The purpose of this formative, cross-sectional study was to describe independent eating occasions (iEOs) among a convenience sample of low-income early adolescents (10–13 years, n = 46) in 10 U.S. states, including environmental context, foods selected and reasons for selection, and parental rules about foods consumed. Participants took pictures of all foods consumed over 24 h and participated in semi-structured interviews to describe the context of each eating occasion using the pictures as a guide. Responses based on a total of 304 eating occasions were coded to classify foods based on United States Department of Agriculture (USDA) MyPlate food groups and to characterize parental rules and reasons for food selection. Average age was 10.9 ± 1.1 years and 60% were female. Approximately 58% of eating occasions were classified as iEOs with approximately 65% as snacks. Most iEOs took place at home. Foods frequently consumed during iEOs were from the sweets, total fruit, dairy, and whole fruit food categories. Primary parental rules for iEOs focused on avoiding certain foods and not eating too much. Early adolescents selected foods for convenience, taste preferences, and availability. Foods selected during iEOs were based on parent, household and early adolescent factors, which could be addressed to influence overall diet quality.

Calcium intake during early adolescence falls short of requirements for maximum bone accretion. Parents and the home food environment potentially influence children’s calcium intakes. This study aimed to quantify parental psychosocial factors (PSF) predicting calcium intakes of Asian, Hispanic, and non-Hispanic white (NHW) early adolescent children from a parental perspective.

BackgroundIn 2014, the Supplemental Nutrition Assistance Program ‐ Education (SNAP‐Ed) incorporated Policy, Systems and Environmental (PSE) approaches to reinforce obesity prevention efforts. This expansion included engagement in multi‐sectoral coalitions which provide community‐level supports for healthy eating and active living. Coalition success depends on creating well‐defined collaborations that share authority, accountability, resources, and achievements. Arizona's SNAP‐Ed utilized the Wilder Collaboration Factors Inventory (WCFI) to evaluate coalitions' effectiveness in supporting food systems and active living PSE goals at the community level.MethodsThe University of Arizona Nutrition Network (UANN), part of the SNAP‐Ed program in Arizona, used the WCFI to assess six coalitions in four counties (Maricopa, Mohave, Pima, and Pinal).The WCFI uses a 40‐question Likert scale (1.0–5.0) questionnaire to evaluate collaborations on 20 success factors. The WCFI identifies areas of collaboration strength (4.0–5.0) and weakness (1.0–3.9). Coalition members were invited to complete the WCFI online or in‐person. Of the 117 surveys distributed, 64 were returned, and 61 provided complete responses. The results (N=61) were aggregated to identify similar factor scores across coalitions.ResultsFour out of six coalitions (66%) scored highly in the same success factor: members see collaboration in their self‐interest (average score: 4.5). Half of the coalitions identified unique purpose as a stronger success factor within their collaboration (average score: 4.2).All coalitions identified the same weaker success factor: lack of sufficient funds, staff, materials, and time (average score: 2.8). Three coalitions had the development of clear roles and policy guidelines as a weak success factor within their coalition (average score: 3.0).ConclusionThe WCFI results suggest that community coalitions in which SNAP‐Ed staff participate in Arizona reflect an invested membership and a unique purpose in their communities, yet sufficient resources and clear goals are areas that should be strengthened. By providing timely and actionable WCFI data and recommendations to these active living and food systems coalitions in Arizona, capacity can be strengthened to achieve the goals of the collaborations in which SNAP‐Ed participates. The coalitions that use the WCFI results to encourage the strengthening of their coalition's capacity will be more likely to succeed in achieving PSE changes in their communities.Support or Funding InformationUSDA HI050073

Parental practices influence intake of calcium-rich foods and beverages (CRFB) in adolescents. This study aimed to test two posters promoting such parental practices for comprehension, cultural and personal relevance, and ability to motivate parents to encourage CRFB intake. Interviews were conducted with 14 Hispanic and 6 Asian parents to evaluate two posters entitled “Good play starts with calcium” and “Strong families start with good nutrition.” Responses were reviewed for themes. For “Good play,” both racial/ethnic groups of parents understood the message to provide CRFB. Only Hispanics, however, recognized the connection between calcium and strong bones. For “Strong families,” both groups had difficulty understanding that foods pictured were calcium rich. Both posters were considered culturally and personally relevant; however, not all respondents indicated motivation to provide CRFB. Modifications are needed to emphasize the connection between images and taglines and calcium intake for use in a future intervention to improve CRFB-promoting practices.

Intervention strategies to increase calcium intake of parents and young adolescent children could be improved by identifying psychosocial factors influencing intake. The objective was to develop a tool to assess factors related to calcium intake among parents and Hispanic, Asian, and non-Hispanic white young adolescent children (10-13 years) meeting acceptable standards for psychometric properties. A parent questionnaire was constructed from interviews conducted to identify factors. Parents (n = 166) in the United States completed the questionnaire, with seventy-one completing it twice. Two constructs (Attitudes/Preferences and Social/Environmental) were identified and described by eighteen subscales with Cronbach's alpha levels from .50 to .79. Test-retest coefficients ranged from .68 to .85 (p<.001). Several subscales were statistically significantly associated with parent characteristics consistent with theory and published literature. This tool shows promise as a valid and reliable measure of factors associated with calcium-rich food intake among parents and young adolescent children.

The Supplemental Nutrition Assistance Program Education (SNAP‐Ed) provides multi‐level obesity prevention interventions in the school setting. The SNAP‐Ed goals for Arizona are to ensure that SNAP‐eligible youth: 1) meet the dietary recommendations for fruit and vegetable consumption, 2) meet dietary recommendations for calcium from low‐fat or fat‐free diary, 3) make half of grains consumed whole grains, and 4) engage in the recommended amount of physical activity (PA) per a day (60 minutes). Interventions in schools may include: nutrition and PA education, taste testing of fruits and vegetables, Local Wellness Policy development, implementation, and revision support. These interventions aim to change student nutrition and PA behaviors. A youth and a teacher survey were used to support interpretation of behavior changes and strengthen the quality of findings.A randomized cohort of students in 4th and 5th grade school classrooms were recruited to participate in youth surveys that assessed nutrition and PA behavior. The youth surveys were administered in the Fall and Spring of 2014–2015. Youth surveys were matched to the students; 536 students took the pre‐survey and 543 took the post survey. Unmatched surveys were excluded for a sample size of 382. Paired t‐tests were used for continuous variables, and the McNemar test was applied to binary data. A multiple choice questionnaire was also given to the 4th and 5th grade teachers in the Spring (N=12), post‐intervention, to assess the teachers’ observations of students’ behaviors. Descriptive statistics were reported for items related to teacher observations of students’ behaviors. Teachers that participated in the teacher questionnaire may or may not have received a SNAP‐Ed intervention in their classroom, during the 2014–15 school year.The youth survey analysis found a significant increase in whole grain consumption (17%, p<0.05) and total PA minutes per day (11% p<0.05). The teacher questionnaire analysis showed that 42% of teachers observed an increase in students’ whole grain consumption and 67% observed students being more physically active.The low sample size for the teacher questionnaire and the unmatched teachers with classrooms were limitations to interpreting the results; however, teacher observations identified trends related to the significant findings of the youth survey. The surveys given to the students and teachers both supported the finding of increased consumption of whole grains and PA among youth in SNAP‐Ed participating schools. Using multiple surveys to assess perceived and observed behavior changes, can strengthen the interpretation of the results and identify trends.

The study reported here aimed to identify the relationship of parents' calcium knowledge with diet-related parental practices and determinants of calcium knowledge. A cross-sectional survey was conducted measuring parental practices, calcium knowledge, and demographics. A convenience sample of 599 racially/ethnically diverse parents of children 10-13y completed questionnaires. Higher education and having a daughter were associated with higher calcium knowledge; being Asian or Hispanic and born outside the U.S. were associated with lower calcium knowledge. Parents with greater calcium knowledge were more likely to engage in healthy parenting practices. These factors may be important considerations for Extension educators in nutrition education.

BACKGROUND/OBJECTIVES:Setting healthful beverage expectations, making calcium-rich foods and beverages (CRF/B) available, and role modeling are parenting practices promoting calcium intake among early adolescents. This study aimed to evaluate emotion-based messages designed to motivate parents of early adolescents to perform these practices.SUBJECTS/METHODS:Emotion-based messages were developed for each parenting practice and tested in 35 parents from 5 states. Findings were used to modify messages and develop a survey administered via Amazon MechanicalTurk to a convenience sample of Asian (n = 166) and Hispanic (n = 184) parents of children 10-13 years. Main outcome measures were message comprehension, motivation, relevance, acceptability, and novelty. Engagement in the parenting practices was also assessed.RESULTS:Message comprehension was acceptable for the majority of parents. Most also agreed that messages were motivational (setting healthful beverage expectations (69.0%), making CRF/B available (67.4%), and role modeling (80.0%)), relevant and acceptable. About 30-50% indicated they had not seen the information before. Many parents indicated they were already engaging in the practices (> 70%). No racial/ethnic differences were observed for responses to messages or engaging in parenting practices.CONCLUSIONS:Results indicate that emotion-based messages designed to motivate parents to engage in parenting practices that promote calcium intake among early adolescents were motivating, relevant, and acceptable.

Dietary calcium sources may differ by race/ethnicity and dietary acculturation. A cross-sectional, convenience sample including 587 United States (US) Asian, Hispanic and non-Hispanic White parent-child (10-13 years) pairs completed a calcium food frequency questionnaire. Calcium sources were ranked by mean percent contribution to total adjusted calcium intake, and compared by ethnic group and parents' location of birth. Five foods (fluid milk, cheese, milk on cereal, yogurt, and lattes) represented 49% of total calcium intake for parents. The same foods (except lattes) represented 55% of total calcium for early adolescent children. Fluid milk provided the largest mean percentage of intake for all race/ethnic groups among parents and children. Several food sources of calcium were greater for foreign-born versus US-born Asian or Hispanic parents and children. Understanding calcium food sources and changes in dietary patterns that affect calcium intake among parents and children is important to better promote adequate intake.

Objective: Consumption of sugar-sweetened beverages (SSB) is linked to obesity. The authors hypothesized that school-based nutrition education would decrease SSB consumption.Design: Self-selected interventional cohort with random selection for pre and post measurements.Setting: Arizona Supplemental Nutrition Assistance Program-Education Program-eligible schools. Participants: Randomly selected (9%) fourth-and fifth-grade classroom students.Intervention: The University of Arizona Nutrition Network provided general nutrition education training and materials to teachers, to be delivered to their students. The University of Arizona Nutrition Network administered behavioral questionnaires to students in both fall and spring.Main Outcome Measure(s): Change in SSB consumption.Analyses: Descriptive statistics were computed for student demographics and beverage consumption on the day before testing. Paired t tests evaluated change in classroom averages. Linear regression assessed potential correlates of SSB consumption.Results: Fall mean SSB consumption was 1.1 (+/- 0.2) times; mean milk and water intake were 1.6 (+/- 0.2) and 5.2 (+/- 0.7) times, respectively. Beverage consumption increased (3.2%) in springtime, with increased SSBs (14.4%) accounting for the majority (P = .006). Change in SSB consumption was negatively associated with baseline SSB and water consumption but positively associated with baseline milk fat (P <= .05).Conclusions and Implications: The results suggest the need for beverage-specific education to encourage children to consume more healthful beverages in warmer weather.

Many Extension programs are turning to the input-output software IMPLAN to demonstrate economic impacts. IMPLAN is a powerful tool that can be used to estimate the total economic activity associated with an industry, event, or policy. One possible application, therefore, is to use program spending data to estimate the economic effects of Extension's presence in the region. Yet results should be interpreted with care because they can report gross‑rather than net—economic effects. This article provides an example of IMPLAN application by estimating the net change in state economic activity resulting from University of Arizona Cooperative Extension SNAP-Ed spending.

The United States Department of Agriculture’s Food and Nutrition Service allocates SNAP-Ed funding to the Arizona Department of Health Services (AZDHS), bringing money into the state economy. The AZDHS then grants competitive funds to the University of Arizona (UA) Cooperative Extension. Since 2002, the share of total competitive grant funds awarded to the UA has increased significantly, as indicated in Figure 1. Since 2012, the UA Cooperative Extension SNAP-Ed program has managed approximately 40% of Arizona’s allocation of SNAPEd funding. SNAP-Ed Economic Contributions to Arizona The funding brought to the state of Arizona through the SNAPEd program contributes to the Arizona economy in a variety of ways. The SNAP-Ed program uses the federal funds it obtains for nutrition and physical activity outreach education, policy, and systems development for people and communities receiving or eligible to receive SNAP. Purchases made for conducting this work generate economic activity throughout the state. These purchases include resources such as curricula, teaching materials and supplies, food demonstration equipment and ingredients. The program also contributes to the economy by employing local residents to deliver the program to SNAP and SNAP eligible participants. Yet, the contribution of SNAP-Ed spending to the state economy extends beyond these direct effects. Based on the tenet that all industries in the economy are linked together, SNAP-Ed program spending generates a ripple of economic

Schools eligible for Supplemental Nutrition Assistance Program Education (SNAP‐Ed) can offer programs to address overweight and obesity among low income youth. This study assessed changes in knowledge and behavior among middle school students in SNAP‐Ed eligible schools after nutrition and physical activity education.Students in SNAP‐Ed eligible schools across five AZ counties received nutrition and nutrition‐integrated physical activity education during the school year. A randomized cohort of 6th‐ 8th grade classrooms (N=40, mean fall class size=25) was surveyed in fall and spring. The anonymous survey asked about behavior the previous day and knowledge of national nutrition and physical activity guidelines. Paired t‐tests assessed change in weighted classroom averages.Significant knowledge gains were found in two of five national guidelines, recommended vegetable consumption (p<0.05) and physical activity (p<0.01). Self‐reported behaviors had a significant increase in whole grain consumption (p<0.05) and a significant decrease in water intake (p<0.05). There was no change in vegetable consumption or in any physical activity category except active travel home from school (p<0.05).These data suggest that behavior change may occur independent of knowledge change. This disconnect underscores the importance of addressing factors other than knowledge (e.g. self‐efficacy and environment) when delivering programs to address overweight and obesity prevalence among low income youth.

Dietary guidelines are designed to reduce the burden of obesity and related health problems. Our aim was to measure change in knowledge and behavior related to USDA dietary guidelines following nutrition education of rural, low‐income, 4th and 5th graders. Eight Apache County, AZ classrooms volunteered to participate; each received three, 45‐minute, education sessions related to USDA recommendations over 2‐3 weeks (N=139 pre, 121 post). Anonymous self‐report behavior and knowledge questionnaires were administered to the children prior to and following the class series. Descriptive statistics were computed for student demographics and consumption of fruits, vegetables, grains, and milk on the prior day. Paired t‐tests were used to evaluate change in weighted classroom averages. Seventy‐six percent were 4th graders, 52% male. Identification of USDA‐recommended milk type increased by 12% (p<0.0001), while knowledge of other recommendations did not improve. Reported consumption of lower fat milk, whole grains, vegetables, and fruit significantly increased (p蠄0.01). The percent of students active during morning break and lunchtime significantly increased (p<0.02). Minutes of afterschool physical activity did not change, but minutes of sedentary time decreased (p=0.01). These data suggest that acute changes in target behaviors are possible in this age group, despite the absence of increased knowledge.Grant Funding Source: USDA HI050073, NIH P30CA023074

Knowledge of U.S. dietary and physical activity recommendations and corresponding behaviors were surveyed among 4th and 5th graders in five Arizona counties to determine the need for related education in SNAP-Ed eligible schools. A <70% target response rate was the criterion. Participants correctly identified recommendations for: fruit, 20%; vegetables, 19%; whole grains, 23%; and physical activity, 37% of the time. Fruit, vegetable, whole grain, and physical activity recommended behaviors were met by 23%, 37%, 30%, and 64%, respectively. Knowledge and behavior were associated only for fruit. These data confirmed the necessity for nutrition and physical activity education in this population.