International and Community Nutrition Commons^™

Nutrient Profile Assessment Of A Meal Program Impact On Older Adults' Diet Quality And Food Security Status, Millicent Yaa Gyasiwaa Ms

Theses and Dissertations--Nutrition and Food Systems

The rise in food insecurity globally has ignited institutions and organizations to implement policies and programs to reduce the burden on vulnerable people including older adults and people living in underserved areas. Though programs such as congregate, home-delivered meals, and pantries have been initiated to contribute to reducing food insecurity the nutrient content of these meals including recovered meals and their effect on food security status, food quality, and health has not been widely studied. The current study, Meals on Wings (MOW), assessed the nutrient profile of the free meals offered 4 times per week for 3 months, from May …

Leveraging Community Health Workers’ Expertise In The Community To Address Food Insecurity In Appalachia, Alexis Kimbro Scott

Theses and Dissertations--Nutrition and Food Systems

Residents of the Appalachian region of Kentucky are disproportionately affected by poor social determinants of health that contribute to the persistence of food insecurity and diet related diseases in this region. Poverty levels persist in rural areas of the Appalachian region while they improve throughout the rest of the United States. As this further perpetuates food insecurity in rural Appalachia, it is critical to identify culturally sensitive solutions to food insecurity. Utilizing Community Health Workers (CHWs), lay members of the community who have deep understanding of the communities they live in and serve, may be the answer to this problem. …

The Effect On Incorporating Fresh Fruits And Vegetables Into An Emergency Food Box Program In Rural Appalachia Kentucky, Zixuan Li

Theses and Dissertations--Nutrition and Food Systems

About 1 in 8 Kentuckians experiencing food insecurity. Low-income Appalachian Kentuckians often utilize food assistance programs and community resources to obtain food and they have lack regular access to fresh food, especially fruits and vegetables. Of concern is nutrition quality and the ability to use food items. The study aimed to explore if and how low-income Appalachian Kentuckians living in a food desert utilized their standard food pantry box as well as a supplemental box of free fresh produce. The study was done through distribution of supplemental fruit and vegetable boxes along with their emergency food box seven different times …

Pilot Study: The Role Of Online Grocery Shopping In Meal Planning & Prepartion: Utilizing Text Message Based Behavioral Nudges, Brittany Nikole Cox

Theses and Dissertations--Nutrition and Food Systems

Purpose: To examine if an online grocery shopping intervention improves meal planning and preparation and subsequent dietary intake. The primary hypothesis was that online shopping can improve meal planning and meal preparation habits while also improving dietary intake.

Method: Participants were randomized to either online only (O), online plus nutritional nudges (O+I), or standard brick and mortar (BM). Those in the O+I arm received behavioral nudges three (3) times per week and were part of a Facebook group assisting them with meal planning, nutrition education, and reminders to shop online. The O arm only received reminders to shop online, and …

Policy Implications Of The Covid-19 Pandemic On Food Security In Rural America: Evidence From Appalachia, Kathryn M. Cardarelli, Emily M. Dewitt, Rachel Gillespie, Rachel Hogg-Graham, Heather Norman-Burgdolf, Janet T. Mullins

Dietetics and Human Nutrition Faculty Publications

Rural communities are disproportionally affected by food insecurity, making them vulnerable to the consequences of supply disruptions caused by the COVID-19 pandemic. While access to food was initially diminished due to food supply disruptions, little is known about the mechanisms through which federal emergency assistance programs impacted food access in rural populations. Through a series of five focus groups in spring 2021, we examined the impact of the COVID-19 pandemic on food access in a rural Appalachian community in Kentucky. Data were analyzed using a Grounded Theory Approach. Findings revealed the following four primary themes: food scarcity in grocery stores; …

Sugar-Sweetened Beverage Consumption Among Adults In Rural Appalachia, Heather Norman-Burgdolf, Emily M. Dewitt, Kathryn M. Cardarelli, Rachel Gillespie, Stacey A. Slone, Alison A. Gustafson

Dietetics and Human Nutrition Faculty Publications

Sugar-sweetened beverage (SSB) consumption is decreasing nationally, yet intakes remain high in certain sub-populations as new varieties of SSBs are introduced. This study aims to expand on SSB intake patterns among adults living in Appalachia to develop policy, systems, and environmental (PSE) interventions to reduce consumption. Baseline cohort surveys were conducted to examine beverage consumption patterns of adults in one rural Appalachian county in Kentucky using a validated BEVQ-15 instrument. Ages were collapsed into three generational groups – Millennials (22–38 years), Generation X (39–54 years), and Boomers/Silents (≥55 years). Over half (n = 81; 54%) of the sample (n = …

Integrating Policies, Systems, And Environments (Pse) Work Into Fcs Extension Programming: Lessons Learned From A Multi-State Training, Lisa T. Washburn, Heather Norman-Burgdolf, Karen L. Franck, Lauren E. Kennedy, Christopher T. Sneed

Dietetics and Human Nutrition Faculty Publications

Public health efforts have emphasized changes to policies, systems and environments (PSEs) to improve health behaviors for individuals and communities. Extension has increasingly emphasized these approaches, particularly for work of Family and Consumer Sciences (FCS) agents. In part, this emphasis on PSEs in Extension has been driven by SNAP-Ed and other federally funded initiatives, such as the Centers for Disease Control and Prevention (CDC) High Obesity Programs (HOP). However, broader adoption and implementation of PSEs at the local level has lagged in some states for various reasons. These include limited understanding about PSE interventions and how this work fits with …

“We’Re, Like, The Most Unhealthy People In The Country”: Employing An Equity Lens To Reduce Barriers To Healthy Food Access In Rural Appalachia, Kathryn Cardarelli, Emily M. Dewitt, Rachel Gillespie, Heather Norman-Burgdolf, Natalie Jones, Janet Tietyen Mullins

Dietetics and Human Nutrition Faculty Publications

Introduction

Obesity disproportionately affects rural communities, and Appalachia has some of the highest obesity rates in the nation. Successful policy, systems, and environmental (PSE) interventions to reduce obesity must reflect the circumstances of the population. We used a health equity lens to identify barriers and facilitators for healthy food access in Martin County, Kentucky, to design interventions responsive to social, cultural, and historical contexts.

Methods

We conducted 5 focus groups in Martin County, Kentucky, in fall 2019 to obtain perspectives on the local food system and gauge acceptability of PSE interventions. We used grounded theory to identify perceived barriers and …

Qualitative Analysis Of Maternal Barriers And Perceptions To Participation In A Federal Supplemental Nutrition Program In Rural Appalachian North Carolina, Sydeena E. Isaacs, Lenka H. Shriver, Lauren Haldeman

Journal of Appalachian Health

Background: Little is known about barriers to and perceptions of participation in the in Women, Infants, and Children (WIC) program in rural Appalachia.

Purpose: To gain a deeper understanding of maternal barriers and perceptions related to WIC participation in rural Appalachia

Methods: Pregnant women and mothers were recruited in-person and via flyers from WIC offices in three counties in Appalachian North Carolina. Four semi-structured focus groups were conducted between May to July 2018. Each focus group was approximately 60 minutes long and included open-ended questions about the overall WIC experience in rural Appalachia. Focus groups were audio-recorded, transcribed verbatim, and …

Consumption Of Added Sugars By Rural Residents Of Southwest Virginia, Maryam Yuhas, Valisa Hedrick, Jamie Zoellner

Journal of Appalachian Health

Introduction: Nationally, rural residents have high consumption of added sugars, yet the top sources have not been explored. Characterizing added-sugar intake in high sugar-sweetened beverage (SSB) consumers in rural areas is an important step to help inform interventions and policies.

Purpose: The objective of this study was to explore the top food and beverage sources of added sugar and to examine variations by sociodemographic characteristics.

Methods: This cross-sectional study analyzed data from a randomized-controlled trial to reduce SSB in eight rural Appalachian counties. Data were obtained from baseline demographic surveys and three 24-hour dietary recalls. Dietary analyses included deriving AS …

A Nutritional And Environmental Analysis Of Local Food Pantries Accessible To College Students In Rural North Carolina, Emily E. Frymark, Jonathon Stickford, Alisha Farris

Journal of Appalachian Health

Introduction: Food insecurity is a growing concern among college students and is especially prevalent in rural areas. Food pantries often serve as a resource to food insecure individuals yet, their policies, standards, and nutritional quality vary due to the unpredictability of food donations.

Purpose: To examine the nutritional quality of food items and adherence of best practices at local food pantries accessible to college students near a university in rural Appalachia.

Methods: Three food pantries in North Carolina were selected due to their proximity to a local, rural university. Food items were analyzed for nutrient and food …

Evaluating The Experiences Of Fcs Cooperative Extension Agents Use Of Policy, Systems And Environmental Strategies To Reduce Obesity In Rural Counties, Jordan Lynn Bressler

Theses and Dissertations--Nutrition and Food Systems

High rates of obesity are seen across the country with rural areas disproportionately affected. Based on the socio-ecological model, policy, system, and environmental approaches targeted at the population level have the potential to create more sustainable health behavior change than individual level approaches. Historically, the Cooperative Extension Service (CES) has provided direct education related to healthy eating and active living in response to high obesity rates. Utilizing the resources and infrastructure of the CES, the Centers for Disease Control challenged CESs across the country to implement PSE strategies in counties with obesity rates greater than 40% through the CDC 1416 …

The Utilization Of Technology As An Approach To Improve Meal Planning And Dietary Intake, Alexa Lauren Kuziel

Theses and Dissertations--Nutrition and Food Systems

The prevalence of obesity is rising in the United States and one factor that contributes to it is the lack of cooking at home and planning out meals. Since text messaging is now a main avenue of communication, it could be used to motivate people to plan out their meals and cook at home instead of consuming fast food. Current research on how weekly nudges might relate to peoples’ goals about meal preparation and dietary intake is very limited. The purpose of this study was to examine if sending weekly nudges, focusing on specific dietary goals, improves meal planning and …

Cultural Sensitivity In Cooperative Extension Nutrition Education Programming In Kentucky, Anna Caroline Durr

Theses and Dissertations--Nutrition and Food Systems

The purpose of this mixed methods study was to learn how cultural sensitivity was integrated and perceived in community nutrition education of an existing program offered by the University of Kentucky Cooperative Extension Service Nutrition Education Program. Data collection consisted of a quantitative cultural competence assessment survey tool used with nutrition education paraprofessionals (n=74), qualitative in-depth interviews of nutrition education paraprofessionals (n=8) and focus groups of Hispanic/Latino nutrition education program participants (n=39). Findings were focused in three areas; the cultural sensitivity needs of the program, the perception of nutrition education by participants and the training and professional development needs of …

Promoting Healthy Eating And Physical Activity: A Qualitative Examination Of Community-Based Obesity Interventions In Rural Kentucky, Brooke F. Butterworth

Theses and Dissertations--Nutrition and Food Systems

Rural Americans are medically underserved groups and are at greater risk of becoming obese than urban Americans. The purpose of this qualitative study was to determine the perceived causes of obesity in six counties of rural Kentucky and to determine how to customize strategies to reduce obesity in these areas. University of Kentucky Cooperative Extension Service Agents formed coalitions in each of the six counties to assess their communities’ needs and assets to inform plans for implementing evidence-based obesity interventions. Between February and August of 2015, the coalitions were convened for a total of 11 meetings. Each of the coalition …

Associations Between Consumption Of Fruits And Vegetables Among Older Consumers And Farmers Market Shopping, Shu-Feng Tsao

Theses and Dissertations--Nutrition and Food Systems

The number of farmers’ markets in the United States has increased over 300% in past two decades. Many studies have also shown a positive association between an increased access to farmers’ markets and consumption of fruits and vegetables. However, few studies have explored relationships between older consumers aged 55+ whose fruit and vegetable consumption and their attendance at farmers’ markets. In Taiwan, no previous studies regarding farmers’ markets had been conducted from nutritional perspectives. The aims of this study were to determine general characteristics of farmers’ markets shoppers and their perceptions regarding the markets in Lexington, Kentucky and Taipei City, …

Adaptability In A Bhutanese Refugee Community: Navigating Integration And The Impacts On Nutritional Health After U.S. Resettlement, Chris Grosh

Theses and Dissertations--Anthropology

Increasing rates of overweight, obesity, and related metabolic diseases documented among refugee communities across the United States necessitate greater attention to how processes of integration impact refugee health. These nutritional health trends (e.g., increasing rates of obesity) suggest potential disconnects between refugees' past environments and their conditions after re-settlement, which may contribute to adverse changes in energy balance (diet and exercise). While Bhutanese refugees were among the largest refugee groups entering the US during the five years leading up to this research, very few studies have examined how they have responded to integration and the impact of this transition on …

The Perceptions, Knowledge, Benefits And Barriers Of Hispanics Regarding The Dietary Guidelines For Americans, Luisyana De Amor Gamboa

Theses and Dissertations--Nutrition and Food Systems

Background: Hispanics are the largest minority group in the U.S. and by the year 2060 the number of Hispanics is projected to double. They are disproportionately affected by obesity and chronic diseases which translate into decreased quality of life, loss of work opportunities and perceptions of injustice for the Hispanic population. The Dietary Guidelines (DG) provide information to help Americans make healthy food and physical activity choices and if followed can be a means of reducing the health disparity gap. However, culturally relevant recommendations specific to Hispanics’ health and nutritional habits are often lacking. The purpose of this study was …

The Role And Impact Of Cooperative Extension In Diabetes Self-Management Education, Brittany Michelle Murray

Theses and Dissertations--Nutrition and Food Systems

Diabetes is increasing globally and nationally. Diabetes complications and costs can be reduced through modification of lifestyle risks and diabetes self-management education (DSME). The Cooperative Extension System (CES) is uniquely positioned to implement DSME. This study assessed the role and impact of the Cooperative Extension System (CES) in DSME. A survey was sent to CES professionals throughout the U.S. a total of 43 participants provided information on 73 DSME programs. Most participants were from the South (n=22, 51.16%) and Midwest (n=12, 27.91%) and most programs targeted adults with and at risk for type 2 diabetes. Most programs were developed and …

Kentucky Wic Participants’ Knowledge, Attitudes, And Beliefs Regarding Grains, Dustin Tyler Reed

Theses and Dissertations--Nutrition and Food Systems

Obesity, diabetes, cardiovascular disease, and poor dietary habits are major healthcare problems in the United States. These issues are especially prevalent in the state of Kentucky and among at-risk populations such as Women, Infants, and Children (WIC) participants. Studies have found that whole grains play a role in weight maintenance, protection against type 2 diabetes, and lowering cholesterol. Interventions aimed at improving WIC participant dietary behavior and intake has been successful as well. This study assessed Kentucky WIC participants’ knowledge of the benefits of consuming grains, attitudes and beliefs regarding food purchasing and grains, and identified grains consumed in a …

Obesity Related Perceptions And Practices Among Educators In The Expanded Food And Nutrition Education Program, Poonam Mahajan

Theses and Dissertations--Nutrition and Food Systems

Childhood obesity has increased significantly in the past decade. The same factors putting adults at risk for obesity apply to children as well. For children, the family environment may be one of the largest factors. Obesity affects both adults and children of low socioeconomic status. It also affects families living in the Appalachian region of the United States more frequently than other regions. The purpose of this study was to examine the relationships between obesity related behaviors and nutrition education among Appalachian participants in the Expanded Food and Nutrition Education Program (EFNEP). For this study eleven educators from the Appalachian …