SNAP-Ed Intervention to Improve the Nutritional Behavioral Habits in Preschoolers in Washington D.C.

Abstract 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.

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Ensuring Access to Fruits and Vegetables for the Nation’s Most Vulnerable – Contributions of WIC and SNAP

The Economists Voice ◽

10.1515/ev-2017-0005 ◽

2017 ◽

Vol 14 (1) ◽

Author(s):

Dena R. Herman

Keyword(s):

Low Income ◽

Fruits And Vegetables ◽

Eating Habits ◽

Food Choices ◽

Safety Net ◽

Supplemental Nutrition ◽

Assistance Program ◽

Supplemental Nutrition Program ◽

Nutrition Assistance ◽

The U.S

AbstractThe Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP) are critical programs in the U.S. because they form the basis of the nation’s nutrition and hunger safety net. SNAP has large effect nationwide offering nutrition assistance to 1 in 7 low-income Americans, while WIC serves more than half of all infants in the U.S. and a quarter of all children ages 1-5 years. Despite the reach of these programs, there is still room for improvement, especially when it comes to increasing access to healthy food items and improving eating habits. The objective of this paper is to make recommendations for how WIC and SNAP can work better together to continue to incentivize purchases and support low-income population’s knowledge and access to healthier food choices, particularly those foods that have traditionally been most expensive – fruits and vegetables.

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The Importance of Federal Waivers and Technology in Ensuring Access to WIC During COVID-19

American Journal of Public Health ◽

10.2105/ajph.2021.306211 ◽

2021 ◽

pp. e1-e4

Author(s):

Shannon E. Whaley ◽

Christopher E. Anderson

Keyword(s):

Nutrition Education ◽

The United States ◽

Infants And Children ◽

Fiscal Year ◽

Structural Barriers ◽

Poverty Level ◽

Assistance Program ◽

Assistance Programs ◽

Good Nutrition ◽

Nutrition Assistance

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a nutrition assistance program that promotes the health of pregnant and postpartum women, infants, and children up to aged five years who are nutritionally at risk and live in households below 185% of the federal poverty level (FPL).1 Unlike other federal nutrition assistance programs, WIC reduces structural barriers to healthy eating by providing monthly food benefits while simultaneously promoting good nutrition through regular individualized nutrition counseling and nutrition education. The effectiveness of WIC has been demonstrated by extensive research illustrating improved health outcomes for the women, infants, and children served by the program.2–5 As the third largest US Department of Agriculture (USDA) nutrition assistance program, WIC served about 6.9 million participants per month in fiscal year 2018, including almost half of all infants born in the United States.1. (Am J Public Health. Published online ahead of print April 15, 2021: e1–e4. https://doi.org/10.2105/AJPH.2021.306211 )

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Determining Nutritional Barriers to Access to Fresh Fruits, Vegetables, and Whole Grains in Older Americans

American Journal of Undergraduate Research ◽

10.33697/ajur.2018.014 ◽

2018 ◽

Vol 15 (2) ◽

Author(s):

Tornia Anderson-Morgan ◽

Melissa Fett ◽

Michelle Jasso ◽

Aisha Moten ◽

Elgloria Harrison

Keyword(s):

Older Adults ◽

African American ◽

Native American ◽

Nutrition Education ◽

Asian American ◽

Fruits And Vegetables ◽

Eating Habits ◽

District Of Columbia ◽

Whole Grains ◽

Unexpected Finding

The University of the District of Columbia is a partner of the Northeast Hatch Multistate Research Collaborative. This research project, known as the UDC NE 1439, was designed as a pilot study to determine the barriers that prevented the consumption of fresh fruits, vegetables, and whole grains among older adults in Wards 5, 7, and 8 in the District of Columbia (DC). The residents of these wards have been shown to have higher rates of chronic diseases. Data shows that Ward 7 has the highest rate of deaths due to diabetes. Furthermore, Wards 5, 7, and 8 have the highest percentage of hypertension and diabetes This project used a quantitative and qualitative survey instrument, which included 53 questions and/or statements using a Likert scale: demographics (8 questions); household information (2 questions); shopping habits (8 questions); eating habits, including the identity of the person who prepared meals in the home (21 questions); physical fitness (11 questions); and policy (3 questions). Ninety-six (96) older adults participated in the survey, with a gender distribution of 77% female (68 individuals), 22% male (24 individuals), and 1% not reported (1 individual). The racial distribution of the participants was 91% (87) African American, .01% (one) Asian American, .01% (one) Caucasian, .01% (one) Native American, and .03% (three) others/not reported. Additionally, according to the participants’ residency results, Ward 5 accounted for 23% of the participants (24 participants), Ward 7 for 38% (33 participants), and Ward 8 for 38% (33 participants). The participants’ average age was ≥ 56, (45 to 76 and over) and most were the primary financial supporters of their households and the primary grocery shoppers in their families. In conclusion, this project determined that access to fresh fruits and vegetables and travel time to a full-service grocer were less prominent barriers; this was an unexpected finding. Though the participants indicated sufficient access to fresh fruits, vegetables, and whole grains, they lacked nutrition-based knowledge. Many of them viewed unfitting food choices as healthy. An intervention centered on nutrition education using food demonstrations and grocer tours would improve nutrition knowledge in this population. This offered these nutrition and dietetics research assistants with an opportunity to provide nutrition education to the population in question. Moreover, it presents an opportunity to extend nutrition education to all seniors across the Washington, DC region. KEYWORDS: Fruits; Vegetables; Whole Grains; Urban; Disease; African American; Health; Nutrition; Food Security; Food Desert, Senior Citizens

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Diet Quality and Associations with Food Security among Women Eligible for Indiana Supplemental Nutrition Assistance Program-Education

Journal of Nutrition ◽

10.1093/jn/nxaa171 ◽

2020 ◽

Vol 150 (8) ◽

pp. 2191-2198

Author(s):

Rebecca L Rivera ◽

Yumin Zhang ◽

Qi Wang ◽

Melissa K Maulding ◽

Janet A Tooze ◽

...

Keyword(s):

Food Security ◽

Nutrition Education ◽

Diet Quality ◽

Whole Grains ◽

Supplemental Nutrition Assistance Program ◽

Supplemental Nutrition ◽

Assistance Program ◽

Food Security Status ◽

Usual Intake ◽

Nutrition Assistance

ABSTRACT Background The diet quality among adults receiving nutrition education lessons through Supplemental Nutrition Assistance Program-Education (SNAP-Ed) is currently unknown. Objectives The objectives of this study were to characterize the diet quality of Indiana SNAP-Ed-eligible women; estimate their mean usual intake of fruits, vegetables, dairy, and whole grains compared to Dietary Guidelines for Americans (DGA) recommendations; and determine if these dietary outcomes differed by food security status. Methods SNAP-Ed paraprofessionals recruited participants from August 2015 to May 2016 for this secondary analysis of cross-sectional data collected as the baseline assessment for a randomized controlled trial. Participants were SNAP-Ed-eligible women aged ≥18 y interested in nutrition education lessons. Dietary outcomes were assessed by one or two 24-h dietary recalls. The Healthy Eating Index (HEI)-2010 was used to characterize diet quality. Mean usual intake of food groups was estimated using the National Cancer Institute Method. Food security status was classified using the US Household Food Security Survey Module. Data were analyzed in October 2019. Results Mean ± SEM HEI-2010 total score was 42 ± 0.9 for the study sample. Mean ± SE usual intake of servings of fruits (0.61 ± 0.08 cups [144.32 ± 18.93 mL]), vegetables [1.4 ± 0.10 cups (331.2 ± 23.66 mL)], dairy [1.5 ± 0.11 cups (354.88 ± 26.02 mL)], and whole grains [0.48 ± 0.06 ounces (13.61 ± 1.70 g)] did not differ by food security subgroup. Mean HEI-2010 total score was significantly higher by 4.8 ± 2.0 points for the food-secure than for the food-insecure subgroup (P = 0.01). Mean HEI-2010 component scores were 1.1 ± 0.5 points higher for whole grain (P = 0.01) and 1.0 ± 0.5 points higher for dairy (P = 0.05) in the food-secure than in the food-insecure subgroup. The proportions of the study sample not meeting the DGA recommendations for food group intake were ≥85% for both food-secure and -insecure subgroups. Conclusions Indiana SNAP-Ed-eligible women reported poor diet quality, highlighting their need for nutrition interventions aiming to improve food security and diet as per DGA recommendations in low-income populations.

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Influence of Sequential SNAP-Ed Nutritional Intervention in Washington D.C. Preschoolers

Current Developments in Nutrition ◽

10.1093/cdn/nzaa048_009 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 603-603

Author(s):

Lillie Monroe-Lord ◽

Hasti Ardekani ◽

Ana Vasquez

Keyword(s):

Nutrition Education ◽

Low Income ◽

Dairy Products ◽

Educational Interventions ◽

Nutritional Intervention ◽

Low Fat ◽

Assistance Program ◽

Dairy Consumption ◽

Nutrition Assistance ◽

Dairy Nutrition

Abstract 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

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Nutritional Quality of Undergraduate Student Meals in an All-You-Care-to-Eat Campus Dining Facility (P04-156-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz051.p04-156-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Audrey Olson ◽

Katie Vieyra ◽

Alexandra Polasky ◽

Amy Best ◽

Lois Durant ◽

...

Keyword(s):

Nutrition Education ◽

Undergraduate Students ◽

Nutritional Quality ◽

Fruits And Vegetables ◽

Saturated Fat ◽

Whole Grains ◽

Research Award ◽

George Mason University ◽

Reported Data

Abstract Objectives To assess the overall nutritional quality of meals chosen by undergraduate students during weekday lunches at campus all-you-care-to-eat dining halls. Methods A previously validated exit survey was used to collect self-reported data from undergraduate students on foods and beverages they consumed during a single visit to two all-you-care-to-eat dining halls on the George Mason University Fairfax campus, during 4 weeks. (n = 468) Nutritional quality of each meal was evaluated on a 7-point rubric, according to the ‘Wellness Meal’ standards from the Partnership for a Healthier America: ≤700 kilocalories, ≤10% calories from saturated fat, ≤800 mg sodium, ≥2 ounces whole grains, ≥1 cup lowfat dairy, ≥ 1.75 cups fruits and vegetables, and ≥ 2 ounces lean protein. Results Of the maximum score of 7 on the meal nutritional quality rubric, 4 participants earned the highest score of 5, whereas 43, 150, 132, 88, and 51 participants had scores of 4, 3, 2, 1, and 0, respectively. The most commonly attained rubric standard was saturated fat, where 60% of participants consumed ≤ 10% calories from saturated fat and average consumption was 9.1% (± 5.4%) of calories. The least achieved rubric category was lowfat dairy, where only 2% of students consumed 1 cup equivalent, followed by only 9% of participants having consumed the 2 ounce equivalent of whole grains. Approximately one-third of students met calorie, lean protein, sodium, and fruit/vegetable standards. Conclusions Despite a wide variety of food options in the campus all-you-care-to-eat dining halls during the lunch hours, most undergraduate students consumed meals of subpar nutritional quality, with the vast majority meeting fewer than half the categories on the meal nutritional quality rubric. All-you-care-to-eat university dining halls may be a prime location for nutrition education and interventions. Funding Sources This research was funded by the George Mason University Provost's Multidisciplinary Research Award.

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Effectiveness of mobile produce markets in increasing access and affordability of fruits and vegetables among low-income seniors

Public Health Nutrition ◽

10.1017/s1368980020002931 ◽

2020 ◽

Vol 23 (17) ◽

pp. 3226-3235

Author(s):

Reece Lyerly ◽

Pasquale Rummo ◽

Sarah Amin ◽

Whitney Evans ◽

Eliza Dexter Cohen ◽

...

Keyword(s):

Rhode Island ◽

Low Income ◽

Fruits And Vegetables ◽

Economic Status ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Assistance Program ◽

Logistic Regression Models ◽

Populations At Risk ◽

Nutrition Assistance

AbstractObjective:Mobile produce markets (MPM) offering Supplemental Nutrition Assistance Program (SNAP) incentive programmes have the potential to provide accessible and affordable fruits and vegetables (FV) to populations at risk of food insecurity. The objective of this study is to characterise the customer base of an MPM and describe their participation at twelve market sites serving low-income seniors.Design:In 2018, customers from an MPM in Rhode Island (RI) participated in a cross-sectional survey (n 330; 68 % response rate), which measured dietary patterns, food security and food shopping behaviours. We compared the shopping habits and market experiences of customers who currently received SNAP benefits with those who did not currently receive SNAP benefits.Setting:An MPM in RI which offers a 50 % discount for FV purchased with SNAP benefits.Participants:This study describes current market customers at twelve market sites serving low-income seniors.Results:Market customers were mostly low-income, female, over the age of 50 years and Hispanic/Latino. Most customers received SNAP benefits, and almost half were food insecure. In addition, three quarters of SNAP customers reported their SNAP benefits last longer since shopping at the markets. Mixed logistic regression models indicated that SNAP customers were more likely to report buying and eating more FV than non-SNAP customers.Conclusions:MPM are critical resources of affordable produce and have been successful in improving access to FV among individuals of low socio-economic status in RI. This case study can inform policy and programme recommendations for MPM and SNAP incentive programmes.

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Impact of a Supplemental Nutrition Assistance Program-Education (SNAP-Ed) Intervention on Usual Dietary Intake Among Indiana Adults (P04-025-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz051.p04-025-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Rebecca Rivera ◽

Yumin Zhang ◽

Qi Wang ◽

Melissa Maulding ◽

Regan Bailey ◽

...

Keyword(s):

Dietary Intake ◽

Nutrition Education ◽

Diet Quality ◽

Food Group ◽

Supplemental Nutrition Assistance Program ◽

Assistance Program ◽

Purdue University ◽

Nutrition Assistance

Abstract Objectives The goal of the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) is to assist low-income households to improve diet quality. The objective of this study was to evaluate the long-term effects of SNAP-Ed nutrition education lessons on diet quality and key nutrient and food group outcomes among Indiana SNAP-Ed-eligible adults. Methods The study design was a parallel-arm randomized controlled nutrition education intervention. The intervention consisted of the first 4 lessons of the Indiana adult SNAP-Ed curriculum delivered to participants during the 4 to 10 weeks after their baseline assessment. Participants (≥18 yrs) eligible for SNAP-Ed and interested in receiving nutrition education lessons (direct SNAP-Ed) were recruited from 31 Indiana counties (N = 261) and completed baseline assessments from August 2015 to May 2016. Follow-up assessments were conducted approximately 1-year after baseline from August 2016 to May 2017 (n = 103). Dietary intake was assessed using up to 2 24-hour dietary recalls at each assessment time point. The main outcome measures were mean usual nutrient (calcium; vitamins D, A, C, E; magnesium; folate; potassium; fiber; dairy; fruit; vegetable; whole grains) the proportion meeting Estimated Average Requirements, exceeding Adequate Intakes, or meeting daily recommended servings, and diet quality as measured by the Healthy Eating Index-2010. This study is registered at www.clinicaltrials.gov as NCT03436784. Significance was P ≤ 0.05. Analyses were completed using SAS 9.4. Results No effect of direct SNAP-Ed was found on diet quality, nutrient, or food group intake in the treatment compared to the control group between baseline and the 1-year follow-up assessment (P > 0.05). Conclusions Direct SNAP-Ed did not improve long-term diet quality, nutrient, or food group intake among Indiana SNAP-Ed eligible adults. Funding Sources Funding for this research was provided by Purdue University as part of AgSEED Crossroads funding to support Indiana's Agriculture and Rural Development, Purdue University Frederick N. Andrews Fellowship, Purdue University Center for Families Justice Family Nutrition Award, the Purdue University Nutrition Education Program, and a USDA NIFA Hatch Project.

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Nutritional knowledge in an Italian population of children, pre-adolescents and adolescents

Public Health Nutrition ◽

10.1017/s1368980013000311 ◽

2013 ◽

Vol 17 (3) ◽

pp. 708-714 ◽

Cited By ~ 7

Author(s):

Anna Tallarini ◽

Alessandra Zabeo ◽

Anita Ferraretto

Keyword(s):

Fast Food ◽

Dairy Products ◽

Fruits And Vegetables ◽

Age Groups ◽

Educational Interventions ◽

Italian Population ◽

Nutritional Knowledge ◽

Healthy Nutrition ◽

School Period ◽

Milk And Dairy Products

AbstractObjectiveTo evaluate general knowledge about nutrition in an Italian population of children, pre-adolescents and adolescents.DesignKnowledge about nutrition-related items such as healthy eating, breakfast, snacks, fast food, beverages, fruits and vegetables, cereals and tubers, meat/fish/legumes/eggs, milk and dairy products, fats and dressings, and sweets was analysed by means of a self-administered questionnaire (QuesCA IT) containing thirty-one questions, that was translated and adapted from a Swiss version (QuesCA) previously used in Geneva and Vaud.SettingNorth of Italy (Bergamo, Milan).SubjectsStudents (n 614) belonging to two different age groups: 9–11 years (GR1) and 12–16 years (GR2).ResultsData analysis showed that nutritional knowledge varied in relation to the age of the participants, increasing in particular in the older group, although this difference was not statistically significant for all the considered items. Nutritional knowledge also varied in relation to the gender of the participants, with females in particular seeming to possess better cognition. For each age group there was poor knowledge about the items healthy diet, snacks, milk and dairy products, meat/fish/legumes/eggs, and fats and dressings. Moreover, the percentage of participants who declared own knowledge as insufficient was higher in GR2 compared with GR1.ConclusionsThe present research demonstrates a lack of knowledge about the main concepts of healthy nutrition both in the youngest and oldest participants of the survey. This evidence, together with the presence of higher self-consciousness in GR2, should be taken into account in specific educational interventions during the school period.

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The impact of financial incentives and restrictions on cyclical food expenditures among low-income households receiving nutrition assistance: a randomized controlled trial

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-021-01223-7 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Sruthi Valluri ◽

Susan M. Mason ◽

Hikaru Hanawa Peterson ◽

Simone A. French ◽

Lisa J. Harnack

Keyword(s):

Low Income ◽

Financial Incentives ◽

Fruits And Vegetables ◽

The United States ◽

Assistance Program ◽

Added Sugar ◽

Food Expenditures ◽

Nutrition Assistance ◽

The Impact ◽

Low Income Households

Abstract Background The Supplemental Nutrition Assistance Program (SNAP) is the largest anti-hunger program in the United States. Two proposed interventions to encourage healthier food expenditures among SNAP participants have generated significant debate: financial incentives for fruits and vegetables, and restrictions on foods high in added sugar. To date, however, no study has assessed the impact of these interventions on the benefit cycle, a pattern of rapid depletion of SNAP benefits that has been linked to worsening nutrition and health outcomes over the benefit month. Methods Low-income households not currently enrolled in SNAP (n = 249) received benefits every 4 weeks for 12 weeks on a study-specific benefit card. Households were randomized to one of four study arms: 1) incentive (30% incentive for fruits and vegetables purchased with study benefits), 2) restriction (not allowed to buy sugar-sweetened beverages, sweet baked goods, or candy using study benefits), 3) incentive plus restriction, or 4) control (no incentive or restriction). Weekly household food expenditures were evaluated using generalized estimating equations. Results Compared to the control group, financial incentives increased fruit and vegetable purchases, but only in the first 2 weeks after benefit disbursement. Restrictions decreased expenditures on foods high in added sugar throughout the benefit month, but the magnitude of the impact decreased as the month progressed. Notably, restrictions mitigated cyclical expenditures. Conclusions Policies to improve nutrition outcomes among SNAP participants should consider including targeted interventions in the second half of the month to address the benefit cycle and attendant nutrition outcomes. Trial registration ClinicalTrial.gov, NCT02643576. Retrospectively registered December 22, 2014.

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