Validation of a Brief Physical Activity Assessment Tool for Adults With Limited Resources.

Objective: To validate a Brief Physical Activity Assessment Tool for the Expanded Food and Nutrition Program (EFNEP).

Design: Phase 1: test-retest reliability based on 2 survey administrations; Phase 2: concurrent validity triangulated with accelerometer data; Phase 3: sensitivity to change and responsiveness and secondary analysis of EFNEP national dataset.

Setting: Community centers and/or EFNEP classes across the US.

Exploring Analysis Approaches for Using the Dopamine Transporter Striatal Binding Ratio in Early- to Mid-Stage Parkinson's Disease Modification Trials.

Background: The dopamine transporter striatal binding ratio (DAT SBR) has been used as an outcome measure in Parkinson's disease (PD) trials of potential disease-modifying therapies; however, both patient characteristics and analysis approach potentially complicate its interpretation.

Objective: The aim was to explore how well DAT SBR reflects PD motor severity across different striatal subregions and the relationship to disease duration, and side of onset.

Methods: DAT SBR for the anterior and posterior putamen and caudate in both hemispheres was obtained using validated automated quantitative software on baseline scans of 132 patients recruited for the Exenatide PD2 and PD3 trials.

Parents Report Positive Changes in Parental Feeding Practices 12 Months After Intervention.

Objective: Determine self-reported parental feeding behavior changes and perspectives on parental feeding intervention at 12-month follow-up.

Methods: Telephone focus groups using a 2 × 2 design (English/Spanish × in-class or online) with Expanded Food and Nutrition Education Program participants (n = 37) with children 2-8 years and high exposure to the Food, Feeding, and Your Family intervention (7 lessons). Researchers (n = 3) independently identified themes.

Using Mobile Technology for Family-Based Prevention in Families with Low Incomes: Lessons from a Randomized Controlled Trial of a Childhood Obesity Prevention Program.

Researchers are increasingly using web-based technologies to deliver family-based, prevention programming. Few studies have examined the success of such approaches for families with low incomes. The purpose of this study was to describe the level of in-class and online engagement in a childhood obesity prevention program for parents with low incomes, to examine the demographic correlates of parent engagement, and to examine dosage effects on parental feeding outcomes as a function of online exposure.

Short-Term Efficacy of a Childhood Obesity Prevention Program Designed to Pair Feeding Content With Nutrition Education.

Family-based programs show considerable promise in preventing overweight and obesity in young children. However, dissemination is difficult because significant participant and staff involvement is required. This study examined the short-term efficacy of adding parental feeding content to a widely-used nutrition education curriculum for families in low-resourced communities comparing the influence of two delivery methods (in-class and online) on parents' feeding knowledge, practices, and styles.

Development of Reliable and Valid Questions to Assess Food Resource Management Behaviors in Adults With Limited Income.

Objective: Develop reliable, valid questions to assess changes in food resource management (FRM) behaviors in adults with limited incomes.

Design: Questionnaire development using a mixed-methods approach: content validity (subject matter and curricula), face validity, temporal reliability (test-retest), sensitivity to change, and exploratory factor analysis (EFA).

Setting: Community settings in 12 states.

Managing pandemics as super wicked problems: lessons from, and for, COVID-19 and the climate crisis.

COVID-19 has caused 100s of millions of infections and millions of deaths worldwide, overwhelming health and economic capacities in many countries and at multiple scales. The immediacy and magnitude of this crisis has resulted in government officials, practitioners and applied scholars turning to reflexive learning exercises to generate insights for managing the reverberating effects of this disease as well as the next inevitable pandemic. We contribute to both tasks by assessing COVID-19 as a "super wicked" problem denoted by four features we originally formulated to describe the climate crisis: time is running out, no central authority, those causing the problem also want to solve it, and policies irrationally discount the future (Levin et al.

Implementation Science Strategies Promote Fidelity in the Food, Feeding, and Your Family Study.

Objective: Use of implementation science strategies to promote fidelity in the Food, Feeding, and Your Family study.

Design: Cluster randomized controlled trial with 3 conditions: control, in-class, or online, delivered in English or Spanish. Observations of 20% of classes.

Exenatide once weekly over 2 years as a potential disease-modifying treatment for Parkinson's disease: protocol for a multicentre, randomised, double blind, parallel group, placebo controlled, phase 3 trial: The 'Exenatide-PD3' study.

Introduction: Parkinson's disease (PD) is a common neurodegenerative disorder with substantial morbidity. No disease-modifying treatments currently exist. The glucagon like peptide-1 receptor agonist exenatide has been associated in single-centre studies with reduced motor deterioration over 1 year.

The Future of Incretin-Based Approaches for Neurodegenerative Diseases in Older Adults: Which to Choose? A Review of their Potential Efficacy and Suitability.

The current treatment options for neurodegenerative diseases in older adults rely mainly on providing symptomatic relief. Yet, it remains imperative to identify agents that slow or halt disease progression to avoid the most disabling features often associated with advanced disease stages. A potential overlap between the pathological processes involved in diabetes and neurodegeneration has been established, raising the question of whether incretin-based therapies for diabetes may also be useful in treating neurodegenerative diseases in older adults.

Positive Change in Healthy Eating Scores Among Adults With Low Income After Expanded Food and Nutrition Education Program Participation.

Objective: Using 24-hour dietary recalls, compare Healthy Eating Index (HEI)-2005 scores of Expanded Food and Nutrition Education Program participants before and after 8-12 weekly lessons.

Design: Analysis of preexisting 24-hour dietary recalls information collected from October, 2012 through September, 2014.

Participants: Participants with complete pre-post dietary data (n = 122,961); subset of those with complete demographic data (n = 97,522).

Diabetes medications and risk of Parkinson's disease: a cohort study of patients with diabetes.

The elevated risk of Parkinson's disease in patients with diabetes might be mitigated depending on the type of drugs prescribed to treat diabetes. Population data for risk of Parkinson's disease in users of the newer types of drugs used in diabetes are scarce. We compared the risk of Parkinson's disease in patients with diabetes exposed to thiazolidinediones (glitazones), glucagon-like peptide-1 (GLP-1) receptor agonists and dipeptidyl peptidase 4 (DPP4) inhibitors, with the risk of Parkinson's disease of users of any other oral glucose lowering drugs.

Development of a National Dietary Behaviors Questionnaire for EFNEP Adult Participants.

Objective: Develop and establish the reliability and validity of dietary behavior evaluation questions for the Expanded Food and Nutrition Education Program (EFNEP).

Design: A mixed-methods study using cognitive interviews, expert panels, test/retest reliability, and pretests/posttests.

Setting: 14 states across the US.

Best Practices in Curricula Revisions: Using the Evidence-Based Eating Smart • Being Active as an Exemplar.

This article describes the processes employed to revise the widely used curriculum, Eating Smart • Being Active. Because of its popularity among nutrition education programs serving the low-income population, the curriculum developers felt it was important to share the revision process after the release of the 2015-2020 Dietary Guidelines for Americans. Extensive feedback during formative evaluation, updated content from the Dietary Guidelines for Americans, and a modern look resulted in a fully revised curriculum released in 2017.

Identification of a Framework for Best Practices in Nutrition Education for Low-Income Audiences.

To promote effective low-income nutrition education programs, an expert panel of nutrition education and public health researchers built consensus around 28 best practices grouped into 5 domains (Program Design, Program Delivery, Educator Characteristics, Educator Training, and Evaluation) targeting direct delivery of nutrition education. These best practices can be used to assess program strengths, promote fidelity in delivery and evaluation, and design research to strengthen programs' evidence base. A survey of Supplemental Nutrition Assistance Program-Education nutrition education leaders helped identify staff development needs and interest relative to specific best practices.

Evaluation and Lessons Learned From the Development and Implementation of an Online Prenatal Nutrition Training for EFNEP Paraprofessionals.

Objective: Design, implement, and evaluate the effectiveness of a video-based online training addressing prenatal nutrition for paraprofessional peer educators.

Methods: Quasi-experimental pre-posttest study with 2 groups of paraprofessionals working for the Expanded Food and Nutrition Education Program in 17 states and US territories: intervention (n = 67) and delayed intervention comparison group (n = 64). An online training was systematically developed using Smith and Ragan's instructional design model, the Cognitive Theory of Multimedia Learning, principles of adult learning, and selected constructs of the Social Cognitive Theory.

Similar 24-Hour Dietary Recall Results from Low-Income Women When Collected by a Paraprofessional Nutrition Educator or Registered Dietitian Nutritionist.

Background: The Expanded Food and Nutrition Education Program (EFNEP) is a federally funded, community nutrition education program that assists the low-income population in acquiring knowledge and skills related to nutrition, food safety, food resource management, food security, and physical activity. Evaluation of EFNEP includes a 24-hour dietary recall (24HDR) administered by paraprofessional educators, yet protocols for most large-scale nutrition research studies employ registered dietitian nutritionists (RDNs) or individuals with educational backgrounds in nutrition or related fields to collect dietary recalls.

Objective: To compare 24HDRs collected by trained paraprofessional educators with recalls collected by an RDN.

Communicating and Assessing Physical Activity: Outcomes From Cognitive Interviews With Low-Income Adults.

Objective: This investigation sought to identify the physical activity (PA) terms and concepts that are best understood by low-income adults.

Design: This was a cross-sectional study using semistructured cognitive interviews that employed retrospective verbal probing techniques.

Setting: Interviews were conducted in Expanded Food and Nutrition Education Program (EFNEP) sites in New Jersey, Tennessee, and Washington.

The Expanded Food and Nutrition Education Program's Impact on Graduates' Quality of Life.

Objective: To determine how the Expanded Food and Nutrition Education Program (EFNEP) affects the quality of life (QoL) of its low-income adult participants.

Methods: A cross-sectional exploratory study using focus groups (n = 15) in 8 states with EFNEP participants (n = 111) 2-4 months after graduation. Focus groups were conducted with non-Hispanic white (4 groups), black (4), English-speaking Hispanic (4), and Spanish-speaking Hispanic (3) respondents.

Methodology for Developing a New EFNEP Food and Physical Activity Behaviors Questionnaire.

Objective: Research methods are described for developing a food and physical activity behaviors questionnaire for the Expanded Food and Nutrition Education Program (EFNEP), a US Department of Agriculture nutrition education program serving low-income families.

Design: Mixed-methods observational study. The questionnaire will include 5 domains: (1) diet quality, (2) physical activity, (3) food safety, (4) food security, and (5) food resource management.

Confirming the Reliability and Validity of Others' Evaluation Tools Before Adopting for Your Programs.

Objective: To confirm the reliability and validity of a previously validated evaluation instrument in a new context.

Methods: In a cross-sectional study, the processes and results of testing Cooking Matters' (CM) use of the Expanded Food and Nutrition Education Program's Behavior Checklist as a retrospective pretest/posttest were described. The researchers determined reliability, face and content validity, and response-shift bias with 95 CM participants.

Collection Methods for the 24-Hour Dietary Recall as Used in the Expanded Food and Nutrition Education Program.

Objective: Identify practices for the collection of the 24-hour dietary recall (24HR) as used by the Expanded Food and Nutrition Education Program (EFNEP) to assess the fidelity with which dietary data are collected.

Methods: An electronic survey sent nationally to all 75 EFNEP coordinators to assess methodology for collection, staff training, and coding of 24HR.

Results: A total of 67 surveys were returned, 53 of which were usable: 57% of programs used multiple collection periods (previous day vs previous 24 hours), 36% did not use a consistent number of passes in recall collection; only 17% exclusively used the validated 5-pass method; 88% trained paraprofessionals for ≤8 hours on recall collection and >6 different training programs were used; and 86% of programs used multiple coders.

EFNEP's Impact on Exemplary Educators' Quality of Life.

Objective: To determine how the Expanded Food and Nutrition Education Program (EFNEP) affects the quality of life (QoL) of its exemplary paraprofessional educators.

Methods: Qualitative telephone interviews with EFNEP supervisors (15), educators (28), and agency partners (15). Template analysis based on the University of Toronto's QoL constructs.