Start Date: May 01, 2009
End Date: Apr 30, 2014
Barriers and facilitators of adherence to the Dietary Guidelines for Americans (DG) will be identified through random nominal group sessions with 5th graders and caretakers in the Delta of Arkansas, Louisiana, and Mississippi. Researchers will examine how differential profiles of adherence relate to obesity in children and adults of the Delta region. This research is part of the ARS multi-location study entitled "Healthy Eating and Lifestyle for Total Health" (HEALTH) and will be conducted concurrently with the other ARS partners. HEALTH study locations include the Delta region plus the six ARS Human Nutrition Research Centers located in Arkansas, California, Massachusetts, Maryland, North Dakota, and Texas. Conceptually and culturally appropriate survey tools will be constructed to assess DG adherence barriers and facilitators for African-American and Caucasian children and their caregivers of the Lower Mississippi Delta region. A pilot test will be conducted to determine the psychometric properties of the survey tools. Barriers and facilitators of DG adherence and other factors as they relate to dietary behavior and body mass index will be examined by administering the surveys to cross-sections of the Lower Mississippi Delta region's population. Utilizing social marketing principles, the research will develop a small steps approach and set of tools termed the Delta DG Small Steps Tool Kit (Delta DGSS Tool Kit) addressing only diet-specific guidelines. Research will examine data previously collected in the LMD to identify gaps in knowledge, skills, and behaviors that interfere with adhering to the DG. From these findings, a priority list of tools, techniques, and technology will be planned through an iterative process with a community advisory committee working with ARS scientists/nutritionists and Delta Obesity Prevention Research Unit (Delta OPRU) collaborators from cooperating institutions. The resulting Delta DGSS Tool Kit (e.g., menus, shopping lists, food selection tips, food preparation) will be tested for feasibility with a small group of family caregivers. A community food environment survey will be conducted to assure local availability of foods and cultural acceptability. The Delta DGSS Tool Kit will be used in an intervention to examine its effectiveness to promote DG adherence in a target group of primary food gatekeeper/caregivers and their families. The effectiveness evaluation of the small steps approach will combine anthropometric, nutritional and dietary assessment in the intervention with biological assessment for biomarkers associated with fruit/vegetable intakes and for other serum markers for chronic disease risks related to obesity, e.g., hypertension, hyperglycemia. This larger study will examine how effective the Delta DGSS Tool Kit is in promoting DG adherence and preventing obesity over time in a target group of young adult mothers who act as the primary gatekeeper for food in their children.