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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 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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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 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]

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]

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]

To evaluate the effectiveness of a nutrition education package on feeding practices, nutrient intakes and growth of infants in rural Tanzania. Cluster-randomized controlled trial in 18 villages allocated to nutrition education package (n = 9) or routine health education (n = 9 villages), measured at baseline (6 months) and end of the trial (12 months). Mpwapwa district. Infants aged 6–12 months and their mothers. Six months of nutrition education package (group education, counseling, cooking demonstrations) and regular home visits by village health workers. Primary outcome measure was the mean change in length-for-age z-scores. Secondary outcomes included mean changes in weight-for-length z-scores (WLZ), intakes of energy, fat, iron and zinc, the proportion of children consuming foods from ≥ 4 food groups (ie, dietary diversity) and consuming the recommended number of semisolid/soft meals and snacks per day (ie, meal frequency). Multilevel mixed-effects regression models. Mean change in length-for-age z-scores (β = 0.20, P = 0.02), energy (in kcal) (β = 43.8, P = 0.02), and fat (in grams) (β =2.7, P = 0.03) intakes were significant in the intervention but not in the control group. There was no effect on iron and zinc intakes. More infants in the intervention than the control group consumed meals from ≥ 4 food groups (71.8% vs 45.3%, P = 0.002). The mean increase in meal frequency (β = 0.29, P = 0.02) and dietary diversity (β = 0.40, P = 0.01) were more significant in the intervention than control. The nutrition education package is feasible and can be implemented with high coverage, demonstrating the potential to improve feeding practices, nutrient intake and growth in rural Tanzania. [ABSTRACT FROM AUTHOR]

To examine the relationship between the diet quality of children aged 2–5 years cared for in family child care homes (FCCHs) with provider adherence to nutrition best practices. Cross-sectional analysis. Family child care home providers (n = 120, 100% female, 67.5% Latinx) and children (n = 370, 51% female, 58% Latinx) enrolled in a cluster-randomized trial. Data were collected over 2 days at each FCCH. The Environment and Policy Assessment and Observation tool was used to document whether providers exhibited nutrition practices on the basis of the Nutrition and Physical Activity Self-Assessment for Child Care. Each practice was scored as either present or absent. Children's food intake was observed using Diet Observation at Child Care and analyzed with the Healthy Eating Index–2015. Multilevel linear regression models assessed the association between providers exhibiting best practices regarding nutrition and children's diet quality. The model accounted for clustering by FCCH and controlled for provider ethnicity, income level, and multiple comparisons. Children in FCCHs in which more of the best practices were implemented had higher diet quality (B = 1.05; 95% confidence interval [CI], 0.12–1.99; P = 0.03). Specifically, children whose providers promoted autonomous feeding (B = 27.52; 95% CI, 21.02–34.02; P < 0.001) and provided nutrition education (B = 7.76; 95% CI, 3.29–12.23; P = 0.001) had higher total Healthy Eating Index scores. Future interventions and policies could support FCCH providers in implementing important practices such as autonomy feeding practices, talking informally to children about nutrition, and providing healthful foods and beverages. [ABSTRACT FROM AUTHOR]

This review aimed to collect evidence about the effectiveness of exercise programs for managing binge eating disorder (BED) (recurrent binge eating episodes). Meta-analysis was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Articles were searched in PubMed, Scopus, Web of Science, and Cochrane Library. Randomized controlled trials were eligible for inclusion if they reported the effect of an exercise-based program on BED symptoms in adults. Outcomes were changes in binge eating symptom severity, measured through validated assessment instruments, after an exercise-based intervention. Study results were pooled using the Bayesian model averaging for random and fixed effects meta-analysis. Of 2,757 studies, 5 trials were included, with 264 participants. The mean age was 44.7 ± 8.1 years for the intervention group and 46.6 ± 8.5 years for the control group. All participants were female. A significant improvement was observed between groups (standardized mean difference, 0.94; 95% credibility interval, −1.46 to −0.31). Patients obtained significant improvements either following supervised exercise programs or home-based exercise prescriptions. These findings suggest that physical exercise, within a multidisciplinary clinical and psychotherapeutic approach, may be an effective intervention for managing BED symptoms. Further comparative studies are needed to clarify which exercise modality is associated with greater clinical benefits. [ABSTRACT FROM AUTHOR]

Examine differences in dietary intake of children aged 2–5 years in early care and education (ECE) setting in the US Affiliated Pacific (USAP). Secondary analysis of cross-sectional data collected by the Children's Healthy Living program. Children (n = 1,423) with complete dietary records and information on the ECE setting. Dietary intake by ECE setting; Head Start (HS), other ECE (OE), and no ECE. Comparison of mean dietary intake across ECE settings and multivariate logistic regression to evaluate ECE setting and likelihood for meeting dietary reference intake (DRI). Children in HS and OE settings had a significantly higher intake of several food groups and nutrients, compared with no ECE; vegetables (0.4 cup-equivalents per thousand kcals [CETK] vs 0.3 CETK; P < 0.001), fruits (0.8 CETK vs 0.6 CETK; P = 0.001), milk (0.9 CETK for HS and 1.0 CETK for OE vs 0.8 CETK; P < 0.001). Sixty-five percent of the HS group met DRI and had greater odds of meeting calcium DRI (odds ratio, 1.8; 95% confidence interval, 1.2–2.7) compared with other groups. The OE group had the lowest proportion of children meeting recommended intakes for 19 out of 25 nutrients. Mean intakes of foods and nutrients for children across the USAP meet some, but not all, recommendations and intakes vary across children attending various ECE setting types. Additional research on the clinical importance of these differences and the impact of the complex food systems in the USAP may identify systematic strategies for improving diet among children. [ABSTRACT FROM AUTHOR]

To characterize food agency (one's capacity to procure and prepare food in particular contexts) among Diabetes Prevention Program (DPP) participants and gather perspectives about experiences with DPP. Photograph-elicitation in-depth interviews and survey measures. Baltimore, Maryland (June–August 2021). Black women (n = 13) who participated in DPP. Food agency and strategies used to procure and prepare food and the influence of DPP on daily food behaviors. Surveys measured food agency using the Cooking and Food Provisioning Action Scale and cooking behaviors. Thematic analysis of qualitative in-depth interviews and descriptive statistics for quantitative measures. As quantitative and qualitative data revealed, participants were frequent and confident cooks with high food agency. Participants viewed cooking as a key strategy for healthy eating and desired more hands-on cooking instruction within DPP to develop new healthy cooking skills. The primary barriers identified were related to lack of time or energy. Food procurement and preparation practices shifted over time, and DPP was a key influence on current behaviors. Food agency is complex and manifests heterogeneously in daily life. A life course, contextual, and food agency-based approach could be considered for future diabetes prevention interventions. [ABSTRACT FROM AUTHOR]

To develop and test the psychometric properties of a responsive feeding questionnaire (RFQ) on the basis of Self-Determination Theory for caregivers of toddlers aged 12–24 months in China. Item generation, preliminary evaluation items, refinement questionnaire, and psychometric properties testing. Toddlers' caregivers from Shandong Province, China, were surveyed online between June 2021 and February 2022 (n = 616). Content, face, and construct validity and reliability of the RFQ. Content validity was performed on the basis of expert panel feedback and cognitive interviews among caregivers. Construct validity was evaluated using principal component analysis with varimax rotation. Test-retest reliability was conducted with a sample of 105 caregivers. Over 3 phases of testing, a new instrument was developed to measure responsive feeding in toddler caregivers. The instrument was reliable, with an internal consistency of 0.87 and an intraclass correlation of 0.92. The principal component analysis identified a 3-factor solution (autonomy support, positive involvement, appropriate response) aligning with a theoretical framework from Self-Determination Theory. The final version of the instrument included 23 items. The 23-item RFQ has been validated in a Chinese population. Future research needs to validate this instrument in other countries and with children of different ages. [ABSTRACT FROM AUTHOR]

This study 1) compares grocery sales to Supplemental Nutrition Assistance Program (SNAP) shoppers in rural and urban grocery stores and 2) estimates changes in sales to SNAP shoppers in North Carolina (NC) since the pandemic. Weekly transaction data among loyalty shoppers at a large grocery chain across NC from October 2019 to December 2020 (n = 32; 182 store weeks) to assess nutritional outcomes. North Carolina large chain grocery stores. Large chain grocery store/SNAP shoppers. Rural/urban status of the stores and COVID-19 pandemic onset. Share of total calories sold from fruits, vegetables, nuts, and legumes (FVNL) with and without additives, sugar-sweetened beverages (SSB), less healthful foods (LHF), and processed meats (PM). Multivariate random effects models with robust standard errors to examine the association of rural/urban status before and since coronavirus disease 2019 with the share of calories sold to SNAP shoppers from each food category. We controlled for county-level factors (eg, sociodemographic composition, food environment) and store-level factors. We did not find significant rural-urban differences in the composition of sales to SNAP shoppers in adjusted models. There was a significant decrease in the mean share of total calories from sugar-sweetened beverages (−0.43%) and less healthful food (−1.32%) and an increase in the share from processed meats (0.09%) compared with before the pandemic (P < 0.05). Urban-rural definitions are insufficient to understand nuances in food environments, and more support is needed to ensure healthy food access. [ABSTRACT FROM AUTHOR]

Identify factors influencing eating behaviors among emerging adults in the military. Focused ethnography using interviews, observations, and artifacts for data. Three US Naval installations. Thirty-two active-duty Sailors aged 18–25 years. Qualitative data were organized in NVivo and analyzed sequentially to categorize culturally relevant domains and themes using a social ecological model (SEM). Descriptive statistics were used to describe questionnaire data in SPSS (version 27.0, IBM, 2020). Leaders encouraged healthy eating through policies and messages, but cultural contradictions and environmental barriers undermined Sailors' efforts to eat healthily. Stress and resource constraints (intrapersonal), peer pressure (social), unhealthy food environments and lack of access to food preparation (environmental), and eating on the go because of mission-first norms (cultural) promoted unhealthy eating behaviors. Nutrition and culinary literacy (intrapersonal); peer support and leadership engagement (social); access to healthy, convenient, and low-cost foods (environmental); and indoctrination to healthy eating during recruit training (cultural) positively influenced eating behaviors. The eating behaviors of service members are influenced by many modifiable factors. Targeted education, leadership engagement, and policies that make nutritious foods easily accessible, appealing, and preferred are needed. [ABSTRACT FROM AUTHOR]

The socioemotional climate when feeding is a focus in childhood obesity prevention efforts. However, little is known about why caregivers create nonsupportive or supportive climates. This cross-sectional study used a Self-Determination Theory perspective to identify factors associated with the socioemotional climate when feeding in ethnically diverse families with low income. Caregivers of children aged 2–5 years (n = 66) completed the Parent Socioemotional Context of Feeding Questionnaire, the Basic Psychological Need (BPN) Satisfaction and Frustration Scale, and demographic surveys at baseline. Multivariable regressions assessed the association between BPN satisfaction/frustration with autonomy-supportive, structured, controlling, and chaotic feeding climates. Participants were predominately Hispanic/Latinx (86.6%), women (92.5%), and born outside the US (60%). Their BPN frustration was positively associated with controlling (β = 0.96; SE = 0.26; P = 0.001) and chaotic (β = 0.79; SE = 0.27; P = 0.01) feeding. This analysis suggests that BPN frustration is associated with controlling and chaotic feeding and may be important to consider when encouraging responsive feeding. [ABSTRACT FROM AUTHOR]

Evaluate Elementary Education college students' familiarity and perceptions of Breakfast in the Classroom (BIC) before and after an educational video intervention. A 5-minute educational video was developed as an intervention in a pilot study. Quantitative data were collected from Elementary Education students using preintervention and postintervention surveys and analyzed using paired sample t tests (P < 0.001). A total of 68 participants completed preintervention and postintervention surveys. Postintervention survey scores indicated that participants' perceptions of BIC improved after watching the video. Paired sample t tests also showed an increase in preference for BIC, familiarity with the 5 school breakfast service models, and confidence to implement BIC in future classrooms. An educational video intervention effectively improves Elementary Education students' perceptions of BIC. Elementary Education students who gain a positive perception of BIC may influence the program's success and ability to benefit students. [ABSTRACT FROM AUTHOR]

To examine the dietary behaviors of mothers from very low food security (VLFS) households following the availability of coronavirus disease 2019 (COVID-19) unemployment and Supplemental Nutrition Assistance Program benefits. Diet and food security status were obtained from 2,584 California mothers during Federal Fiscal Year 2020. Fruits, vegetables, and 100% fruit juice (FV100%FJ), sugar-sweetened beverages, and water intake, and Healthy Eating Index-2015 scores, were compared across 4 groups (before vs after COVID-19 benefits by VLFS vs non-VLFS households) with race/ethnicity and age as covariates. Before COVID-19 benefits, VLFS was associated with fewer cups of FV100%FJ (P = 0.010), more fluid ounces of sugar-sweetened beverages (P = 0.004), and poorer diet quality (P = 0.003). After COVID-19 benefits, mothers from VLFS vs non-VLFS households reported similar dietary outcomes. VLFS mothers reported 0.96 (95% confidence interval, 0.53–1.38) more cups of FV100%FJ after COVID-19 benefits. Coronavirus disease 2019 benefits may have reduced dietary inequities among low-income families. Associations between increased Supplemental Nutrition Assistance Program and unemployment benefits and decreased costs associated with the negative health outcomes linked to food insecurity and poor diets would be of value. [ABSTRACT FROM AUTHOR]

To understand Supplemental Nutrition Assistance Program-Education (SNAP-Ed) Implementing Agencies'(SIAs) use of the SNAP-Ed Evaluation Framework (Framework), which is a tool that includes 51 indicators that SNAP-Ed programs can use to measure the success of their programs in the first 5 years after its release. A repeated cross-sectional study design was utilized to administer electronic surveys to between 124 and 154 SIAs who received SNAP-Ed funding in fiscal years 2017, 2019, and 2021. Analyses included descriptive statistics and tests of proportions. Most SIAs indicated that they used the Framework to inform both data collection instruments and program planning decisions and the rates remained relatively constant over the 3 time points (> 80%). The most common specific use of the Framework across all 3 time points was to define, count, or measure the work accomplished, but this statistically decreased from 2017 (76%) to 2021 (57%) (z-score = 3.31; P < 0.001). The results of this analysis confirmed that 5 years after its introduction, uptake and use of the Framework was high and that, as a whole, SIAs focused on priority indicators set by the US Department of Agriculture, with no notable increases in addressing and measuring longer-term, multisector, and population-wide outcomes. The systematic study of the Framework's usability over time has a broader application to other national health promotion initiatives with shared frameworks. [ABSTRACT FROM AUTHOR]

To estimate the number, distribution, and predictors of food pantries across counties in the US in 2020. A cross-sectional, secondary data analysis of geocoded food pantry locations and social, demographic, and economic characteristics at the county level. Publicly disclosed food pantry locations were collected from websites in all counties. Pantry locations were merged with data from the American Community Survey 2015–2019. The number of food pantries per county. A negative binomial regression estimated the association between the number of pantries per county and community characteristics. We found 48,581 food pantries from publicly disclosed websites, covering 98% of counties. The mean and median number of pantries per county were 15.5 and 6, respectively. Selected characteristics positively associated with the number of pantries per county were income inequality, percentage of noncitizens, and percentage of single-parent households. Selected characteristics negatively associated with the number of pantries per county were percent with a high school education or less, percent of households in poverty, and rurality. The US has an extensive network of food pantries. Future work could assess the potential causal pathways between pantry placement and county-level characteristics. [ABSTRACT FROM AUTHOR]

To explore the approaches applied by nutrition educators who work with the US Department of Agriculture Gus Schumacher Nutrition Incentive Program (GusNIP), Nutrition Incentive (NI), and Produce Prescription (PPR) programs. Multiple data collection methods, including descriptive survey (n = 41), individual interviews (n = 25), and 1 focus group (n = 5). Interviewees were educators who deliver nutrition education as a component of GusNIP NI/PPR programs. Descriptive statistics were calculated from survey responses. Transcripts were coded using thematic qualitative analysis methods. Four overarching themes emerged. First, educators have many roles and responsibilities beyond providing curriculum-based nutrition education. Second, interviewees emphasized participant-centered nutrition education and support. Third, partnerships with collaborating cross-sector organizations are essential. Fourth, there are common challenges to providing nutrition education within GusNIP NI/PPR programs, and educators proposed solutions to mitigate these challenges. Nutrition educators promote multilevel solutions to improve dietary intake, and it is recommended they be included in conversations to improve GusNIP NI/PPR programs. [ABSTRACT FROM AUTHOR]

Examine the impact of Fuel for Fun: Cooking with Kids Plus Parents and Play (FFF) on children's culinary self-efficacy, attitude, fruit and vegetable (FV) preferences, physical activity (PA), and body mass index. Randomized controlled trial. Eight elementary schools in 2 Northern Colorado districts. Fourth-grade students; 7-month interventions: school (S.FFF)—theory-based cooking + tasting lessons, active recess, lesson-driven cafeteria promotions; or school + family (S+F.FFF) with added family nights and home activities. Cooking self-efficacy and attitudes, FV preferences, PA, and measured height/weight. Individual outcomes nested by classroom, school, and district and assessed > 12 months with repeated measures controlled by sex and baseline cooking experience, with a significance level of P < 0.05. The sample included 1,428 youth, 38 teachers, 4 cohorts, 50% boys, 75% White, and 15% Hispanic. No intervention effect was observed. Those who cooked retained higher self-efficacy, attitude, and FV preferences (P < 0.001). Girls reported higher self-efficacy and attitude than boys. Moderate-to-vigorous PA and metabolic equivalent minutes increased for all students; boys retained higher levels (P < 0.001). Body mass index percentile remained stable. Cooking and sex were associated with all outcome measures and should be considered for intervention tailoring. Treatment impacts were not evident nesting by classroom, school, and district. Accurate assessment of school-based interventions requires rejecting student independence from group assignment assumptions. [ABSTRACT FROM AUTHOR]