Objective Targeted and effective curricula for older adults are needed for nutrition education practitioners to mitigate negative health outcomes. The objective of this evaluation is to determine the effectiveness of Healthy Eating and Staying Active as We Age (HESA). Use of Theory or Research Healthy Eating and Staying Active as We Age was developed using adult learning theory and dialogue-based approaches. Lessons align with the Dietary Guidelines for Americans and the Physical Activity Guidelines for Americans. Target Audience Adults aged ≥ 60 years. Program Description Healthy Eating and Staying Active as We Age, a 9-lesson educational series, was created for use with older adults. Healthy Eating and Staying Active as We Age focuses on nutrients of interest and corresponding behaviors for older adults, such as decreasing sodium, added sugars, and saturated fat, and increasing fiber and protein consumption. Physical activity to prevent falls and maintain activities of daily living is also included. Evaluation Methods Prepost questionnaires were completed by participants. Paired samples t tests were used to determine differences in key outcomes from preintervention to postintervention participation. Repeated measures analysis of variance tests were used to determine differences in behavior change between age groups (60–74, 75–84, and 85–99 years) to determine if HESA was effective across the older adult life span and by implementation modality (in person, phone, and online). Results There were statistically significant improvements from pre to post participation in mean self-reported behaviors for outcomes of interest. There were no statistically significant differences by age group. Participants improved in behaviors of interest regardless of modality, but larger gains were reported by phone participants compared with in-person groups for fruit, vegetable, and whole grain consumption (P < 0.001). Respondents aged > 70 gt; 70 years and those residing in rural areas were most likely to participate in HESA via phone. Conclusions Healthy Eating and Staying Active as We Age is an effective curriculum that can be used across older adult age groups and is adaptable to different modalities. Phone participants may have experienced greater gains because of the one-on-one nature of the education provided compared to in person, group-based programming. Cooperative Extension, public health, and community nutrition educators can consider using HESA to promote healthy aging among their older adult participants. Funding Supplemental Nutrition Assistance Program-Education

Healthy food retail initiatives have been common approaches to promote nutrition security in the U.S.; however, they have under-emphasized planetary health promotion, despite the close connections of healthy earth systems to ensuring nutrition security. The purpose of this study was to explore the perceptions of independent food retail owners and managers about their role in planetary health promotion, identify potential planetary health promotion practices, and describe barriers and facilita tors to implementation. Twelve semi-structured interviews, informed by the Consolidated Framework for Implementation Research (CFIR) 2.0, were conducted with independent groceries, cooperatives, and on-farm store members of Virginia Fresh Match, a statewide fruit and vegetable incentive food retailer network. Descriptive inductive codes and a priori barrier and facilitator codes from CFIR constructs were used by two independent coders to describe and categorize the data. Results showed that retailers had a range of interest in planetary health promotion, with cooperatives including planetary health in all business decisions, farm stores primarily focusing on agricultural practices, and grocers most interested in those practices that aligned with profit potential and customer expectations. Among all retailers, amenability to planetary health practices varied by community context. Planetary health practices included: agricultural practices of suppliers, bulk offerings, energy usage, food miles, local foods, animal source protein reduction, and waste reduction. Profit potential and alignment with customer expectations were the most important consideration for retailers to implement any planetary health practice and were barriers and facilitators depending on practice and community context. Partnerships and other external supports were identified as facilitators for planetary health promotion. The results can inform future research that investigates differences in retailer-preferred practices across contexts, explorations of how to frame planetary health messages to align with customer expectations, and tailoring of implementation strategies.

Background The Supplemental Nutrition Assistance Program-Education (SNAP-Ed), a state-administered, evidence-based nutrition education and obesity prevention program with positive food and nutrition outcomes for individuals and families with low income, was abruptly defunded in July 2025, creating uncertainties for implementers, partners, and participants. In Virginia, SNAP-Ed is implemented by the Virginia Cooperative Extension Family Nutrition Program using multiple approaches, including volunteer-led nutrition education and policy, systems, and environmental (PSE) change initiatives. The Supplemental Nutrition Assistance Program-Education will sunset September 30, 2026. Objective To explore the accomplishments of SNAP-Ed in Virginia, the impacts of SNAP-Ed defunding, strategies to sustain SNAP-Ed activities, and anticipated future impacts. Study Design, Setting, Participants Using a purposive sampling approach, 15 SNAP-Ed agents and 7 SNAP-Ed partners (n = 22) were interviewed on Zoom from August through October 2025. In-depth semistructured interview guides were used to assess SNAP-Ed implementer experiences and recommendations for the sustainability of SNAP-Ed initiatives. Measurable Outcome/Analysis Two independent coders conducted an inductive qualitative thematic analysis of interview transcripts to determine the main themes of SNAP-Ed defunding emerging from the interviews. Areas of disagreement were resolved by 2 additional researchers. Final themes were agreed on by all the 4 researchers. Results Overarching themes were (1) accomplishments of SNAP-Ed, including long-term development and training of staff and capacity building for PSE initiatives; (2) opportunities to sustain specialized SNAP-Ed work, including sharing SNAP-Ed tools and resources with partners; (3) defunding occurred within a context of other program funding cuts, resulting in compounded impacts; (4) negative emotional impacts; and (5) anticipated future risks including losses of institutional knowledge over time. Each theme had multiple subthemes. Participants communicated that without continued and sustained investments in staff, funding, training, and time into implementation platforms such as Extension, the positive and equitable accomplishments of SNAP-Ed may diminish, as noted in this illustrative quote: “I think it’s gonna be a real struggle.” Conclusions Participants identified SNAP-Ed accomplishments and provided recommendations to sustain elements of SNAP-Ed. Without continued investments, the defunding of SNAP-Ed risks future sustainable public health nutrition programming and PSE changes in Virginia. Funding SNAP-Ed

Environmental sustainability is essential for food systems to support population health, yet is under-emphasized in diet-related population health efforts in the United States (U.S.). Corporate food retailers authorized for the Supplemental Nutrition Assistance Program (SNAP) are a meaningful sample for an exploration of environmental sustainability commitments, given their geographic spread and reach across socioeconomic segments of the population. There is no documentation of the landscape of environmental sustainability commitments by corporate SNAP-authorized food retailers to inform integrated population health and environmental sustainability research, practice, and policy. The purpose of this study was to identify the public commitments made by SNAP- authorized food retailers related to environmental sustainability. Corporate SNAP-authorized food retailers were defined as prominent and considered for study inclusion by the number of physical locations nationwide. Supermarkets and groceries were classified as traditional retailers, and all other store formats were non-traditional. Corporate commitments were collected on public facing websites between June- September 2024 as data sources for a content analysis. Commitments to environmental sustainability were categorized into nine relevant United Nations Sustainable Development Goal (SDGs). A total of 48 retailers (n = 13 traditional and n = 35 non-traditional) were included, and 31 retailers had commitments included in the content analysis. The most retailers (n = 31) had commitments related to SDG 12: Responsible Consumption and Production, while few food retailers (n = 7) had commitments related to SDG 3: Good Health and Well-Being. Between 16 and 28 food retailers committed towards five relevant SDGs including: Zero Hunger, Clean Water, Affordable Energy, Climate Action, Life Below Water, Life on Land, and Strong Institutions. Food retailers committed to a range of environmental sustainability topics, representing opportunities for partnerships, future research, and policy action. Developing partnerships for topics of interest to food retailers, like those within SDG 12: Responsible Consumption and Production, may be viable opportunities for public health practitioners.

Background There is a need for cooking-based programs that focus on food resource management skills and nutrition behaviors, especially for caregivers of young children who are eligible for the Supplemental Nutrition Assistance Program. Objective This study aimed to evaluate In the Kitchen, a cooking-based curriculum for income-eligible caregivers of young children, to determine program outcomes using a peer educator model and the impact on behaviors of interest. Potential modifications needed for implementation were also assessed. Study Design, Setting, Participants A mixed-methods evaluation was conducted. To determine the feasibility of implementation for peer educators, 11 peer educators were invited to participate in semistructured interviews. One peer educator did not respond; 10 educators were interviewed. Data from 54 caregivers of children who participated in an In the Kitchen series pilot and completed preintervention and postintervention self-reported questionnaires were included. Measurable Outcome/Analysis Qualitative data were analyzed using a content coding approach by 2 researchers to determine program feasibility. Descriptive statistics were run to determine differences in mean and SD values across behaviors of interest. Responses were on a Likert-type scale. Paired t tests were run to determine differences in self-reported behaviors from preintervention to postintervention participation. A Bonferroni adjustment was used, and the threshold for significance was set at P < 0.003 to account for type I error. Results Results from interviews consisted of 3 themes: new foods and recipes, tailoring the curriculum content, and strong relationships. There were statistically significant increases in caregivers’ behaviors and skills, including spice utilization instead of salt (0.5 ± 1.1) (P < 0.001), confidence using a chef’s knife during meal preparation (0.4 ± 1.2) (P < 0.001), and physical activity duration (0.8 ± 2.5) (P < 0.001). Conclusions In the Kitchen is an effective cooking-based curriculum that resulted in behavior change for SNAP-eligible caregivers. These data demonstrate that it may be an effective curriculum for use by EFNEP or Cooperative Extension. Future studies are needed to determine the impact on stakeholders and adjustments for further behavior change. Funding Supplemental Nutrition Assistance Program

Introduction:Higher education dining services can leverage their institutional food procurement and marketing influence to accelerate and support eating patterns and food environments aligned with planetary health. Although behavioral economics and nudge-based choice architecture offer low-cost tools to shift demand, sector-wide evidence on how university and college foodservice operations apply these marketing-mix choice architecture strategies beyond the lab and trials in dining settings is limited. Methods:We conducted a systematic scoping review (2010-2024) across five databases, Google Scholar, gray literature resources, news articles, media releases, and targeted organizational websites to identify United States higher education institutions applying marketing-mix choice architecture strategies to encourage customers to select plant-rich menu options. We categorized evidence describing higher education institutions and their use of behavior change strategies into eight marketing-mix choice architecture strategy domains: place, profile, portion, pricing, promotion, default picks, priming/prompting, and proximity. Results:The search yielded 363 reports covering 166 higher education institutions located across 36 states and the District of Columbia. Institutions most commonly used profile (96.99%) followed by priming/prompting (45.18%), promotion (39.76%), portion (15.66%), default picks (10.24%), proximity (6.02%), pricing (5.42%), and place (1.20%). Discussion:Our results contribute to the knowledge to practice gap by revealing how higher education institutions have used behavioral economics strategies to encourage sustainable dietary patterns. This study may provide guidance for university decision-makers, campus dining and foodservice management, and researchers aiming to foster sustainable food environments by documenting the interventions that are commonly applied by higher education institutions at scale beyond the lab setting.

Background Sustainable dietary patterns promote individual health; have low environmental impacts; and are accessible, affordable, and equitable. Current US dietary patterns remain misaligned with these goals, highlighting the need for institutional-level action. University students are in a transitional period of their lives during which higher education institutions can instill healthy and sustainable behaviors through supportive food environments. Benchmarking university food environments, policies, and practices can identify opportunities for university leadership to encourage sustainable dietary patterns for students, faculty, and staff. Objective To benchmark the university systems and governance, campus facilities, and food retail environment by piloting the University Food Environment Assessment (Uni-Food) tool at a US university. Study Design, Setting, Participants This study took place at Virginia Tech from 2025 to 2026. We applied participatory research methods in collaboration with undergraduate co-researchers and dining services to assess online evidence describing university policies, programs, and plans, 9 food retail outlets, and 15 vending machines across campus. Measurable Outcome/Analysis We used the Uni-Food tool’s 68 indicators across 16 domains and 3 components to evaluate how the university food environment promoted human nutrition, environmental sustainability, and food equity for the Virginia Tech community. Results Preliminary findings show the university food environment scored a weighted score of 51%, suggesting an overall medium implementation of best practices for sustainable food environments. The preweighted component scores for university systems and governance (49%), campus facilities (55%), and the food retail environment (48%), along with their corresponding subdomains, informed recommendations for policy, systems, and environmental change strategies to improve the campus food environment. Conclusions Universities can be a driver of food system change to support personal and planetary health. There are opportunities for university leadership to develop policy, systems, and environmental change strategies to address the accessibility, availability, price, and promotion of sustainable foods, beverages, and menu options. Nutrition education practitioners and researchers can use the Uni-Food tool to help assess and inform university-level changes that will promote sustainable eating patterns. Funding None

Background As higher education institutions seek to support student success, students with caregiving responsibilities may face unique structural barriers to food access. Caregiving roles and responsibilities may come with increased strain on finances, housing, and time, increasing vulnerability to food insecurity. Objective To examine the association between caregiving status and food insecurity among college students and to identify structural factors that may be associated with this relationship. Study Design, Setting, Participants A cross-sectional survey of university students ata large Southern public university in the US (n = 672). Measurable Outcome/Analysis Food insecurity status as measured by the US Department of Agriculture Household Food Security Survey Module (10-item). Pearson’s chi-square tests assessed bivariate differences. Multivariate logistic regression models estimated odds ratios (OR) and adjusted odds ratios (AOR) with 95% confidence intervals (CI), adjusting for sociodemographic, academic, and food access/housing variables. Results Eleven percent of the students provided care within the past 30 days. Food insecurity was significantly higher among caregivers than noncaregivers (60.00% vs 33.00%, P < 0.001). In unadjusted analysis, caregivers had 3-fold higher odds of food insecurity (OR = 3.05 [95% CI, 1.87–5.03]). The association remained after adjusting for sociodemographic and academic factors (AOR = 3.88 [95% CI, 2.10–7.42] and AOR = 3.28 [95% CI, 1.86–5.94], respectively). However, when food access and housing stability were included, caregiving status was attenuated, while inability to afford a dining plan (AOR = 5.67 [95% CI, 2.70–12.2]), limited meal access within an hour of class (AOR = 5.51 [95% CI, 2.92–10.60]), and risk of housing loss (AOR = 4.38 [95% CI, 2.44–8.09]) were strongly associated with food insecurity. Conclusions Student caregivers experience disproportionately high food insecurity, which is associated with structural barriers to food and housing access. To promote student flourishing through purpose, connection, and community, institutions should seek to strengthen existing programs while addressing systemic food and housing issues and intentionally support caregiving students as vital contributors to campus communities. Funding None

Strategies to promote healthy behaviors among older adults are needed to mitigate vulnerabilities to negative health outcomes, especially for those with low income. Healthy Eating and Staying Active as We Age (HESA), a nine-lesson educational series for Supplemental Nutrition Assistance Program-eligible older adults, was created to promote health among aging audiences. The purpose of this study was to evaluate the behavior change of older adults following participation in HESA, which covers food resource management, nutrition, food safety, and physical activity behaviors, as well as perceived food affordability and accessibility, and to determine if HESA is appropriate across the age span of older adults. Pre- and post-evaluation data from HESA participants were collected at the first and last sessions of the HESA series. Paired samples t-tests were used to determine differences in outcome measures from pre- to post-HESA participation. There were statistically significant improvements in mean self-reported behaviors for all outcomes (p < 0.001). There were no differences in mean self-perceived behavior changes between age groups. Based on these results, HESA is a promising curriculum that addresses key needs among this vulnerable population of older adults.

OBJECTIVE:To assess the mean differences in outcomes of 3 delivery modalities of a nutrition education program targeting older adults. METHODS:A natural experiment was conducted from March 2020 to September 2021, with presurveys and postsurveys used to assess dietary and physical activity behaviors. Results were analyzed using descriptive statistics, t tests, and ANOVA, with a Bonferroni-corrected significance threshold at P < 0.001. RESULTS:There were 3 groups: in-person (n = 212), Zoom (n = 61), and phone (n = 104). Respondents aged > 70 years and in rural areas were more likely to be enrolled in person (P < 0.001). Across all modalities, there were significant improvements from before to after for most outcomes. The phone group reported significantly larger mean differences than the in-person group for fruit, vegetable, and whole grain consumption (P < 0.001). CONCLUSIONS AND IMPLICATIONS:Healthy Eating, Staying Active as We Age can be delivered across all modalities. Future practitioners can use the findings to consider alternative modalities that may better meet the needs of their audience.

In the United States, almost 10% of Americans will experience an eating disorder in their lifetime. Despite evidence that eating disorders occur across socio-economic backgrounds, the stereotypes of eating disorders being a disease of affluence persist. The experience of food insecurity, defined as limited or inconsistent physical and economic access to a sufficient amount and variety of nutritious food needed for a healthy life, is significantly associated with greater eating disorder symptoms. There are several reasons eating disorder symptoms may develop in people experiencing food insecurity, including food/benefit distribution cycles, shame, and weight bias. This Perspective highlights the relationship between food insecurity and eating disorders and provides informed recommendations specific to dietetic practice. Guidance is provided for Registered Dietitian Nutritionists (RDNs) in settings that serve individuals at risk of, or experiencing, food insecurity. RDNs should be informed on best practices for screening for eating disorders and providing appropriate referrals to eating disorder specific care, as well as encouraging realistic, achievable health behaviors, and using non-stigmatizing language.

This report provides an overview of the development of core competencies for implementers of policy, systems, and environmental (PSE) change initiatives within the Supplemental Nutrition Assistance Program Education. The development process included an expert panel of PSE implementers from around the US. The 9 identified duties focused on activities related to community capacity building, assessment, planning, implementation, collaboration, management, reporting and evaluation, information dissemination, and administrative tasks related to PSEs. These competencies can be used to inform recruitment and hiring, training and technical assistance, and assess employee performance.

The White House National Strategy on Hunger, Nutrition, and Health (National Strategy) encourages actions across government and society to promote nutrition security. Nutrition security includes adequate food, diet quality, and equity, and food retail settings can promote these major concepts. Of all National Strategy whole-of-society calls to action, food retailers can contribute to 15 calls as key actors. However, there is currently no standardized monitoring tool to track food retailers' commitments and actions toward the National Strategy to promote nutrition security. The Business Impact Assessment-Obesity and population-level nutrition (BIA-Obesity), a tool originally developed for corporate accountability monitoring, can be tailored for the National Strategy and nutrition security, given its standardized indicators and process to assess food company policies and commitments across six domains. We discuss the fit of the BIA-Obesity indicators for tracking food retailers' commitments and actions across four pillars of the National Strategy. Existing indicators are appropriate to monitor components of Pillar 1: Improve Food Access and Affordability; Pillar 2: Integrate Nutrition and Health; Pillar 3: Empower All Consumers to Make and Have Access to Healthy Choices; and Pillar 5: Enhance Nutrition and Food Security Research. We suggest expanding current indicators to include equity, local foods, the digital food environment, and food waste reduction to improve alignment of the BIA-Obesity with the National Strategy. Application of the BIA-Obesity as an existing tool can facilitate data cohesion and more rapid assessment of the food retailer landscape to mutually meet nutrition security goals by 2030.

Background: Food insecurity can have lasting physical and mental health consequences. The experience of food insecurity within a household may disproportionately impact mothers because they tend to manage the household food environment. Objective: This study sought to understand the stresses faced by United States mothers experiencing food insecurity, related coping mechanisms, and the impacts of these stressors on their mental health. Methods: Semistructured interviews were conducted in May and June 2022 with a purposive sample of Virginia mothers who reported experiences of food insecurity. Participants were recruited from a related survey and university and community LISTSERVs. Interviews were transcribed and analyzed by trained coders. A thematic analysis was conducted to describe themes that emerged from the data. Virtual interviews were 20-60 min in duration. Mothers with children living in their household, having experienced food insecurity, and living in Virginia were eligible. Results: The following 3 themes emerged from the interviews with the mothers (n 1/4 15): 1) food insecurity added stress to mothers' lives in multiple ways (e.g. worry about obtaining the "right" foods and internalized or experienced stigma), 2) mothers used positive and negative coping strategies to address the impacts of these stressors (e.g. use of community resources and reduced personal food intake), and 3) the stressors and coping strategies had varying impacts on mothers' mental health (e.g. added to existing mental health challenges or reduced their mental capacity to make changes). Conclusions: Study findings suggest that a multilevel and tailored approach to address diverse stressors is warranted. Future research should explore emotional coping strategies that comprehensively empower mothers to manage stressors, leverage resources, and reduce social stigma associated with food insecurity and accessing nutrition and mental health assistance. This may improve their household food security and mitigate the burden of stressors on their mental health because system -level solutions to food insecurity are pursued.

Background Core competencies, which are knowledge, skills, and tasks required to successfully fulfill duties of a job, have been identified and utilized for EFNEP and SNAP-Ed state program coordinators, state supervisors, and paraprofessional educators, but not for professional positions with policy, systems, and environmental (PSE) change responsibilities. Objective The purpose of this project was to develop a list of core competencies required for PSE implementers within SNAP-Ed. Study Design, Settings, Participants The Developing a Curriculum (DACUM) occupational analysis method was used with a panel of expert, SNAP-Ed PSE implementers from across the country. Data were collected through a mix of an in-person workshop and follow-up, online sessions held via Zoom. Measurable Outcome/Analysis The panel identified duties (clusters of related tasks) and corresponding tasks (specific meaningful units of work). The panel also identified lists of knowledge, skills, and equipment required for successful PSE change programs. Results PSE implementers created a total of nine duties. Duties focused on activities related to community capacity-building, assessment, planning, implementation, collaboration, and evaluation of PSEs. A total of 98 tasks were identified with a range 8 to 13 for a specific duty. The average number of tasks was 10.9 across duties. Conclusions The identified duties and tasks serve as a list of core competencies for SNAP-Ed PSE implementers. This list can be used for recruitment, hiring, and training development and provide supervisors with a structure to assess employee performance. Funding Supplemental Nutrition Assistance Program - Education

United States (U.S.) and global experts recommend that populations reduce red and processed meat (RPM) intake and transition to plant-rich, sustainable diets to support human and planetary health. A systematic scoping review was conducted to identify the landscape of media campaigns that promote plant-rich dietary patterns, traditional plant proteins, and novel plant-based meat alternatives (PBMA) and that encourage or discourage RPM products to Americans. Of 8321 records screened from four electronic databases, 103 records were included, along with 62 records from gray literature sources. Across 84 media campaigns (1917–2023) identified, corporate marketing campaigns (58.6%) were most prevalent compared to public information (13.8%), corporate sustainability (12.6%), countermarketing (5.7%), social marketing (4.6%), and public policy (4.6%) campaigns. Findings indicate that long-running corporate RPM campaigns, many with U.S. government oversight, dominated the landscape for decades, running alongside traditional plant protein campaigns. Novel PBMA campaigns emerged in the past decade. Many civil society campaigns promoted plant-rich dietary patterns, but few utilized social norm or behavior change theory, and only the Meatless Monday campaign was evaluated. The U.S. government, academia, businesses, and civil society should commit more resources to and evaluate the impact of media campaigns that support a sustainable diet transition for Americans, restrict and regulate the use of misinformation in media campaigns, and prioritize support for plant-based proteins and plant-rich dietary patterns.