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BACKGROUND: Numerous school-based interventions have used cooking and gardening approaches to improve dietary intake; however, research is limited on the mediation effect of dietary psychosocial factors on the link between the intervention and increased vegetable intake, particularly in children from low-income and racial and ethnic minority US families. OBJECTIVE: Our aim was to examine the effects of the Texas Sprouts intervention on dietary psychosocial factors related to intake of vegetables, and whether these psychosocial factors mediate the link between the intervention and increased intake of vegetables in schoolchildren from low-income and racial and ethnic minority US families. DESIGN: This was an analysis of data on secondary outcomes from the Texas Sprouts program, a 1-year school-based gardening, nutrition, and cooking cluster randomized controlled trial consisting of elementary schools that were randomly assigned to either the Texas Sprouts intervention or to control. PARTICIPANTS/SETTING: Participants were 2,414 third- through fifth-grade students from low-income and racial and ethnic minority US families from 16 schools (8 intervention and 8 control) in Austin, TX. INTERVENTION: The intervention group received eighteen 60-minute gardening, nutrition, and cooking student lessons in an outdoor teaching garden and 9 monthly parent lessons throughout the academic year. MAIN OUTCOME MEASURES: Child psychosocial and dietary measures were collected at baseline and post intervention via validated questionnaires. STATISTICAL ANALYSES PERFORMED: Generalized linear mixed models assessed the intervention effects on dietary psychosocial factors. Mediation analyses examined whether these psychosocial factors mediated the link between the intervention and increased child vegetable intake. RESULTS: Children in Texas Sprouts, compared with controls, showed significant increases in the mean scores of gardening attitudes, cooking self-efficacy, gardening self-efficacy, nutrition and gardening knowledge, and preferences for fruit and vegetables (all, P < .001). Each of the dietary psychosocial factors mediated the association between the Texas Sprouts intervention and child vegetable intake. CONCLUSIONS: Besides targeting dietary behaviors, future school-based interventions should also focus on understanding the mechanisms through which teaching children to cook and garden influence dietary psychosocial factors as mediators of change in healthy eating behaviors.

Dental caries is a chronic oral condition that disproportionately affects low-income women. The aim of this research was to investigate relationships between dental nutrition knowledge, socioecological factors, and prevalence of dental caries in low-income women. This quantitative cross-sectional study involved 220 women who were recruited from Central Texas. Participants completed demographics, the Dental Nutrition Knowledge Competency Scale, United States Adult Food Security Survey Module, and the Multidimensional Home Environment Scale. Two dentists measured dental caries via the Decayed, Missing, Filled Teeth Index. Regression models were conducted to test the effects of dental nutrition knowledge and Multidimensional Home Environment Scale factors on dental caries. Finally, mediation analysis explored relationships between dental nutrition knowledge and dental caries, adjusting for Multidimensional Home Environment Scale scores. Results showed that dental nutrition knowledge and Multidimensional Home Environment Scale score were significantly associated with dental caries. Subscales of self-efficacy for eating healthy, oral hygiene practices, emotional eating, availability of unhealthy foods at home, and social support were related to dental caries. The relationship between dental nutrition knowledge and caries was mediated by Multidimensional Home Environment Scale scores. This research emphasizes the role of dental nutrition knowledge and socio-ecological factors on prevalence of dental caries. Public health interventions to reduce dental caries should involve strategies that increase dental nutrition knowledge and encourage behavior change in low-income populations.

BACKGROUND: Cooking interventions have been linked to reductions in obesity and improvements in dietary intake in children. OBJECTIVE: To assess whether child cooking involvement (CCI) was associated with fruit intake (FI), vegetable intake (VI), vegetable preference (VP), and vegetable exposure (VE) in children participating in the Texas, Grow! Eat! Go! (TGEG) randomized controlled trial. METHODS: Baseline data from TGEG included 1231 3rd grade students and their parents. Conducted in 28 low-income, primarily Hispanic schools across Texas, TGEG schools were assigned to: 1) Coordinated School Health (CSH) only (control group), 2) CSH plus gardening and nutrition intervention (Learn, Grow, Eat & Go! or LGEG group), 3) CSH plus physical activity intervention (Walk Across Texas or WAT group), and 4) CSH plus LGEG plus WAT (combined group). Height, weight, dietary intake, VE, VP, and CCI were collected at baseline and postintervention. Linear regressions were used to assess the relation between baseline CCI and fruit and vegetable (FV) intake, VE, and VP. A priori covariates included age, sex, race/ethnicity, and TGEG treatment group. RESULTS: Children who were always involved in family cooking had higher VP and VE when compared with children who were never involved in family cooking (β = 3.26; 95% CI: 1.67, 4.86; P < 0.01 and β = 2.26; 95% CI: 0.67, 3.85; P < 0.01, respectively). Both VI and FI were higher for children who were always involved in family cooking compared with children who never cooked with their family (β = 2.45; 95% CI: 1.47, 3.44; P < 0.01 and β = 0.93; 95% CI: 0.48, 1.39; P < 0.01, respectively). VI and fruit consumption were higher for children who reported being sometimes involved in family cooking compared with children who were never involved in family cooking, (β = 1.47; 95% CI: 0.51, 2.42; P < 0.01, and β = 0.64; 95% CI: 0.20, 1.08; P < 0.01, respectively). CONCLUSIONS: Results show a positive relation between family cooking and FV intake and preference in high-risk, minority children.

Introduction: National data reveal that the age-adjusted prevalence of leisure-time physical inactivity is higher among Blacks and Hispanics compared with Whites. However, these estimates do not consider nonleisure physical activity (PA). Also, race/ethnicity in these findings may by confounded by socioeconomic status disparities in PA. Here, we examine racial/ethnic differences in multiple measures of PA within a lower socioeconomic status sample. Methods: Participants in the current cross-sectional study (n = 1526 adults, aged ≥ 18 y) were recruited from Supplemental Nutrition Assistance Program-Education classes (nutrition education classes that target low-income people) in Texas. Self-report data were obtained using survey questionnaires in spring and fall 2018. PA outcomes of 4 different intensities were assessed: mean daily time spent walking, engaging in moderate and vigorous PA, and sitting. Additional PA-related measures included use and awareness of community PA resources. Linear regression models examined racial/ethnic differences in the 4 PA outcomes after adjusting for participant gender, age, household composition measures, and various socioeconomic status measures. Results: In this low-income sample, Hispanic and Black participants spent 6 to 9 more minutes per day walking and engaging in moderate and vigorous PA compared with White/other participants (P <.05 for each measure). Conversely, White/other participants reported spending 82 more minutes sitting per day than Black and Hispanic participants (P <.01). Overall, Black participants were most likely to utilize community PA resources and report ease of engaging in exercise. Discussion: Together, these results reveal greater engagement in PA by racial/ethnic minorities in low-income communities compared with Whites. Our results have implications for tailoring PA programming to these communities. [ABSTRACT FROM AUTHOR]

Objective: Despite growing awareness about the harmful physiological effects of energy drinks, especially among young people, there is little regulation governing the marketing and sale of these products to adolescents. Thus, in contrast to substances such as cigarettes and alcohol, energy drinks are readily available to adolescents, and widely consumed. It is not known if the easy availability of energy drinks has the effect of increasing usage of these substances among adolescents, and reducing sociodemographic differences in the consumption of energy drinks. In this study, we use pooled data (2010-2015) from the nationally representative Monitoring the Future survey (n=43,283), to compare consumption of energy drinks with other substance use, and to compare the sociodemographic correlates of energy drink consumption among high school students (10th and 12th grade) with those of cigarette and alcohol consumption. Methods: Covariate-adjusted estimates for prevalence of consumption of energy drinks, cigarettes, and alcohol for each of different sociodemographic strata were obtained via logistic regression analysis. Additional analyses examined the extent to which socioeconomic disparities in prevalence of consumption of energy drinks are predicated by cigarette smoking and alcohol use. Results: While the patterning of differences in energy drink use by sex, grade, race and parental education (as a measure of socioeconomic status) were similar to those seen in cigarette smoking and ever-use of alcohol, the magnitude of differences across subgroups varied across these behaviors. Racial/ethnic, socioeconomic and age differences were smaller in the case of energy drink use compared to alcohol or cigarette use. Gender differences were larger than in the case of cigarette smoking. In all cases, energy drink use were higher among students who were current users of alcohol or cigarettes, but there was little evidence that sociodemographic variables were differentially associated with energy drink use within these strata. Conclusions: Ready availability of energy drinks has resulted in elevated use of these products relative to cigarette smoking and alcohol, and some narrowing of socioeconomic differentials in use. Regardless of socioeconomic status, use of energy drinks is higher among current users of cigarettes and / or alcohol.

Purpose: To examine the relationships between "westernization" and nutrition and physical activity behaviors among older adolescents in Delhi, India. These relations have not been explored, despite increasingly strong and pervasive socio-cultural influences from the West. Methods: Students (n=1818) in 8th and 10th grades in 4 Private (higher SES) and 4 Government (lower SES) schools in Delhi, India participated in a cross-sectional study. Height and weight were measured to determine weight status. Information on "westernization" and nutrition, physical activity, sedentary, and dieting behaviors was collected in a survey. The measure of "westernization" assessed 4 domains of culture on a bi-dimensional scale that focused on these young people's identification with Indian (a=0.86) and Western (a=0.81) ways of living. Mixed-effects regression models were used to investigate the association between "westernization," weight status, and health behaviors. Gender, school type (SES), and grade were evaluated as effect modifiers. Results: "Westernization" was not directly associated with weight status or BMI (p>0.500). However, adolescents' identification with Western ways of living was consistently related to both unhealthy (e.g., fast food consumption). Conclusions: The influence of "westernization" on nutrition and physical activity behaviors of older adolescents in Delhi, India is complex and not wholly negative, as might be hypothesized. (This work was presented in part at the Annual Meeting of the International Society for Behavioral Nutrition and Physical Activity, on May 25, 2012.)

We examined whether Central Texans shop at their nearest supermarket, how far they travel for groceries, and explored differences by race/ethnicity, urbanicity, motivations for store selection, and other demographic characteristics. Using cross-sectional data and GIS, continuous network distances from participants' homes to nearest and usual supermarkets were calculated and multivariate linear regression assessed differences. <19% shopped at their nearest supermarket. Regression models found that urbanicity played a large role in distance traveled to preferred supermarket, but other factors varied by race/ethnicity. Our findings demonstrate that racial/ethnic and urbanicity disparities in food access and multiple domains of food access need greater consideration. [ABSTRACT FROM AUTHOR]

Background: Research suggests that perceived weight poses separate risks from objective weight on adolescents' risks of being bullied. We examined if the prevalence of bullying victimization differed by perceived and objective weight status, and how these associations varied by sex. Methods: Data were analyzed for 6716 8th and 11th graders from the School Physical Activity and Nutrition project, a Texas statewide survey of public school students. Participants reported demographics, bullying victimization, and weight perceptions. Height and weight were measured. Results: In the last 6 months, 10.8% of students reported being bullied. Nearly 70% of normal weight and overweight and 50% of obese adolescents perceived themselves as weighing the right amount. Perceiving oneself as weighing too little or too much was significantly associated with increased bullying victimization (p < 0.05 for both), whereas objective weight was not. Statistical interactions between perceived weight and sex were significantly associated with victimization (p < 0.05) among boys only; boys who perceived themselves as weighing too little had higher predicted probabilities of victimization. Conclusions: Perceived weight may play a greater role in bullying victimization than objective weight, especially among boys. Interventions to prevent bullying should consider adolescents' self-perceptions of weight to effectively identify those at greater risk for victimization.

Background: A cluster-randomized trial at 30 early care and education centers (Intervention = 15, waitlist Control = 15) showed the "Lunch Is in the Bag" intervention increased parents' packing of fruits, vegetables, and whole grains in their preschool children's bag lunches (parent-child dyads = 351 Intervention, 282 Control). Purpose: To examine the utility of structuring the trial's process evaluation to forecast use, sustainability, and readiness of the intervention for wider dissemination and implementation. Method: Pretrial, the research team simulated user experience to forecast use of the intervention. Multiattribute evaluation of user experience measured during the trial assessed use and sustainability of the intervention. Thematic analysis of posttrial interviews with users evaluated sustained use and readiness for wider dissemination. Results: Moderate use was forecast by the research team. Multiattribute evaluation of activity logs, surveys, and observations during the trial indicated use consistent with the forecast except that prevalence of parents reading the newsletters was greater (83% vs. 50%) and hearing their children talk about the classroom was less (4% vs. 50%) than forecast. Early care and education center-level likelihood of sustained use was projected to be near zero. Posttrial interviews indicated use was sustained at zero centers. Discussion: Structuring the efficacy trial's process evaluation as a progression of assessments of user experience produced generally accurate forecasts of use and sustainability of the intervention at the trial sites. Conclusion: This approach can assist interpretation of trial outcomes, aid decisions about dissemination of the intervention, and contribute to translational science for improving health.

Background: Narrative communication is gaining attention in the health education literature. In this article, we evaluate the acceptability and psychosocial impact of a book of role model stories presenting low-income women's success stories in changing diet and physical activity. Methods: Free copies of the "Be Well" book were distributed through organizations, and recipients were asked to fill out a paper or online questionnaire on completion of the book. Of the 317 recipients who returned valid questionnaires, 62.5% indicated that they had read at least one story in the book. Regression models were run to examine the strength of change in psychosocial and cognitive measures by degree of exposure; that is, number of stories read. Results: Overall, exposed respondents reported significantly greater self-efficacy and slightly greater knowledge and intent to change than unexposed respondents. Among exposed respondents, reported knowledge and intent to change behaviors varied directly with number of stories read. Discussion: The role model stories presented in the "Be Well" book were acceptable to the participants and successful in increasing readiness for behavior change. Translation to Health Education Practice: A narrative communication approach presented as a book of role model stories can bring about positive change in lifestyle behaviors and associated cognitions.