Location:2010 Annual Report
1a. Objectives (from AD-416)
1. Identify dietary and physical activity patterns associated with lower and higher incidences of overweight/obesity and related chornic diseases for the Mississippi Delta population. Dietary pattern analysis that incorporates both food consumption and food behavioral patterns will be employed. 2. Develop and evaluate culturally appropriate dietary and physical activity interventional strategies, based upon the Dietary Guidelines for Americans (DGA), for obesity prevention and health promotion in this population.
1b. Approach (from AD-416)
Objective 1 will be accomplished using two existing datasets representative of the Mississippi Delta population: the Jackson Heart Study (JHS) and Foods of Our Delta (FOODS 2000). The JHS is a longitudinal cohort study of 5303 African American men and women residing in the Jackson, MS, metropolitan area. Using data from the JHS we will evaluate the association of dietary and physical activity patterns with outcome measures including weight gain, change in waist circumference, carotid intima medial thickness, and incidence of diabetes, hypertension, and hypercholesterolemia. The FOODS 2000 study was a cross-sectional representative dietary phone survey of 1751 adults and 485 children from the Lower Mississippi Delta Region encompassing Mississippi River alluvial plain of Mississippi, Arkansas, and Louisiana. Using data from FOODS, we will identify dietary and physical activity patterns of Delta residents, using cluster analysis and examine the association of these patterns with demographic characteristics (race, age, gender, socioeconomic status), dietary quality (as measured by Health Eating Index 2005 (HEI-2005) components, and BMI. Objective 2 will be accomplished in two stages. We will first develop and evaluate relevant and culturally appropriate dietary modifications aimed at effecting significant improvement in adherence to the 2005 DGA in Delta populations. This will be accomplished by performing analysis of existing data from the FOODS 2000 study and food supply adequacy study to develop specific culturally acceptable dietary modification that can improve scores for specific HEI-2005 dietary components using familiar and available foods. The potential population impact of these modifications will be evaluated using data simulations methods. Finally we will utilize these dietary modifications to develop a culturally appropriate church-based intervention aimed at improving dietary quality and physical activity frequency among Delta African Americans.
3. Progress Report
Cooperative research projects are currently underway with faculty from University of Southern Mississippi (USM) Department of Nutrition and Food Systems, Delta Health Alliance (DHA), Mississippi Valley State University (MVSU). A church-based dietary intervention program is being implemented among African American churches in the Delta region in a cooperative project with DHA and MVSU. This intervention program plans to enroll approximately 350-400 subjects from 10-15 churches with the program likely concluding within this next performance year. Six churches were successfully recruited to participate as either an intervention or control church during the past year. Four intervention churches completed the baseline survey and clinical assessments. Three intervention churches completed the six month intervention and have had baseline and follow-up clinical and survey measures assessed; one intervention church withdrew from the project due to terminal illness of the pastor. Both control churches have completed baseline assessments. Follow-up survey and clinical assessments for one control church are complete and one church has yet to complete their follow-up assessments (August 2010). Five new churches have enrolled in the second intervention cohort and recruitment remains open for 1-2 additional churches. Intervention activities for cohort two churches began in June 2010. Collaborative work with USM is also being performed in the form of a data simulation study to identify dietary modifications that improve dietary quality based on Healthy Eating Index scores (HEI-2005) to then be utilized to develop dietary interventions for the Mississippi Delta region.
1. Obesity and Chronic Disease Rates Among the Mississippi Delta Population are Among the Highest in the Nation. A collaborative study with University of Southern Mississippi (USM)identified the leading food sources that drive the Healthy Eating Index (HEI)-2005 component scores relevant to obesity and chronic disease prevention within the Delta population. Based upon these findings, we identified dietary modifications for use in intervention programs that improve dietary quality and are culturally acceptable. A research manuscript was submitted to the Journal of the American Dietetic Association reporting our findings from this collaborative study and is currently under review by the journal. Additionally, a data simulation study evaluating the potential population impact of these dietary modifications on dietary quality is currently being undertaken. These dietary modifications will be incorporated into a dietary intervention program currently under development by USM focusing on women’s social groups including African American sororities and garden clubs.
2. Efforts to Improve Dietary Quality in the Mississippi Delta Region to Prevent Obesity and Chronic Disease must be Culturally Sensitive. We are currently implementing a church-based dietary intervention program among African American churches in the Delta region in a cooperative project with Delta Health Alliance and Mississippi Valley State University (MVSU). Six churches were successfully recruited to participate as either an intervention or control church during the past year. Four intervention churches completed the baseline survey and clinical assessments. Three intervention churches completed the six month intervention and have had baseline and follow-up clinical and survey measures assessed; one intervention church withdrew from the project due to terminal illness of the pastor. Both control churches have completed baseline assessments. Follow-up survey and clinical assessments for one control church are complete. To date, from the first cohort of churches, 213 participants have completed baseline assessments and 110 participants have completed follow-up assessments. On average, 100 participants (across the 3 intervention churches in cohort 1) attended the monthly intervention events. To date, 110 participants have been screened for baseline surveys and clinical measures for cohort two churches as of July 2010. We were awarded an additional $190,878 by Health Resources and Services Administration (HRSA) and the Delta Health Alliance to support the implementation of this project.
5. Significant Activities that Support Special Target Populations
The majority of program research activities are focused on improving dietary quality and preventing obesity and chronic disease among African Americans in the largely rural and highly impoverished Mississippi Delta Region. A dietary intervention program is being implemented in African American churches that will impact approximately 10-15 churches over a 2 year period.