Helping parents provide vegetable snacks: Investigating price and taste as barriers.

Snacks contribute nearly one-quarter of children's daily energy intake in the USA. Snack time therefore represents an opportunity for parents to provide foods with key nutrients. Instead, the most common snack foods are major contributors to children's consumption of added sugars and sodium.

Processed and Packed: How Refined Are the Foods That Children Bring to School for Snack and Lunch?

Background: Increasing consumption of highly processed foods has been associated with adverse health outcomes among children. In the US, children consume up to half of their daily energy intake at school.

Objectives: We sought to characterize foods that children bring from home to school according to processing level and to evaluate the effectiveness of a school-based intervention, Great Taste Less Waste (GTLW), in reducing the proportion of energy brought from highly processed foods from home compared with control.

Addressing Challenges with the Categorization of Foods Processed at Home: A Pilot Methodology to Inform Consumer-Facing Guidance.

The objective of this study was to inform consumer-facing dietary guidance by (1) adapting the current University of North Carolina at Chapel Hill (UNC) food processing framework to include a home processing (HP) component and (2) pilot testing the adapted version using a nationally representative sample of foods consumed in the U.S. The UNC framework was adapted to include guidelines for categorizing home-prepared (HP) foods.

Processed food consumption is associated with diet quality, but not weight status, in a sample of low-income and ethnically diverse elementary school children.

Excess consumption of highly processed foods may be associated with lower diet quality and obesity prevalence, but few studies have examined these relationships in children from low-income households. Therefore, the objective of this study was to evaluate the relationship between food consumption by processing category, diet quality as measured by the Healthy Eating Index-2015 (HEI-2015) and body mass index (BMI) in a sample of low-income children. Data from a study assessing the impact of Summer Food Service participation on diet quality and weight status (N = 131) was used to conduct a cross-sectional analysis of children aged six to twelve years from low-income communities in the Northeastern U.

A qualitative exploration of potential determinants of accelerated summer weight gain among school-age children: perspectives from parents.

Background: There is growing evidence that school children in the United States gain weight more rapidly during the summer than the school year, but few studies have explored the causes of this phenomenon. The goal of this study was to qualitatively explore potential determinants of accelerated summer weight gain by interviewing parents of school-age children.

Methods: Key informant interviews were conducted with parents of third and fourth grade students enrolled in a school-based physical activity intervention in three peri-urban communities in Eastern Massachusetts.

Accelerated Summer Weight Gain in a Low-Income, Ethnically Diverse Sample of Elementary School Children in Massachusetts.

Several studies have found that children in the United States gain weight at a faster rate in the summer than in the school year, but little is known about the prevalence of this problem, its effect on high-risk subgroups, or its determinants. This study compares school year and summer weight change in a low-income, ethnically diverse sample of school-age children in Massachusetts and explores differences by race/ethnicity, weight status, and exposure to school year physical activity (PA) programming. Diet and PA are examined as potential mediators of summer weight gain.

Factors Influencing Fluid Milk Waste in a Breakfast in the Classroom School Breakfast Program.

Objective: To determine predictors of fluid milk waste in a Breakfast in the Classroom School Breakfast Program.

Design: Cross-sectional with 3 repeated measures/classroom.

Setting: Elementary schools in a medium-sized, low-income, urban school district.

Branding a School-Based Campaign Combining Healthy Eating and Eco-friendliness.

Objective: To develop a branding strategy for a campaign to improve the quality of foods children bring from home to school, using a combined healthy eating and eco-friendly approach and for a control campaign focusing solely on nutrition.

Methods: Formative research was conducted with third- and fourth-grade students in lower- and middle-income schools in Greater Boston and their parents. Phase I included concept development focus groups.

Nutritional, Economic, and Environmental Costs of Milk Waste in a Classroom School Breakfast Program.

Objectives: To measure fluid milk waste in a US School Breakfast in the Classroom Program and estimate its nutritional, economic, and environmental effects.

Methods: Fluid milk waste was directly measured on 60 elementary school classroom days in a medium-sized, urban district. The US Department of Agriculture nutrition database, district cost data, and carbon dioxide equivalent (COe) emissions and water footprint estimates for fluid milk were used to calculate the associated nutritional, economic, and environmental costs.

The critical role of communications in a multilevel obesity-prevention intervention: Lessons learned for alcohol educators.

Objective: Multilevel interventions to prevent underage drinking are more effective than individual-level strategies, and messaging campaigns are key to such approaches. Recognizing the benefits of translating best practices across public health domains, this paper details the communications campaign from Shape Up Somerville (SUS), an exemplar for multilevel community-based approaches to address pediatric obesity, highlighting lessons learned for alcohol educators.

Methods: All elements of SUS, including the communications strategy, were developed collaboratively with local partners.

National Dissemination of StrongWomen-Healthy Hearts: A Community-Based Program to Reduce Risk of Cardiovascular Disease Among Midlife and Older Women.

Objectives: We describe the national dissemination of an evidence-based community cardiovascular disease prevention program for midlife and older women using the RE-AIM (reach effectiveness adoption implementation maintenance) framework and share key lessons learned during translation.

Methods: In a 2010 to 2014 collaboration between the StrongWomen program and the National Extension Association of Family and Consumer Sciences, we assessed reach, adoption, implementation, and maintenance using survey methods, and we assessed effectiveness using a pretest-posttest within-participants design, with weight change as the primary outcome.

Results: Overall reach into the population was 15 per 10,000.

Lessons learned from two decades of research in nutrition education and obesity prevention: Considerations for alcohol education.

Objective: Effective health interventions involve an understanding of the specific needs and wants of the population to be served. Lessons from more than two decades of obesity prevention can be applied to understanding how to design and implement other behaviorally-focused health interventions, including those for alcohol education.

Methods: Three obesity prevention campaigns were reviewed and evaluated for elements critical to their success in achieving desired outcomes.

Great Taste, Less Waste: a cluster-randomized trial using a communications campaign to improve the quality of foods brought from home to school by elementary school children.

Objective: Great Taste, Less Waste (GTLW), a communications campaign, capitalized on the synergy between healthy eating and eco-friendly behaviors to motivate children to bring more fruits and vegetables and fewer sugar-sweetened beverages (SSBs) to school.

Methods: A cluster-randomized trial in Eastern Massachusetts elementary schools in 2011-2012 tested the hypothesis that GTLW would improve the quality of foods from home more than a nutrition-only campaign--Foods 2 Choose (F2C)--or control. Lunch and snack items from home were measured at baseline and 7 months later using digital photography.

The StrongWomen-Healthy Hearts program in Pennsylvania: RE-AIM analysis.

Dissemination of evidence-based programs is needed to reduce CVD risk among midlife and older women. The aim of this study is to examine the public health impact of StrongWomen-Healthy Hearts in Pennsylvania using the RE-AIM framework. Reach, adoption, implementation, and maintenance were assessed using qualitative and quantitative measures; effectiveness was assessed using a pretest-posttest within-participants design.

Household and family factors related to weight status in first through third graders: a cross-sectional study in Eastern Massachusetts.

Background: Early environmental influences have been linked to child weight status, however further understanding of associations in diverse populations is needed.

Methods: A cross-sectional analysis of household and family factors associated with overweight was conducted on a culturally diverse, urban dwelling sample of 820 first through third graders (mean age 7.6 ± 1.

Changes in diet and physical activity resulting from the Shape Up Somerville community intervention.

Background: The purpose of this study is to describe the behavioral changes in children resulting from Shape Up Somerville (SUS), a community-based, participatory obesity prevention intervention that used a multi-level, systems-based approach. It was set in Somerville, an urban, culturally diverse community in Massachusetts, USA.

Methods: This was a non-randomized, controlled 2-year community-based intervention trial with children enrolled in grades 1 to 3 (ages 6-8 years).

Shape Up Somerville two-year results: a community-based environmental change intervention sustains weight reduction in children.

Objective: The objective of this study was to test the hypothesis that community-based environmental change intervention prevents undesirable weight gain in children.

Method: The method used in this study was a two-year, non-randomized, controlled trial (2003-2005) using community-based participatory methodology in three diverse cities in Massachusetts: one intervention and two socio-demographically-matched control communities (pooled for analysis). Children (n=1028), with a mean age=7.

Permissive parental feeding behavior is associated with an increase in intake of low-nutrient-dense foods among American children living in rural communities.

Parents play an important role in shaping children's eating habits. Few studies have evaluated the influence of both parenting style and parenting practices on child outcomes such as dietary intake. During spring 2007, 99 parent-child dyads from four rural US areas participated in this cross-sectional study.

Using the Community Readiness Model to select communities for a community-wide obesity prevention intervention.

To build on a growing interest in community-based obesity prevention programs, methods are needed for matching intervention strategies to local needs and assets. We used the Community Readiness Model (CRM), a structured interview guide and scoring system, to assess community readiness to act on childhood obesity prevention, furthering a replication study of a successful intervention. Using the CRM protocol, we conducted interviews with 4 stakeholders in each of 10 communities of similar size, socioeconomic status, and perceived readiness to implement a community-wide obesity prevention intervention.

Communicating actionable nutrition messages: challenges and opportunities.

As long as health communications have existed in the USA, Americans have faced the task of sorting the agenda of the source from the advice it provides. That task has become more complicated as advances in the science of nutrition and the technology used to present it have heightened the complexity of nutrition communications. Getting consumers to adopt a healthier diet has been a protracted undertaking with limited successes along the way.

Comparison of online and face-to-face dissemination of a theory-based after school nutrition and physical activity training and curriculum.

This study was conducted to compare two different online delivery methods to train after school program leaders (ASPLs) to implement a nutrition and physical activity curriculum for children to each other and to a face-to-face (FTF) training model. A three-group design was used in which ASPLs from 12 states were randomized to either standard (n = 34) or an enhanced interaction (n = 31) online training, while a FTF group (n = 24) served as comparison. All ASPLs completed training and implemented curriculum lessons over 16 weeks from March to June 2007.

Parent-child interactions and objectively measured child physical activity: a cross-sectional study.

Background: Parents influence their children's behaviors directly through specific parenting practices and indirectly through their parenting style. Some practices such as logistical and emotional support have been shown to be positively associated with child physical activity (PA) levels, while for others (e.g.

Parent behavior and child weight status among a diverse group of underserved rural families.

The purpose of this study was threefold: to investigate the association between three parenting behaviors (parenting style, feeding style, and feeding practices), to evaluate whether these behaviors were associated with child weight, and to determine whether style (parenting and feeding) moderated the relationship between feeding practice and child weight. Ninety-nine parent-child dyads were recruited for a cross-sectional study where parents self-reported their parenting style, feeding style, and feeding practices along with demographic characteristics. Height and weight were measured for each dyad.

The effects of school garden experiences on middle school-aged students' knowledge, attitudes, and behaviors associated with vegetable consumption.

This study describes the effects of garden-based education on children's vegetable consumption. As part of a pre-post panel study, 236 students complete the Garden Vegetable Frequency Questionnaire and 161 complete a taste test. Results indicate that school gardening may affect children's vegetable consumption, including improved recognition of, attitudes toward, preferences for, and willingness to taste vegetables.