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Sanchez SO, Funderburk K, Reznicek E, Parmer SM, Hinnant JB. Impact of School Gardens on Nutrition Education Among Limited-Income Communities in Alabama. THE JOURNAL OF SCHOOL HEALTH 2024. [PMID: 39460463 DOI: 10.1111/josh.13513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 08/26/2024] [Accepted: 08/28/2024] [Indexed: 10/28/2024]
Abstract
BACKGROUND We sought to determine the impact of school gardens and nutrition education on student fruit and vegetable consumption from limited-income communities in Alabama. METHODS Third grade students at 99 Alabama schools with and without gardens on-site were randomized to receive either nutrition education or to a wait-list control group. Multi-level models were used to assess the effects of treatment and control with and without school gardens. RESULTS Students attending schools with gardens demonstrated highest consumption of fruits and vegetables prior to treatment. Nutrition education alone translated into significant dietary improvements. Both gardens and education translated into greatest dietary improvements. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Devising financially accessible, practical, and culturally relevant ways to improve student health through garden and nutrition education may help improve student diet. Forming comprehensive Extension, SNAP-Ed, and school collaboration to support gardens, nutrition education, and healthy school policies and systems can be a way to support and sustain healthy student learning environments. CONCLUSIONS Combined gardening and nutrition education is associated with increases in fruit and vegetable consumption among majority rural, Southern students from limited-resource communities.
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Affiliation(s)
- Sofia O Sanchez
- Alabama Cooperative Extension System, Supplemental Nutrition Assistance Program-Education, 208 Duncan Hall, Alabama Cooperative Extension System at Auburn University, 36849, AL
| | - Katie Funderburk
- Alabama Cooperative Extension System, Supplemental Nutrition Assistance Program-Education, 205 Duncan Hall, Auburn University, 36849, AL
| | - Erin Reznicek
- Alabama Cooperative Extension System, Supplemental Nutrition Assistance Program-Education, 206 Duncan Hall, Auburn University, 36849, AL
| | - Sondra M Parmer
- Alabama Cooperative Extension System, Supplemental Nutrition Assistance Program - Education, 201 Duncan Hall, Auburn University, Auburn, 36849, AL
| | - J B Hinnant
- College of Human Sciences, Human Development & Family Science, 288 Spidle Hall, Auburn University, 36849, AL
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Cran S, Cihon TM, Borba A, Kazaoka K, Smith M. A Pilot Study Exploring Practices that Support the Longevity of Community Gardens Supported by Religious Organizations. BEHAVIOR AND SOCIAL ISSUES 2023; 32:1-37. [PMID: 38625135 PMCID: PMC10177712 DOI: 10.1007/s42822-023-00124-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 04/17/2024]
Abstract
Current food production methods in the United States (US) contribute to environmental degradation as well as food insecurity. Food production by means of community gardens has the potential to reduce the deleterious effects of current production methods. However, many community gardens face challenges that hinder their longevity, thereby reducing the likelihood of the support they might provide for environmentally sustainable food production and decreased food insecurity for community members. Researchers conducted a literature review regarding best practices for community gardens, and used ethnographic research methods to inform a culturo-behavioral systems analysis using the Total Performance System and matrix (systems interdependency) analysis to better understand the cultural practices of two established community gardens in the southwest region of the US. The results of the analyses are presented in terms of recommendations to support each community garden's sustainability. Recommendations regarding future research include environmental manipulations to identify functional relations and potential outcome measures for improving the longevity of community gardens. Supplementary Information The online version contains supplementary material available at 10.1007/s42822-023-00124-7.
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Lee RE, Szeszulski J, Lorenzo E, Arriola A, Bruening M, Estabrooks PA, Hill JL, O'Connor TM, Shaibi GQ, Soltero EG, Todd M. Sustainability via Active Garden Education: The Sustainability Action Plan Model and Process. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5511. [PMID: 35564909 PMCID: PMC9102810 DOI: 10.3390/ijerph19095511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/16/2022] [Accepted: 04/27/2022] [Indexed: 02/06/2023]
Abstract
Sustainability of intervention programming is challenging to achieve under real world conditions, since few models exist and many studies do not plan far beyond the funding period. Programming content in early care and education centers (ECECs) is often driven by guidelines. However, implementation is very sensitive to contextual factors, such as the setting and implementer (teacher) characteristics. This paper presents the model, definitions, and methodology used for the sustainability action plan capitalizing on a community-based participatory research (CBPR) approach, developed for a multi-site, multi-level garden-based childhood obesity prevention study, Sustainability via Active Garden Education (SAGE). The Ecologic Model of Obesity is applied to develop a sustainability action plan (SAP) and accompanying measures to link early care and education (ECE) environment, the community, policies, and classroom practices to an early childhood obesity prevention program. The SAGE SAP provides an example of how to iteratively evaluate and refine sustainability processes for an obesity prevention intervention utilizing CBPR approaches and will be applied to assess the sustainability of SAGE in a cluster randomized controlled trial. This SAP model can also help inform intervention delivery and scalability within ECECs.
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Affiliation(s)
- Rebecca E Lee
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd St., Phoenix, AZ 85004, USA
| | - Jacob Szeszulski
- Institute for Advancing Health through Agriculture (IHA), Texas A&M AgriLife Research, 17360 Coit Rd., Dallas, TX 75252, USA
| | - Elizabeth Lorenzo
- School of Nursing, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA
| | - Anel Arriola
- City of Phoenix Office of Arts and Culture, 200 W. Washington St., 10th Floor, Phoenix, AZ 85003, USA
| | - Meg Bruening
- College of Health Solutions, Arizona State University, 550 N. 3rd St., Phoenix, AZ 85004, USA
| | - Paul A Estabrooks
- College of Health, University of Utah, 260 1850 E, Salt Lake City, UT 84112, USA
| | - Jennie L Hill
- Population Health Sciences, University of Utah, 295 S Chipeta Way, Salt Lake City, UT 84108, USA
| | - Teresia M O'Connor
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd St., Phoenix, AZ 85004, USA
| | - Erica G Soltero
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd St., Phoenix, AZ 85004, USA
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Yi SS, Lee M, Russo R, Li Y, Trinh-Shevrin C, Kwon SC. Dietary Policies and Programs: Moving Beyond Efficacy and Into "Real-World" Settings. Health Equity 2021; 5:194-202. [PMID: 33937605 PMCID: PMC8080927 DOI: 10.1089/heq.2020.0050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2020] [Indexed: 12/19/2022] Open
Abstract
Purpose: Dietary behaviors are key modifiable risk factors in averting cardiovascular disease (CVD), the leading cause of morbidity, mortality, and disability in the United States. Before investing in adoption and implementation, community-based organizations, public health practitioners, and policymakers—often working with limited resources—need to compare the population health impacts of different food policies and programs to determine priorities, build capacity, and maximize resources. Numerous reports, reviews, and policy briefs have synthesized across evidence-based policies and programs to make recommendations, but few have made a deep acknowledgment that dietary policies and programs are not implemented in a vacuum, and that “real-world” settings are complex, multifaceted and dynamic. Methods: A narrative review was conducted of currently recommended evidence-based approaches to improving dietary behaviors, to describe and characterize applied and practical factors for consideration when adopting and implementing these dietary policies and programs across diverse settings. Results: From the narrative review, six key considerations emerged to guide community-based organizations, public health practitioners, and policymakers on moving from the evidence base, toward implementation in local and community settings. Conclusions: Considerations of “real-world” contextual factors are necessary and important when adopting and selecting evidence-based policies and programs to improve dietary behaviors and ultimately improve CVD outcomes. Promising approaches include those that apply community-partnered research and systems science to examine the equitable implementation of evidence-based dietary policies and programs.
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Affiliation(s)
- Stella S Yi
- Department of Population Health, NYU School of Medicine, New York, New York, USA
| | - Matthew Lee
- Department of Population Health, NYU School of Medicine, New York, New York, USA.,Department of Sociomedical Sciences, Columbia Mailman School of Public Health, New York, New York, USA
| | - Rienna Russo
- Department of Population Health, NYU School of Medicine, New York, New York, USA
| | - Yan Li
- Department of Population Health Science and Policy, Mt. Sinai Icahn School of Medicine, New York, New York, USA
| | - Chau Trinh-Shevrin
- Department of Population Health, NYU School of Medicine, New York, New York, USA
| | - Simona C Kwon
- Department of Population Health, NYU School of Medicine, New York, New York, USA
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Implementation of a Multi-Component School Lunch Environmental Change Intervention to Improve Child Fruit and Vegetable Intake: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113971. [PMID: 32503325 PMCID: PMC7312556 DOI: 10.3390/ijerph17113971] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/24/2020] [Accepted: 06/01/2020] [Indexed: 11/23/2022]
Abstract
Nudge interventions are widely used to promote health in schools, yet implementation metrics are seldom used to understand intervention outcomes. A multi-component intervention consisting of cafeteria decorations, creative names, social norming taste tests, and flavor station components was implemented in three rural elementary school cafeterias by school nutrition services (SNS) and extension staff. Selection and consumption of fruits and vegetables at lunch were measured through monthly plate waste assessments over eight months (n = 1255 trays). Interviews were conducted with SNS staff (n = 3) upon completion of the intervention to assess implementation outcomes using validated acceptability and feasibility metrics. Consumption findings were generally inconsistent across schools and time points, yet fruit consumption increased at School 1 (p < 0.05) during the taste test and flavor station intervention months and School 2 (p < 0.001) during the creative names intervention months compared to baseline. Odds of selecting a vegetable at School 3 were three times higher than baseline during the taste test intervention months (odds ratio (OR), 3.0; 95% confidence interval (CI), 1.3–6.5). Cafeteria decorations and taste tests had higher reported implementation metrics for acceptability and feasibility than other interventions. Thematic analysis underscored the facilitating role of extension support, as well as systems factors, which served as facilitators and barriers across schools and interventions. These findings suggest that nudge interventions are a promising strategy to improve vegetable selection and fruit consumption in school meal programs.
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