Formative Evaluation of a Grocery Store-Based Nutrition Incentive Program in a Primarily Rural State.

Increasing the reach of nutrition incentive programs (NIP) requires their successful implementation beyond farmers markets into grocery stores. This report describes our approach to formative evaluation and key lessons during the expansion of the Double Up Oklahoma (DUO) NIP into 10 grocery stores over a two-year period.

Defining what Matters: Use of Q Methodology to Identify Food Values among People Living with HIV Affected by Food Insecurity.

Objectives/background: To inform the development of a "food is medicine" (FIM) intervention, the present study aimed to describe how people living with HIV (PLWH) prioritize daily food choices in the context of food insecurity.

Methods: Interviews with PLWH experiencing various levels of food insecurity (n=24) were conducted using Q-Methodology. Participants ranked 57 food-choice value statements from "most like me" to "least like me" in a process called forced distribution.

Food insecurity and childhood outcomes: a cross-sectional analysis of 2016-2020 National Survey of Children's Health data.

Context: Racial inequalities across social determinants of health (SDOHs) are often influenced by discriminatory policies that reinforce systems that further uphold these disparities. There is limited data describing the influence of food insecurity (FI) on childhood racial discrimination.

Objectives: Our objective was to determine if the likelihood of experiencing racial discrimination was exacerbated by FI.

Planting Seeds for Food Is Medicine: Pre-Implementation Planning Methods and Formative Evaluation Findings From a Multi-Clinic Initiative in the Midwest.

Food is medicine (FIM) initiatives are an emerging strategy for addressing nutrition-related health disparities increasingly endorsed by providers, payers, and policymakers. However, food insecurity screening protocols and oversight of medically-tailored food assistance programs are novel for many healthcare settings. Here, we describe the pre-implementation planning processes used to successfully engage federally-qualified health centers (FQHCs) across Kansas to develop new FIM initiatives.

Maternal periconception food insecurity and postpartum parenting stress and bonding outcomes.

Food insecurity during pregnancy is associated with various adverse pregnancy outcomes for the mother and infant, but less is known about the role of periconception food insecurity and its links to maternal and child wellbeing in the postpartum period. In a sample of 115 diverse (41% white) and predominately low-income mothers, results of hierarchical regression analyses showed that periconception food insecurity was positively associated with parenting stress at 2 months postpartum. A negative association between food insecurity and maternal-infant bonding at 6 months postpartum was mediated after controlling for prenatal depression, social support, and demographic factors.

Associations of social determinants of health and childhood obesity: a cross-sectional analysis of the 2021 National Survey of Children's Health.

Context: Childhood obesity is a growing health problem in the United States, with those affected having an increased likelihood of developing chronic diseases at a younger age. Social determinants of health (SDOH) are known to influence overall health. Families who are of low socioeconomic status (SES) have also been shown to be more likely to experience food insecurity.

Food Is Medicine for Individuals Affected by Homelessness: Findings from a Participatory Soup Kitchen Menu Redesign.

Health disparities among people experiencing homelessness are likely exacerbated by limited access to healthy, fresh, and minimally processed foods. Soup kitchens and shelters serve as essential food safety nets for preventing hunger in this population, and community interest is growing in the potential of "food is medicine" interventions to improve the mental and physical wellbeing of people who receive meals from these providers. This study describes our two-phase approach to first identify and prioritize nutrition needs within an urban soup kitchen community and then test and implement new recipes and menu guidelines to help the standard soup kitchen menu better align with those priorities.

Native opportunities to stop hypertension: study protocol for a randomized controlled trial among urban American Indian and Alaska Native adults with hypertension.

Introduction: American Indian and Alaska Native (AI/AN) adults experience disproportionate cardiovascular disease (CVD) morbidity and mortality compared to other races, which may be partly attributable to higher burden of hypertension (HTN). Dietary Approaches to Stop Hypertension (DASH) is a high-impact therapeutic dietary intervention for primary and secondary prevention of CVD that can contribute to significant decreases in systolic blood pressure (BP). However, DASH-based interventions have not been tested with AI/AN adults, and unique social determinants of health warrant independent trials.

Geographic and social economic disparities in the risk of exposure to ambient air respiratory toxicants at Oklahoma licensed early care and education facilities.

Background: Early life exposures to hazardous air pollutants has been associated with adverse asthma-related outcomes. Neighborhood-level social and economic factors play an essential role in the distribution of hazardous air pollutants and children spend a substantial amount of time at early care and education (ECE) facilities. While the indoor air quality of these facilities has been described, particularly for criteria air pollutants such as volatile organic compounds and particulate matter, little is known about the ambient air quality of ECE facilities.

Unpacking determinants and consequences of food insecurity for insulin resistance among people living with HIV: Conceptual framework and protocol for the NOURISH-OK study.

Background: Over the past four decades, advances in HIV treatment have contributed to a longer life expectancy for people living with HIV (PLWH). With these gains, the prevention and management of chronic co-morbidities, such as diabetes, are now central medical care goals for this population. In the United States, food insecurity disproportionately impacts PLWH and may play a role in the development of insulin resistance through direct and indirect pathways.

Cleaning Products Commonly Used in Oklahoma Family Child Care Homes: Implications for Respiratory Risk and Children's Health.

Little is known about the cleaning products used by early care and education programs that contribute to childhood asthma, particularly in Oklahoma where rates of uncontrolled asthma are higher than national rates (60.0% vs. 50.

Design and Methods of a Participatory Healthy Eating Intervention for Indigenous Children: The FRESH Study.

Objective: To increase vegetable and fruit intake, reduce body mass index (BMI), and improve parental blood pressure among American Indian families.

Design: Randomized, wait-list controlled trial testing a multi-level (environmental, community, family, and individual) multi-component intervention with data collection at baseline and 6 months post-intervention.

Setting: Tribally owned and operated Early Childhood Education (ECE) programs in the Osage Nation in Oklahoma.

Methods for Assessing Willingness to Try and Vegetable Consumption among Children in Indigenous Early Childcare Settings: The FRESH Study.

Food preferences begin in early childhood, and a child's willingness to try (WTT) new vegetables is an important determinant of vegetable intake. Young children living in rural communities are at increased risk for food insecurity, which may limit exposure to and consumption opportunities for vegetables. This manuscript describes the validation of the Farfan-Ramirez WTT (FR-WTT) measure using baseline data from the FRESH study, a gardening intervention for Native American families with preschool-aged children in Osage Nation, Oklahoma.

Development and Implementation of a Hybrid Online and In-Person Food Sovereignty and Nutrition Education Curriculum for Native American Parents: The FRESH Study.

The Food Resource Equity and Sustainability for Health ("FRESH") study is an Indigenous-led intervention to increase vegetable and fruit intake among Native American children. As part of this study, we developed a hybrid (online and in-person) food sovereignty and nutrition education curriculum for the parents of these children. This 16-week curriculum was developed to promote household- and community-level healthy eating and food sovereignty practices to parents of preschool-aged children residing in Osage Nation, Oklahoma.

Beyond Groceries: An Analysis of Referral Needs to Address Underlying Causes of Child Hunger among Households Accessing Food Pantries.

Very low food security among children (VLFS-C), often referred to as child hunger, can profoundly hinder child development, family well-being, and community health. Food pantries are important community resources that routinely serve at-risk families. This study investigated the influence of various candidate risk factors for VLFS-C within a food pantry population to inform the development of the "Pantry Assessment Tool against Child Hunger (PATCH).

Environmental Health-Related Policies and Practices of Oklahoma Licensed Early Care and Education Programs: Implications for Childhood Asthma.

Little is known about the environmental health-related policies and practices of early care and education (ECE) programs that contribute to childhood asthma, particularly in Oklahoma where child asthma rates (9.8%) and rates of uncontrolled asthma among children with asthma (60.0%) surpass national rates (8.

Promoting nutrition equity for individuals with physical challenges: A systematic review of barriers and facilitators to healthy eating.

Impaired mobility is the most common form of functional disability in the US, affecting one out of every sixteen working-age adults. Little is known about the barriers to and facilitators of healthy eating among people with impaired mobility (PWIM), who are at increased risk for diet-related chronic disease. The pathways by which impaired mobility influence dietary intake are unclear, yet likely involve a complex interplay between structural determinants of health and individual factors.

Creating a Nonprofit Spin-Off to Implement a Community Health Improvement Plan: A Case Study of a Midsize Health Department in the Midwest.

A common problem faced by local health departments is engaging cross-sector stakeholders to achieve shared community goals. Community engagement is critical for effective Community Health Improvement Plan (CHIP) development and implementation, while also being a standard for health department accreditation. This case study describes one city-county health department's development of a nonprofit arm to act as a catalyst for connecting community leaders to identify and collaboratively address community health goals.

Community Health Improvement Plans: An Analysis of Approaches Used by Local Health Departments.

Context: The Public Health Accreditation Board requires accredited local health departments (LHDs) to complete community health improvement plans (CHIPs). Evidence suggests that participatory planning frameworks, cross-sector collaboration, social determinants of health (SDOHs), and steering organizations are integral to effective public health planning. However, little is known about the degree to which LHDs incorporate these aspects during the CHIP process.

Challenges and opportunities to increasing fruit and vegetable distribution through the US charitable feeding network: increasing food systems recovery of edible fresh produce to build healthy food access.

This qualitative study describes opportunities and challenges to produce recovery identified by food banking executive leadership across the US ( = 33). Identified challenges included regional variation in fresh produce availability, long transportation times, and lack of refrigerated storage. Opportunities included high client demand for fresh produce, internal benchmarks for fresh produce distribution, and organizational partnerships to create regional sourcing and distribution efficiencies.

Diabetes and Obesity Associated with Poor Food Environments in American Indian Communities: the Tribal Health and Resilience in Vulnerable Environments (THRIVE) Study.

Background: American Indians (AIs) have significantly higher rates of diet-related chronic diseases than other racial/ethnic groups, and many live in environments with limited access to healthy food.

Objective: As part of the Tribal Resilience in Vulnerable Environments (THRIVE) study, we examined the relations between the perceived food environment, utilization of food retailers, fruit and vegetable intake, and chronic diseases, including obesity, hypertension, and type 2 diabetes among AI adults.

Methods: Through a community-based participatory research partnership, we surveyed a cross-sectional sample of 513 AIs living within the Chickasaw Nation and the Choctaw Nation of Oklahoma.

Community-Based Participatory Intervention Research with American Indian Communities: What is the State of the Science?

We conducted a 2-phase systematic review of the literature to examine the nature and outcomes of health research using a community-based participatory research (CBPR) approach with AI communities to assess both the value and the impact of CBPR, identify gaps in knowledge, and guide recommendations for AI research agendas. Using PRISMA guidelines, we searched the peer-reviewed literature published from 1995 to 2016 and identified and reviewed 42 unique intervention studies. We identified and catalogued key study characteristics, and using the Reliability-Tested Guidelines for Assessing Participatory Research Projects, we quantified adherence to participatory research principles across its four domains.

Nutrition-Focused Food Banking in the United States: A Qualitative Study of Healthy Food Distribution Initiatives.

Background: Nutrition-focused food banking is broadly defined as organizational and programmatic efforts to address nutrition-related health disparities among charitable food clients. Additional information is needed to systematically describe how US food banks, as key influencers of the charitable food system, are working to advance nutrition-focused food banking initiatives in their communities.

Objective: Our aim was to describe food bank leadership-identified organizational strategies, "best practices," and innovative programs for advancing nutrition-focused food banking in the United States.

Characteristics of Households of People With Diabetes Accessing US Food Pantries: Implications for Diabetes Self-Management Education and Support.

Purpose: The purpose of this study is to explore the associations between food insecurity (FI) and coping strategies of relevance to diabetes self-management among households of people with diabetes (HHDM) who access US food pantry programs.

Methods: The authors conducted a secondary data analysis of HHDM accessing US food pantry programs from the Hunger in America 2014 study ( = 16 826). Weighted analyses included descriptive statistics for household sociodemographics, food pantry service utilization, FI, and coping behaviors.