandemic among EFNEP Participants in Micronesia</a>, American Public Health Association Annual Meeting 2022 <div>Presenter: Melissa D. Olfert, Tanisha Aflague</div> <div>Melissa D. Olfert, DrPH, RDN1, Tanisha F. Aflague, PhD, RDN2, Margaret Weital3, Ayron E Walker, MS1, Rachel A. Wattick, MS, RDN1 1West Virginia University, 2University of Guam, 3Cooperative Research and Extension, College of Micronesia</div> </div> <div> </div> <div><a href="https://apha2022sessions.hubb.me/AbstractDetail.aspx?id=928469" target="_blank" data-saferedirecturl="https://www.google.com/url?q=https://apha2022sessions.hubb.me/AbstractDetail.aspx?id%3D928469&source=gmail&ust=1663145339591000&usg=AOvVaw1VMCOVtuT3kTR3i42IUcy6">Food Insecurity Worsens Among EFNEP Participants in North Mariana Islands During COVID-19 Pandemic</a>, American Public Health Association Annual Meeting 2022 <div>Presenter: Melissa D. Olfert, Aflague</div> <div>Patricia Coleman, MS1, Melissa D. Olfert, DrPH, RDN2, Tanisha F. Aflague, PhD, RDN3, Ayron E. Walker, MS2, Rachel A. Wattick, MS, RDN2 1Northern Marianas College, CNMI, 2West Virginia University, 3College of Natural and Applied Sciences, University of Guam</div> <div> </div> <div>Esquivel M, Yamanaka A, Aflague T, Butel J, Coleman P, Deenik J, Fleming T, Shallcross L, Novotny R. Food insecurity and the food environment in the US Affiliated Pacific. National Institutes of Health: Food insecurity, neighborhood food environment, and nutrition health disparities: state of the science virtual workshop. National Virtual Meeting. September 23, 2021</div> </div>

Impact Statements

Strengthened capacity to address food and nutrition status of individuals and communities across the U.S. Affiliated Pacific Region through research, monitoring, and training.

Date of Annual Report: 02/26/2024

Report Information

Annual Meeting Dates: 07/31/2023 - 08/04/2023
Period the Report Covers: 08/08/2022 - 07/30/2023

Participants

Aflague Tanisha CHL FS taflague@triton.uog.edu
Belyeu-Camacho Tayna CHL FS tayna.belyeu-camacho@marianas.edu
Butel Jean CHL Center jbutel@hawaii.edu
Damian Gabrielle (Gabby) CHL FS ookag@triton.uog.edu
De leon Guerrero Jesse CHL FS jesse.dlguerrero@marianas.edu
Dela Cruz Rica CHL Center ricadc@hawaii.edu
Esquivel Monica CHL Center monicake@hawaii.edu
Fleming Travis CHL FS t.fleming@amsamoa.edu
Franck Karen CHL FS kfranck@utk.edu
Galbreath Jennifer CHL Trainee jrkg@hawaii.edu
Hammond Kristi CHL Trainee kristimh@hawaii.edu
Hill Erik CHL Center erikhill@hawaii.edu
Hingle Melanie CHLN hinglem@arizona.edu
Hovmand Peter CHL FS psh39@case.edu
Ing (Townsend Ing) Claire CHL FS clairemt@hawaii.edu
Juarez Ruben CHL FS rubenj@hawaii.edu
Kai Jessie CHL Center jessiek@hawaii.edu
Loke Matthew CHLFS loke@hawaii.edu
Lozano (Panizza) Chloe CHL Center cpanizza@hawaii.edu
McFall Pauline CHL Trainee pmcfall@hawaii.edu
Novotny Rachel CHL Center novotny@hawaii.edu
Olfert Melissa CHLN Melissa.Olfert@mail.wvu.edu
Oshiro Jordan CHL Center jordanmo@hawaii.edu
Revilla (Fialkowski) Marie CHL Center mariekf@hawaii.edu
Shai Hannah CHL Trainee hshai@hawaii.edu
Shallcross Leslie CHL FS lashallcross@alaska.edu
Shvetsov Yurii CHL Center yshvetso@cc.hawaii.edu; yurii@hawaii.edu
Sikayun Ashley CHL FS ashley.sikayun@marianas.edu
Sikes Amelia CHL FS absikes@alaska.edu
Strasburger Sabine CHL Center sabines@hawaii.edu
Toncan Fiorenzo CHL Center ftoncan@hawaii.edu
Vanden Brink Heidi CHLN heidi.vandenbrink@ag.tamu.edu
Wilkens Lynne CHL Center Lynne@cc.hawaii.edu; wilkens@hawaii.edu
Yamanaka Ashley CHL Center aby@hawaii.edu
Yan Feixue CHL Center fyan@hawaii.edu
Bowen Walter CHL/CHLN Walter Bowen
Coleman Patricia (Patty) CHL FS patricia.coleman@marianas.edu
Young Christina CHL Trainee chyoung3@hawaii.edu
Chipman Helen CHLN helen.chipman@usda.gov
Clemens Brett CHL FS bclemens@hawaii.edu
Deenik Jonathan CHL jdeenik@hawaii.edu
Koenings Mallory CHLN mallory.koenings@usda.gov
Lagai Molly CHL FS m.lagai@amsamoa.edu
Ibanez Iesha CHL FS ibanezi@triton.uog.edu
Rios Dareon CHL FS riosd@triton.uog.edu
Rivadeneyra Camino Ivan CHL FS irivaden@hawaii.edu
Tufa Aifili John CHL FS a.tufa@amsamoa.edu

Brief Summary of Minutes

Accomplishments

CHL website: <a href="https://www.chl-pacific.org/">https://www.chl-pacific.org/</a> <img class="wp-image-23670 lazy loaded" src="https://www.chl-pacific.org/wp-content/uploads/2024/04/RESEARCH-IMPACT_04.03.2024.png" alt="" width="1366" height="768" data-src="https://www.chl-pacific.org/wp-content/uploads/2024/04/RESEARCH-IMPACT_04.03.2024.png" data-srcset="https://www.chl-pacific.org/wp-content/uploads/2024/04/RESEARCH-IMPACT_04.03.2024.png 1366w, https://www.chl-pacific.org/wp-content/uploads/2024/04/RESEARCH-IMPACT_04.03.2024-300x169.png 300w, https://www.chl-pacific.org/wp-content/uploads/2024/04/RESEARCH-IMPACT_04.03.2024-1024x576.png 1024w, https://www.chl-pacific.org/wp-content/uploads/2024/04/RESEARCH-IMPACT_04.03.2024-768x432.png 768w" data-sizes="(max-width: 1366px) 100vw, 1366px" data-was-processed="true" />

Publications

IMPACT: <a href="https://www.chl-pacific.org/impact/">https://www.chl-pacific.org/impact/</a>   Publications from Children's Healthy Living (CHL) Center: <a href="https://www.chl-pacific.org/impact/publications-from-program/">https://www.chl-pacific.org/impact/publications-from-program/</a>

Impact Statements

Date of Annual Report: 08/07/2024

Report Information

Annual Meeting Dates: 07/08/2024 - 07/12/2024
Period the Report Covers: 08/04/2023 - 07/12/2024

Participants

Hingle, Melanie (hinglem@arizona.edu) - University of Arizona; Olfert, Melissa (Melissa.Olfert@mail.wvu.edu) - West Virginia University; Coleman, Patricia (patricia.coleman@marianas.edu) - Northern Marianas College; Novotny, Rachel (novotny@hawaii.edu) - University of Hawaii at Manoa; Butel, Jean (jbutel@hawaii.edu) - University of Hawaii at Manoa; Fialkowski Revilla, Marie Kainoa (mariekf@hawaii.edu) - University of Hawaii at Manoa; Esquivel, Monica (monicake@hawaii.edu) - University of Hawaii at Manoa; Aflague, Tanisha (taflague@triton.uog.edu) - University of Guam; Shallcross, Leslie (lashallcross@alaska.edu) - University of Alaska Fairbanks; Flemming, Travis (t.fleming@amsamoa.edu) - American Samoa Community College; Franck, Karen (kfranck@utk.edu) - University of Tennessee; Panizza Lozano, Chloe (cpanizza@hawaii.edu) - University of Hawaii at Manoa; Vanden Brink, Heidi (heidi.vandenbrink@ag.tamu.edu) - Texas A&M University

Brief Summary of Minutes

Accomplishments

Accomplishments Short-Term outcomes: Recipe protocol project: Developed recipe protocol for recipe submissions. Protocol incorporated into Hawai’i Foods website (https://nutritioncenter.ctahr.hawaii.edu/hawaii-foods/). Applied USDA Smart Snack criteria for nutrition that encourage consumption of local grown/produced foods in U.S. Affiliated Pacific (USAP) jurisdictions to recipe protocol. Expanded Food and Nutrition Education Program (EFNEP) and Children’ Healthy Living (CHL) Diet Quality project: Enhanced knowledge by sharing preliminary findings of association between EFNEP adult HEI and CHL child HEI. Expanded Food and Nutrition Education Program (EFNEP) food security project: Shared status of food security data measures being conducted in the CHL jurisdictions. Obtained multi-year data from EFNEP to conduct analysis. Collected and presented data on food subsistence among EFNEP and SNAP-Ed participants in Guam and Hawaii. Outputs CHL Healthy Snack protocol developed (see attached protocol) CHLN page created on CHL website (https://www.chl-pacific.org/chln/) Availability of Locally Produced Foods in the Children’s Healthy Living Food Cost Survey for the United States Affiliated Region manuscript – submitted Assessing and Measuring Food Security in U.S.-Affiliated Pacific Households: A Scoping Review Protocol – created on Open Science Framework (https://osf.io/sxphj/). Inventory of “gray literature” food security measures across the USAP region (see attached spreadsheet) Preliminary findings of association between EFNEP adult HEI and CHL child HEI. Activities Recipe Protocol project • Refine protocol based on feedback from CHLN members • Prepare and publish manuscript • Present at conference (SNEB or ASNNA?) • Place protocol on CHLN webpage o Monitor website traffic/metrics pre and post EFNEP and CHL Diet Quality project • Conduct survey with EFNEP coordinators to understand the diet recall process used in EFNEP • Prepare and publish manuscript • Present at conference (EFNEP conference or ASN?) EFNEP Food Security project • Complete Scoping Review • Prepare and publish scoping review manuscript • Finalize study design and methods • Clean EFNEP data • Conduct analysis • Draft manuscript NEW PROJECT: Explore the concepts around subsistence, and non-vendor distributed methods of food acquirements as they relate to household nutrition security. • Conduct meetings to understand components of subsistence and non-vendor distributed methods of food acquirements. • Develop definition(s) subsistence and non-vendor distributed methods of food acquirements as they relate to household nutrition security. • Conduct literature review for measures of nutrition security, subsistence and non-vendor distributed methods of food acquirements. Milestones To establish a CHL Healthy Snacks Recipe Protocol by July 2025 1) CHL Healthy Snacks recipe protocol - COMPLETED 2) Pilot testing of CHL Healthy Snacks recipe protocol - COMPLETED 3) Revise CHL Healthy Snack recipe protocol based on pilot feedback – September 2024 4) Disseminate protocol – July 2025 a) Protocol on website (CHLN and Hawai’i Foods) – January 2025 b) Prepare manuscript for publishing – March 2025 Study associations between EFNEP adult HEI and CHL child HEI by July 2025 1) Conduct preliminary analysis – COMPLETED 2) Revise analysis based on preliminary feedback from CHLN meeting – October 2024 3) Revise EFNEP coordinator survey – August 2024 4) Conduct EFNEP coordinator survey – September 2024 5) Prepare manuscript for publication – December 2024 Conduct a descriptive study of EFNEP data related to food security by July 2025 1) Prepare scoping review of food security in USAP – March 2025 2) Develop study design and methods – October 2024 3) Clean EFNEP data – January 2025 4) Conduct analysis – May 2025

Publications

Publications Sparks KS, Fialkowski MK, Dela Cruz R, Grandinetti A, Wilkens L, Banna JC, Bersamin A, Paulino Y, Aflague T, Coleman P, et al. Acculturation and Health Status in the Children’s Healthy Living Program in the Pacific Region. International Journal of Environmental Research and Public Health. 2024; 21(4):448. https://doi.org/10.3390/ijerph21040448 Ryan, S. T., Okely, A. D., Chong, K. H., Stanley, R. M., Randle, M., Waqa, G., Yamanaka, A. B., Guerrero, R. L., Coleman, P., Shallcross, L., Wilkens, L. R., Deenik, J. L., & Novotny, R. (2024). Proportion and Correlates of Children in the US-Affiliated Pacific Region Meeting Sleep, Screen Time, and Physical Activity Guidelines. Journal of physical activity & health, 1:11. Advance online publication. https://doi.org/10.1123/jpah.2023-0463 Dela Cruz, R., Galbreath, J., Butel, J., Yamanaka, A. B., Wilkens, L. R., Aflague, T., Coleman, P., Shallcross, L., McFall, P., & Novotny, R. (2024). Social determinants of health literacy among parents and caregivers in the US-Affiliated Pacific. Health promotion international, 39(1), daae002. https://doi.org/10.1093/heapro/daae002 Dela Cruz, R., Novotny, R., Wilkens, L. R., Shvetsov, Y. B., Yamanaka, A. B., Butel, J., Aflague, T. F., Coleman, P., Shallcross, L., Deenik, J., Mapa, V. L. R., Boushey, C. J., & Fleming, T. (2023). Diet Quality of Young Children in the US-Affiliated Pacific's Children's Healthy Living (CHL) Program. Journal of the Academy of Nutrition and Dietetics, S2212-2672(23)01309-6. Advance online publication. https://doi.org/10.1016/j.jand.2023.08.003 Novotny, R., Aflague, T., Butel, J., Coleman, P., Fleming, T., Frank, K., Hovmand, P., Ing, C., Oshiro, J., Shallcross, L., Wilkens, L. (2023). Putting People Back Into Community Food Systems: Community-Based System Dynamics Children’s Healthy Living Food Systems. Current Developments in Nutrition, 7 (Suppl 1). <a href="https://doi.org/10.1016/j.cdnut.2023.100267">https://doi.org/10.1016/j.cdnut.2023.100267</a> Perez, R., Aflague, T., Badowski, G., Guerrero, R. L., Yamanaka, A., Wilkens, L., & Novotny, R. (2023). Association Between Healthy Food Store Accessibility and Obesity Prevalence Among School-Age Children in Guam. Journal of Nutrition Education and Behavior, 55(7), 61-62.   Abstracts Butel, J., Yamanaka A., Braun, K.L., Revilla M.K., Esquivel, M., Fleming, T., Coleman, P., Shallcross, L., Aflague, T., and Novotny, R. Sustaining a Multi-level, Multi-Site Intervention: A Case-Study from the Children’s Healthy Living Program. International Society of Behavioral Nutrition and Physical Activity, Omaha, NE (May 2024).

Impact Statements

Strengthened capacity to address food patterns and nutrition status of individuals and communities across the U.S. Affiliated Pacific Region through research, monitoring, extension, and training.
Development of CHL Healthy Snack recipe protocol using USDA healthy snack criteria to identify healthy snacks and reduce consumption of snacks that are high in calories, saturated fat, sodium and/or added sugars but low in nutrient density.
Obtained EFNEP data to study associations between dietary patterns between adults and children to better understand diet patterns in the USAPR.
Obtained EFNEP data to describe food security at the individual and household level to better understand food security in the region.
Develop questions to measure food subsistence and non-vendor distributed methods of food acquirements as they relate to household nutrition security.

Date of Annual Report: 09/24/2025

Report Information

Annual Meeting Dates: 07/17/2025 - 07/18/2025
Period the Report Covers: 07/12/2024 - 07/17/2025

Participants

Brief Summary of Minutes

Project/Activity Number: W2194

Project/Activity Title: Children’s Healthy Living Network (CHLN) in the U.S. Affiliated Pacific Region

Period Covered: 07/12/2024 to 07/17/2025

Date of This Report:

Annual Meeting Date(s): 07/17/2025

Participants

Hingle, Melanie (hinglem@arizona.edu) - University of Arizona (Not present); Olfert, Melissa (Melissa.Olfert@mail.wvu.edu) - West Virginia University (Not present); Coleman, Patricia (patricia.coleman@marianas.edu) - Northern Marianas College; Novotny, Rachel (novotny@hawaii.edu) - University of Hawaii at Manoa; Butel, Jean (jbutel@hawaii.edu) - University of Hawaii at Manoa; Fialkowski Revilla, Marie Kainoa (mariekf@hawaii.edu) - University of Hawaii at Manoa; Esquivel, Monica (monicake@hawaii.edu) - University of Hawaii at Manoa; Aflague, Tanisha (taflague@triton.uog.edu) - University of Guam; Shallcross, Leslie (lashallcross@alaska.edu) - University of Alaska Fairbanks; Flemming, Travis (t.fleming@amsamoa.edu) - American Samoa Community College; Franck, Karen (kfranck@utk.edu) - University of Tennessee; Panizza Lozano, Chloe (cpanizza@hawaii.edu) - University of Hawaii at Manoa; Vanden Brink, Heidi (heidi.vandenbrink@ag.tamu.edu) - Texas A&M University; Ashley Yamanaka (aby@hawaii.edu) - University of Hawaii at Manoa; Ashley McGuigan (aamcguig@hawaii.edu) – University of Hawaii at Manoa

Please see attached spreadsheet of non-CHLN member attendees, CHLN annual meeting agenda

Brief Summary of Minutes of Annual Meeting

Attached file:

CHLN Annual meeting notes

CHLN Annual meeting slides

Accomplishments

Short-Term outcomes:

Recipe protocol project: Tested recipe protocol for recipe submissions at the Western Region Expanded Food and Nutrition Education Program (EFNEP). Submitted a Great Educational Materials (GEM) article to the Journal of Nutrition Education and Behavior.

Expanded Food and Nutrition Education Program (EFNEP) and Children’ Healthy Living (CHL) Diet Quality project: Conducted survey with EFNEP coordinators to better understand the 24-hour diet recall training. Presented survey results. Presented analysis of CHL participant HEI 2020 scores and EFNEP participant HEI 2020 scores for the USAP region. Identified similarities and differences between the two groups.

Expanded Food and Nutrition Education Program (EFNEP) food security project: Developed method for analyzing EFNEP food security questions across the 3 versions of the EFNEP survey cycles so food security could be compared from 2013 through 2023 among EFNEP participants. Analyzed differences between those who were food secure versus those who were food insecure by EFNEP survey question domains (food resource management, diet quality, food safety and physical activity). Presented results for all CHLN represented states and jurisdictions, and USAP jurisdictions only. Update and preliminary findings on Assessing and Measuring Food Security in U.S.-Affiliated Pacific Households: A Scoping Review.

Explore the concepts around subsistence, and non-vendor distributed methods of food acquirements as they relate to household nutrition security. Identified peer-reviewed and gray literature food security surveys that included questions on subsistence and non-vendor food acquirements.

Outputs

CHL Healthy Snack protocol article submitted.

CHLN and EFNEP data presented at EFNEP National Conference (see attached pdf).

Assessing and Measuring Food Security in U.S.-Affiliated Pacific Households: A Scoping Review peer-review literature and gray literature identified, data extraction spreadsheet developed and completed.

Further analysis of findings of association between EFNEP adult HEI and CHL child HEI and EFNEP 24-hour recall survey completed and findings presented.

Activities

Recipe Protocol project

Showcase learning activities, tools and trainings on how to use the tool on CHL website

Revise and resubmit JNEB article

EFNEP Food Security project

Prepare and publish scoping review manuscript

Add in an “Contiguous States” column

Make changes based on feedback from CHLN annual meeting

Prepare abstract for a future conference

Draft manuscript and send out for review

Consider other manuscripts based on results.
- Manuscript idea: Comparing food security measures across survey cycles.
- Manuscript idea: Explore food security measures that are relative to the Pacific.

Explore the concepts around subsistence, and non-vendor distributed methods of food acquirements as they relate to household nutrition security.

Examine CHL data from the Freely Associated States that collected data on food sources.

Evaluate Impact of CHL Training Program activities to address child health in the USAP.

Compile evaluations of training program activities and trainee presentations

Develop a network map of past CHL trainees

Regional Food Composition

Compile comparative list of analytical capabilities and instrumentation across CHLN sites

Improve breastfeeding support in the CHLN jurisdictions

Examine CHL data for prevalence and duration of breastfeeding in the USAP

Develop materials and campaigns for supporters of breastfeeding women

Milestones

Establish a CHL Healthy Snacks Recipe Protocol by July 2026

CHL Healthy Snacks recipe protocol - COMPLETED

Pilot testing of CHL Healthy Snacks recipe protocol - COMPLETED

Revise CHL Healthy Snack recipe protocol based on pilot feedback – COMPLETED

Disseminate protocol – ONGOING
1. Protocol on website (CHLN and Hawai’i Foods) – January 2026
2. Prepare manuscript for publishing – COMPLETED
3. Showcase tools and trainings on CHLN website – July 2026
4. Develop recipes using the protocol – January 2026

Study associations between EFNEP adult HEI and CHL child HEI by July 2025

Conduct preliminary analysis – COMPLETED

Revise analysis based on preliminary feedback from 2024 CHLN meeting – COMPLETED

Revise EFNEP coordinator survey – COMPLETED

Conduct EFNEP coordinator survey – COMPLETED

Prepare manuscript for publication – December 2025

Conduct a descriptive study of EFNEP data related to food security by July 2026

Prepare scoping review of food security in USAP – COMPLETED

Develop study design and methods – COMPLETED

Clean EFNEP data – COMPLETED

Conduct analysis – COMPLETED

Disseminate results – July 2026
1. Prepare scoping review manuscript for publishing – December 2025
2. Prepare descriptive EFNEP food security manuscript for publishing – May 2026

Subsistence, and non-vendor distributed methods of food acquirements

Impacts

Strengthened capacity to address food patterns and nutrition status of individuals and communities across the U.S. Affiliated Pacific Region through research, monitoring, extension, and training.

Indicators:

Development of CHL Healthy Snack recipe protocol using USDA healthy snack criteria to identify healthy snacks and reduce consumption of snacks that are high in calories, saturated fat, sodium and/or added sugars but low in nutrient density.

Analyzed EFNEP and CHL data for associations between dietary patterns between adults and children to better understand diet patterns in the USAPR.

Analyzed EFNEP data to describe EFNEP survey responses by food security status to better understand food security in the region.

Identified food subsistence and non-vendor distributed methods of food acquirements in peer-reviewed and gray literature.

Publications

Jacobs, J., Backholer, K., Allender, S., Brown, V., Orellana, L., Novotny, R., Wolfenden, L., Moodie, M., & Nichols, M. (2025). The impact of community-based childhood obesity prevention interventions in Australia by socio-economic position: An individual participant data meta-analysis. Pediatric obesity, e70031. Advance online publication. https://doi.org/10.1111/ijpo.70031

Hovmand, P. S., Franck, K., Butel, J., Galbreath, J., Esquivel, M., Coleman, P., ... & Novotny, R. (2025). Developing Group Model Building Workshops for Children’s Healthy Living (CHL) Food Systems. Current Developments in Nutrition, 104583.

Shvetsov, Y. B., Yamanaka, A. B., Dela Cruz, R., Butel, J., Hammond, K., Aflague, T. F., Coleman, P., Shallcross, L., Fleming, T., Fialkowski, M. K., Wilkens, L. R., & Novotny, R. (2025). Two a priori dietary indices among young children in the Children's Healthy Living (CHL) Trial: validation and association with health outcomes. The Journal of nutrition, S0022-3166(25)00170-1. Advance online publication.

Butel, J., Yamanaka, A., Shallcross, L., Fleming, T., Coleman, P., Aflague, T., Novotny, R. (2025). Availability of Locally Produced Foods in the Children’s Healthy Living Center’s Food Cost Survey for the United States Affiliated Region. Hawaii J Health Soc Welf. 2024;84(2):38-44.

Dela Cruz, R., Galbreath, J., Butel, J., Yamanaka, A. B., Wilkens, L. R., Aflague, T., Coleman, P., Shallcross, L., McFall, P., & Novotny, R. (2024). Social determinants of health literacy among parents and caregivers in the US-Affiliated Pacific. Health promotion international, 39(1), daae002. https://doi.org/10.1093/heapro/daae002

Dumuid, D., Yamanaka, A. B., Chong, K. H., Okely, A. D., Wilkens, L. R., Shvetsov, Y. B., Lozano, C. P., & Novotny, R. (2025). Diet, Activity and Sleep Clusters Associated With Obesity Markers of Children in the US-Affiliated Pacific. Acta paediatrica (Oslo, Norway : 1992), 10.1111/apa.70012. Advance online publication.

Seale, L. A., Yamanaka, A. B., Hammond, K., Lim, E., Wilkens, L. R., McFall, P., ... & Novotny, R. (2025). Dietary Micronutrient Intake and the Prevalence of Metabolic Conditions among Children from the United States–Affiliated Pacific Region in the Children’s Healthy Living Program. Current Developments in Nutrition, 9(1), 104531.

Jacobs, J., Wolfenden, L., Bolton, K. A., Brown, V., Sultana, M., Backholer, K., Allender, S., Novotny, R., Peeters, A., & Nichols, M. (2024). Umbrella review of systematic reviews to inform the development and translation of community-based childhood obesity prevention interventions. Obesity reviews: an official journal of the International Association for the Study of Obesity, e13864. Advance online publication. https://doi.org/10.1111/obr.13864.

Chong, K. H., Suesse, T., Cross, P. L., Ryan, S. T., Aadland, E., Aoko, O., Byambaa, A., Carson, V., Chaput, J. P., Christian, H., Cliff, D. P., De Craemer, M., de Lucena Martins, C. M., Delisle Nyström, C., Draper, C. E., El Hamdouchi, A., Florindo, A. A., Guan, H., Ha, A. S., Hamzavi Zarghani, N., … Okely, A. D. (2024). Pooled Analysis of Physical Activity, Sedentary Behavior, and Sleep Among Children From 33 Countries. JAMA pediatrics, 178(11), 1199–1207. https://doi.org/10.1001/jamapediatrics.2024.3330

Novotny, Rachel, Rica Dela Cruz, Ashley Yamanaka, Jean Butel, Jordan Oshiro, Lynne Wilkens, Karen Franck et al. "Regional Causal Loop Diagram With Action Ideas for Improving Child Diet Quality and Weight Status in the Children’s Healthy Living Food Systems (CHLFS) Program." Current Developments in Nutrition 8 (2024).

Yamanaka, Ashley B., Lucia A. Seale, Kristi Hammond, Eunjung Lim, Leslie Shallcross, Tanisha Aflague, and Rachel Novotny. "Micronutrient Intake and Metabolic Status Among Children in the US-Affiliated Pacific Region." Current Developments in Nutrition 8 (2024).

Conference Presentations

Butel, J. CHL Network Multistate Project (W2194). Expanded Food and National Nutrition Education Program Coordinators Conference. Washington, D.C. Feb. 2025

Galbreath, J. Assessing and Measuring Food Security in U.S.-Affiliated Pacific Households: A Scoping Review. Alaska Food Festival and Conference, March 27-29, in Kodiak, AK (8th sesquiennial conference).

Accomplishments

Milestones Establish a CHL Healthy Snacks Recipe Protocol by July 2026 <ul> <li>CHL Healthy Snacks recipe protocol - COMPLETED</li> <li>Pilot testing of CHL Healthy Snacks recipe protocol - COMPLETED</li> <li>Revise CHL Healthy Snack recipe protocol based on pilot feedback – COMPLETED</li> <li>Disseminate protocol – ONGOING <ol> <li>Protocol on website (CHLN and Hawai’i Foods) – January 2026</li> <li>Prepare manuscript for publishing – COMPLETED</li> <li>Showcase tools and trainings on CHLN website – July 2026</li> <li>Develop recipes using the protocol – January 2026</li> </ol> </li> </ul> Study associations between EFNEP adult HEI and CHL child HEI by July 2025 <ul> <li>Conduct preliminary analysis – COMPLETED</li> <li>Revise analysis based on preliminary feedback from 2024 CHLN meeting – COMPLETED</li> <li>Revise EFNEP coordinator survey – COMPLETED</li> <li>Conduct EFNEP coordinator survey – COMPLETED</li> <li>Prepare manuscript for publication – December 2025</li> </ul> Conduct a descriptive study of EFNEP data related to food security by July 2026 <ul> <li>Prepare scoping review of food security in USAP – COMPLETED</li> <li>Develop study design and methods – COMPLETED</li> <li>Clean EFNEP data – COMPLETED</li> <li>Conduct analysis – COMPLETED</li> <li>Disseminate results – July 2026 <ol> <li>Prepare scoping review manuscript for publishing – December 2025</li> <li>Prepare descriptive EFNEP food security manuscript for publishing – May 2026 </li> </ol> </li> </ul> Subsistence, and non-vendor distributed methods of food acquirements

Publications

Publications Jacobs, J., Backholer, K., Allender, S., Brown, V., Orellana, L., Novotny, R., Wolfenden, L., Moodie, M., & Nichols, M. (2025). The impact of community-based childhood obesity prevention interventions in Australia by socio-economic position: An individual participant data meta-analysis. Pediatric obesity, e70031. Advance online publication. <a href="https://doi.org/10.1111/ijpo.70031">https://doi.org/10.1111/ijpo.70031</a> Hovmand, P. S., Franck, K., Butel, J., Galbreath, J., Esquivel, M., Coleman, P., ... & Novotny, R. (2025). Developing Group Model Building Workshops for Children’s Healthy Living (CHL) Food Systems. Current Developments in Nutrition, 104583. Shvetsov, Y. B., Yamanaka, A. B., Dela Cruz, R., Butel, J., Hammond, K., Aflague, T. F., Coleman, P., Shallcross, L., Fleming, T., Fialkowski, M. K., Wilkens, L. R., & Novotny, R. (2025). Two a priori dietary indices among young children in the Children's Healthy Living (CHL) Trial: validation and association with health outcomes. The Journal of nutrition, S0022-3166(25)00170-1. Advance online publication. Butel, J., Yamanaka, A., Shallcross, L., Fleming, T., Coleman, P., Aflague, T., Novotny, R. (2025). Availability of Locally Produced Foods in the Children’s Healthy Living Center’s Food Cost Survey for the United States Affiliated Region.  Hawaii J Health Soc Welf. 2024;84(2):38-44. Dela Cruz, R., Galbreath, J., Butel, J., Yamanaka, A. B., Wilkens, L. R., Aflague, T., Coleman, P., Shallcross, L., McFall, P., & Novotny, R. (2024). Social determinants of health literacy among parents and caregivers in the US-Affiliated Pacific. Health promotion international, 39(1), daae002. https://doi.org/10.1093/heapro/daae002 Dumuid, D., Yamanaka, A. B., Chong, K. H., Okely, A. D., Wilkens, L. R., Shvetsov, Y. B., Lozano, C. P., & Novotny, R. (2025). Diet, Activity and Sleep Clusters Associated With Obesity Markers of Children in the US-Affiliated Pacific. Acta paediatrica (Oslo, Norway : 1992), 10.1111/apa.70012. Advance online publication. Seale, L. A., Yamanaka, A. B., Hammond, K., Lim, E., Wilkens, L. R., McFall, P., ... & Novotny, R. (2025). Dietary Micronutrient Intake and the Prevalence of Metabolic Conditions among Children from the United States–Affiliated Pacific Region in the Children’s Healthy Living Program. Current Developments in Nutrition, 9(1), 104531. Jacobs, J., Wolfenden, L., Bolton, K. A., Brown, V., Sultana, M., Backholer, K., Allender, S., Novotny, R., Peeters, A., & Nichols, M. (2024). Umbrella review of systematic reviews to inform the development and translation of community-based childhood obesity prevention interventions. Obesity reviews: an official journal of the International Association for the Study of Obesity, e13864. Advance online publication. https://doi.org/10.1111/obr.13864. Chong, K. H., Suesse, T., Cross, P. L., Ryan, S. T., Aadland, E., Aoko, O., Byambaa, A., Carson, V., Chaput, J. P., Christian, H., Cliff, D. P., De Craemer, M., de Lucena Martins, C. M., Delisle Nyström, C., Draper, C. E., El Hamdouchi, A., Florindo, A. A., Guan, H., Ha, A. S., Hamzavi Zarghani, N., … Okely, A. D. (2024). Pooled Analysis of Physical Activity, Sedentary Behavior, and Sleep Among Children From 33 Countries. JAMA pediatrics, 178(11), 1199–1207. https://doi.org/10.1001/jamapediatrics.2024.3330 Novotny, Rachel, Rica Dela Cruz, Ashley Yamanaka, Jean Butel, Jordan Oshiro, Lynne Wilkens, Karen Franck et al. "Regional Causal Loop Diagram With Action Ideas for Improving Child Diet Quality and Weight Status in the Children’s Healthy Living Food Systems (CHLFS) Program." Current Developments in Nutrition 8 (2024). Yamanaka, Ashley B., Lucia A. Seale, Kristi Hammond, Eunjung Lim, Leslie Shallcross, Tanisha Aflague, and Rachel Novotny. "Micronutrient Intake and Metabolic Status Among Children in the US-Affiliated Pacific Region." Current Developments in Nutrition 8 (2024).   Conference Presentations Butel, J. CHL Network Multistate Project (W2194). Expanded Food and National Nutrition Education Program Coordinators Conference. Washington, D.C. Feb. 2025 Galbreath, J. Assessing and Measuring Food Security in U.S.-Affiliated Pacific Households: A Scoping Review. Alaska Food Festival and Conference, March 27-29, in Kodiak, AK (8th sesquiennial conference).

Impact Statements

Strengthened capacity to address food patterns and nutrition status of individuals and communities across the U.S. Affiliated Pacific Region through research, monitoring, extension, and training.