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

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.

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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)

Current Developments in Nutrition ◽

10.1093/cdn/nzz051.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.

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

Preventive Medicine Reports ◽

10.1016/j.pmedr.2019.100880 ◽

2019 ◽

Vol 14 ◽

pp. 100880 ◽

Cited By ~ 1

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

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The Impact of Responsive Feeding Practice Training on Teacher Feeding Behaviors in Tribal Early Care and Education: The Food Resource Equity and Sustainability for Health (FRESH) Study

Current Developments in Nutrition ◽

10.1093/cdn/nzz105 ◽

2019 ◽

Vol 4 (Supplement_1) ◽

pp. 23-32

Author(s):

Kaysha Sleet ◽

Susan B Sisson ◽

Dipti A Dev ◽

Charlotte Love ◽

Mary B Williams ◽

...

Keyword(s):

Native American ◽

Eating Habits ◽

Food Resource ◽

Feeding Practices ◽

Early Care And Education ◽

Feeding Practice ◽

Early Care ◽

Total N ◽

Healthy Eating Habits ◽

The Impact

ABSTRACT Background Establishing healthy eating habits early affects lifelong dietary intake, which has implications for many health outcomes. With children spending time in early care and education (ECE) programs, teachers establish the daytime meal environment through their feeding practices. Objective We aimed to determine the effect of a teacher-focused intervention to increase responsive feeding practices in 2 interventions, 1 focused exclusively on the teacher's feeding practices and the other focused on both the teacher's feeding practices and a nutrition classroom curriculum, in ECE teachers in a Native American (NA) community in Oklahoma. Methods Nine tribally affiliated ECE programs were randomly assigned to 1 of 2 interventions: 1) a 1.5-h teacher-focused responsive feeding practice training (TEACHER; n = 4) and 2) TEACHER plus an additional 3-h training to implement a 15-wk classroom nutrition curriculum (TEACHER + CLASS; n = 5). Feeding practice observations were conducted during lunch at 1 table in 1 classroom for 2- to 5-y-olds at each program before and 1 mo after the intervention. The Mealtime Observation in Child Care (MOCC) organizes teacher behaviors into 8 subsections. Descriptive statistics and the Shapiro–Wilk test for normality were calculated. Paired t tests were calculated to determine change in each group. Results A mean ± SD of 5.2 ± 2.0 (total n = 47) children and 1.7 ± 0.5 (total n = 14) teachers/center were observed at baseline, and 5.6 ± 1.7 (total n = 50) children and 1.7 ± 0.7 teachers (total n = 14) were observed/center postintervention. Total MOCC scores (max possible = 10) improved for TEACHER (6.1 ± 0.9 compared with 7.5 ± 0.3, t = 4.12, P = 0.026) but not for TEACHER + CLASS (6.5 ± 0.8 compared with 6.4 ± 1.0, t = −0.11, P = 0.915). No other changes were observed. Conclusions Teacher intervention–only programs demonstrated improvements in responsive feeding practices, whereas the programs receiving teacher and classroom training did not. Greater burden likely decreased capacity to make changes in multiple domains. We demonstrated the ability to implement interventions in NA ECE. Further research with larger communities is necessary. This trial was registered at clinicaltrials.gov as NCT03251950.

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KETIDAKEFEKTIFAN KEBIJAKAN ANTI-DUMPING PRODUK IMPOR BAJA INDONESIA: SEBUAH ANALISIS AWAL

Buletin Ilmiah Litbang Perdagangan ◽

10.30908/bilp.v11i2.230 ◽

2017 ◽

Vol 11 (2) ◽

pp. 143-168

Author(s):

Aditya Paramita Alhayat

Keyword(s):

Government Regulation ◽

Best Practice ◽

Secondary Data ◽

Information Services ◽

Global Trade ◽

Trade Patterns ◽

Safeguard Measures ◽

The Us ◽

Before And After ◽

The Government

Meskipun Indonesia telah mengenakan tindakan anti-dumping terhadap beberapa jenis produk baja, namun impor produk tersebut masih meningkat. Salah satu kemungkinan penyebabnya adalah importasi melalui produk yang dimodifikasi secara tidak substansial atau melalui negara ketiga yang tidak dikenakan tindakan anti-dumping, yang dalam perdagangan internasional umum disebut sebagai praktik circumvention. Studi ini ditujukan untuk membuktikan bahwa circumvention mengakibatkan tindakan anti-dumping atas impor produk baja Indonesia tidak efektif dan untuk memberikan masukan berdasarkan praktik di negara lain supaya kebijakan anti-dumping Indonesia lebih efektif. Circumvention dianalisis dengan membandingkan pola perdagangan antara sebelum dan setelah pengenaan bea masuk anti-dumping (BMAD) menggunakan data sekunder dari Badan Pusat Statistik (BPS) maupun Global Trade Information Services (GTIS). Hasil analisis menunjukkan adanya indikasi kuat bahwa circumvention mengkibatkan pengenaan tindakan anti-dumping impor produk baja di Indonesia menjadi tidak efektif. Oleh karena itu, sangat penting bagi Pemerintah Indonesia untuk segera melakukan penyempurnaan terhadap Peraturan Pemerintah No. 34/2011 tentang Tindakan Antidumping, Tindakan Imbalan, dan Tindakan Pengamanan Perdagangan dengan memasukkan klausul tindakan anti-circumvention yang setidaknya mencakup bentuk-bentuk dan prosedur tindakan, sebagaimana yang telah dilakukan beberapa negara seperti: AS, EU, Australia, dan India. Although Indonesia has imposed anti-dumping measures on several types of steel products, the import of steel products is still increasing. One possible cause is that imports are made by non-substantial modification of product or through a third country which is not subject to anti-dumping measures, which is generally referred as circumvention practice. This study is aimed to prove that circumvention made Indonesian anti-dumping actions on the steel products ineffective. This also study provides recommendation for a best practice for other countries so that Indonesia's anti-dumping policy can be more effective. Circumvention was analyzed by comparing trade patterns between before and after the imposition of anti-dumping duty using secondary data from the Central Bureau of Statistics (BPS) and the Global Trade Information Services (GTIS). The results of the analysis indicate that circumvention became the reason why Indonesian anti-dumping measures on imported steel products are ineffective. Therefore, it is very important for the Government of Indonesia to immediately make amendments to the Government Regulation No. 34/2011 on Antidumping, Countervailing, and Safeguard Measures by adopting clauses of anti-circumvention. This can be done bycovering the forms/types and procedures of action, as has been implemented by several countries such as the US, EU, Australia, and India.

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Delivery of the National Child Measurement Programme in England

Public Health Nutrition ◽

10.1017/s1368980020004991 ◽

2020 ◽

pp. 1-21

Author(s):

Martin Čadek ◽

Stuart W. Flint ◽

Ralph Tench

Keyword(s):

Public Health ◽

Local Government ◽

Best Practice ◽

Online Survey ◽

The Other ◽

Service Availability ◽

Healthy Weight ◽

Weight Category ◽

Convenience Sampling

Abstract Objective: The National Child Measurement Programme (NCMP) is a mandatory initiative delivered in England to children in reception and year 6. To date, no research has explored the methods used to deliver the NCMP by Local Government Authorities (LGA) across England. Design: An online survey was administered between February 2018 and May 2018 to explore the delivery of the NCMP across the 152 LGAs in England and disseminated using non-probability convenience sampling. Setting: LGAs received an anonymous link to the survey. Participants: A total of 92 LGAs participated in the survey. Results: Most LGAs who responded provide result feedback (86%), a proactive follow-up (71%) and referrals to services (80%). Additionally, 65% of the authorities tailor Public Health England specimen result letters to suit their needs, and 84% provide attachments alongside. Out of 71% of LGAs who provide proactive follow-up, 19 (29%) provide the proactive follow-up only to upper weight categories, and only 4 (6 %) include Healthy Weight category with other categories in proactive follow-up. Regarding the service availability for children, out of 80% of LGAs who indicated that services are available, 32 (43%) targeted solely upper weight categories while the other 42 (57%) offered services across all weight categories. Finally, most LGAs (88%) commission providers to manage various parts of the NCMP. Conclusions: The results show that LGAs in England localise the NCMP. Further guidance regarding standards of best practice would help LGAs to find the most suitable localisation out of various options that exist across other LGAs.

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Cooperation & Liaison between Universities & Editors (CLUE): recommendations on best practice

Research Integrity and Peer Review ◽

10.1186/s41073-021-00109-3 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Elizabeth Wager ◽

◽

Sabine Kleinert

Keyword(s):

Peer Review ◽

Best Practice ◽

Research Integrity ◽

Decision Makers ◽

Publication Ethics ◽

List Type ◽

Research Institutions ◽

Academic Journals ◽

Before And After ◽

Published Research

Abstract Background Inaccurate, false or incomplete research publications may mislead readers including researchers and decision-makers. It is therefore important that such problems are identified and rectified promptly. This usually involves collaboration between the research institutions and academic journals involved, but these interactions can be problematic. Methods These recommendations were developed following discussions at World Conferences on Research Integrity in 2013 and 2017, and at a specially convened 3-day workshop in 2016 involving participants from 7 countries with expertise in publication ethics and research integrity. The recommendations aim to address issues surrounding cooperation and liaison between institutions (e.g. universities) and journals about possible and actual problems with the integrity of reported research arising before and after publication. Results The main recommendations are that research institutions should: develop mechanisms for assessing the integrity of reported research (if concerns are raised) that are distinct from processes to determine whether individual researchers have committed misconduct; release relevant sections of reports of research integrity or misconduct investigations to all journals that have published research that was investigated; take responsibility for research performed under their auspices regardless of whether the researcher still works at that institution or how long ago the work was done; work with funders to ensure essential research data is retained for at least 10 years. Journals should: respond to institutions about research integrity cases in a timely manner; have criteria for determining whether, and what type of, information and evidence relating to the integrity of research reports should be passed on to institutions; pass on research integrity concerns to institutions, regardless of whether they intend to accept the work for publication; retain peer review records for at least 10 years to enable the investigation of peer review manipulation or other inappropriate behaviour by authors or reviewers. Conclusions Various difficulties can prevent effective cooperation between academic journals and research institutions about research integrity concerns and hinder the correction of the research record if problems are discovered. While the issues and their solutions may vary across different settings, we encourage research institutions, journals and funders to consider how they might improve future collaboration and cooperation on research integrity cases.

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An ecological latent class model of adolescent risk and protective factors: Implications for substance use and depression prevention

International Journal of Behavioral Development ◽

10.1177/01650254211005567 ◽

2021 ◽

pp. 016502542110055

Author(s):

Benjamin L. Bayly ◽

Sara A. Vasilenko

Keyword(s):

Substance Use ◽

Native American ◽

Latent Class ◽

Latent Class Model ◽

Single Parent ◽

Low Risk ◽

Heavy Episodic Drinking ◽

Health Study ◽

Adolescent Risk ◽

Parent Relationship

To provide a comprehensive view of the unique contexts shaping adolescent development in the U.S., we utilized latent class analysis (LCA) with indicators of risk and protection across multiple domains (family, peers, school, neighborhood) and examined how latent class membership predicted heavy episodic drinking, illicit substance use, and depression in adolescence and 6 years later when participants were young adults. Data came from Wave 1 (W1) and Wave 3 (W3) of the nationally representative U.S.-based Add Health study ( N = 6,649; Mage W1 = 14.06; Mage W3 = 20.38; 53.8% female; 56.1% White/European American, 22.8% Black/African American, 9.5% Hispanic, 6.7% Biracial, Asian or Pacific Islander 4.2%, American Indian/Native American 0.7%). A six-class solution was selected with classes named: Two Parent: Low Risk, Two Parent: Relationship Risks, Two Parent: Neighborhood Risks, Single Parent: Low Risk, Single Parent: Relationship Risks, and Single Parent: Multidimensional Risk. Subsequent analyses suggested that adolescent social relationships are particularly important for prevention interventions as the classes marked by substance using peers and a lack of closeness to parents and teachers in adolescence (Two Parent: Relationship Risks and Single Parent: Relationship Risks) had consistently poorer outcomes in adolescence and young adulthood.

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A Cultural Approach to Conducting HIV/AIDS and Hepatitis C Virus Education Among Native American Adolescents

The Journal of School Nursing ◽

10.1177/1059840508319866 ◽

2008 ◽

Vol 24 (4) ◽

pp. 229-238 ◽

Cited By ~ 6

Author(s):

John Lowe

Keyword(s):

Native American ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Cultural Values ◽

Prevention Program ◽

Public High School ◽

Convenience Sample ◽

Self Reliance ◽

Before And After ◽

Hiv Aids

This pilot study tests the feasibility of using a Talking Circle approach and measures cultural values and beliefs within a HIV/AIDS and hepatitis C virus (HCV) prevention program conducted among a Native American (Cherokee) youth population. A descriptive correlation design was used to examine the relationship between Cherokee self-reliance and HIV/AIDS and HCV knowledge, attitudes, and behaviors. The study used three questionnaires that were administered before and after the prevention program to collect data from a convenience sample of 41 students at a public high school within the boundaries of the Cherokee Nation in Oklahoma. Statistical analysis revealed immediate differences between pretests and posttests related to knowledge, attitudes, and behavioral intentions concerning HIV/AIDS and HCV and the cultural dynamic of Cherokee self-reliance.

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Abstract MP35: Physical Activity Before and After Cancer Diagnosis and Total and Cause-Specific Mortality

Circulation ◽

10.1161/circ.137.suppl_1.mp35 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Paulette D Chandler ◽

Deirdre Tobias ◽

Jule E Buring ◽

I-Min Lee ◽

Daniel Chasman ◽

...

Keyword(s):

Physical Activity ◽

Cancer Diagnosis ◽

Cancer Mortality ◽

Total Mortality ◽

Health Study ◽

Specific Mortality ◽

Before And After ◽

After Cancer ◽

Cvd Mortality

Background: Given the increased prevalence of cancer survivors in the United States, it is imperative to define risk factors for potential reductions in total and cause-specific mortality. Physical activity (PA) represents a promising target for intervention. Design: We prospectively evaluated PA from questionnaires before and after cancer diagnosis with total and cause-specific mortality among 13,297 subjects diagnosed with invasive cancer combined from the Physicians’ Health Study (PHS) (n=6328), Physicians’ Health Study II (PHS II) (n=912), and Women's Health Study (WHS) (n=6057). WHS and PHS participants were free of baseline cancer; PHS II participants reported no active cancer at baseline. We ascertained PA before and after an incident cancer diagnosis based on reports on repeated follow-up questionnaires. Death was ascertained by medical records and death certificates. Cox regression estimated combined hazard ratios (HRs) of mortality by PA adjusted for age, randomized treatments, BMI, and other lifestyle/demographic factors. We evaluated the interaction between PA before and after cancer diagnosis by comparing PA ≤1 versus ≥2 times/wk. Results: The mean follow-up after cancer diagnosis was 8.0, 7.5, and 5.2 y for WHS, PHS, and PHS II, respectively, during which there were 5623 deaths (WHS, 2164; PHS, 3269; PHS II; 190). Higher PA before cancer diagnosis was associated with significantly lower mortality. Compared with PA ≤ once/wk, the HRs (95% CIs) associated with PA 2-4 and >4 times/wk were 0.87 (0.82-0.93) and 0.88 (0.82-0.94) for total mortality; 0.77 (0.63-0.95) and 0.79 (0.62-0.997) for CVD mortality, and 0.90 (0.83-0.98) and 0.90 (0.83-0.98) for cancer mortality. Higher PA after cancer diagnosis was associated with significantly lower total and cancer mortality and non-significantly lower CVD mortality, with HRs (95% CIs) of 0.65 (0.58-0.72) and 0.66 (0.59-0.73) for total mortality; 0.78 (0.59-1.03) and 0.82 (0.61-1.10) for CVD mortality, and 0.66 (0.57-0.77) and 0.64 (0.55-0.74) for cancer mortality. There was a significant interaction of PA before and after cancer diagnosis for total (p int =0.02) and cancer (p int =0.007) mortality, but not CVD mortality (p int =0.38). Conclusions: Greater PA both before and after cancer diagnosis were significantly associated with lower total and cancer mortality. Higher PA before cancer diagnosis was also associated with lower CVD mortality. PA may be an important target for lower mortality after cancer diagnosis.

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Application of Lean principles to improve early cardiac care in the emergency department

CJEM ◽

10.2310/8000.2011.110284 ◽

2011 ◽

Vol 13 (05) ◽

pp. 325-332 ◽

Cited By ~ 9

Author(s):

Zoë Piggott ◽

Erin Weldon ◽

Trevor Strome ◽

Alecs Chochinov

Keyword(s):

Emergency Department ◽

Cardiac Care ◽

Early Care ◽

Rapid Improvement ◽

Lean Principles ◽

Standard Work ◽

Coronary Syndrome ◽

Physician Assessment ◽

Before And After ◽

Electrocardiogram Ecg

ABSTRACTObjective:To achieve our goal of excellent emergency cardiac care, our institution embarked on a Lean process improvement initiative. We sought to examine and quantify the outcome of this project on the care of suspected acute coronary syndrome (ACS) patients in our emergency department (ED).Methods:Front-line ED staff participated in several rapid improvement events, using Lean principles and techniques such as waste elimination, supply chain streamlining, and standard work to increase the value of the early care provided to patients with suspected ACS. A chart review was also conducted. To evaluate our success, proportions of care milestones (first electrocardiogram [ECG], ECG interpretation, physician assessment, and acetylsalicylic acid [ASA] administration) meeting target times were chosen as outcome metrics in this before-and-after study.Results:The proportion of cases with 12-lead ECGs completed within 10 minutes of patient triage increased by 37.4% (p< 0.0001). The proportion of cases with physician assessment initiated within 60 minutes increased by 12.1% (p= 0.0251). Times to ECG, physician assessment, and ASA administration also continued to improve significantly over time (pvalues < 0.0001). Post-Lean, the median time from ECG performance to physician interpretation was 3 minutes. All of these improvements were achieved using existing staff and resources.Conclusions:The application of Lean principles can significantly improve attainment of early diagnostic and therapeutic milestones of emergency cardiac care in the ED.

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