Schools are an ideal setting to improve child nutrition and food security and are critical environments in which to implement policy, systems, and environmental (PSE) public health interventions. Federal mandates for the Supplemental Nutrition Assistance Program-Education, known as CalFresh Healthy Living in California, require PSE interventions for obesity prevention efforts combined with direct and indirect education interventions. Researchers at the University of California Division of Agriculture and Natural Resources, Nutrition Policy Institute developed a new method to evaluate the ‘dose' score of complex and multicomponent SNAP-Ed interventions in schools, which can then be linked to student health outcomes. The method also proposes how to calculate dose scores for different intervention categories, including direct education, PSE, garden-based interventions, and physical education. This novel evaluation method can be used in future SNAP-Ed evaluations to inform practitioners and policymakers about the most promising school-based public health interventions to support children's health. The proposed method was published in the American Journal of Evaluation. Study authors include researchers from the NPI CalFresh Healthy Living evaluation team, Sridharshi Hewawitharana, Janice Kao, Carolyn Rider, Evan Talmage, Karen Webb, Wendi Gosliner, and Gail Woodward-Lopez, and Sadie Costello from UC Berkeley.
The California Nutrition Incentive Program (CNIP) provides CalFresh shoppers a dollar-for-dollar match when purchasing California-grown fruits and vegetables at participating Certified Farmers Markets and small food stores. Over 4.6 million Californians with low-income receive money to spend on food through CalFresh, also known as the federal Supplemental Nutrition Assistance Program (SNAP). Nutrition Policy Institute (NPI) researchers conducted an evaluation of the CNIP program operating at California farmers' markets in 2018. Interviews were conducted with 386 CalFresh shoppers from ten farmers' markets offering maximum incentives ranging from $0 to $20, and from nine nearby supermarkets not offering incentives. Researchers found that CalFresh CNIP shoppers who reported using more of the match incentive reported lower levels of food insecurity. Additionally, farmers' market shoppers consumed more fruits and vegetables than supermarket shoppers, though no differences in consumption were found between CNIP and non-CNIP shoppers. Program participants expressed consistent and overwhelmingly positive appreciation for the CNIP program. “I'm eating better because I can afford to get fresh food, fresh vegetables and fruit that I wouldn't get otherwise,” said one CalFresh shopper about the CNIP program, “It gives me a chance to taste and to eat foods that I might not otherwise be exposed to, and foods that I wouldn't feel like I could afford." Despite the overwhelming support for the CNIP program from those using it, researchers found that fewer than one-in-five supermarket shoppers were aware of the CNIP program; after learning about CNIP, nearly all said they would be likely to use it. Findings from the evaluation are available in an online research brief. The research was led by NPI researchers Wendi Gosliner, Ron Strochlic, and Sridharshi Hewawitharana and included UC Berkeley graduate student researchers Celeste Felix and Caroline Long. The evaluation was funded by the California Department of Food and Agriculture.
The American Public Health Association (APHA) Annual Meeting and Expo is the largest yearly gathering of public health professionals. This year, the annual meeting is being held virtually October 24-28, 2020. Researchers from the University of California, Division of Agriculture and Natural Resources, Nutrition Policy Institute will be presenting their work on a variety of collaborative food and nutrition policy studies related to the child care food environment, school meals, the federal Supplemental Program for Women, Infants and Children (WIC), and more. A full list of on-demand poster presentations and live oral presentations is below.
Child care food environment:
- California childcare centers and homes in the federal child and adult care food program offer more nutritious foods to infants
Presenters: Danielle Lee, Klara Gurzo, Lilly Nhan, Elyse Homel Vitale, Sallie Yoshida, Lorrene Ritchie
Poster presentation - Online training increases child care provider knowledge of healthy beverage policy and practices for young children
Presenters: Kaela Plank, Danielle Lee, Abbey Alkon, Marisa Neelon, L. Karina Diaz Rios, Katherine Soule, Lorrene Ritchie
Poster presentation
School meals:
- Impact of a district-wide chocolate milk removal policy on students' milk selection and consumption
Presenters: Hannah Thompson, Lorrene Ritchie, Kristine Madsen, Esther Park, Wendi Gosliner
Oral presentation, Wednesday, October 28, 2020, 8:15-8:30 AM PDT
WIC:
- Families with children 1-5 years old: WIC program perspectives on nutrition education and food benefits
Presenters: Marisa Tsai, Lorrene Ritchie, Shannon Whaley, Catherine Martinez, Martha Meza, Lauren Au, Hallie Randel-Schreiber, Susan Sabatier
Oral presentation, Wednesday, October 28, 2020, 8:00-8:15 AM PDT - Children on WIC followed through age 4 years: What are they eating?
Presenters: Lorrene Ritchie, Lauren Au, Shannon Whaley, Christine Borger
Oral presentation, Wednesday, October 28, 2020, 9:30-9:50 AM PDT - Feeding beliefs and practices among low-income caregivers: Findings from year 4 of the WIC infant and toddler feeding practices study-2
Presenters: Courtney Paolicelli, Christine Borger, Lorrene Ritchie, Shannon Whaley
Oral presentation, Wednesday, October 28, 2020, 9:50-10:10 AM PDT
- Prevalence of overweight and obesity among children receiving WIC
Presenters: Christine Borger, Shannon Whaley, Lorrene Ritchie
Oral presentation, Wednesday, October 28, 2020, 10:10-10:30 AM PDT - Longer participation in WIC is associated with healthier outcomes for children at age 4 years
Presenters: Shannon Whaley, Christine Borger, Lauren Au, Lorrene Ritchie
Oral presentation, Wednesday, October 28, 2020, 10:30-10:50 AM PDT
Other topics:
- Exploring housing and food insecurity among California university students: A holistic and comprehensive definition of students' basic needs
Presenters: Suzanna Martinez, Erin Esaryk, Laurel Moffat, Lorrene Ritchie
Oral presentation, Tuesday, October 27, 12:00-12:15 PM PDT - Healthy default beverages in kids' meals: Evaluating policy implementation and impact in California and Delaware
Presenters: Allison Karpyn, Wendi Gosliner, Laura Lessard, Kathleen McCallops, Marisa Tsai, Tara Tracy, Phoebe Harpainter, Danielle Lee, Anna Martin, Lorrene Ritchie, Gail Woodward-Lopez
Oral presentation, Tuesday, October 27, 4:45-5:00 PM PDT - Perceived produce availability and child fruit and vegetable intake: The healthy communities study
Presenters: Laurel Moffat, Lorrene Ritchie, Wendi Gosliner, Kaela Plank, Lauren Au
Oral presentation, Wednesday, October 28, 2020, 10:15-10:30 AM PDT - Limited progress found in healthy checkout among food stores in economically disadvantaged California neighborhoods, 2011-2017
Presenters: Wendi Gosliner, Sriddharshi Hewawitharana, Janice Kao, Sadie Costello, Gail Woodward-Lopez
Poster presentation - A replication study of school-based SNAP-ed programmatic efforts to address student nutrition and physical activity outcomes
Presenters: John Pugliese, Lauren Whetstone, Sridharshi Hewawitharana, Gail Woodward-Lopez
Poster presentation
- Author: Danielle L. Lee
Daily physical activity supports youth physical and phychosocial health and is also important for obesity prevention. Schools are an important location for physical activity promotion and obesity prevention given youth spend up to half of their waking hours in school. The latest study from Nutrition Policy Institute (NPI) researchers suggests that United States Department of Agriculture (USDA) Supplemental Nutrition Assistance Program Education (SNAP-Ed, and known asCalFresh Healthy Living (CFHL) in California) physical activity interventions at school-sites are associated with slightly lower body mass index (BMI) and greater cardiovascular fitness in students compared to sites that did not receive these interventions. Further, schools with higher intervention levels had students with the highest cardiovascular fitness levels. Interventions included physical activity-related direct education, where students were actively engaged with an educator; indirect education, where students received information or resources related to physical activity; or changes to the school or district's physical activity related policies, systems, and/or environments (PSE). Student-level FitnessGram(R) data from between 2015-2016 was obtained from the California Department of Education for the study. Researchers compared BMI and student cardiovascular fitness levels from over 97,000 fifth and seventh grade students from 904 California public schools that implemented the SNAP-Ed physical activity interventions to over 372,000 fifth and seventh grade students from 3,506 California public schools that did not implement the interventions. These findings are important as the California Department of Public Health's Nutrition Education and Obesity Prevention Branch distributes over $50 million in CFHL funding to local health departments to implement physical activity and nutrition interventions, which primarily occur in the public school setting. Also, California has more public schools than any other US state. The study was published online in the journal Preventive Medicine Reports. The study was conducted by NPI's Hannah Thompson, Sridharshi Hewawitharana, Janice Kao, Carolyn Rider, Evan Talmage, Wendi Gosliner and Gail Woodward-Lopez in collaboration with Lauren Whetstone of the California Department of Public Health. The study was funded by the California Department of Public Health, with funding from the USDA Supplemental Nutrition Assistance Program. The full study is available online.
- Author: Danielle L. Lee
A recent study by Nutrition Policy Institute (NPI) researchers assessed differences in quick-service, or fast-food, restaurants with and without voluntary healthy default beverage standards for kids' meals. ‘Voluntary standards' are restaurant commitments to offer healthier drinks with kids' meals. Researchers evaluated the beverages shown on kids' meal menu boards, beverages offered by cashiers with kids' meals, and kids meal beverages selected by customers in 111 quick-service restaurants--70 with voluntary standards and 41 without--in SNAP-Ed eligible neighborhoods in 11 California counties. Data was collected by menu board and cashier order observations and customer surveys in December 2018 prior to the January 2019 implementation of a new California law (SB-1192) that requires all restaurants offering a kids' meal make the default beverage offered water, unflavored milk or a nondairy milk alternative and that only these beverages be displayed on kids' meal menus or advertisements.
Results from the study showed that significantly more quick-service restaurants with voluntary healthy default beverage standards for kids' meals offered unflavored milk or water on their menu boards compared to restaurants without voluntary standards. Customers at restaurants with voluntary standards reported purchasing healthier drinks and less soda compared with customers at restaurants without voluntary standards. These results suggest the voluntary healthy default beverage standards were effective at positively influencing restaurant practices and customer behavior. However, not all quick-service restaurants followed their own standards and much room for improvement remains. Additional intervention may be necessary to support full implementation of the standards and to maximize the impact on customer behavior and jurisdictions passing healthy default beverage laws for restaurant kids' meals may need to provide education and outreach alongside enforcement to ensure full implementation. The study was published online on July 22, 2020 in the International Journal of Environmental Research and Public Health by NPI researchers Phoebe Harpainter, Sridharshi Hewawitharana, Danielle Lee, Anna Martin, Wendi Gosliner, Lorrene Ritchie and Gail Woodward-Lopez. Read the full study online.