scholarly journals The development of child and adult care food program best-practice menu and training for Native American head start programs: The FRESH study

2019 ◽  
Vol 14 ◽  
pp. 100880 ◽  
Author(s):  
Susan B. Sisson ◽  
Kaysha Sleet ◽  
Rachel Rickman ◽  
Charlotte Love ◽  
Mary Williams ◽  
...  
Keyword(s):  
Native American ◽  
Head Start ◽  
Best Practice ◽  
Adult Care ◽  
Head Start Programs ◽  
And Training

scholarly journals The Development of Child and Adult Care Food Program Best-Practice Menu and Training for Native American Head Start Programs: The FRESH Study (P04-026-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Susan Sisson ◽  
Kaysha Sleet ◽  
Rachel Rickman ◽  
Charlotte Love ◽  
Mary Williams ◽  
...  
Keyword(s):  
Native American ◽  
Low Income ◽  
Best Practice ◽  
Technical Assistance ◽  
Food Resource ◽  
Lessons Learned ◽  
Funding Agency ◽  
Adult Care ◽  
Effect Change ◽  
And Training

Abstract Objectives New Child and Adult Care Food Program (CACFP) meal patterns and best-practices were implemented nationally in 2017 to address the need to prevent chronic diseases. Young Native American children have disproportionately higher risk of chronic disease. Some Native American tribes operate early care and education (ECE) programs and have the opportunity to participate in the CACFP. The purpose of this paper is to describe a CACFP best-practice menu and training developed and implemented as part of the Food Resource Equity and Sustainability for Health (FRESH) study. Methods FRESH is a community-based participatory research (CBPR) intervention implemented within ECE programs in the Osage Nation of Oklahoma. Site managers and cooks from each of the nine ECE programs attended meetings and provided feedback to investigators which shaped the best-practice menu and training. Each site participated in a three-hour training in January 2018 to discuss the best-practice menu and ways to overcome implementation barriers. Goals of the menu aimed to increase intake of fruit and vegetables and whole grains and reduce pre-fried and processed foods without increasing cook burden. Training included application activities individually and in small and large groups. Results Though the project is still underway, lessons learned have emerged including the need for technical assistance, improved communication between ECE program staff and food supply vendors, and infrastructure barriers (e.g., limited space, lack of supplies) that challenge work-flow. Conclusions Efforts to improve menus in rural and low-income ECE programs must consider these issues in developing feasible intervention strategies. Collaboration with the site manager and cook is essential to fully understand perceived and actual barriers to provide training that can provide necessary background rationale for nutrition recommendations as well as beneficial and productive activities and hands-on training to effect change outside the training. Funding Sources This study was funded by the National Institute on Minority Health and Health Disparities (R01MD011266). The funding agency did not participate in the study design, data collection, analysis, decision to publish, or preparation of the manuscript.

scholarly journals Impact of the 2017 Child and Adult Care Food Program Meal Pattern Requirement Change on Menu Quality in Tribal Early Care Environments: The Food Resource Equity and Sustainability for Health Study

2019 ◽  
Vol 4 (Supplement_1) ◽  
pp. 12-22 ◽  
Author(s):  
Susan B Sisson ◽  
Kaysha Sleet ◽  
Rachel Rickman ◽  
Charlotte Love ◽  
Alexandria Bledsoe ◽  
...  
Keyword(s):  
Native American ◽  
Best Practice ◽  
Food Resource ◽  
Saturated Fat ◽  
Health Study ◽  
Healthy Weight ◽  
Early Care ◽  
Adult Care ◽  
Nutrient Analysis ◽  
Before And After

ABSTRACT Background Native American (NA) children have a high prevalence of obesity contributing to lifespan health disparities. Dietary intake is important to promote healthy weight gain, growth, and development. In 2017, the USDA enforced changes to the Child and Adult Care Food Program (CACFP). The CACFP provides reimbursement to qualifying Early Care and Education (ECE) programs that serve foods that uphold the program's nutrition requirements. Objective This study had the following 2 objectives: 1) Describe a novel index to evaluate ECE menus based on revised CACFP requirements (accounting for food substitutions) and best practices for 3- to-5-y-old children, and 2) analyze CACFP requirement and best practice compliance and nutrient changes in 9 NA ECE programs before and after enforcement of the revised CACFP requirements. Methods This longitudinal study is within a larger community-based participatory research study. Menus and meals served were evaluated for 1 wk at each of 9 programs before and after enforcement of the revised meal patterns. Nutrient analysis, CACFP requirement and best practice compliance, and substitution quality were evaluated. Differences were determined using a paired t-test or Wilcoxon matched test. This trial was registered at clinicaltrials.gov as NCT03251950. Results Total grams of fiber consumed increased (5.0 ± 1.2 compared with 5.9 ± 0.8 g, P = 0.04) and total grams of sugar consumed decreased (53.8 ± 12.6 compared with 48.4 ± 7.9 g, P = 0.024), although room for further improvement exists. Although total grams of fat remained unchanged, grams of saturated fat significantly increased (7.8 ± 1.4 compared with 10.5 ± 3.4, P = 0.041). Other nutrients remained unchanged. Overall CACFP requirement and best practice compliance scores improved, although this finding was not statistically significant. No significant changes in food quality associated with substitutions occurred. Conclusions This study provides early evidence to support the beneficial impact of the revised CACFP requirements. Understanding barriers to compliance within rural NA communities would be an important next step in enhancing the health of vulnerable children.

Gender Nonbinary Mental Health

2020 ◽  
pp. 295-304
Author(s):  
Lore M. Dickey
Keyword(s):  
Mental Health ◽  
Native American ◽  
Ethnic Minority ◽  
Global South ◽  
Additional Research ◽  
American People ◽  
Psychological Literature ◽  
Nonbinary Gender ◽  
And Training ◽  
Racial And Ethnic Minority

In this chapter the author explores the mental health of those with nonbinary gender identities and focuses on the issues they face. The author defines nonbinary identities and discusses how these identities are different than people who have binary identities. There is a summary of the extant psychological literature focusing on people with nonbinary identities. Attention is also brought to how racial and ethnic minority individuals, including Native American people, conceptualize nonbinary identities. The chapter ends with information about the lack of attention to the Global South and the need for additional research and training in the mental health of those with nonbinary identities.

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