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Parents play an important role in developing the eating behaviors of their children by adopting specific parenting practices. As the prevalence of obesity is high amongst African American adolescents, investigations into associations of specific parenting practices and adolescents’ eating behaviors are essential. In this exploratory study, 14 African American parent–adolescent dyads were interviewed to characterize the influence of eight different parenting practices on the consumption of three main food categories (dairy, fruits and vegetables, and unhealthy snacks). The results revealed that authoritarian parenting practices were correlated with a higher BMI percentile in adolescents, whereas modeling and monitoring are correlated with a higher parent BMI. In addition, reasoning, monitoring, modeling, and authoritative parenting practices were associated with less unhealthy snack consumption among adolescents. Reasoning and monitoring were the only parenting practices associated with higher fruit and vegetable consumption. Finally, a significant correlation was found between eating fruits and vegetables and unhealthy snacks and the location of eating. In conclusion, different parenting practices and environmental factors may impact BMI and food consumption of African American dyads. The results of this study can be used to guide improvement in, and/or development of, nutritional education interventions considering the cultural differences of racial minorities.

This cross-sectional study examined how the COVID-19 pandemic impacted the food practices, physical activity (PA) levels, and stress levels of aging adults ages 40 years and older from seven states. It also explored to what extent the COVID-19 outcomes were affected by the social determinants of health (SDH).Respondents (Respondents were mostly White (75.9%), married (58.7%), age 60 years and older (61.8%), with a high school education or higher (97.4%). Most of the respondents (85.8%) live in areas that respondents perceived as supportive of health and well-being opportunities for older adults. Nearly one-half of the respondents reported maintaining their pre-pandemic grocery shopping/food buying frequency (44.7%) and PA levels (48.1%). However, 48.6% reported being "somewhat or very stressed" due to the pandemic. Findings revealed that the COVID-19 impacts on food-buying, PA levels, and stress levels were significantly influenced by age, gender, race, education, location, community, nutritional risk, quality of life, food security, and income (These findings provide valuable information as we continue to confront the impact the COVID-19 pandemic has had on the health and well-being of aging adults. We can use this information to inform future public health programming interventions and opportunities.

Objective To develop and test parent and early adolescent questionnaires to assess food parenting practices that influence early adolescent food consumption during independent eating occasions (iEOs). Methods Cross-sectional online questionnaires were completed by 206 and 62 low-income parent/early adolescent (11–14 years) dyads at Time 1 and 2, respectively, recruited via a Qualtrics (Provo, UT) US national panel database. Principal component analyses, internal consistency, and test–retest reliability checks were performed. Results Six parallel components were identified for parents and early adolescents with acceptable internal consistency and test–retest reliability. Scales included autonomy support, monitoring, availability, indulgence, expectations, and modeling. All except indulgence were positively correlated with importance of helping early adolescents make healthy choices during iEOs. Conclusions and Implications Additional research is needed to test the questionnaires’ validity regarding relationships between parenting practices and early adolescent consumption during iEOs. Findings could inform development of interventions to improve consumption during these occasions.

Covid-19 has changed individuals eating behavior. This study examines how protein consumption changed since Covid-19 pandemic. This is a cross-sectional study design with a total of 10,035 adults aged 40-100 years old surveyed through Qualtrics by dietary screening tool. The protein consumption was questioned by “How often do you eat chicken or turkey?” and “How often do you eat not-fried fish or seafood?”. Pre and since pandemic responses were compared by Wilcoxon signed-rank tests. Participants were 57% female, 43% male, 75% White, 14% African American, %7 Asian, and 4% Hispanic. According to the analysis, chicken, or turkey (p

Parents influence adolescents’ weight status through different strategies used in the home environment, including parenting styles (PSs), food parenting practices (FPPs), and family meal frequency. As the prevalence of obesity is higher among African American adolescents, investigation of which parental strategies serve as an adjustable factor for the prevention of obesity is critical. First, this study aims to examine the relationship between the different parenting influences and obesity statuses of both parents and 10–17-year-old adolescents among African American families. Second, it aims to examine the correlation between PSs and FPPs and frequency of family meals. A total of 211 parent–adolescent dyads completed an online survey using Qualtrics. Four PSs (i.e., authoritative, authoritarian, setting rules/expectations, and neglecting) and four FPPs (i.e., monitoring, reasoning, copying, and modeling) were identified for this study, along with family meal frequency. Body mass index (BMI) percentile and BMI were used to assess the obesity status of the adolescents and parents, respectively. No correlation was found between the adolescents’ and parents’ obesity status and the PSs and FPPs, while the adolescents’ BMI percentile was significantly correlated with parental BMI. However, a higher number of family meals decreased the likelihood of obesity among the adolescents to some extend and depended on the type of BMI used. An authoritative PS was the only style related to family meal frequency, while three FPPs, namely, monitoring, reasoning, and modeling, were related to a greater number of family meals in African American families. The findings of this study can be used in the development of parental education workshops/sessions, with consideration of the cultural differences in African American families, and can help parents to adopt the best parenting strategy to promote the healthy weight status of their adolescents.

Improving care for the older population is a growing clinical need in the United States. Ageism and other attitudes of healthcare professionals can negatively impact care for older adults. This study investigated healthcare professionals’ (N = 140) views towards aging and characterized a confluence of factors influencing ageism perspectives in healthcare workers using path analysis models. These models proposed relationships between aging anxiety, expectations regarding aging, age, ageism, and knowledge. Aging anxiety had a less critical role in the final model than hypothesized and influenced ageism in healthcare workers through its negative effect (β = −0.27) on expectations regarding aging. In contrast, aging knowledge (β = −0.23), age (β = −0.27), and expectations regarding aging (β = −0.48) directly and inversely influenced ageism. Increased knowledge about the aging process could lower ageism amongst healthcare professionals and improve care for older adults. The results put forth in this study help to characterize and understand healthcare workers’ complex views towards the aging population they often encounter. Moreover, these results highlight the need and utility of leveraging practitioner education for combating ageism in the clinical setting.

OBJECTIVES: The objective of this project was to determine the changes in nutrition behaviors of older adults before and since COVID-19 pandemic. METHODS: An online survey administered by Qualtrics was used for data collection. The survey was administered between August 9, 2020 through September 15, 2020. The sample size included 9,969 participants with 5,733 females (57%) and 4,236 males (43%). The age ranged from 40 to100 years (M = 62.09, SD = 11.22). The 24-item Dietary Screening Tool (DST) was used for data collection. Data were analyzed using SPSS (version 20: IBM, Inc.) Descriptive statistics were provided as mean and standard deviation (SD) for continuous variables and frequency and percentages for categorical variables. Differences between nutritional items before and since COVID-19 were examined using paired-sample t-test (11 pairs) for normal distribution, Wilcoxon's signed-rank tests (8 pairs) for nonparametric distributions and McNemar test for 12 yes/no questions (6 pairs). RESULTS: Changes in consumption before and since COVID-19 were measured. For total participants, drinking alcohol decreased significantly (48.1% vs. 46.9%). The decrease in drinking alcohol was statistical significance with gender (male: 57.2 vs.55.2%; female:41.4% vs. 40.7%). The number of servings of milk, cheese and yogurt decreased significantly since COVID-19 (P

Obesity is more prevalent among racial minority children in the United States, as compared to White children. Parenting practices can impact the development of children’s eating behaviors and habits. In this study, we investigated the relationships among racial/ethnic backgrounds, parenting practices and styles, and eating behaviors in adolescents. Fifty-one parent–adolescent dyads were interviewed to characterize parenting practices and styles, as well as the consumption of dairy, fruits and vegetables, and unhealthy snacks. Height and weight were measured to calculate parent BMI and adolescent BMI-for-age percentiles. Three parenting practice categories—modeling, authoritative, and authoritarian—were found to be related to race/ethnicity. A higher score in authoritarian parenting practices was related to higher BMI percentiles among African American adolescents, whereas a higher score in monitoring practices was related to lower BMI percentiles among non-Hispanic White adolescents. Modeling, reasoning, and monitoring led to higher consumption of fruits and vegetables among adolescents; however, the consumption of unhealthy snacks was higher with rule-setting and lower with reasoning and authoritative practices. Finally, an analysis of the relationships between environmental factors and snack intake showed that adolescents consumed significantly more unhealthy snacks when performing other activities while eating. In conclusion, the findings from this study suggest that families’ racial heritages are related to their parenting practices, BMI percentiles, and their adolescents’ food consumption and eating behaviors. The results of this study can be used to develop and improve adolescent nutrition education and interventions with consideration of their racial/ethnic backgrounds.

OBJECTIVES: Many preschoolers do not consume the daily recommended intake of dairy products, especially those living in a low-income family. The Supplemental Nutrition Assistance Program Education (SNAP-Ed) conducted two series of educational interventions directed toward the low-fat dairy consumption of preschoolers in Washington D.C. This study aimed to examine the influence that sequential educational intervention had on enhancing the preschoolers’ knowledge of dairy products, including types and related health benefits. METHODS: In January 2018, SNAP-Ed educators implemented intervention I in 105 classes in 25 diverse sites. In July 2018, they conducted intervention II in 34 classes in 12 diverse sites. Two-question pre- and post-assessments were given in each intervention to 1232 and 409 preschoolers aged 2 to 5 years old, respectively. In intervention I, the children were asked to raise their hand if they agreed: Q1. Milk is a dairy food. Q2. Dairy foods help to keep our bones and teeth strong. In intervention II, the children were asked to raise their hand if they agreed: Q1. Calcium and Vitamin D help to keep our teeth and bones strong. Q2. Yogurt gives us calcium for strong bones and teeth. RESULTS: Results showed that in both interventions there was a positive change. In intervention I, initially, 27% and 30% of preschoolers correctly answered Q1 and Q2. After the intervention, 98% and 99% of preschoolers correctly answered Q1 and Q2, respectively. In intervention II, initially, 55% and 60% of preschoolers correctly answered Q1 and Q2, respectively. However, after the intervention, 86% and 90% of preschoolers correctly answered Q1 and Q2, respectively. With intervention I, preschoolers showed a 71% and 69% increase in their knowledge in Q1 and Q2, respectively. While in intervention II, they showed a 31% and 30% increase in their knowledge in Q1 and Q2, respectively. CONCLUSIONS: Both SNAP-Ed dairy nutrition education interventions significantly increased preschoolers’ knowledge of dairy products. Initial results of intervention II revealed the improvement in the preschoolers’ knowledge of low-fat dairy resulted from intervention I. Future studies can include intervention for daily recommended intake of dairies. FUNDING SOURCES: Healthy, Hunger-Free Kids Act of 2010

OBJECTIVES: The Supplemental Nutrition Assistance Program Education (SNAP-Ed) offers complementary education programs to improve public health through improving nutritional behavioral habits in preschoolers in Washington D.C. This study examines the influence of the SNAP-Ed program on changing a set of positive nutritional behaviors in preschoolers to encourage healthier eating habits. These nutritional behavioral changes include recognizing, choosing, and consuming nutritious and healthy foods. METHODS: The SNAP-Ed program implemented nutritional education in 37 preschools, schools, and community centers located in Washington D.C for Fiscal Year 2019. During the program, the nutritional behavior of 1679 children aged 2 to 5 years old was examined before and after educational interventions. Interventions focused on the types and the related benefits of different groups of foods including fruits, vegetables, dairy, and whole grains. Designed questionnaires were filled out by 130 teachers based on their observations of the children's nutritional behavioral habits. Teachers were asked if children had an increase in the amount of food consumption from different groups. Children were also observed for an increase in independently choosing healthier foods. RESULTS: The SNAP-Ed program observed a positive change in all questions in comparison to the beginning of the program. According to the questionnaires, there were 75%, 75%, 78%, and 75% increases in the amount of fruits, vegetables, dairy, and whole grains preschoolers consumed, respectively. After the educational interventions, 78% of preschoolers showcased healthy food choices, 76% of them selected fruits and vegetables in the cafeteria and 75% of them brought fruits and vegetables as a healthy snack. CONCLUSIONS: SNAP-Ed nutrition education positively changed preschoolers’ nutritional knowledge and established healthier eating habits. Further research, done in multiple states, is essential to enhance the knowledge of preschoolers nationwide. More research can also be done to examine how effective nutritional education was between SNAP eligible and non-eligible preschoolers. FUNDING SOURCES: Congress, through the Nutrition Education and Obesity Prevention Grant Program in the Healthy, Hunger-Free Kids Act of 2010.

Background Acculturation is a dynamic and complex process that adopts elements of the dominant culture, which include food, attitudes, beliefs, languages, art, music, rituals, and faith/religion. This melting pot vs. salad bowl framework may impact health. The melting pot advocates for assimilation into 1 dominant culture whereas the salad bowl encourages distinctions that contribute to unique aspects of every group. The salad bowl approach to health suggests that health promotion and disease prevention are broad goals that coincide with identity and heritage. Objective To determine whether there is a relationship between level of acculturation and diet quality among first- and second-generation Hispanic adolescents in the United States. Study Design, Setting, Participants We utilized the 2015-2016 National Health and Nutrition Examination Survey (NHANES) sample, consisting of 447 Hispanic adolescents ages 12 to 19 (46.5% male, 53.5% female) in the US. Diet quality from the Healthy Eating Index (HEI) was measured using 2-day food records. Measurable Outcome/Analysis Data was cleaned and analyzed using SAS version 4.0. Level of acculturation was scored via NHANES content of generational items for parental citizenship status and language items for frequency of native language spoken at home. HEI was scored as poor (0 to 49), moderate (50 to 79), and good (80 to 100). Multiple logistic regression measured acculturation vs. diet quality, and controlled for gender, age, and income. The Tukey test confirmed findings. Results Gender and income had no influence on HEI whereas older age groups were associated with higher HEI scores (P Conclusions Findings suggest that Americanized Hispanic adolescents consume more standard American foods and fewer meals prepared at home. Future investigations should explore the impact of acculturation on diet quality among other ethnicities and evaluate culturally appropriate interventions in the US.

Background Decreased accessibility to farmland and food insecurity in urban areas have expanded the need for emergency food assistance. The culture of food banks is evolving from a system that supplied non-perishable foods for immediate needs to more sustainable initiatives that emphasize access to healthier foods and nutrition education due to the rise of obesity and chronic diseases. Furthermore, minimal evaluation on produce consumption behaviors of underserved clients using resources from local and federal programs has been conducted. Objective Evaluate the relationship between usage of federal nutrition programs, local resources, and fresh produce consumption among clients on charitable food assistance. Study Design, Setting, Participants A cross-sectional design during Summer 2018 was implemented with 91 respondents (87% African American and 13% other) who met inclusion criteria for socioeconomic status at 5 faith-based and healthcare food pantries and clinics in Washington DC. Subjects completed informed consent, demographics, and the Eating at America's Table survey of fruit and vegetable consumption patterns. Measurable Outcome/Analysis R software version 3.5.3 was used for data analysis. Analysis of variance (ANOVA) Fisher Test measured the relationship between number of federal programs used and mean intakes of fresh produce as well as number of local nutrition resources used and mean intakes of fresh produce. ANOVA findings were confirmed via Tukey, Scheffe, and least square difference testing. Results Subjects who reported participation in 1 or more federal programs reported higher intakes of fruit, potatoes, non-starchy vegetables, and beans than those who did not (P Conclusions To improve food security and sustainability, urban communities, especially underserved areas, may benefit from multiple subsystems, including local food production and nutrition support from federal and decentralized community resources.

To evaluate the implementation of the Bodywise program, a free program designed to promote health, wellness, and fitness for elder DC residents.Physical activity and its association with healthy aging is an important public health issue. Physical activity decreases different causes of mortality and plays an important role in the prevention of many aging-related chronic diseases. However, the number of older adults who are physically active enough to maintain wellness is low and decreases with age. The University of the District of Columbia (UDC) worked to improve physical activity in older adults by offering free exercise classes.Participants were DC residents aged 60 or older.The Bodywise program includes water aerobics, yoga, low-impact aerobics, and chair exercise classes, conducted by certified instructors. These classes not only aim to improve the health and wellness of participants but also provide great opportunities to socialize.A designed evaluation survey was filled out by participants which collected demographic data, the quality/satisfaction of classes, and each participant's opinion.There were 33 participants including 29 female, 4 male, 29 non-Hispanic, and 29 with an academic degree. Overall satisfaction with the Bodywise program was 93% and 81% of participants reported overall satisfaction with their instructor, specifically related to knowledge, skill level, and appropriateness of music. About 70% of participants preferred classes 2 times per week with Wednesday and Friday classes being the most popular. Encouragement to stay physically active and opportunity for socialization were mentioned as the main reasons participants engaged in the Bodywise program.The Bodywise program gained the overall satisfaction of participants. Further research is necessary to investigate the impact of this program on behavioral changes of the participants.

Background Physical activity (PA) is an integral part of successful aging. However, many older adults (OAs) are not meeting current PA recommendations. Objective To assess the PA needs, preferences, and practices of community-residing OAs. Study Design, Setting, Participants This qualitative study assessed the PA needs and preferences of 117 community-residing OAs. Thirteen focus groups (FG) were held in Iowa (IA, 5 FG) and Washington, DC (DC, 8 FG). FG discussions centered on perceived PA needs, motivators and barriers, and preferred PA programming attributes. Each FG was audio-recorded. Participants also completed a sociodemographic survey. IA participants (n = 51) were recruited at congregate meal sites while DC participants (n = 66) were recruited from 2 OAs volunteer programs. Measurable Outcome/Analysis FG recordings were transcribed verbatim and reviewed for major themes using standard theme analysis protocols. Sociodemographic data were analyzed using descriptive statistics. Kruskal-Wallis H Test assessed between group differences for sociodemographic attributes (P Results The mean age of participants was 74.4 ± 7.0 years. Participants were mostly educated (77.2%) females (83.1%) in “average or higher” health (84.8%). IA participants were more educated than DC participants (P Conclusions This sample of community-residing OAs are not meeting PA recommendations. The perceived PA needs and preferences were similar regardless of being rural- or urban-residing. These findings provide useful information to better enable tailoring of PA messaging and programming for community-residing OAs.

The purpose of this formative, cross-sectional study was to describe independent eating occasions (iEOs) among a convenience sample of low-income early adolescents (10&ndash, 13 years, n = 46) in 10 U.S. states, including environmental context, foods selected and reasons for selection, and parental rules about foods consumed. Participants took pictures of all foods consumed over 24 h and participated in semi-structured interviews to describe the context of each eating occasion using the pictures as a guide. Responses based on a total of 304 eating occasions were coded to classify foods based on United States Department of Agriculture (USDA) MyPlate food groups and to characterize parental rules and reasons for food selection. Average age was 10.9 &plusmn, 1.1 years and 60% were female. Approximately 58% of eating occasions were classified as iEOs with approximately 65% as snacks. Most iEOs took place at home. Foods frequently consumed during iEOs were from the sweets, total fruit, dairy, and whole fruit food categories. Primary parental rules for iEOs focused on avoiding certain foods and not eating too much. Early adolescents selected foods for convenience, taste preferences, and availability. Foods selected during iEOs were based on parent, household and early adolescent factors, which could be addressed to influence overall diet quality.

An increase in physical activity (PA) level is associated with reduction in chronic diseases. However, the number of older adults who meet the PA guideline is low and decreases with age. Bodywise is a free program that aims to promote healthy behavior and to encourage older adults who live in Washington, DC to adopt a healthy habit by increasing their PA. The Bodywise program offers water aerobics, yoga, low-impact aerobics, and chair exercise classes, conducted by trained instructors at the University of the District of Columbia. This study reports an evaluation of the implementation of this program based on the surveys completed by participants after finishing the classes. Participants were DC residents aged 60 or older. According to the surveys, 68% of participants have adopted one or more healthy habits since joining the Bodywise program. In addition, more than 62% of participants have an increase in awareness of healthy behavior through this program. Overall satisfaction with the Bodywise program is 93%, satisfaction with the variety of classes offered is 72% and satisfaction with offered skill levels is 75%. Furthermore, 81% of participants reported overall satisfaction with their instructor, specifically 100% satisfaction related to their knowledge and skill level, and appropriateness of selected music, moves, and exercises. In conclusion, the Bodywise program leads to an overall change in both awareness of healthy behavior and development of healthy habits in participants. Further research can investigate the correlation of health awareness and healthy habits with overall satisfaction with the program and the instructor.

Background: This research study illustrates the perceptions, opinions, beliefs, and attitudes of older adults residing in an urban community as major factors to understanding barriers and motivators in older African Americans, Hispanics, and Asians adults within Washington, DC. Methods: Eight focus group sessions conducted with 58 older adults to determine their understanding of physical activity and exercise, as well as of barriers to, motivators for, and benefits of physical activity and exercise. Results: The results showed that dance was the preferred physical activity and exercise, fixed or limited income were the main barriers, and prolonged life, more energy, and a stronger body were the main benefits. Conclusion: The results will assist in recommendations to policy makers on programs for older adults that will increase physical activity and exercise for local citizens. These interventions are more likely to increase older adults’ ability to remain in their communities and improve their overall health and well-being.

Background Nutritional-related diseases such as hypertension and diabetes continue unabated in the District of Columbia Ward 8 whose residents are primarily African Americans. Wards are administrative divisions with approximately 75,000 persons. The District of Columbia Behavioral Risk Factor Surveillance System (BRFSS) Annual Health Report confirmed that fruit and vegetable (FV) consumption were low among African Americans, especially in Ward 8 (Anderson-Morgan, Fett, Jasso, Moten, & Harrison, 2018) May - November 2018 a mobile Farmers’ Market was located at the Bellevue Library to provide the residents with access to fresh FV. Recipe tastings and demonstrations were included to demonstrate the ease of preparing produce that was purchased from the Farmers’ Market. Six recipes were introduced: pasta veggie salad; 3-bean salad; radish tomato salsa; summer squash salad; tangy savory slaw, and mint citrus water. Data was collected to determine whether residents planned to prepare these recipes at home. Objective Three main objectives of this research were: a) determine the frequency of consumption of FV; b) determine the ease of recipe preparation, and c) determine improvement in the health and nutritional status of the residents. Study Design, Settings, Participants A five-question survey was administered to 152 attendees at the Famers’ Market located in Ward 8. Results for question two are included here “After tasting this recipe, do you plan to make it at home?” Measurable Outcome/Analysis Attendees who tasted recipes during this six-week period, 93% planned to make these recipes at home. Results The results of attendees showed that 93% said yes, 5% said no, 2% did not respond, and 1% said maybe. Conclusion Nutrition-education and recipes that are tasty and easy to make are key steps in changing behaviors of residents who are at high risk of nutritional-related diseases.

OBJECTIVES: Farmers Markets are a valuable source of affordable quality foods for Supplemental Nutrition Assistance Program (SNAP) recipients. However, according to a study in the American Journal of Agricultural Economics, farmers markets increase the number of foodborne illnesses. Low-income individuals are at the highest risk of foodborne illnesses and is thought to be related to poor food safety knowledge and limited food preparation skills. Reduced produce consumption has also been indicated in low-income populations. Produce is a major source of foodborne illnesses. Therefore, in addition to increasing access to produce, efforts must be made to ensure that consumers practice proper food safety. The purposes of this study were to 1) assess the food safety knowledge of farmers-market consumers in low-income neighborhoods, 2) their likelihood to use food assistance benefits, 3) consume produce and 4) cook a recipe provided by a SNAP-Ed program. METHODS: In 2018, the University of the District of Columbia (UDC) SNAP-Ed nutrition educators delivered nutrition and food safety education in 17 DC Farmers Markets located in low-income communities. 822 subjects completed a 3 question post-assessment on eating behaviors and of those, 669 participated in an additional 2 question survey on food safety. RESULTS: The results show that after the education, 99.0% plan on eating more produce; 95.6% of participants plan to cook the provided recipe; and 92.7% will use SNAP, WIC, Produce Plus or Farmers’ Market Nutrition Program benefits at the Farmers’ Market that day. Additionally, 92.8% think that contamination of food by germs is a serious food safety problem, and 94.3% wash or rinse fresh produce purchased at the Farmers’ Market prior to consumption. CONCLUSIONS: Majority of low-income farmers market participants had general food safety knowledge and planned on consuming more produce, use food assistance benefits and try a new recipe. Further research is necessary to assess food safety knowledge of other domains and identify the impact of SNAP-Ed food safety education on behavior change. FUNDING SOURCES: This project was funded through money appropriated by Congress through the Nutrition Education and Obesity Prevention Grant Program in the Healthy, Hunger-Free Kids Act of 2010 to states for evidence-based nutrition education and obesity prevention interventions and projects. SUPPORTING TABLES, IMAGES AND/OR GRAPHS

OBJECTIVES: According to the CDC's national foodborne illness surveillance system, children are disproportionally affected by foodborne illnesses: those under the age of 15 years account for approximately half of all cases. These diseases can result in short- and long-term health consequences and even death. Children from low-income families face greater food safety risks. This can be a result of poor nutrition, increased exposure to food safety risks, and reduced access to health care. Understanding food safety knowledge and properly practicing food safety behavior is important in preventing foodborne illness. Supplemental Nutrition Assistance Program Education (SNAP-Ed) provides food safety skills to at-risk youth. This study examines the program's impact on increasing food safety knowledge at the preschool level. METHODS: In October of 2017, the University of the District of Columbia (UDC) SNAP-Ed nutrition educators implemented food safety education in 91 classrooms from 21 different elementary schools and child development centers located in low-income areas in Washington, D.C. • 1: Raise your hand if you agree that we need to wash our hands for at least 20 seconds. • 2: Raise your hand if you agree that we should wash our hands every time before we eat. RESULTS: UDC SNAP-Ed observed a positive change in both questions. Initially, only 307 students (25%) correctly answered question one. After the intervention, 97% answered correctly, resulting in a positive change of 72% or 890 students. Before the intervention, only 341 students (28%) correctly answered the second question. After the intervention, 1191 (97%) answered correctly, resulting in a positive change of 70% or 850 students. CONCLUSIONS: SNAP-Ed Nutrition education positively impacted preschool students’ knowledge of food safety practices. Further research is necessary to understand the implementation of food safety techniques following food safety education intervention. FUNDING SOURCES: This project was funded through money appropriated by Congress through the Nutrition Education and Obesity Prevention Grant Program in the Healthy, Hunger-Free Kids Act of 2010 to states for evidence-based nutrition education and obesity prevention interventions and projects. SUPPORTING TABLES, IMAGES AND/OR GRAPHS

Background In the United States, infant mortality rates remain more than twice as high for African Americans as compared to other racial groups. Lack of adherence to prenatal care schedules in vulnerable, hard to reach, urban, poor women is associated with high infant mortality, particularly for women who abuse substances, are homeless, or live in communities having high poverty and high infant mortality. This issue is of concern to the women, their partners, and members of their communities. Because they are not part of the system, these womens' views are often not included in other studies. Methods This qualitative study used focus groups with four distinct categories of people, to collect observations about prenatal care from various perspectives. The 169 subjects included homeless women; women with current or history of substance abuse; significant others of homeless women; and residents of a community with high infant mortality and poverty indices, and low incidence of adequate prenatal care. A process of coding and recoding using Ethnograph and counting ensured reliability and validity of the process of theme identification. Results Barriers and motivators to prenatal care were identified in focus groups. Pervasive issues identified were drug lifestyle, negative attitudes of health care providers and staff, and non-inclusion of male partners in the prenatal experience. Conclusions Designing prenatal care relevant to vulnerable women in urban communities takes creativity, thoughtfulness, and sensitivity. System changes recommended include increased attention to substance abuse treatment/prenatal care interaction, focus on provider/staff attitudes, and commitment to inclusion of male partners.