Location: Office of The Area Director
2015 Annual Report
Objectives
1. Determine the effects of a diet and activity enhanced Maternal, Infant, and Early Childhood Home Visiting program on weight and health related outcomes in mothers and their infants.
2. Determine associations between dietary patterns (identified using variant statistical and epidemiologic approches) and health inicatiors in children using the most recent NHANES datasets.
Approach
1. The Delta Healthy Sprouts Project is an 18-month, randomized, controlled comparative effectiveness trial. Participants are randomly assigned to 1 of 2 treatment arms (75 participants per arm) – Parents as Teachers (PaT) or Parents as Teachers Enhanced (PaTE). All participants receive monthly PaT lessons and materials. Only participants in the experimental arm receive PaTE supplemental nutrition and physical activity lessons and materials. The control arm utilizes the PaT curriculum which is a nationally recognized, evidence based MIECHV program that includes one-on-one home visits, monthly group meetings, developmental screenings, and resource networks for families. Through these activities, PaT seeks to increase parental knowledge of child development, improve parenting practices, provide early detection of developmental delays, prevent child abuse, and increase school readiness. PaTE, delivered to experimental participants, builds on PaT by adding culturally tailored, maternal weight management and early childhood obesity prevention components. These components include healthy weight gain during pregnancy, nutrition and physical activity in the gestational and postnatal periods, breastfeeding, appropriate introduction of solid foods, and parental modeling of positive nutrition and physical activity behaviors. The interventions are delivered in the home to women beginning early in their second trimester of pregnancy by community based, trained Parent Educators.
2. Dietary patterns will be determined for 2-18 year old U.S. children using the 2 most recent cycles of NHANES datasets with available dietary data. Analyses will be conducted separately by gender, age group (2-5, 6-11, and 12-18 years), race/ethnicity, and poverty income ratio (PIR) given sufficient sample sizes. The first dietary pattern identification method is based upon existing recommended dietary guidelines and current knowledge. The Health Eating Index-2010 (HEI-2010) ranks individuals in terms of compliance with the 2010 Dietary Guidelines for Americans. Total HEI-2010 scores range from 0-100 and are computed by summing scores for 12 components including: total fruit; whole fruit; total vegetables, greens and beans; whole grains; dairy; total protein foods; seafood and plant proteins; fatty acids; refined grains; sodium; and empty calories. For the first 9 components, higher intakes result in higher scores (healthier diet). For the last 3 components, lower intakes (more beneficial) result in higher scores. Latent class analysis (LCA), the second dietary pattern identification method, derives empirical dietary patterns based on current study data. Similar to cluster analysis, LCA partitions data into groups so that observations (children) within a group are as similar as possible to each other (foods consumed) and as dissimilar as possible to the observations in other groups. Differing from cluster analysis, LCA does not absolutely assign observations to groups, but assigns a probability of group membership. Associations between identified dietary pattern scores, excess adiposity, physical activity, and sedentary behavior will be determined.
Progress Report
In collaboration with the University of Illinois at Chicago, ARS researchers completed enrollment for and are implementing an 18-month, randomized, controlled, comparative trial testing the impact of two Maternal, Infant, and Early Childhood Home Visiting programs on weight status, dietary intake, and health behaviors of 82 primarily African American mothers and their infants residing in the rural Lower Mississippi Delta. The control arm, Parents as Teachers, is an evidence-based approach to increase parental knowledge of child development and improve parenting practices. The experimental arm, Parents as Teachers Enhanced, builds on the Parents as Teachers curriculum by including nutrition and physical activity components designed for the gestational and postnatal periods. Baseline data analysis is complete, although data collection is on-going. These efforts have resulted in 2 manuscripts submitted for publication to peer-reviewed journals.
In collaboration with the University of Southern Mississippi, ARS researchers completed preliminary analyses for a 6-month nutrition education intervention targeting a rural, health disparate population in the Lower Mississippi Delta. Results indicated that the diets of residents in this region have not changed over the past 11 years, thus demonstrating a significant need for nutrition interventions in these at risk adults with high prevalence of chronic diseases, such as obesity, diabetes, and hypertension. These efforts have resulted in one published paper.
Accomplishments
Review Publications
Connell, C.L., Thomson, J.L., Huye, H.F., Landry, A.S., Crook, L.B., Yadrick, K. 2015. Mississippi Communities for Healthy Living: implementing a nutrition intervention effectiveness study in a rural health disparate region. Contemporary Clinical Trials. 42:196-203.
Thomson, J.L., Landry, A., Zoellner, J., Connell, C., Madson, M., Molaison, E., Yadrick, K. 2015. Participant adherence indicatiors predict changes in blood pressure, anthropometric measures, and self-reported physical activity in a lifestyle intervention: HUB City Steps. Health Education and Behavior. 42(1):84-91.
Landry, A., Thomson, J.L., Madson, M., Zoellner, J.M., Mohn, R., Noble, J., Connell, C., Yadrick, K. 2015. Changes in psychosocial constructs predict post-intervention changes in physical activity and dietary outcomes in a lifestyle intervention: HUB City Steps. Preventing Chronic Disease. 12:140525.
Tussing Humphreys, L.M., Thomson, J.L., Onufrak, S. 2015. A church-based pilot study designed to improve dietary quality for rural, Lower Mississippi Delta, African American Adults. Journal of Religion and Health. 54:455-469.
Thomson, J.L., Tussing-Humphreys, L.M., Goodman, M.H., Zoellner, J.M. 2015. Engagement indicators predict health changes in a lifestyle intervention. American Journal of Health Behavior. 2015;39(3):409-420. https://doi.org/10.5993/AJHB.39.3.13.
