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Develop and test a Food-Related Control Scale (FRCS) measuring resident-perceived control in long-term care food service. A bank of 15 initial items based on a multidimensional locus of control construct was developed initially. Expert review, cognitive interviews, a pilot study, and factor analysis were used to validate the instrument and assess reliability. Individual phone-based cognitive interviews and 16 skilled nursing facilities in the US. Cognitive interviews included a convenience sample of independently living adults aged ≥ 65 (n = 13), whereas the pilot study included skilled nursing facility-residing adults (n = 166). Perception of food-related control in a long-term care setting. Cognitive interviews were analyzed to develop items. Quantitative data from skilled nursing facility residents were analyzed using SAS software for structural equation modeling and factor analysis. A 2-dimensional construct (9 items) of the FRCS demonstrated reliability with factor analysis. Concurrent validity within the locus of control construct was demonstrated with the Multidimensional Health Locus of Control Scale (standardized estimate of 0.430; P < 0.1). The FRCS may be used to determine how residents in long-term care perceive control over their food experiences. Further testing is necessary to determine the appropriateness of the FRCS for different population uses. [ABSTRACT FROM AUTHOR]

To understand the perspectives of key informant experts regarding the relationship between food insecurity and gestational diabetes mellitus risk reduction behaviors among young American Indian and Alaska Native females. Participants were adult key informants with expertise in food/nutrition and health within Tribal communities (N = 58) across the US. Data were collected through 1:1 interviews using a semistructured moderator guide and analyzed using thematic content analysis methods. Three themes included (1) diet and nutrition habits are formed through intergenerational food preferences and are driven by lasting implications of colonization; (2) young people are influenced by what their peers eat and the food environment, including outside of the home; and (3) the methods used to understand household food insecurity and nutrition habits in the parent study were likely limited. Findings provide guidance as to where nutrition education and interventions may best support young Native females. [ABSTRACT FROM AUTHOR]

Test an obesity intervention for families with low incomes. A total of 208 families were included (a parent with a body mass index [BMI] ≥ 30 and a child aged 6–12 years). A 12-month randomized controlled trial combining family health coaching (motivational interviewing) and connection to community resources. Comparison group: referrals for basic needs, written educational materials. Questionnaires, accelerometry, and anthropometrics. Intention-to-treat analysis of change in outcomes. Two-sided t test with multiple imputation. Parents were 95% female, 31% Black, and 27% Hispanic. Children had a mean BMI-Z score of 1.15. Primary outcomes did not differ between groups at 12 months. Both groups significantly (P < 0.05) improved on the Family Nutrition and Physical Activity Scale for behaviors related to childhood obesity (mean ± SE: comparison, 2.8 ± 1.0; intervention, 2.2 ± 0.9), increased child sedentary activity (comparison, 32.5 ± 12.1; intervention, 39.9 ± 12.4 min/d), and decreased child moderate-vigorous physical activity (comparison, −9.6 ± 3.3; intervention −7.0 ± 3.0 min/d). Parents had no change in BMI. We successfully embedded screening and referral to address social needs within an obesity intervention. The coaching intervention did not provide additional benefits. Future research could explore ways to make these interventions more accessible, valuable, and effective for families. [ABSTRACT FROM AUTHOR]

Compare the diet quality of a meal consumed at a community café (café meals), a pay-what-you-can restaurant, to a meal consumed for an equivalent eating occasion on the day before (comparison meal) by guests with food insecurity. Dietary recalls were collected from café guests with food insecurity to determine the Healthy Eating Index-2020 (HEI-2020) total and component scores. Healthy Eating Index-2020 scores were compared between meals using paired-sample t tests and Wilcoxon signed-rank tests. Most participants (n = 40; 80% male; 42.5% Black) had very low food security (70.0%). Café meal had a higher HEI-2020 total score (46.7 ± 10.5 vs 34.4 ± 11.6; P < 0.001) and total vegetables (2.6 ± 2.0 vs 1.2 ± 1.7; P = 0.004), total fruits (2.1 ± 2.2 vs 0.6 ± 1.5; P < 0.001), whole fruits (1.6 ± 2.0 vs 0.3 ± 0.9; P < 0.001), and refined grains (7.8 ± 3.5 vs 3.9 ± 3.9; P < 0.001) scores than comparison meals. The café meal had better diet quality than the comparison meal, suggesting its potential for improving diet quality among guests with food insecurity. [ABSTRACT FROM AUTHOR]

To explore the goals, barriers, and facilitators set by caregivers of preschool-aged children to improve food parenting practices and household food environments. Secondary qualitative analysis of collaborative goal sheets completed during in-home and telephone visits as part of a home-based pilot intervention. Thirty-three Hispanic/Latinx caregivers, predominantly of low income. Patterns in goal content and anticipated barriers and facilitators. Thematic analysis of goal sheets with a mixed inductive-deductive approach. Almost half of the goals were to support a healthy environment (40.7%) by increasing the availability of healthy foods through food shopping and meal planning. Other goals were to increase structure (33.7%) by establishing food-related routines and decreasing distractions. Goals related to autonomy support (25.4%) included involving their children (eg, cooking together). Caregivers' perceived barriers encompass individual (eg, stress, lack of time), interpersonal (eg, other family members' eating behaviors), and environmental-level (eg, food availability) factors. Caregivers only identified facilitators at the individual and interpersonal levels (eg, motivation). Understanding goals, barriers, and facilitators can be used to tailor key messages to improve food parenting practices and children's diets. Future interventions can target broader environmental barriers while increasing awareness of individual, interpersonal, and environmental-level facilitators. [ABSTRACT FROM AUTHOR]

Validate the Preschool Nutrition Education Practices Survey. Iterative approach combining design-based research and Standards for Educational and Psychological Testing. Los Angeles, CA and Philadelphia, PA Early Care and Education (ECE) classrooms. Expert panel members (n = 7); ECE teachers: interviews (n = 8), pilot survey (n = 31), and final survey (n = 136). Early care and education nutrition education practices used in the classroom either during class time or mealtime. Qualitative content analysis was implemented for content, response process, and consequences of testing validity evidence. Rasch rating scale analysis was conducted for the response process and internal structure validity and reliability evidence. Qualitative field-testing produced strong content, response process, and consequences of testing validity evidence to inform survey modifications. Quantitative field-testing generated a psychometrically sound, well-targeted 12-item survey on a 4-point frequency scale with excellent item and person reliability (0.97 and 0.93 respectively) and separation (5.36 and 3.77 respectively); good Rasch Principal Components Analysis findings (60.3%); and productive item fit statistics (0.50–1.50 logits). Robust validity (content, response process, consequences of testing, internal structure) and reliability evidence were demonstrated for using the Preschool Nutrition Education Practices Survey to assess ECE teachers' use of nutrition education practices. Future research is needed to examine its relationship to other variables, such as nutrition teaching efficacy, and to determine its ability to detect change in ECE nutrition education practices over time and across groups. [ABSTRACT FROM AUTHOR]

Determine self-reported parental feeding behavior changes and perspectives on parental feeding intervention at 12-month follow-up. 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. Parental behavior changes that (1) positively influenced children's diets, (2) involved children in food-related activities, (3) eased stressful situations around food, (4) led to healthier food choices, and (5) saved money when food shopping. Commonly implemented practices included establishing structured mealtime routines, introducing new foods multiple times, and encouraging children's eating competence. Online participants noted materials were easily accessible via text messages. Incorporating parental feeding content (in-class or online) into nutrition education interventions, such as the Expanded Food and Nutrition Education Program , supports developing positive parental feeding behaviors in families with low income. [ABSTRACT FROM AUTHOR]

Explore health professionals' perceptions toward how to address malnutrition within the first 1,000 days of life in underresourced communities. A qualitative explorative-descriptive study using 8 face-to-face focus group discussions. Health facilities serving underresourced communities within Nelson Mandela Bay, Eastern Cape Province, South Africa. Fifty-six health professionals (n = 13 doctors, n = 28 nurses, n = 6 dietitians, and n = 9 social workers) aged between 20 and 60 years, with 1–16 years (5 years average) of working experience. The majority (n = 53; 94.6%) were women. Health professionals' perceptions of effective methods or strategies to address malnutrition are referred to as undernutrition. Content analysis. Health professionals perceived socioeconomic conditions; caregiver lack of nutrition knowledge; and behavioral, cultural, and generational infant feeding practices as contributing factors to malnutrition. Participants recommended efforts to strengthen the availability, accessibility, and utilization of contraception, especially for teenagers, increase support to caretakers of children from families, health facilities, and communities, and a multisector and multidisciplinary approach to improve social determinants of health in underresourced communities. To address malnutrition within the first 1,000 days of life, data supports that health professionals in underresourced communities require a multisector, multidisciplinary approach. This approach entails educational interventions, peer mentoring and community empowerment through support to and involvement of caregivers of children. [ABSTRACT FROM AUTHOR]

The primary objective of this study was to develop and validate a Social Cognitive Theory-based instrument to identify psychosocial factors that influence diet and physical activity among Chinese children aged 10–12 years. This is a cross-sectional study, with data collected from questionnaires. Two elementary schools in Beijing, China. Fourth to sixth-grade students (N = 1,486) aged 10–12 years were recruited. Gender, height, weight, nation, and grade were collected. Energy-balanced eating behaviors and their related sociopsychological factors were surveyed. Confirmatory factor analysis, Pearson correlations, Cronbach α index, and mediation analysis were used. (1) Confirmatory factor analysis revealed a 6-factor solution (51 items) and all factor loadings > 0.32, indicating that the model fitness was acceptable. (2) All correlation coefficients are statistically significant. All of the Cronbach α indexes were > 0.65, indicating acceptable reliability. (3) The mediating effect of goal intention and outcome expectations between self-efficacy and habit strength was statistically significant (P < 0.01), verifying the theory structure. This questionnaire exhibits good internal consistency, reliability, and structural validity. It can be effectively employed to investigate energy-balanced eating behaviors related to the Social Cognitive Theory in Chinese children. [ABSTRACT FROM AUTHOR]

Explore participants' perceptions of urban gardens and peer nutritional counseling intervention for people with HIV and food insecurity on antiretroviral therapy in the Dominican Republic. Semistructured endline interviews (n = 21) with intervention participants about their perceptions of diet, health, and quality of life. A codebook was applied to verbatim transcripts, and coded data were analyzed using matrices to identify themes. Participants were mostly Dominican (86%; 14% Haitian); 57% were men; the mean age was 45 years. The most salient experiences described by intervention participants were improved dietary quality and diversity, improved food security, and saving money. Participants also emphasized improved social interactions, mental health, and emotional well-being. Urban gardens and peer nutritional counseling may improve participants' diet and psychosocial well-being. Nutrition programs with marginalized populations may need to improve access to healthy foods and build camaraderie and linkages to programs addressing structural factors. [ABSTRACT FROM AUTHOR]

Describe the adaptation, implementation, and perceptions of Kids SIPsmartER's classroom component during the coronavirus disease-impacted 2020–2021 school year. Mixed methods process evaluation. Seven rural Appalachian middle schools (US). Middle-school teachers (n = 14) and principals (n = 6). Kids SIPsmartER was a multilevel, school-based intervention designed to decrease sugar-sweetened beverage intake. The 12-lesson classroom component was supported by an implementation protocol. Implementation protocol adaptations, program perceptions, and the school context were assessed using teacher and principal interviews, teacher-completed fidelity checklists, and researcher-maintained field notes. Adaptations were mapped to the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME). Qualitative data were content coded. Quantitative data were summarized using descriptive statistics. All schools maintained Kids SIPsmartER and delivered 100% of lessons. Ten adaptations were made to the implementation protocol. Schools used adapted delivery approaches to meet individual needs. Teachers and principals identified more benefits than barriers to implementing the program. Using a strategically adapted implementation protocol that was flexible to schools' individual needs allowed all middle schools to deliver Kids SIPsmartER during the 2020–2021 school year. Findings identify adaptation considerations that other school-based evidence-based interventions could incorporate to facilitate delivery during high-stress times. [ABSTRACT FROM AUTHOR]

To evaluate the conditional effect of time spent in the kitchen on the association between frailty status and healthy diet among older women. Secondary analysis of an online cross-sectional survey conducted in January 2023. Six hundred Japanese women (aged ≥ 65 years). Frailty status evaluated using the Kihon Checklist (25 affirmative questions assessing daily functions, weight status, and mental condition); healthy diet assessed by the days of consuming ≥ 2 meals that include staple, main and side dishes in a meal (SMS meal) in a day; and time spent in the kitchen. Moderation analysis was used to evaluate the conditional effect of time spent in the kitchen on frailty status and SMS meal intake. Chi-square tests for independence were used to evaluate the differences in the Kihon Checklist items by frailty status. Spending longer time in the kitchen indicated more frequent SMS meal intake and the trend was stronger among older women with frailty than those with robustness. All items except for 1 item regarding weight status (P = 0.15) were significantly associated with frailty status (P < 0.001). Further studies are needed to evaluate the causal relationship between frailty status, healthy diet, and kitchen use. [ABSTRACT FROM AUTHOR]

Assess the impact of a weight-inclusive podcast (WIP) intervention on body appreciation, intuitive eating (IE), anti-fat attitudes, and weight and health attitudes in university students enrolled in an upper-division nutrition course. Quasi-experimental design: Intervention participants listened to 8 weekly WIP episodes (n = 16); the comparison group listened to 8 weekly general nutrition podcasts (n = 29). Intuitive eating, body appreciation, anti-fat attitudes, and general weight and health attitudes were measured preintervention and postintervention. Two-way, repeated measures analysis of variance revealed significant interaction effects of time × group, with participants in the WIP group experiencing significantly greater improvements in body appreciation (P = 0.03) and IE (P = 0.02) and greater reductions in anti-fat attitude scores (P = 0.006) than the comparison group. Podcasts may be a cost-effective tool to improve body appreciation and IE and reduce anti-fat attitudes in future nutrition professionals. Future research would benefit from recruiting prehealth professionals across different majors. [ABSTRACT FROM AUTHOR]

This study examined college students' food security status, Choose MyPlate familiarity, and confidence in preparing healthy meals using food pantry ingredients. A sample of 354 student users of a college food pantry in the US southeastern region were surveyed before using the food pantry for the first time. Of the respondents, 81.3% were food insecure, and 47% of the overall sample experienced very low food security. About one-third (37.3%) recognized MyPlate; of those, 89.4% stated intention to use MyPlate knowledge making pantry selections. Students familiar with MyPlate (P = 0.003) and intending to use MyPlate when making food selections (P = 0.02) exhibited greater confidence. Differences were not observed on the basis of food security status. These findings suggest that familiarity with simple nutritional guidelines such as MyPlate may improve students' intended food pantry selections and healthy meal selection confidence. [ABSTRACT FROM AUTHOR]

Gather perspectives on healthy retail policies and strategies from a national sample of Supplemental Nutrition Assistance Program (SNAP) participants. Anonymous web-based survey fielded in English and Spanish. The survey measured support for healthy retail policies and strategies. National Qualtrics panel fielded on September 30 and October 19, 2022. A total of 1,559 adult SNAP participants (in the last 12 months) participated in the Qualtrics SNAP survey panel. Overall support for retail policies and strategies was calculated using response frequencies and proportions. Cross-tabulations and chi-square tests of independence assessed differences in policy support by online shopping behavior and nutrition security status. Significance was determined at P < 0.05. Most SNAP participants were broadly supportive of policies and strategies to improve the healthy food retail environment. More restrictive policies were less popular than policies that expanded consumer choice. Support also varied by online shopping status and nutrition security status. Policies and strategies that improve the healthy food retail environment are popular among a national sample of SNAP participants. Policy discussions must understand SNAP participants' perspectives regarding changes to the retail environment that may impact their ability to access healthy foods. [ABSTRACT FROM AUTHOR]

To identify common themes of the meaning of food among people who identify with a specific religious tradition, particularly focusing on potential applications for nutrition education and professional practice at multiple levels of the Social-Ecological Model. Virtual and in-person focus groups were used to collect qualitative data. A midsized city in eastern Washington State. Nine focus groups (n = 35), each representing a distinct religious congregation. Meaning of food in the context of religion. Qualitative, reflexive thematic analysis using web-based software to organize data. Four key themes were identified that applied to both of the overarching focus group topic areas (general and religious): (1) food fosters connection, (2) food influences health, (3) relationships with food are complicated, and (4) food choices reflect values. Subthemes were specific to topic areas. In religious contexts, the meaning of food was more likely understood at a community level in addition to individual and relational levels of the Social-Ecological Model. Acknowledgment and consideration of the religious identities of patients and clients may provide greater opportunities for community connection, which may have potential implications for community-level nutrition interventions. [ABSTRACT FROM AUTHOR]

This study aimed to discover the prevalence of school nutrition state legislation and to identify the correlates of enactment. An online legislative database, Legiscan, was used to collect bills related to school nutrition from the US from 2010 to 2019. Bills were coded and compiled into a study database with state-level dietary variables (obesity prevalence, fruit, and vegetable intake, sugar-sweetened beverage consumption), community variables (percent White, poverty), and bill-characteristic variables (party affiliation in legislature, strength of language, party of governor, school gardens, vegetable intake, and other salient variables). Multivariable models were built to examine predictors of bill enactment. Of the 462 bills introduced, 38.7% (n = 156) were enacted. In a multivariable model, the strength of bill language, political party affiliation, implementation of school gardens, and vegetable intake were the variables associated with bill passage. Bills with strong language were less likely to be enacted (P <0.001). Bills introduced by Democrats were more likely to be enacted (P = 0.01). This study showed a better understanding of legislative support for child nutrition via policy surveillance of bills and their correlates of enactment. This information can be used to prioritize advocacy efforts and identify ways research can better inform policy. [ABSTRACT FROM AUTHOR]

To develop a consumer nutrition environment assessment tool to assess policy, systems, and environmental initiatives that are implemented in food pantries, which incorporates recent national guidance, and evaluate its validity and reliability. Illinois, US. This study had 4 phases: (1) tool revision, (2) pilot testing, (3) content validity assessment, and (4) interrater and test-retest reliability assessment. The original Nutrition Environment Food Pantry Assessment Tool (NEFPAT) was revised to incorporate evidence from updated guidelines and evidence. The NEFPAT+ was pilot-tested by 9 professionals at 5 food pantries. After revisions, 18 experts rated the content validity. Interrater and test-retest reliability was based on 2–4 professionals completing independent evaluations at 21 food pantries twice, 1 month apart. Content validity indices and intraclass correlation (ICC) coefficients for reliability estimates were compared with established thresholds. The NEFPAT+ was rated content valid by 94% of experts. The ICC for NEFPAT+ scores indicated excellent interrater reliability (ICC, 0.96; 99% confidence interval, 0.75–0.97) and good test-retest reliability (ICC: 0.80; 99% confidence interval, 0.60–0.92). Evidence supports the content validity, interrater reliability, and test-retest reliability of the NEFPAT+. Future studies can assess how NEFPAT+ scores relate to intervention outcomes and dietary behaviors. [ABSTRACT FROM AUTHOR]

Quantify and compare reported breastfeeding support practices in the Baby-Friendly Hospital Initiative (BFHI) and non-BFHI facilities. Cross-sectional survey. Regions across the US. Two hundred and eighty-six facilities (110 BFHI and 176 non-BFHI) selected by a stratified (by hospital size) random sample of 50% BFHI and 50% non-BFHI facilities. Emailed survey Fall 2019 through Spring 2020. Reported adherence to the 10 Steps to Successful Breastfeeding. Wilcoxon rank sum test with continuity correction, Pearson chi-square test of independence, and Fisher's exact test. Baby-Friendly Hospital Initiative facilities were more likely to report adherence to the 10 Steps to Successful Breastfeeding. Only 2 of the reported steps were not significantly different: immediate postnatal care and responsive feeding. This research supports breastfeeding support interventions within hospitals as both BFHI and non-BFHI facilities have room for improvement. Interventions targeting non-BFHI facilities are an opportunity to close the disparity in breastfeeding care. [ABSTRACT FROM AUTHOR]

Characterize experiences with cancer and perceptions of the preventable cancer burden attributable to diet among firefighters. A cross-sectional survey was distributed to assess cancer history and perceptions of cancer. US. US-based firefighters. History of cancer, perceptions of cancer, and perceptions of diet as a means to prevent cancer. Descriptive statistics and use of the Behaviour Change Technique Taxonomy v1 (BCTTv1) to evaluate qualitative responses. A total of 471 firefighters participated. Nearly half (48.4%) voiced they strongly agreed that they were at risk for cancer, whereas 44.6% agreed that changing diet could decrease cancer risk. The most common BCTTv1 codes focused on types of education, including "Instruction on how to perform the behavior" (45.1%, n = 189), followed by those centered on behavior execution (eg, "Action planning" [24.8%, n = 104]). Qualitatively, many were concerned about misinformation. Firefighters acknowledge the role of diet in cancer risk and have a desire for knowledge and behavioral support (eg, goal setting) that includes an emphasis on evidence and tackling misinformation. This information should serve as the basis of future interventions that target diet. [ABSTRACT FROM AUTHOR]

To assess the impact of the Philadelphia Beverage Tax on perceived beverage healthfulness, and awareness and opinions of the tax. Natural experiment Small independent stores in Philadelphia (n = 61) and Baltimore (untaxed control site; n = 65) Shoppers in Philadelphia (n = 2,731) and Baltimore (n = 4,600) pre- and post-tax implementation. Perceptions of 4 beverages (unhealthy vs healthy/neutral), tax awareness, and tax opinions (oppose vs favor/neutral). Mixed-effects linear probability models estimated changes in perceived beverage healthfulness in Philadelphia, relative to Baltimore, following a difference-in-differences approach. Mixed-effects linear probability models estimated pre-post changes in tax awareness and opinions in Philadelphia-only. The probability of perceiving taxed beverages as unhealthy increased 2-years post-tax relative to Baltimore (regular soda: 5.7% [95% confidence interval (CI), 0.9–10.6], P = 0.02; diet soda: 7.7% [95% CI, 1.5–13.8], P < 0.001; sports drinks: 6.4% [95% CI, 0.4–12.4], P = 0.04), with similar changes at 1-year post-tax, whereas perceived healthfulness of untaxed 100% fruit juice did not change. Tax awareness was high at baseline (72%) and increased post-implementation; however, the probability of opposing the tax (22%) also increased over time. Decreases in the perceived healthfulness of taxed beverages suggest the tax had a health-signaling effect. Consumer awareness and health education efforts could complement tax policies to enhance understanding of health risks. [ABSTRACT FROM AUTHOR]

To better understand caregivers' decisional processes related to offering novel and disliked foods to their infants and toddlers. As part of a parent study on young children's food acceptance that took place in Denver, CO, this secondary analysis used a basic qualitative approach to explore caregivers' decisional processes related to repeated exposure and children's food rejection. English-speaking caregivers of infants and toddlers (aged 6–24 months; n = 106) were recruited via flyers and social media and interviewed (from July, 2017 to January, 2018) during a laboratory visit focused on introducing a novel food. Factors influencing caregiver decisions to (dis)continue offering novel or disliked foods. Using a combined deductive and inductive coding approach, trained researchers coded transcripts and codes, which were reviewed and discussed by all investigators to identify themes. Three major themes (and 2 subthemes) were generated regarding caregivers' decisions about re-offering rejected foods: 1) Caregivers understand that multiple experiences with new foods are needed because children's reactions can be unpredictable and depend upon time, developmental stage, and child traits; 2) Caregivers vary in their persistence and decisions to keep offering foods depending on responsiveness to child cues (sub-theme) and adult-centered beliefs, needs, and decisions (sub-theme); 3) Child food acceptance will change with time, circumstances, and development if you keep trying. Although caregivers are aware of repeated exposure, additional implementation research focused on translating theory into effective home practices could assist caregivers to persist in offering novel or disliked foods. [ABSTRACT FROM AUTHOR]

To examine whether household type (eg, families with children) moderated the effects of an optimal defaults grocery intervention and examine intervention effects on grocery purchases to be consumed by the participant vs others in the household. Participants (n = 65) diagnosed with or at risk for type 2 diabetes were recruited and randomized into an optimal default online grocery intervention or an online or in-person control group. Grocery receipt data were coded into Dietary Approaches to Stop Hypertension nutritional quality scores, and energy, carbohydrate, and sugar content were calculated. Repeated measures analysis of variance examined household types (eg, single vs multi-resident) as moderators of intervention effects. Parallel models explored foods purchased for the participant and foods purchased for other household members separately. Household type was not a significant moderator of intervention effects on nutritional quality or other nutrients of interest (P > 0.10). The default intervention significantly increased the nutritional quality of groceries purchased across household types and for other household members besides the participant (P < 0.05). Optimal defaults may improve grocery purchases across different household types and extend to others in the household, supporting use across household types. [ABSTRACT FROM AUTHOR]

This study describes program implementation through a research-restaurant partnership and assesses participant satisfaction, program costs, and percent body weight changes. Participants (n = 60) in a virtual synchronous (n = 43) or virtual asynchronous (n = 17) 12-week plant-based nutrition program received restaurant vouchers. Class satisfaction data were collected weekly. Assessments were completed at baseline, 3 months, and 9 months, along with interviews (n = 13) between 3 and 9 months. The costing approach estimated costs per participant. Interviews were coded using a content analysis and constant comparative method. Participants rated the intervention favorably. Program costs were $198.63/participant, and participants' willingness to pay postintervention was $101.50 ± $63.90. Participants shared satisfaction with course content, the restaurant partnership, and suggestions for future delivery. No changes in participants' percent body weight were observed between 3 and 9 months (P = 0.98), indicating maintenance of 3-month weight loss. A research-restaurant partnership successfully implemented a nutrition program and generated positive feedback. With the lifting of coronavirus disease 2019 pandemic restrictions, future research can now test alternative implementation methods (in person vs online) in other restaurants. [ABSTRACT FROM AUTHOR]

Understand the correlates of ultra-processed food (UPF) intake and examine the association of UPF on body mass index in children aged 3–5 years. Secondary analysis of a prospective cohort of 3–5-year-olds/parent, followed 1-year between March 2014 and October 2016. Usual UPF intake from 2 3-day food records completed 1 year apart, a standardized nutrient database customized with child-specific foods, and a NOVA food classification system was used. Child/parent characteristics and media use were measured via parent-reported surveys. Child weight/height objectively measured. New Hampshire community. Six hundred and sixty-seven parent-child dyads were screened, and 624 were enrolled with 90% follow-up. Primary outcome: identify correlates of UPF intake. Secondary outcome: determine if UPF intake is associated with body mass index change. Adjusted β linear regression, linear regression, P <0.05. Ultra-processed food accounted for 67.6% of total caloric intake. In adjusted models, children's UPF intake was positively associated with increasing child age, greater hours watching television, and more frequent parent soda/fast-food intake. Ultra-processed food intake was negatively associated with higher parent education and reported race/ethnicity other than non-Hispanic White. There was no association between UPF intake and weight. There are several predictors of UPF intake in young children. Family-level interventions could be implemented to encourage the intake of minimally processed foods before and during preschool years. [ABSTRACT FROM AUTHOR]

To describe the results of a technology-integrated intervention on sugar-sweetened beverage (SSB) and energy-dense snack intake with third graders experiencing low income. A 2 × 2 quasi-randomized cluster-block, parallel-group experimental research design. Low-income schools in Rhode Island. Two-hundred seventeen intervention and 242 control third-grade students in low-income (89.6% and 88.2% free/reduced meals, respectively), ethnically and racially diverse (63% Hispanic/20% Black and 62% Hispanic/18% Black, respectively) schools. A 13-week in-school program held once per week for 1 hour. The hands-on, technology-integrated program used a modified version of the Body Quest: Food of the Warrior curriculum. Intake of SSB and energy-dense snacks, both salty and sweet snacks, using baseline (week 1) and postassessment (week 13) previous day self-recall. Generalized mixed modeling with nesting. Intervention students significantly reduced their SSB intake by 38% (0.5 times/d; F[1, 540] = 4.26; P = 0.04) and salty snack intake by 58% (0.8 times/d; F[1, 534] = 6.58, P < 0.01) from baseline to postassessment as compared with the control students. Findings suggest a technology-integrated curriculum is effective in decreasing SSB and salty snacks in elementary-aged students of low-income, minoritized populations. Improved dietary habits can potentially influence other facets of students' lives. [ABSTRACT FROM AUTHOR]

To evaluate if parent perceptions of school meals influence student participation. In May 2022, an online survey was used to evaluate parents' perceptions of school meals and their children's participation. A total of 1,110 California parents of kindergarten through 12th-grade students. Student participation in school lunch and breakfast. Principal component analysis and Poisson regression models. Three groups of parental perceptions were identified: (1) positive perceptions (eg, liking school meals and thinking that they are tasty and healthy), (2) perceived benefits to families (eg, school meals save families money, time, and stress), and (3) negative (eg, concerns about the amount of sugar in school meals and stigma). More positive parental perceptions about school meals and their benefits to families were associated with greater student meal participation. In contrast, more negative parental perceptions were associated with reduced student participation in school meals (P < 0.05). Parent perceptions of school meals may affect student participation in school meal programs. Working to ensure parents are familiar with the healthfulness and quality of school meals and the efforts schools are making to provide high-quality, appealing meals may be critical for increasing school meal participation rates. [ABSTRACT FROM AUTHOR]

Examine the associations between subjective social status (SSS), diet, and health outcomes in college students. Cross-sectional study of 841 students enrolled at a large Midwestern university. Subjective social status within the US, as well as within the university, was measured using the MacArthur Scale of SSS. Outcomes included dietary intake (assessed using the Dietary Screening Questionnaire), body mass index, sleep, physical activity, alcohol use, and vaping behavior. Generalized linear models adjusting for students' sociodemographic characteristics were used to assess associations between SSS and outcomes of interest. Higher SSS-US was associated with 4%, 3%, and 1% higher intake of fruits, whole grains, and fiber, respectively (P < 0.05). Higher SSS-US and SSS-university rankings were both significantly associated with lower body mass index and better sleep duration (P < 0.05). Higher SSS-university rankings were also associated with more days of physical activity and alcohol consumption (P < 0.05). In this exploratory study, higher SSS, apart from alcohol intake, was associated with more favorable health outcomes. More research is needed to consider additional psychological and biological mediators and dynamic aspects of SSS, examine potential interactions between SSS and racial and ethnic identities, and explore potential mechanisms underlying the observed associations. [ABSTRACT FROM AUTHOR]

To qualitatively describe breastfeeding experiences among mothers who used galactagogues to increase their milk supply. One-time, semistructured phone interviews. US. Breastfeeding mothers (n = 19) who reported ever consuming foods, beverages, or herbal supplements to increase their milk supply in a cross-sectional online survey were purposefully sampled to participate in this qualitative study. Participants were diverse in terms of race and ethnicity, education, income, infant age (0–18 months), and prior breastfeeding experience (32% first-time breastfeeding). Reasons for trying to increase milk supply, sources of information about increasing milk supply, and strategies tried to increase milk supply. Interviews were transcribed verbatim and analyzed using reflexive thematic analysis. Participants expressed determination and commitment to breastfeeding but unexpectedly struggled to breastfeed and increase their milk supply. They sought information from multiple sources and used individualized approaches to address milk supply concerns on the basis of recommendations from others, as well as the perceived convenience, cost, palatability, and safety of potential strategies. Results suggest a need to expand breastfeeding education and support so that lactating parents anticipate common breastfeeding challenges and are aware of evidence-based strategies for increasing their milk supply. [ABSTRACT FROM AUTHOR]

The primary objective of this study was to assess the feasibility and acceptability of Weeknight Supper Savers , a family-based intervention designed to promote meal preparation and food waste reduction. The 4-week program was piloted using a single-arm, prepost design. Based on the Theory of Planned Behavior, the intervention included a chef-led online cooking class, a food waste toolkit, and 4 text messages/wk. Postintervention surveys were used to assess the feasibility and acceptability of the interventions. Eighteen families (95%) attended their scheduled cooking class. All parents who completed the survey (17 mothers and 12 fathers) reported being satisfied with the overall program, the cooking class, and the toolkit. Approximately 73% of the children (n = 21) reported being satisfied with the overall program, and 77% reported being satisfied with the cooking class and the toolkit. The intervention was feasible and well-received by families. Results could help inform future public health programs focused on reducing household food waste. [ABSTRACT FROM AUTHOR]

To assess whether using a Dietary Approaches to Stop Hypertension (DASH) diet recommendation application increases primary care physicians' knowledge and dietary counseling skills. A randomized controlled trial. Brazilian public primary care service. Two hundred and twenty-two physicians (intervention group: n = 111; control group: n = 111). Thirty days of using the Dieta Dash application. The application provides information about nutritional recommendations for hypertension management. Nutrition knowledge score. Secondary outcomes: self-assessment of knowledge, self-confidence, assessment of eating habits, and barriers to dietary counseling. Linear mixed-effects models for repeated measures and generalized estimating equations for comparing changes between groups. A total of 66.2% of participants completed the follow-up. There was no significant difference between the groups regarding the mean knowledge score (P = 0.15). The prevalence of high knowledge increased by 12% (prevalence ratio [PR] = 1.12; 95% confidence interval [CI], 1.00–1.25) in the intervention group and showed an improvement in the self-confidence assessment (PR = 1.21; 95% CI, 1.02–1.44), and increased assessment of eating habits (PR = 1.26; 95% CI, 1.10–1.55). The Dieta Dash application helped address dietary counseling, improving knowledge and self-confidence. However, innovative strategies are needed to minimize the primary care barriers. [ABSTRACT FROM AUTHOR]

To examine whether prenatal or concurrent household food insecurity influences associations between maternal and toddler fruit and vegetable (FV) intake. Application of a life-course framework to an analysis of a longitudinal dataset. Early childhood obesity prevention program at a New York City public hospital. One-hundred and fifty-six maternal-toddler dyads self-identifying as Hispanic or Latino. Maternal and toddler FV intake was measured using Centers for Disease Control and Prevention dietary measures when toddlers were aged 19 months. Household food insecurity (measured prenatally and concurrently at 19 months) was measured using the US Department of Agriculture Food Security Module. Regression analyses assessed associations between adequate maternal FV intake and toddler FV intake. Interaction terms tested whether prenatal or concurrent household food insecurity moderated this association. Adequate maternal FV intake was associated with increased toddler FV intake (B = 6.2 times/wk, 95% confidence interval, 2.0–10.5, P = 0.004). Prenatal household food insecurity was associated with decreased toddler FV intake (B = −6.3 times/wk, 95% confidence interval, −11.67 to −0.9, P = 0.02). There was a significant interaction between the level of maternal-toddler FV association (concordance or similarity in FV intake between mothers and toddlers) and the presence of food insecurity such that maternal-toddler FV association was greater when prenatal household food insecurity was not present (B = −11.6, P = 0.04). Strategies to increase FV intake across the life course could examine how the timing of household food insecurity may affect intergenerational maternal–child transmission of dietary practices. [ABSTRACT FROM AUTHOR]

We examined food insecurity prevalence among college students included as part of a large, ongoing, nationally representative survey and examined trends and associations with sociodemographic measures. Data come from the Panel Study of Income Dynamics, a nationally representative longitudinal household panel survey, and include 2,538 college students from 2015–2019. Food security status was assessed using the US Department of Agriculture's 18-item Household Food Security Survey Module. From 2015 to 2019, 11% of college students experienced marginal food security, and 15% experienced food insecurity. Food insecurity was 12% in 2015 and 14% in 2017 and 2019. More Black and Hispanic students experienced food insecurity than White students (21% and 26%, vs 9%, respectively; P <0.001), as did first-generation than non-first-generation students (18% vs 10%; P = 0.01). College food insecurity is an urgent public health issue demanding greater response from colleges and universities and state and federal governments. [ABSTRACT FROM AUTHOR]

To quantify self-reported difficulty accessing Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-issued infant formula among participants early in the coronavirus disease 2019 (COVID-19) pandemic, to determine if infant formula redemption was associated with self-reported difficulty accessing infant formula, and to quantify changes in formula redemption during the 2022–2023 US infant formula shortages. A cross-sectional study and time series data. Families participating in the WIC program in the Los Angeles metropolitan area from November 2019 to June 2023. Families with infants (aged 0–12 months) issued infant formula by WIC with a completed 2020 Los Angeles County WIC Survey (n = 1,897) or issued infant formula by a large WIC program in Southern California between November 2019 and June 2023 (n = 109,135). Incidence of ≥ 30% reduction in infant formula redemption and interval-scaled infant formula redemption. Special Supplemental Nutrition Program for Women, Infants, and Children formula redemption data were matched to 2020 Los Angeles County WIC Survey data to determine if self-reported difficulty accessing infant formula was associated with administrative infant formula redemption data using negative binomial regression and were used to quantify the prevalence and severity of incomplete formula redemption during 2020–2023 formula shortages using ordinal logistic regression (outcome: interval-scaled formula redemption). Few (13.0%) caregivers reported difficulty accessing the WIC-issued formula early in the COVID-19 pandemic. The 2.8% who reported an unresolved shortage early in the COVID-19 pandemic had 201% higher rates of ≥ 30% declines in formula redemption (incidence rate ratio [IRR], 3.01; 95% confidence interval, 1.57–5.79, P < 0.001) than those with no difficulties. Incomplete formula redemption odds were significantly elevated throughout the COVID-19 pandemic from March 2020 to January 2022 and increased further during the 2022–2023 infant formula shortages from February 2022 to June 2023, reaching 342% higher in October 2022 than February 2020 (odds ratio, 4.42; 95% confidence interval, 4.14–4.72; P < 0.001). Special Supplemental Nutrition Program for Women, Infants, and Children redemption data are an adequate proxy for population-level infant formula access issues among households with low income but are insufficiently sensitive for screening at a household level. US formula shortages (2020–2023) demonstrate the need for improved coordination between nutrition assistance programs, regulatory bodies, and commercial food systems, particularly during acute supply crises. [ABSTRACT FROM AUTHOR]

To explore factors influencing the adoption of direct education programs and policy, systems, and environmental (PSE) change initiatives focused on physical activity for Supplemental Nutrition Assistance Program -eligible audiences by Virginia Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education (SNAP-Ed) staff. Online survey with Expanded Food and Nutrition Education Program and SNAP-Ed peer (paraprofessional) educators (n = 28) and SNAP-Ed agents (master of science level) (n = 9) in Virginia. Descriptive statistics were computed for sociodemographic characteristics and responses to questions on the basis of Likert-type scales. Exploratory factor analyses were run to identify the underlying structures of the different variables. The main factors for peer educators were related to substituting nutrition programs or content for physical activity programs. Other factors included staff qualifications and expectations about leading vs teaching physical activities. For PSEs, the top factors were the capacity to reach many community members, attract new partners and stakeholders, and personal interest in the PSE. The results provide insight into potential barriers and motivators for adopting physical activity education and PSEs within community-based initiatives and can be used to inform program planning and staff training. Additional research is warranted to examine other factors influencing the adoption and implementation of physical activity programs and PSEs. [ABSTRACT FROM AUTHOR]

To describe the experiences of first-time visitors with low food security seeking food assistance during the coronavirus disease 2019 pandemic. A qualitative study. Emergency food distribution sites in West Central Florida. Adults (aged 18–64 years) seeking food assistance between November, 2020 and July, 2021. Using food security as a multidimensional concept, in-depth interviews explored the impact of emergency food assistance on food availability, access, utilization, and stability. Applied thematic analysis was conducted to identify emergent themes. Participants (n = 18) were White (55.6%), female (72.2%), and aged 40–59 years (55.6%). Seven salient themes described participants' experience seeking food assistance (eg, the crisis resulting in seeking food assistance, mixed quality of pantry foods, and gaining firsthand insight on hunger). Although food assistance increased food availability and access, there were barriers to using the pantry foods (eg, foods not preferred, health/allergies). Study findings suggest that first-time visitors seeking emergency food assistance during the coronavirus disease 2019 pandemic may be experiencing temporary cycles of financial instability, which could impact dietary quality. Because pantry foods are often the primary source of household food supply, client-focused emergency food distribution tailored to client needs can increase food availability, access, and utilization. [ABSTRACT FROM AUTHOR]

We investigated the relationship between nutrition literacy, diet quality, carotenoid status, and cognition. Adults aged 37.5 ± 17.0 years (n = 52) completed the 42-item Nutrition Literacy Assessment Instrument (NLit). The Dietary History Questionnaire III was analyzed to determine the Healthy Eating Index. Skin carotenoids were assessed as a diet quality biomarker. Selective attention, relational memory, and pattern separation abilities were assessed using the flanker, spatial reconstruction, and mnemonic similarity tasks, respectively. Statistical adjustments included age, sex, education, and body mass index. No correlations were observed for NLit scores and NLit subscales with Healthy Eating Index and skin carotenoid status. However, the NLit's food label and numeracy subscale was related to greater pattern separation abilities (ρ = 0.33 , r 2 = 0.11, P = 0.03). Comprehension of food labels and numeracy information was associated with memory abilities. Future work is needed to test whether targeting working memory and attentional processes during memory retrieval in larger samples may facilitate the acquisition of nutrition knowledge. [ABSTRACT FROM AUTHOR]

Evaluate the acceptability and feasibility and explore the potential health impacts of a hospital-based herb and vegetable garden. Mixed-method program evaluation assessed dietetic and food service staff health, well-being, and garden engagement. Surveys were administered at baseline and follow-up (6 months). Key informant interviews (n = 6) were conducted at 6 months to evaluate program feasibility. There was good acceptance and engagement with the garden, with 18 participants volunteering to maintain the garden. Key informant interviews identified workforce, leadership, and garden design engagement factors. Participants also noted several psychosocial benefits. A hospital-based garden for staff is feasible if programmatic improvements are addressed. More robust evaluations considering challenges with measuring key outcomes with survey methodology and extended periods are warranted. [ABSTRACT FROM AUTHOR]

To assess change in attitudes toward women who have experienced trauma and to describe interns' reflections regarding the provision of universal trauma precautions and the training sessions. Dietetic interns participated in 3 2-hour trauma-informed care (TIC) training sessions. A multiple-methods design was used, incorporating a presurvey and postsurvey to assess change in attitudes and thematic analysis to assess self-reflections. The attitudes of the interns improved across all statements. Two components measuring attitudes about sympathetic feelings toward mothers with underlying trauma and substance use disorder during pregnancy and retaining custody of their children reached statistical significance (P < 0.05). Four themes were identified in the self-reflections: TIC training was informative, valuable, and warranted, and interns felt comfortable discussing TIC. Students positively assessed the TIC training and changed their attitudes. Trauma-informed care can be effectively incorporated within dietetics education to support students in developing therapeutic relationships in their future nutrition care standards. [ABSTRACT FROM AUTHOR]

To examine the moderation effect of Supplemental Nutrition Assistance Program (SNAP) participation on the baseline fruit and vegetable (FV) intake of Hispanic/Latino and African American children and parents participating in the Brighter Bites program. Cross-sectional. Houston, Austin, and Dallas, TX; Washington, DC; and Southwest Florida. Self-reported surveys (n = 6,037) of Hispanic/Latino and African American adult-child dyads enrolled in Brighter Bites in Fall 2018. Dependent variable, child FV intake; Independent variable, parent FV intake, and FV shopping behavior; Effect Measure Modifier, SNAP participation. Quantitatively used mixed effects linear regression models to test if the effect of parental baseline FV intake and shopping behavior on a child's baseline FV intake differed by SNAP participation. Analyses were performed using STATA with significance set at P < 0.05 and 95% confidence intervals (CIs). For parents that consumed FV ≥ 2 times/d at baseline, there was a 0.1 times increase in child FV intake at baseline among those who participated in SNAP as compared with those who did not participate in SNAP (ß = 0.1; 95% CI, 0.1–0.2; P = 0.001), and for parents who shopped at convenience stores ≥ 2 times/wk for FV, there was 0.6 times increase in child FV intake at baseline for those who participated in SNAP as compared with those that did not participate in SNAP (ß = 0.6; 95% CI, 0.3–0.9; P < 0.001). Supplemental Nutrition Assistance Program participation moderated the associations between FV intake among African American and Hispanic/Latino parents and children and FV shopping at convenience stores and child FV intake. Findings indicate a need for future interventions to promote SNAP participation among those eligible and improve access to FV. [ABSTRACT FROM AUTHOR]

To describe mothers' awareness and use of paced bottle-feeding (PBF) and to investigate whether the use of PBF was associated with maternal characteristics and infant feeding practices. Cross-sectional, online survey. Participants were mothers of infants < 12 months of age (n = 197). Participants self-reported their awareness and use of PBF, demographic characteristics, and infant feeding practices. Of the 41% of participants who indicated they had or maybe had heard of PBF, 23% used PBF and 35% sometimes used PBF. Use of PBF was not associated with mother or infant characteristics. Participants who used PBF were significantly less likely to encourage their infant to finish the bottle (odds ratio, 0.04; 95% confidence interval, 0.01–0.79). Paced bottle-feeding was associated with lower likelihood of one dimension of pressuring feeding practices, encouraging infant bottle-emptying. More research is needed to determine the effectiveness of PBF in promoting healthy feeding outcomes. [ABSTRACT FROM AUTHOR]

The effectiveness of the National Diabetes Prevention Program (DPP) in improving diet quality (DQ) in community settings is largely unknown. This study aimed to evaluate the DQ changes of Extension DPP participants. A single-group, repeated-measures design was used to evaluate an Extension-implemented DPP using the PreventT2 curriculum. Participants were overweight adults with or at high risk for prediabetes (n = 88). Weight and DQ (Healthy Eating Index–2015, Dietary Screener Questionnaire) were evaluated using mixed-effects regression. There was no change in the Healthy Eating Index–2015 total score. Predicted fiber, fruit, and vegetable intake increased (P < 0.05) but remained below recommendations. Clinically meaningful DQ changes of Extension DPP participants were limited. The effect of the DPP on DQ in Extension and other implementation settings should be evaluated through randomized controlled trials. Diabetes Prevention Program curriculum revisions that include more specific dietary goals and educational tools may promote greater DQ changes in DPP participants. [ABSTRACT FROM AUTHOR]

This study aimed to explore the presence of body image and diet culture rhetoric in videos under the hashtag #HealthyLifestyle on TikTok. The top 250 videos under #HealthyLifestyle were categorized using a codebook of wellness topics. We conducted descriptive statistics and interrater reliability analysis. #HealthyLifestyle videos had high rates of all coded categories, including negative and positive messages about body image and diet culture. Nearly all content with positive connotations was counteracted by coexisting negative messaging. Our findings suggest that content under #HealthyLifestyle contains messaging conflicting with the definition of a healthy lifestyle. Considering the young audience consuming this content, improved nutrition education and health literacy in schools is essential. [ABSTRACT FROM AUTHOR]

Examine the relationship between nutrition knowledge, diet quality, and eating behavior among active-duty US Army Soldiers. Cross-sectional study with data collection in February 2018 via paper surveys during the validation of the Military Eating Behavior Survey. Among 440 US Army Soldiers, nutrition knowledge was positively and significantly associated with diet quality (b = 0.29, P < 0.001). For every 1-point increase in nutrition knowledge, the Healthy Eating Index-2015 score was expected to increase by 0.29 points. Nutrition knowledge was not significantly associated with skipping breakfast (odds ratio, 1.01; 95% confidence interval, 0.98–1.04) or dining out (odds ratio, 1.01; 95% confidence interval, 0.98–1.03). The outcomes of this study warrant further investigation to determine what interventions provide the strongest outcomes for improving nutrition knowledge and diet quality, as well as create and support an environment that enhances healthy behaviors regarding nutrition that lead to improved diet quality among active-duty Soldiers. [ABSTRACT FROM AUTHOR]

To improve understanding of psychosocial factors, their changes, and racial differences with implications for behavioral obesity treatments. Women with obesity of White (n = 64) and Black (n = 33) racial groups participated in cognitive-behavioral community-based obesity treatment and were assessed on body satisfaction, emotional eating, and weight changes over 3, 6, 12, and 24 months via mixed-model repeated-measures analysis of variance and stepwise multiple regression analyses. Baseline body satisfaction scores were significantly higher (P < 0.001) in Black participants. White participants had significantly higher (P = 0.04) emotional eating scores. Significant overall improvements (P < 0.001) in body satisfaction, emotional eating, and weight were found, with weight reduction significantly greater (P = 0.05) among the White women. Weight reductions were significantly predicted by changes in body satisfaction and emotional eating (R 2 = 0.12–0.20, P < 0.01). When racial group was entered into the analyses, the explained variance in weight change over 6 and 12 months significantly increased (P < 0.05). Findings suggest addressing body satisfaction, emotional eating, and racial differences by adjusting obesity treatment targets could improve outcomes. Research-to-practice needs include a control group and further identification/elucidation of other psychosocial and economic factors that might affect outcomes. [ABSTRACT FROM AUTHOR]

To examine cooking practices, online information-seeking habits, and intervention preferences among parents with low income to inform the development of a digital cooking intervention on the basis of the Healthy Cooking Index. This formative research study included a brief survey followed by in-depth interviews (from February to April, 2021) with parents of a child aged 6–11 years with low income (n = 20; 100% female, 70% African American or Hispanic White). Interview transcripts were analyzed using a semistructured hybrid coding approach. Three main themes were identified to inform the development of the intervention: (1) current Healthy Cooking Index behaviors, (2) preferences for digital cooking intervention content, and (3) design and delivery preferences. A 7-step process was used to develop the intervention and integrate qualitative findings. Online culinary programs targeting parents with low income may consider short, mobile-friendly video formats and focus on easy-to-prepare recipes adaptable to family preferences. [ABSTRACT FROM AUTHOR]

To examine the association between food insecurity and dysfunctional eating behaviors among adults in Puerto Rico. Data from 865 participants were obtained from baseline interviews from the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT) cohort. The association between food insecurity and emotional eating (EE) and uncontrolled eating (UE) (categorized as no/moderate/high) was examined using multinomial logistic models. Potential mediation by perceived stress was explored. The prevalence of food insecurity was 20.3%. Compared with adults with food security, adults with food insecurity had higher odds of both moderate EE (odds ratio [OR], 1.91; 95% confidence interval [CI], 1.18–3.09) and high EE (OR, 2.85; 95% CI, 1.75–4.64), and both moderate UE (OR, 1.78; 95% CI, 0.91–3.50) and high UE (OR, 3.28; 95% CI, 1.70–6.33). Perceived stress slightly attenuated these associations. Food insecurity was associated with a higher likelihood of engaging in dysfunctional eating behaviors. Interventions alleviating food insecurity or stress might help adults sustain healthy eating behaviors. [ABSTRACT FROM AUTHOR]

Assess the quality of free, commercially available infant-feeding mobile applications (apps) and their appropriateness for audiences with low income and of racial and ethnic diversity using the App Quality Evaluation tool. Researchers selected apps using an iterative process (n = 6). Health professionals (n = 10) who work with mothers with infants and low income who completed the App Quality Evaluation tool for each app, consisting of 7 domains of app quality. Average domain scores were calculated for each app (> 8 indicates high quality). Evaluators highly rated app function and purpose for WebMD Baby (8.0 ± 1.8 and 8.2 ± 0.9, respectively) and Baby Center (8.0 ± 2.1 and 8.0 ± 2.6, respectively). For other apps, no domains were highly rated. No apps were rated highly for appropriateness (range 5.7–7.7) nor provided high-quality infant-feeding information for mothers with low income. Few apps were rated highly appropriate for mothers who are Black or Hispanic. Commercially available infant-feeding apps are of limited quality, indicating the need to develop high-quality apps for audiences with low income and Black and Hispanic identities. [ABSTRACT FROM AUTHOR]

To validate a culturally tailored 7-day beverage intake questionnaire for Latino children (BIQ-L). Cross-sectional. Federally qualified health center in San Francisco, CA. Latino parents and their children aged 1–5 years (n = 105). Parents completed the BIQ-L for each child and three 24-hour dietary recalls. Participants' height and weight were measured. Correlations between the mean intake of beverages in 4 categories as determined by the BIQ-L and three 24-hour dietary recalls were assessed. Multivariable linear regression examined the association between sugar-sweetened beverages (SSB) servings as determined by the BIQ-L and child body mass index z-score. Mean daily intake of SSB (r = 0.52, P < 0.001), 100% fruit juice (r = 0.45, P < 0.001), flavored milk (r = 0.7, P < 0.001), and unflavored milk (r = 0.7, P < 0.001) from the BIQ-L were correlated with intake assessed via three 24-hour dietary recalls. In the multivariable model, weekly servings of SSBs were associated with child body mass index z-score (β = 0.15, P = 0.02). Culturally specific beverages comprised 38% of the SSB intake reported on the BIQ-L. The BIQ-L is a valid tool for assessing beverage intake among Latino children aged 1–5 years. The inclusion of culturally specific beverages is critical for accurately assessing beverage intake among Latino children. [ABSTRACT FROM AUTHOR]

Inadequate consumption of fruits and vegetables (FV) can negatively impact health. Cost-offset, or subsidized, community-supported agriculture (CO-CSA) may change FV preparation behaviors among caregivers in low-income households. We assessed changes in FV preparation frequency and methods during and after participation in a CO-CSA plus tailored nutrition education intervention. Longitudinal comparison of outcomes at baseline, end of CO-CSA season, and 1 year later. Caregivers of children aged 2–12 years from households with low income in rural areas of 4 US states (n = 148). Summer season, half-price CO-CSA share plus tailored nutrition education classes. Comparison to a control group not included in this analysis. Monthly frequency of preparing 9 FV for children's snacks and 5 vegetables for dinner; use of healthy preparation methods for dinner. Repeated measures ANCOVA including state with Bonferroni correction and 95% confidence. At baseline, caregivers prepared fruit for children's snacks and vegetables for dinner almost daily and vegetables for children's snacks every other day. The frequency of total FV preparation and most vegetable varieties increased during the intervention. Increases in total vegetables for snacks, dinner, and leafy greens were maintained 1 year later (n = 107). Community-supported agriculture plus education is a promising approach to sustained increases in vegetable preparation for children's snacks and dinner meals. [ABSTRACT FROM AUTHOR]