SAES-422 Multistate Research Activity Accomplishments Report

Status: Approved

Basic Information

Participants

Attendees: Thursday, September 28-30 1. Beatrice Phillips, Tuskegee, Alabama 2. Barbara Lohse, Pennsylvania State University 3. Megumi Murashima, Michigan State University, grad student 4. Seung-yeon Lee, Michigan State University, post doc 5. Adrienne White, University of Maine 6. Kendra Kattelmann, South Dakota State University 7. Linda Boeckner, University of Nebraska 8. Susan Welsh, CSREES, USDA 9. Sarah Dayton, NY Syracuse NY 10. Tanya Horacek, Syracuse NY 11. Geoff Greene, University of Rhode Island 12. Tanda Kidd, Kansas State University Thursday, September 28, 2006 Attendees: Tanya Horacek NY; Sarah Dayton NY; Maria Erdman NY; Susan Welsh CSREES; Linda Boeckner NE; Kendra Kattelmann SD; Adrienne White ME; Seung yeon Lee MI; Megumi Murashima MI; Bea Phillips AL; Sharon Hoerr MI; Geoff Greene RI; Tanda Kidd KS

9/28/2006 NC219 Annual Meeting September 28-30, 2006 Fayetteville, NY Host: Syracuse University 1. Introductions and State Reports; AL, PA, ME, SD, WI, NE, CSREES, NY, RI, MI CSREES Report. o An agency wide review was held this year. There were 14 portfolio reviews. Some panelists involved were Laura Sims; Margery Caldwell; Larry Jones; Tammy Bray; Judy Wilson; Roger Clemens, Susan Nitzke (IPA); o Welsh will do several CSREES department-wide reviews this year. o National program leaders have been assigned to states, not areas of expertise. Welsh has OH and WV. o Welsh is the liaison to the nutrition department chairs who will meet in WDC November 13-15. A goal is to establish more research between food science and human nutrition, e.g., bioactive food components. Other topics include: § Tailoring functional foods to promote energy balance. § Linda Myers will talk about the new DRI process. § NASs ranking of FS & HN nutrition doctoral programs. § ADA will discuss the new MS required for dietetics. § Possibility of new credentialing program for community nutrition from SNE. § Initiate discussion on integrated programs between nutrition and sports medicine " The USDA budget hasnt passed yet; funding levels are about the same as in former years. o The Farm Bill specifically mentions obesity. NC1028-Promtoing healthful eating to prevent excessive weight gain in young adults is one of two Multi state research funded projects addressing obesity. o The federal administration is still interested in making formula funding (HATCH) more competitive with investigators submitting proposals to be reviewed nationally. " CSREES is interested in working with NASLGUC to identify model campuses for healthy living, especially to reduce obesity. " The NRI was just released with section on obesity 31.5. Proposals are due June 5th. Panels will have expertise on physical activity, economics, and human development, as well as in human nutrition. " There will be a session at EB, 2007 Obesity prevention: integrating research and outreach to consumers. The Nutrition Education RIS recommended this program. It is intended to attract researchers with NRI funding for integrated projects. " Cindy Tuttle is the new nutrition person at CSREES and Director of Nutrition Family/Consumer Sciences. 2. PRECEDE-PROCEED 4 hr workshop. Tanya Horacek & Maria Erdman. " Green & Krueter. (4th ed) Health Program Planning: an Educational and Ecological Approach. McGraw Hill, 2005. " This is a planning model incorporating aspects from several disciplines and behavioral theories. It is a rigorous, iterative application of all four types of evaluation (formative, process, outcome, impact) throughout that involves the community participants at each step and addresses policy and environmental factors as well as individual qualities. " The first step of social diagnosis incorporates assessment of the target groups values, attitudes, lifestyle, etc. " Advantage and limitations of this model are that it features the differences between groups, rather than suppressing differences as does a national level intervention that would use one standardized evaluation form, for example. 3. IFAFS Sprouts (subprojects) update " Progress on projects were reviewed. " Research partners worked in small groups on IFAFS manuscripts in process. Friday, September 29, 2006 1. Subcommittees worked on Webhealth projects and IFAFS manuscripts. 2. Webhealth conference call. Attendees: § Adrienne reported that the online survey has been completed and four focus groups were completed last week for Lesson Exercise #1. § Sue Schembre reported that one student went to the wrong lesson. This problem can be avoided in the future by being sure that students type in the full correct address. A. Adrienne reported for Brian Rahill about updating the Web design and timing for when the lessons will be pilot tested. § SD starts a focus group next week. § The second lesson is set for October 16th and was ready by Sept 29th. Comments must be returned by October 6th. § Each state should get an outside person to provide an outside review; there is a short time line for this. § Lessons 1 and10 will need to be pilot tested informally, but not through the focus group procedures. § Suzanne Shoff and Sue Schembre offered technical assistance to review the lessons. B. Sarah Dayton reported on the systematic approach to incorporate instructional and motivational design models into the curriculum process. She will evaluate the entire curriculum for both internal and external consistency with objectives. This is a two step process: 1) technical-immediate; 2) Sarahs lesson evaluation-in November. " Technical changes will likely be those that can be incorporated in October. " Each lesson will be evaluated using Sarahs lesson evaluation model (incorporating the Dick and Carey model and the ARCs model). This comprehensive assessment tests for lesson consistency as well as ability to motivate the audience. " Volunteers to do this were SD, NY, WI, MI, AL, RI. Sarah will be the organizer of this assessment. C. Barbara reported for the instrument committee (Suzanne, Kendra, Barb). 1. Instruments to be used this fall: " For this set of focus groups, we have the 12-item GHQ-12 Quality of life, BMSLSS instruments to be able to control for other life stressors. " Two other items: course credit load, work load outside of school " F/V intake 2 item self assessment; perceived F/V goal. " Self assessed physical activity from myPyramid. 2. Sue Schembre reported on the training DVD for the step test. " There are four measuresHeight, weight, waist circumference, step test. " There also needs to be written instructions and a paper reporting form for these test. " All states need to use a wall mounted stadiometer and a digital or balance beam scale for the anthropometric measurements. " Suzanne Shoff will send the reporting form to Sue Schembre. 3. Barb reminded us that states wishing to collect additional data must submit a SPIDER and the instruments for prior approval. § Barb will do cheek swabs for a genetic marker test in her states pilot for 25 subjects. § Michigan wants to do parenting style (and possibly feeding style). § Adrienne pointed out that the incentive for the pilot test was only $20, so additional measures must be limited to only one. 4. Other points related to instruments. " The directions to subjects must provide the time for measurements, proper attire, to arrive fasted, etc. " The step test is from Queens College and Deb Reibe will send us the reference on its validity and reliability to predict VO2Max. " Students will be able to see their results on the website. There needs to be some explanatory text. Each states IRB will need to approve this. " Each state should also include a paper IRB form when the physical assessment is done. Susan Shoff will modify the on-line consent form for the pen and paper form used in the intervention. 5. Recruitment (Linda) Committee reported that states should send names recruitment coordinators to her by October 15. " By November15, each state should have made connections on campus for the recruitment process. IRB approval will be necessary for this recruitment and assessment. " Linda will resend the recruitment manuals. D. Tanya led the discussion on SPIDERS and asked each state to discuss theirs. Directions to the minutes on the web are: http://www.nutritionlearning.com/minutes/ username:webhealth; password: webhealth All manuscripts and theses or dissertations must go through this process. Each PI should communicate directly with Tanya regarding joining a spider. § Barb discussed her spiders a. Cheek swabs for genotype testing. N=25 mostly for the lab techs time ~$2500. PPARS. b. Examination to see if the 4 eating competence lessons are applicable to FSNEP audience and funding. Barb will need additional copies of these 4 lessons. c. Examination of the eating competence outcome status of this group in the focus group data and how it relates to the other data collected. § Megumi and Sharon discussed the idea related to childs parenting style and health status of young adults. § Adrienne reported on her use of online focus groups with young adults § Geoff reported on 2 manuscripts related to the fall focus 2005 groups. We will need apportion investigators to various papers to avoid too many authors on one paper a. Seung yeon reported on one paper about body image and body acceptance, eating and regulation. b. Molly has a paper on the barriers and benefits to maintaining healthy weight. § Sue Schembre will restructure the TFEQ and examine predictive validity with weight change. Her instrument development will result in a new instrument. § Sarahs spider was reprised on curriculum evaluation. E. Adrienne updated the schedule for the spring pilot testing that states should modify based on their semester schedule. " Jan 16-26 recruitment and assessment " Jan 29-Apr 20 intervention " Apr 23-24 post assessment F. Next Web Health conference call October 10, 2pm EST, 1pm CST. 207-581-3555. 3. NC 1028 and IFAFS conference call Sept. 29, 2006 1-3pm Attendees: Tanda Kidd; Adrienne White; Sharon Hoerr; Beatrice Phillips; Linda Boeckner; Sarah Colby; Tanya Horaeck; Susan Nitzke; Geoff Greene; Kendra Kattelmann; Steve Hertzler until 2:20; Nancy Betts for Janice Hermann until 2:20 Absent: Kim Shafer; Janice Hermann. New NC1028 members: Steve Hertzler hertzler@iastate.edu Iowa state Sarah Colby scolby@gfhnrc.ars.usda.gov ARS Janet Hermann (not yet signed up) Oklahoma State Kimberly Schafer (not yet signed up) USDA, Grand Forks A. NC1028 Leadership " Tanda Kidd (Kansas) Secretary from 2006-07. (Sarah Colby  ARS/USDA volunteered to serve for 2007-2008.) Bea Phillips (Tuskegee)  Chair for 2006-07 B. Annual Meeting: NC1028 and NRI: June 5-7, 2007 at URI, Spring Pine, RI. C. Timeline (NC1028) " Tanya reprised a brief overview of the PRECEDE-PROCEED Model to be used in NC1028 intervention. Discussion ensued on processes for involving key players on each campus as participants in the process (establishing relationships). Linda will e-mail reading materials on PRECEDE-PROCEED to those members on the phone call, but who missed the workshop the previous day. " Sarah Colby is holding focus groups with students on her campus dealing with barriers to weight management. Adrienne will send WebHealth focus group questions to Sarah. " Linda Boeckner led a discussion of the first year objectives of the NC1028 proposal. 1. Enhance participatory research skills: Sarah Colby, Tanya and Sharon. Sharon & Tanya will attend the Evaluating Nutrition Education and Health Promotion Conference, October 14-15 in Houston. 2. Establishing partnerships with outreach educators and young adult populations. Each state will do this on our own campuses. Geoff and Seung-Yeon will develop a reporting form to identify how we are doing each period. 3. Initiate epidemiology literature review: Sarah Colby; Susan Nitzke; Adrienne White; Maria Erdman will organize this. 4. Develop grant proposal due June 5th to NRI. Tanda, Linda, Kendra will comprise the writing team. Each state will address college students and some might reach out to other target groups. An NRI goal might be a model for creating healthy living on campus to prevent obesity. They will begin by reformatting the approved NC1028 proposal into the NRI proposal framework. D. Conference Calls- will be every two months. First date: November 16 at 3:00 ET/ 2:00 CT / 1:00 MT Alternate date: November 20 at 9:00 ET/ 8:00 CT / 7:00 MT. Bea Phillips will set up this first conference call. The agenda is to schedule the remaining phone conferences. Susan Nitzke will check into transferring the IFAFS website into the NC1028 website. Username: grantme Password: 3wishes E. Ordering IFAFS materials. Susan Nitzke " " Susan ordered a printing of 10,000 copies of the F & V Connection, available to states. " " FV Express Bites WILL SOON BE available in Spanish as well as English. " " All the newsletters will be printed in English and two in Spanish. All THE UPDATED FILES WILL SOON BE available online. " An order form was sent to all the NC219 group members. Orders received by next week will be shipped free. AFTER THAT, A WAY TO COVER SHIPPING EXPENSES WILL HAVE TO BE IDENTIFIED. " IFAFS distribution committee: Susan, Geoff, Barb, Linda F. Reports " Linda Boeckner has a 5 year report for NC219. " Susan Nitzke must do a 5 year IFAFS report. " Kendra recommended checking with NIMMS to check the reporting formats. " We should be sure to indicate that there are additional publications in process and list the specific topics. " The list of NC219 publications was reviewed. o Under related publications there will be two subheadings: NRI & NC1028 o There are a high number of publications listed with collaborative authorship among NC 219 members. Meeting adjourned 5pm Submitted by Sharon L Hoerr and Beatrice Phillips

Accomplishments

Accomplishments Objective 1: Qualitatively assess the preferred delivery method, as well as the acceptability of stage tailored newsletters in young adults in diverse populations. Print materials (magazine, newsletters, individualized computer-generated letter reports) were designed and field tested in year one of the project, with young adults in each of the participating states. A specialized guidebook and videotape demonstrating interview techniques was used to standardize collection of qualitative data for this phase of the research . 246 individuals were interviewed individually or in focus groups, with proceedings audiotaped, transcribed and analyzed in Nebraska. Information to improve the appearance and wording of the print materials were used by RI to revise a series of colorful theory-based newsletters and an F&V Connection magazine. Methods for distributing these materials (training materials, manuals and newsletters) to stakeholders were determined. Some of these educational materials and training manuals have also been placed on the Food Stamp Nutrition Connections database of reviewed and recommended materials. Manuscripts for scientific peer review were prepared, submitted, and published. Objective 2: Develop a sustained, 6-month stage-tailored intervention for young adults designed to increase consumption of vegetables and fruits tailored for diverse populations of young adults. Work groups were formed for instrument development (Lead: OR, ME), preparation of mailed educational print materials (Lead: RI, NE, OR), standardization of protocols for subject recruitment (Lead: NY, AL, ME, SD), training and procedures for the educational phone call component of the intervention (Lead: NE, KS, RI), and for planning and management of data analysis (Lead: (KS, ME, MI, WI). Materials developed included: screening survey form, recruiting manual and posters, electronic and print templates for subject records, educational phone call procedures manual and stage-based scripts. Instruments developed in previous NC219 research were revised, tested and adapted to meet the telephone time limits for each assessment phone call conducted by WI survey research center. Extension partners contributed to development and testing of many of these recruitment and assessment materials, and refinement of the educational materials. Manuscript about the extension-research partnership was prepared, submitted and published. Electronic files for educational materials were revised to reflect 2005 Dietary Guidelines and distributed via CD to each participating state. Objective 3: Test the efficacy of the intervention compared to a non-treatment control and compare the efficacy across diverse populations. Testing intervention efficacy began in 2003 and was completed in 2004. NC219 research and Extension partners collectively recruited 2042 low income young adults, determined their fruit and vegetable stage of change, administered consent procedures, and implemented the study protocol. The intervention group received stage-tailored newsletters, individualized progress reports and educational phone calls with a focus on improving fruit and vegetable intakes. The intervention was completed by 1255 subjects (61% completion). Manuscript about the intervention outcomes is currently under review. Impacts In the IFAFS-funded research, follow-up interviews 6 months after the 6-month intervention period showed that positive results were achieved and maintained. Participants in the experimental group had higher intakes of fruit and vegetables than controls (perceived daily intakes of 4.90 vs. 4.60 servings per day, F=3.49, p<0.05 and 4.31 vs. 3.92 servings/day via 5-A-Day Screener, F=4.78, p<0.01) and greater progression to action or maintenance stages (66% progress in fruit for intervention vs. 55% progress in fruit for controls; 47% vs. 32% progress for vegetables, p=0.0080 and 0.0001, respectively). Education and supervision of graduate students have been an integral part of the NC219 activity. Graduate students have assisted in all aspects of the integrated projects that have been part of the NC219 multi-state project, have presented their work at national professional conferences, conducted ancillary data collection/analysis and, thus, gained professional experience to enhance their skills and expertise. The work of this group has been extended via Extension systems in the cooperating states. Printed educational materials have been made available to each state in the project, and inservice education on Transtheoretical Model for Behavior Change (Stages of Change) for Extension personnel has been conducted. A web-based educational tool, using the content of the stage-based newsletters and magazine and the adapted assessment instruments, was developed and evaluated for delivery to young adult audiences through the Web (F and V Express Bites, http://www.nutrisci.wisc.edu/fav/). Implications for the use of educational phone calls to support educational delivery leading to eating behavior changes have been identified. Plans to share that information via peer-reviewed research publication are in progress. The majority of work of this group was supported by a USDA IFAFS grant that was awarded in 2001 through 2005 with a no-cost extension until August 2006. A National Research Initiative grant funded a second project with young adults, using stage-based newsletters to enhance fruit and vegetable intake. In 2005, a National Research Initiative Integrated Projects grant was received to support additional work with young adults related to weight management and healthy food and physical activity choices. These additional funding sources are: 2001-2005 A Stage-Based Intervention to Increase Fruit and Vegetable Intakes of Young Adults. USDA/IFAFS. Susan Nitzke, Principal Investigator with subcontracts to each of the states in the Multi-State Research Project. Total Award: $2 million. 2001-2005 Using the Stages of Change Model to Increase Fruit and Vegetable Intake. USDA/NRI. Nancy Betts, Principal Investigator. Total Award: $400,000. 2005-2009 Behavior Modification for Obesity Prevention in Young Adults. USDA/NRI Integrated Project. Geoffrey Greene, Principal Investigator with subcontracts to ME, NY, AL, MI, WI, SD, PA. Total Award: $1,127,707. The work of this research group is being continued through a recently approved Multi-State Research Project NC-1028: Promoting healthful eating to prevent excessive weight gain in young adults, 2006-2011. The NC219 project team was successful in developing theory-based education strategies for low-income young adults between the ages of 18-24. However, the researchers discovered that young adults were more likely to drop from the intervention study if they had very low incomes (< $800 per month), were of ethnic minority status and/or were parents. The new multi-state project will use principles of community based participatory research to further increase relevance and accessibility of nutrition education programs, and reduce the attrition found within harder-to-reach segments of young adult audiences.

Impacts

  1. In the IFAFS-funded research, follow-up interviews 6 months after the 6-month intervention period showed that positive results were achieved and maintained. Participants in the experimental group had higher intakes of fruit and vegetables than controls (perceived daily intakes of 4.90 vs. 4.60 servings per day, F=3.49, p<0.05 and 4.31 vs. 3.92 servings/day via 5-A-Day Screener, F=4.78, p<0.01) and greater progression to action or maintenance stages (66% progress in fruit for intervention vs. 55% progress in fruit for controls; 47% vs. 32% progress for vegetables, p=0.0080 and 0.0001, respectively).
  2. The work of this group has been extended via Extension systems in the cooperating states. Printed educational materials have been made available to each state in the project, and inservice education on Transtheoretical Model for Behavior Change (Stages of Change) for Extension personnel has been conducted. A web-based educational tool, using the content of the stage-based newsletters and magazine and the adapted assessment instruments, was developed and evaluated for delivery to young adult audiences through the Web (F and V Express Bites, http://www.nutrisci.wisc.edu/fav/). Implications for the use of educational phone calls to support educational delivery leading to eating behavior changes have been identified.

Publications

NC-219 Using Stages of Change Model to promote consumption of grains, vegetables and fruits by young adults NC219 Refereed Publications 2001 Ma J, Betts NM, Horacek T. (2001). Measuring stage of change for assessing readiness to increase fruit and vegetable intake. Am J Health Promot. 16(2):88-97. Shafer, KJ, Knous, BL. (2001). A Longitudinal Study of Cognitive and Affective Behavior in a Didactic Program in Dietetics: Implications for Dietetics Education. J Am Diet Assoc. 101:1051-1054. 2002 Chung SJ, Hoerr SL, Levine R, Song WO, Coleman G. (2002). Validity for classifying the stages of change among dietary assessment methods on eating fruits and vegetables for American college students. Kor J Comm Nutr. 4(3): 143-150. Horacek T, Greene G, Georgiou C, White A, Ma J. (2002). Comparison of three methods for assessing fruit, vegetable, and grain Stages of Change for young adults. Top Clin Nutr. 17(5): 36- 61. Horacek T, White A, Betts N, Hoerr S, Georgiou C, Nitzke S, Ma J, Greene G. (2002). Stage of change for fruit and vegetable intake. Nutr Res Newsl. 21(11):7-11. Horacek T, White A, Greene G, Betts NM, Hoerr S, Georgiou C, Nitzke S, Ma J. (2002). Decisional balance, self-efficacy and weight satisfaction discriminate stages of change for fruit and vegetable intakes among young men and women. J Am Diet Assoc. 102:1466-1470. Ma J, Betts NM, Horacek T, Georgiou C, White A, Nitzke S. (2002). The importance of decisional balance and self-efficacy in relation to stages of change for fruit and vegetable intakes by young adults. Am J Health Promot. 16:157-166. 2003 Greene G, Horacek T, White A, Ma J. (2003). Use of a diet interview method to define Stages of Change in young adults for fruit, vegetable and grain intake. Top Clin Nutr 18(1): 32-41. Ma J, Betts NM, Horacek T, Georgiou C, White A. (2003). Assessing stages of change for fruit and vegetable intake in young adults: A combination of traditional staging algorithms and food frequency questionnaires. Health Educ Res. 18:224-236. 2004 Nitzke, S. N., K.R. Kritsch, B. Lohse, T. Horacek, A. White, G. Greene, C. Georgiou, N. Betts, L. Boeckner. (2004). Extension and research professionals join forces to address a critical nutrition issue. J. Extens. 42(5):1-7, Accessible at: wwwjoe.org/joe/2004october/iwl.shtmi 2005 Chung SJ, Hoerr SL. (2005). Predictors of fruit and vegetable intakes in young adults by gender. Nutr Res. 25(5):413-513. Ruud JS, Betts NM, Kritsch K, Nitzke S, Lohse B, Boecker L. (2005). Acceptability of stage-tailored newsletters about fruits and vegetables by young adults. J Am Diet Assoc. 105:174-178. 2006 Richards A, Kattelmann K, Rem C. (2006). Motivating 18 to 24 year olds to increase their fruit and vegetable consumption. J Am Diet Assoc. 106:1405-1411. Chung SJ, Hoerr SL, Coleman G, Levine R. (In press, 2006) Processes underlying young women's decisions to eat fruits and vegetables. Br J Nutr Diet. 19(4). Nitzke S, Kritsch K, Boeckner L, Greene G, Hoerr S, Horacek T, Kattelmann K, Lohse B, Oakland MJ, Phillips B, White A. (In review: accepted with revisions, 2006). A stage-based intervention increases fruit and vegetable intakes of low-income young adults. Am J Health Promot.
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