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The high prevalence of childhood overweight and obesity demonstrates the need for effective intervention strategies. The Shaping Healthy Choices Program (SHCP) is a school-based intervention that promotes nutrition and physical education, develops family and community partnerships, and incorporates foods available on the school campus, with the goal of achieving sustainable student health outcomes. Partnerships developed through implementation of the SHCP were analyzed using the RE-AIM: Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework to assess the potential for adoption, scaling and sustainability of the program. The RE-AIM framework is a comprehensive approach to evaluating public health interventions through reach, effectiveness, adoption, implementation and maintenance. Partners of the SHCP include site staff (teachers, administration and health professionals), parents, peer teachers, and state and federal agencies, such as the Supplemental Nutrition Assistance Program Education (SNAP-Ed), which funds CalFresh Healthy Living, University of California (CFHL, UC), and UC Cooperative Extension. This analysis highlights how partnerships developed and sustained with the SHCP may serve as a model for other programs to expand, while also enabling programs to remain responsive to the diverse challenges and needs of local community partners.

The Adult Autism Quotient (AQ), the Empathy Quotient (EQ) and the Relative's Questionnaire (RQ) were used as part of the Adult Asperger's Assessment (AAA) by a diagnostic service for adults without an intellectual disability with suspected autism spectrum disorder (ASD). This service is part of the National Health Service (NHS) in England. Little is known about the utility of these structured questionnaires despite wide use in clinical practice. It was investigated whether the questionnaires could discriminate between individuals with and without a diagnosis of ASD. Receiver Operating Curve analysis showed good levels of sensitivity to detect a positive diagnosis, but the specificity to exclude those without a diagnosis was poor. A binary logistic regression showed that a combination of the questionnaires also showed limited diagnostic validity. These findings have clinical implications in reviewing the efficiency of the assessment process.

Objective: (1) Identify demographic and academic differences among university students who are food secure or food insecure and (2) explore CalFresh knowledge, attitudes, and practices (KAPs) among university students. Design: A questionnaire, including the 10-item USDA Adult Food Security Survey Module, CalFresh KAPs, and student factors was distributed in Winter 2020 to 10,000 university students. Chi-square test of independence, logistic and linear regressions were used to assess associations between food-secure status and student factors. Exploratory factor analysis determined factors relating to CalFresh KAPs. Kendall’s tau assessed association between CalFresh KAPs factors. Setting: A public research university in California. Participants: Enrolled undergraduate and graduate/professional students (n = 10,000). 1535 responses with 1408 included in analysis for having complete data. Results: Food insecurity was associated with: race/ethnicity (Latino/a, OR = 1.97; p < 0.001); first-generation status (OR = 2.01; p < 0.001); and transfer status (OR = 1.58; p = 0.01). Exploratory factor analysis identified five factors related to CalFresh knowledge and attitudes: (1) CalFresh knowledge, (2) Positive attitudes around participating in CalFresh, (3) Negative attitudes around participating in CalFresh, (4) Negative attitudes around others participating in CalFresh, and (5) Fortunate attitudes for not participating in CalFresh. CalFresh knowledge was correlated with positive attitudes towards CalFresh participation (τb = 0.15, p = 0.025); negative attitudes towards other individuals’ CalFresh participation (τb = −0.28, p < 0.001); feeling fortunate for not needing CalFresh (τb = 0.12, p = 0.004); and CalFresh participation OR = 1.40; p = 0.02). Conclusions: CalFresh knowledge may influence program participation. Populations who are most impacted by food insecurity should be a focus for improving CalFresh knowledge to promote CalFresh participation.

Food insecurity (FI) is associated with many adverse outcomes in college students. The Supplemental Nutrition Assistance Program (SNAP, known as CalFresh in California) has been observed to alleviate FI; however, on college campuses, the benefits of food assistance programs are not well understood. This study investigated whether college students benefit from CalFresh participation. It was hypothesized that students would experience increased FI over time and that CalFresh participation would moderate the effect of FI on grade point average (GPA). A comprehensive FI and CalFresh questionnaires were distributed during the 2020-2021 academic year to 849 students. The chi-square test of independence assessed differences between FI and student factors. A Friedman test assessed differences in FI during the three quarters. Moderation analysis assessed whether CalFresh participation moderated FI's effect on GPA. Differences were observed among food security scores in Winter 2021 (median = 1.69) and Fall 2020 (median = 2.14; p = 0.013) and Spring 2020 (median = 2.17; p = 0.009). In the moderation model, the interaction of FI score and CalFresh participation was positively correlated with GPA (B = 0.11; p = 0.002). These results indicate that SNAP/CalFresh participation was particularly beneficial for mitigating the negative effects of FI on GPA. Given these benefits, encouraging SNAP/CalFresh enrollment should be a priority for university administrators.

Dietary behavior change is difficult to accurately measure in a low-income youth population. Objective tools to measure fruit and vegetable consumption without relying on self-report present the opportunity to do this with less respondent burden and bias. A promising tool for quantifying fruit and vegetable consumption via proxy is skin carotenoids as measured by reflection spectroscopy through a device called the Veggie Meter®. To assess whether the Veggie Meter® is able to detect changes in skin carotenoids as a proxy for fruit and vegetable consumption in a low-income school setting, skin carotenoid measurements were collected at three time points, along with student level demographics, anthropometric measurements, and nutrition knowledge. A secondary goal of this study was to refine the protocol to be used based on researcher observations. Repeated measures analysis of variance with Bonferroni correction for multiple comparisons indicate that there was a significant difference in VM scores over the course of the study (F(2, 68) = 6.63, p = 0.002), with an increase in skin carotenoids from Fall 2018 to Spring 2019 (p = 0.005). This increase was sustained over the summer months when measured in Fall 2019. Changes to the protocol included the addition of a hand cleaning step and using the non-dominant ring finger for data collection. With these refinements, the results demonstrate that the Veggie Meter® is usable as a non-invasive tool for measuring fruit and vegetable consumption in a population that is traditionally difficult to assess.