Source: SOUTHERN UNIV & A&M COLLEGE submitted to
DELTA NUTRITION INTERVENTION RESEARCH INITIATIVE -SOUTHERN UNIVERSITY & A&M COLLEGE
Sponsoring Institution
Agricultural Research Service/USDA
Project Status
TERMINATED
Funding Source
USDA COOPERATIVE AGREEMENT
Reporting Frequency
Annual
Accession No.
0402813
Grant No.
58-6251-9-013
Project No.
6251-53000-004-16S
Proposal No.
(N/A)
Multistate No.
(N/A)
Program Code
(N/A)
Project Start Date
Sep 1, 1999
Project End Date
Aug 31, 2004
Grant Year
1999
Project Director
BOGLE M L
Recipient Organization
SOUTHERN UNIV & A&M COLLEGE
(N/A)
BATON ROUGE,LA 70813
Performing Department
AGRICULTURE & HOME ECONOMICS
Non Technical Summary
(N/A)
Animal Health Component
(N/A)
Research Effort Categories
Basic
50%
Applied
50%
Developmental
0%
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
70360101010100%
Knowledge Area
703 - Nutrition Education and Behavior;

Subject Of Investigation
6010 - Individuals;

Field Of Science
1010 - Nutrition and metabolism;
Goals / Objectives
The objective of this cooperative research project is to evaluate the nutritional health in the Lower Mississippi Delta, to identify nutritionally responsive problems, and to design and evaluate interventions which may be sustained at the community level and implemented on a larger scale in similar areas of the United States.
Project Methods
Developing capacity as necessary, the Lower Mississippi Delta Nutrition Intervention Research Initiative (Delta NIRI) Consortium will identify environmental and community characteristics related to nutritional status; measure dietary intake; assess nutritional risk factors; design, conduct, and evaluate interventions in the Lower Mississippi Delta. Southern University & A&M College specifically will develop and establish a Nutrition and Health Survey Research Center (NHSRC) to support dietary intake and food consumption assessments of the research investigations and activities of the Delta NIRI.

Progress 09/01/99 to 08/31/04

Outputs
1. What major problem or issue is being resolved and how are you resolving it (summarize project aims and objectives)? How serious is the problem? What does it matter? The Lower Mississippi Delta (LMD) area of Arkansas, Louisiana, and Mississippi is characterized by high rates of poverty, low education attainment, and food insecurity. There is a high prevalence of hypertension, diabetes, obesity, anemia, and heart disease, all of which are influenced by nutrition. We are attempting to resolve these problems through the efforts of the Lower Mississippi Delta Nutrition Intervention Research Initiative (Delta NIRI). The Delta NIRI Consortium consists of the original partners: scientists from Alcorn State University, Alcorn State, MS (ASU); Arkansas Children's Hospital Research Institute, Little Rock, AR (ACHRI); Pennington Biomedical Research Center, Baton Rouge, LA (PBRC); Southern University and A&M College, Baton Rouge, LA (SU); The University of Arkansas at Pine Bluff, Pine Bluff, AR (UAPB); The University of Southern Mississippi, Hattiesburg, MS (USM); and the Agricultural Research Service (ARS) of USDA, Little Rock, AR. The Delta NIRI Consortium also now includes representatives from the Arkansas, Louisiana, and Mississippi Cooperative Extension Service; the College of Public Health of the University of Arkansas for Medical Sciences, Little Rock, AR; a private researcher, Jackson, MS; and members from the Delta communities of Marvell, AR; Hollandale, MS; and Franklin Parish, LA. The ARS has initiated agreements with other scientists with needed expertise for specific research requirements. For example, the Children's Nutrition Research Center (CNRC) in Houston is collaborating with a Baylor College of Medicine scientist that has nutrition epidemiology skills, and the Human Nutrition Research Center on Aging (HNRCA) at Tufts University in Boston is providing expertise on the development of an original adult food frequency questionnaire. These scientists, Extension, and community members participate fully in the Delta NIRI Consortium. The Consortium is diverse in its composition: including minorities, many research disciplines (nutrition, food science, family economics, sociology, medicine, community development, community grass root, agriculture, etc.), and a variety of professionals (nutritionists, pediatricians, nurses, food scientists, sociologists, agriculture economists, etc.). This diversity is necessary because of the complexity of the food concerns, poverty, isolation, and low educational attainment in parts of the Delta region. The Delta NIRI Consortium is evaluating the nutritional health in the LMD, to identify nutritionally responsive problems, and to design and evaluate interventions using a community participatory research model. Use of this model will promote capacity- building and sustainability at the community level. Lessons learned about successful intervention approaches will be disseminated in order to facilitate implementation on a larger scale in similar areas of the United States. Rates of rural poverty and nutrition-related chronic diseases in the LMD are among the nation's highest. Arkansas, Mississippi, and Louisiana traditionally rank at or near the bottom in health rankings of the United States and continue to worsen compared with other states. Food insecurity, adult and child obesity, and high blood pressure and diabetes among adults are higher in each of these states than for the National average. The area is underserved by food and nutrition and other health professionals, thus the burden of food-related health problems is carried by minority, low-income, and educationally disadvantaged individuals and families in the Delta communities. The presence of these problems severely limits the quality of life, productivity, and the future of this rural, at-risk population, while propelling them into the high-user category for nutrition assistance programs and high-cost health care and treatment of nutrition-related disease. The Lower Mississippi Delta Nutrition Intervention Research Initiative falls under the National Program 107 - Human Nutrition, and addresses established performance goal 3.1.2 through developing and transferring effective nutrition intervention strategies. 2. List the milestones (indicators of progress) from your Project Plan. Year 1 (2000) Southern University will assist in the implementation of FOODS 2000 survey, the Community Assessment, and the Nutrition Assessment Study. Southern University will establish a Nutrition and Health Survey Research Center. The role of the Center will be to support dietary intake and food consumption assessments proposed for the Nutrition Assessment Survey and for related research activities associated with implementation of interventions. Year 2 (2001) Southern University will establish a Nutrition and Health Survey Research Center. The role of the Center will be to support dietary intake and food consumption assessments proposed for the Nutrition Assessment Survey and for related research activities associated with implementation of interventions. Designing interventions to improve the nutritional well- being of adolescents and young adults in the Delta based on findings of the Nutritional Assessment Survey, Part I; implementation of a lifestyle intervention to control diabetes in Delta residents. Southern University scientists will assist in the implementation of the Food Store Survey, Community Nutrition and Health Profile, and the Focus Group Study components of the Community Assessment Study. Year 3 (2002) Designing interventions to improve the nutritional well-being of adolescents and young adults in the Delta. Implement Summer Feeding Study in collaboration with the University of Southern Mississippi. Year 4 (2003) Design interventions to improve the nutritional well-being of adolescents and young adults in Winnsboro, LA. Implement a lifestyle intervention to control diabetes in Delta residents. Design and scientifically test methods for disseminating nutrition and health information and education materials explicitly designed for limited-resource individuals. Complete the Nutrition and Health Survey Research Center. Year 5 (2004) Design interventions to improve the nutritional well-being of adolescents and young adults in Franklin Parish, LA. Determine the feasibility of a lifestyle intervention to control diabetes risk in Delta residents: Assessment of Feasibility of a Nutrition and Health Promotion Intervention for African-American Women At-Risk for Type 2 Diabetes Mellitus. Operate the Nutrition and Health Survey Research Center to support dietary intake and food consumption assessments related to the implementation and monitoring of interventions in Arkansas, Louisiana, and Mississippi. 3. Milestones: A. List the milestones that were scheduled to be addressed in FY 2004. How many milestones did you fully or substantially meet in FY 2004 and indicate which ones were not fully or substantially met, briefly explain why not, and your plans to do so. Design interventions to improve the nutritional well-being of adolescents and young adults in Franklin Parish, LA. This objective has been substantially met. Determine the feasibility of a lifestyle intervention to control diabetes risk in Delta residents: Assessment of Feasibility of a Nutrition and Health Promotion Intervention for African-American Women At- Risk for Type 2 Diabetes Mellitus. This objective was not fully met. Efforts were altered to utilize the Comprehensive Participatory Planning and Evaluation (CPPE) model to determine the primary nutrition health concerns of Franklin Parish residents. Operate the Nutrition and Health Survey Research Center to support dietary intake and food consumption assessments related to the implementation and monitoring of interventions in Arkansas, Louisiana, and Mississippi. This objective has been substantially met. B. List the milestones that you expect to address over the next 3 years (FY 2005, 2006, & 2007). What do you expect to accomplish, year by year, over the next 3 years under each milestone? A new replacement project is being established. Anticipated milestones and accomplishments represent what is planned on the new project. Year 2005 Develop nutrition interventions in Franklin Parish, LA, through community- based participatory research (CBPR): 1) Establish Community Groups and Research Teams. Community Groups and Research Teams will be established to identify intervention strategies to improve food choices through food selection and meal preparation; healthy weight through food selection and physical activity; and food security through food availability and food selection. 2) Identify community-specific nutritional problems/concerns. Community-specific nutritional problems will be successfully identified through community meetings that encompass the community-based participatory process, focus groups, and the comprehensive community planning and evaluation process. 3) Identify community resources/environmental conditions. To further develop intervention strategies, community readiness levels will be determined and strategies will be enhanced. Design the nutrition intervention research for Franklin Parish, LA, using Comprehensive Participatory Planning and Evaluation (CPPE): 1) Evaluate proposed intervention strategies. Proposed intervention strategies will be evaluated that is needed to address key health issues. 2) Develop community-specific research plans/protocols. Manual of Operations will be finalized and training programs will be administered to outline the research plans and protocols. 3) Modify and develop new data collection instruments. Data collection instruments will be modified to tailor to the needs of the Lower Mississippi Delta NIRI research and minimize collection errors. Implement and evaluate nutrition intervention strategies in Franklin, LA: 1) Complete training on data collection/intervention strategies. Community liaisons, community NIRI members, Delta NIRI partners, students, and other individuals involved with the Delta NIRI will be trained using guidance from the manual of operations, to prepare for the implementation of the nutrition/physical activity interventions in the community. 2) Pre-test data collection instruments/procedures. The pretest data collection will be completed. 3) Complete operational plan/research protocol. The Manual of Operations will be finalized in each community group. 4) Implement community-specific nutrition interventions. Community interventions will be initiated in each community. Year 2006 Further develop additional community-specific research plans/protocols. Modify and develop new data collection instruments. Continue implementation and evaluation of nutrition intervention strategies in Franklin parish, LA. Intervention will be monitored and additional data will be collected and analyzed. Interventions will be refined or expanded as necessary to meet the needs of the community. Year 2007 Further develop additional community-specific research plans/protocols. Modify and develop new data collection instruments. Continue implementation and evaluation of nutrition intervention strategies in Franklin Parish, LA. Interventions will continue to be monitored and data will be collected and analyzed. Successful interventions will be considered for other comparable communities in the Lower Mississippi Delta. 4. What were the most significant accomplishments this past year? A. Single most significant accomplishment during FY 2004: A variety of nutrition/physical activity interventions are needed in the Franklin Parish, LA, area to determine which interventions are most successful in improving the resident's nutrition and health status. The Franklin NIRI, in cooperation with Lower Mississippi Delta NIRI nutritionists and cooperators (Southern University, Pennington Biomedical Research Center, and Louisiana Cooperative Extension Service), successfully designed and have planned two interventions targeting healthy weight, fruit and vegetable consumption, nutritional knowledge, and food security of Franklin Parish, LA community residents. Church- and neighborhood-based food choice interventions are planned to be implemented during the fall of 2004, with the goal of increasing the nutritional knowledge and habits of Franklin Parish residents. Information gained from these studies will be utilized to plan and design additional nutrition/physical activity interventions. B. Other significant accomplishment(s), if any. None C. Significant activities that support special target populations. None 5. Describe the major accomplishments over the life of the project, including their predicted or actual impact. Southern University scientists contributed two chapters to the monograph entitled "Nutrition and Health Status in the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi: A Review of Existing Data." The monograph provides information on the existing nutritional health of Lower Delta residents. Southern University scientists participated in the planning, implementation, and completion of the Key Informant Survey. A sample of 500 people from Arkansas, Louisiana, and Mississippi participated in the survey. Southern University staff interviewed and collected data from one half of the LA participants. The study provided information on the perceptions of the nutrition and health concerns and problems in Delta counties and parishes. The top nutrition concern in all three states was consumption of high-fat foods. The top health problem in Louisiana was high blood pressure. Southern University scientists participated in the planning and implementation of the Foods of Our Delta Study (FOODS). A sample of 409 adults and children from 313 households with telephones and 144 households without telephones were surveyed. The study validated the telephone methodology for rural areas. Southern University scientists participated in development and pre-testing of an adult food frequency questionnaire. Southern University Scientists contributed to the development of FOODS 2000 to assess the nutrition and health status of a representative sample of the population in the 36 Delta counties in Arkansas, Louisiana, and Mississippi. FOODS 2000 was designed as a baseline cross-sectional telephone survey of a representative sample of the population 3 years of age and older. These data are being used to design and implement nutrition interventions in Franklin Parish, LA. Scientists from Southern University participated in the planning, pre- testing of instruments, and implementation of the Community Assessment Survey, which included a survey of approximately 360 food stores conducted in 18 Delta counties/ parishes in Arkansas, Louisiana, and Mississippi to learn more about the food choices available to people, as well as the food choices they make. Southern University staff screened all stores in Louisiana prior to the Survey. Southern University served as the Coordinating Center for the Delta NIRI Focus Group Study. The Focus Group Study obtained community-level information on perceptions of the problems associated with healthy food consumption, food security, grocery shopping, and barriers associated with acquisition of healthy foods; all are critical to community-based nutrition interventions. The Southern University Coordinating Center recruited participants and conducted 36 focus groups in 9 counties of LMD and prepared the Focus Group Study Technical Report. Data were analyzed with the development of the Summaries and Emerging Themes for the areas of behavioral change, shopping, food security, and healthy food. The impact of this study will guide future decisions on the types of nutrition interventions that are acceptable and sustainable for Delta residents. Franklin parish was selected for the first nutrition intervention in Louisiana, and the residents had no decision-making group. Southern University, Pennington Biomedical Research Center, ARS Delta NIRI, and Franklin Parish residents established a Community Research Group. The group was able to identify and prioritize nutrition and health problems in Franklin Parish through participatory planning. These problems will define the interventions to be used in Franklin Parish. Southern University assisted in the collection of data for the Community Resource Assessment aimed at identifying community resources and the Community Readiness Study. 7. List your most important publications in the popular press and presentations to organizations and articles written about your work. Eugene, J. A Perspective of the Delta NIRI Focus Group Study. MANNRS Conference, Des Moines, IA, March 2004.

Impacts
(N/A)

Publications

  • Thornton, A., McGee, B.B, Mellad, K., Fomby, B., Eubanks, G.E., Paeratakul, S. The influence of sociodemographic factors on psychosocial beliefs and food security in rural lower Mississippi Delta residents. Journal of the American Dietetic Association. 2001(Supplement). v. 101. Abstract p. A40.


Progress 10/01/02 to 09/30/03

Outputs
1. What major problem or issue is being resolved and how are you resolving it? The Lower Mississippi Delta (LMD) area of Arkansas, Louisiana, and Mississippi is characterized by high rates of poverty, low education attainment, and food insecurity. There is a high prevalence of hypertension, diabetes, obesity, anemia, and heart disease, all of which are influenced by nutrition. We are attempting to resolve these problems through the efforts of the Lower Mississippi Delta Nutrition Intervention Research Initiative (Delta NIRI). The Delta NIRI consortium consists of scientists from Alcorn State University, Alcorn State, MS (ASU); Arkansas Children's Hospital Research Institute, Little Rock, AR (ACHRI); Pennington Biomedical Research Center, Baton Rouge, LA (PBRC); Southern University and AM College, Baton Rouge, LA (SU); The University of Arkansas at Pine Bluff, Pine Bluff, AR (UAPB); The University of Southern Mississippi, Hattiesburg, MS (USM); and The Agricultural Research Service (ARS) of USDA, Little Rock, AR. The ARS has initiated agreements with other scientists with needed expertise for specific research requirements. For example: The Children's Nutrition Research Center (CNRC) in Houston is collaborating by providing a Baylor Medical Center scientist with nutrition epidemiology skills; the Human Nutrition Research Center (HNRC) at Tufts University in Boston is providing expertise on the development of an original adult food frequency questionnaire; and the Iowa State University at Ames has contributed through a rural sociologist with specific skills in community development. These scientists participate fully in the Delta NIRI Consortium. The Consortium is diverse, including minorities, many disciplines (nutrition, food science, family economics, sociology, medicine, agriculture, etc.), and a variety of professionals (nutritionists, pediatricians, nurses, food scientists, sociologists, agriculture economists, etc.). This diversity is necessary because of the complexity of the food problems, poverty, isolation, and low educational attainment in the Delta. The Consortium is evaluating the nutritional health in the Lower Delta, to identify nutritionally responsive problems, and to design and evaluate interventions that may be sustained at the community level and implemented on a larger scale in similar areas of the United States. In addition, a capacity building goal is to increase and continue expertise within each Partner to enhance their teaching and research skills in the areas of food, nutrition, and health in order to sustain successful interventions in this high-risk population. 2. How serious is the problem? Why does it matter? Rates of rural poverty and nutrition-related chronic diseases in the LMD are among the nation's highest. Arkansas, Mississippi, and Louisiana traditionally rank in or near the bottom in health rankings of the United States and continue to worsen compared with the other states. Food insecurity is higher in each of these states than the average for the US and 212 times the national average in the LMD. The area is underserved by food and nutrition and other health professionals. National surveys have not included this area in their sampling of the US. Therefore, information on the food intake, nutrition-related health problems, and food access and security within the area is scarce to nonexistent. The burden of food-related health problems is carried by minority, low-income, and educationally disadvantaged individuals and families in the communities of the Delta. The presence of these problems severely limits the quality of life, productivity, and the future of this at-risk population and at the same time propels them into the high-user category for nutrition assistance programs and high-cost health care and treatment of nutrition-related disease. 3. How does it relate to the National Program(s) and National Program Component(s) to which it has been assigned? The National Program in Human Nutrition, #107, has five specific program components that are being addressed by this research: nutrition monitoring; composition of the diet; nutritional needs of a diverse population; diet, genetics, lifestyle, and the prevention of obesity and chronic disease; and health-promoting intervention strategies for targeted populations. The Delta NIRI provides the USDA, ARS with a unique opportunity to strengthen existing efforts to improve the nutritional health of disadvantaged and at-risk populations through nutrition intervention research. The participation of the Partners allows scientists to evaluate and generate knowledge about nutrition and health needs, food habits, and food consumption in the 36 counties in the LMD. The Initiative will enable the Consortium to design and evaluate nutrition interventions that will be sustainable in the LMD. Delta NIRI surveys have determined the composition of the diet and nutritional needs of the diverse population of the Delta. The telephone methodology for obtaining food and nutrition information is important to nutrition monitoring in the LMD, as well as the rest of the US. We are collaborating with Tufts Human Nutrition Research Center to develop an adult food frequency questionnaire based on what adults are eating in the LMD and with the Jackson Heart Study in Mississippi to provide validation of this adult food frequency instrument, allowing it to be used widely in nutrition research. A similar collaborative effort is underway with the CNRC in Houston, with Baylor scientists assisting in the development of a child food frequency questionnaire. These are examples of additional collaboration within the ARS Human Nutrition Program. We continue to collaborate with USDA, Economic Research Service (ERS) to develop a measure of community food security that will assist in nutrition interventions for the targeted population of the LMD. 4. What were the most significant accomplishments this past year? A. Single Most Significant Accomplishment during FY 2003: Franklin parish was selected for the first nutrition intervention in Louisiana, and the residents had no decision-making group. Southern University, Pennington Biomedial Research Center, ARS Delta NIRI, and the residents of Franklin Parish established a Community Research Group. The group was able to identify and prioritize nutrition and health problems in Franklin Parish through participatory planning. These problems will define the interventions to be used in Franklin Parish. B. Other Significant Accomplishments: None. C. Significant Accomplishments/Activities that Support Special Target Populations: None. 5. Describe the major accomplishments over the life of the project, including their predicted or actual impact. Southern University scientists contributed two chapters to the monograph entitled "Nutrition and Health Status in the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi: A Review of Existing Data." G. Harrison, Editor, Westat, Rockville, MD, 1997. The monograph provides information on the existing nutritional health of lower Delta residents. Southern University scientists participated in the planning, implementation, and completion of the Key Informant Survey in 1997. A sample of 500 people from Arkansas, Louisiana, and Mississippi participated in the survey. Southern University staff interviewed and collected data from one half of the LA participants. The study provided information on the perceptions of the nutrition and health concerns and problems in Delta counties and parishes. The top nutrition concern in all three states was consumption of high-fat foods. The top health problem in Louisiana was high blood pressure. Southern University scientists participated in the planning and implementation of the Foods of Our Delta Study (FOODS) in 1998. A sample of 409 adults and children from 313 households with telephones and 144 households without telephones were surveyed. The study validated the telephone methodology for rural areas. Southern University scientists participated in the development and pre-testing of an adult food frequency questionnaire for the LMD. Southern University Scientists contributed to the development of FOODS 2000 to assess the nutrition and health status of a representative sample of the population in the 36 Delta counties in Arkansas, Louisiana, and Mississippi. FOODS 2000 was designed as a baseline cross sectional telephone survey of a representative sample of the population 3 years of age and older. These data are being used to design and implement nutrition intervention in Winnsboro, LA. Scientists from Southern University participated in the planning, pre- testing of instruments, and implementation of the Community Assessment Survey, which included a survey of approximately 360 food stores conducted in 18 Delta counties/ parishes in Arkansas, Louisiana, and Mississippi to learn more about the food choices available to people, as well as the food choices they make. Southern University staff screened all stores in Louisiana prior to the Survey. Southern University served as the Coordinating Center for the Delta NIRI Focus Group Study. The Focus Group Study obtained community-level information on perceptions of the problems associated with healthy food consumption, food security, grocery shopping, and barriers associated with acquisition of healthy foods; all are critical to community-based nutrition interventions. The Southern University Coordinating Center recruited participants and conducted 36 focus groups in 9 counties of LMD and prepared the Focus Group Study Technical Report. Data were analyzed with the development of the Summaries and Emerging Themes for the areas of behavioral change, shopping, food security, and healthy food. The impact of this study will guide future decisions on the types of nutrition interventions that are acceptable and sustainable for Delta residents. 6. What do you expect to accomplish, year by year, over the next 3 years? 2004: Design interventions to improve the nutritional well-being of adolescents and young adults in Franklin Parish, Louisiana. Determine the feasibility of a lifestyle intervention to control diabetes risk in Delta residents: Assessment of Feasibility of a Nutrition and Health Promotion Intervention for African American Women At-Risk for Type 2 Diabetes Mellitus. Operate the Nutrition and Health Survey Research Center to support dietary intake and food consumption assessments related to the implementation and monitoring of interventions in Arkansas, Louisiana, and Mississippi. 2005: Monitor and evaluate interventions to improve the nutritional well-being of residents in Franklin Parish, Louisiana. Design and scientifically test methods for disseminating nutrition and health information and education materials explicitly designed for limited resource individuals. Operate the Nutrition and Health Survey Research Center to support dietary intake and food consumption assessments related to the implementation and monitoring of interventions in Arkansas, Louisiana, and Mississippi. 2006: Determine if intervention strategies could be used in other Louisiana Parishes. Continue monitoring and evaluating the interventions in Franklin Parish.

Impacts
(N/A)

Publications

  • Thornton, A., McGee, B.B, Mellad, K., Fomby, B., Eubanks, G.E., Paeratakul, S. The influence of sociodemographic factors on psychosocial beliefs and food security in rural lower Mississippi Delta residents. Journal of the American Dietetic Association. 2001(Supplement). v. 101. Abstract p. A40.


Progress 10/01/01 to 09/30/02

Outputs
1. What major problem or issue is being resolved and how are you resolving it? The Lower Mississippi Delta (LMD) area of Arkansas, Louisiana, and Mississippi is characterized by high rates of poverty, low education attainment, and food insecurity. There is a high prevalence of hypertension, diabetes, obesity, anemia, and heart disease, all of which are influenced by nutrition. We are attempting to resolve these problems through the efforts of the Lower Mississippi Delta Nutrition Intervention Research Initiative (Delta NIRI). The Delta NIRI consortium consists of scientists from Alcorn State University, Alcorn State, MS (ASU); Arkansas Children's Hospital Research Institute, Little Rock, AR (ACHRI); Pennington Biomedical Research Center, Baton Rouge, LA (PBRC); Southern University and A&M College, Baton Rouge, LA (SU); The University of Arkansas at Pine Bluff, Pine Bluff, AR (UAPB); The University of Southern Mississippi, Hattiesburg, MS (USM); and The Agricultural Research Service (ARS) of USDA, Little Rock, AR. The ARS has initiated agreements with other scientists with needed expertise for specific research requirements. For example: the Children's Nutrition Research Center (CNRC) in Houston is collaborating by providing a Baylor Medical Center scientist with nutrition epidemiology skills; the Human Nutrition Research Center (HNRC) at Tufts University in Boston is providing expertise on the development of an original adult food frequency questionnaire; and the Iowa State University at Ames contributes through a rural sociologist with specific skills in community development. These scientists participate fully in the Delta NIRI Consortium. The Consortium is diverse, including minorities, many disciplines (nutrition, food science, family economics, sociology, medicine, agriculture, etc.), and a variety of professionals (nutritionists, pediatricians, nurses, food scientists, sociologists, agriculture economists, etc.). This diversity is necessary because of the complexity of the food problems, poverty, isolation, and low educational attainment in the Delta. The Consortium is evaluating the nutritional health in the Lower Delta, to identify nutritionally responsive problems, and to design and evaluate interventions that may be sustained at the community level and implemented on a larger scale in similar areas of the United States. In addition, a capacity building goal is to increase and continue expertise within each Partner to enhance their teaching and research skills in the areas of food, nutrition, and health in order to sustain successful interventions in this high-risk population. 2. How serious is the problem? Why does it matter? Rates of rural poverty and nutrition-related chronic diseases in the LMD are among the nation's highest. Arkansas, Mississippi, and Louisiana traditionally rank in or near the bottom in health rankings of the United States and continue to worsen compared with the other states. Food insecurity is higher in each of these states than the average for the US and 212 times the national average in the LMD. The area is underserved by food and nutrition and other health professionals. National surveys have not included this area in their sampling of the US. Therefore, information on the food intake, nutrition-related health problems, and food access and security within the area is scarce to nonexistent. The burden of food-related health problems is carried by minority, low-income, and educationally disadvantaged individuals and families in the communities of the Delta. The presence of these problems severely limits the quality of life, productivity, and the future of this at-risk population and at the same time propels them into the high user category for nutrition assistance programs and high-cost health care and treatment of nutrition-related disease. 3. How does it relate to the national Program(s) and National Program Component(s) to which it has been assigned? The National Program in Human Nutrition, #107, has five specific program components that are being addressed by this research: nutrition monitoring; composition of the diet; nutritional needs of a diverse population; diet, genetics, lifestyle, and the prevention of obesity and chronic disease; and health-promoting intervention strategies for targeted populations. The Delta NIRI provides the USDA,ARS with a unique opportunity to strengthen existing efforts to improve the nutritional health of disadvantaged and at-risk populations through nutrition intervention research. The participation of the Partners allows scientists to evaluate and generate knowledge about nutrition and health needs, food habits, and food consumption in the 36 counties in the LMD. The Initiative will enable the Consortium to design and evaluate nutrition interventions that will be sustainable in the LMD. Delta NIRI surveys have determined the composition of the diet and nutritional needs of the diverse population of the Delta. The telephone methodology for obtaining food and nutrition information is important to nutrition monitoring in the LMD, as well as the rest of the US. We are collaborating with Tufts Human Nutrition Research Center to develop an adult food frequency questionnaire based on what adults are eating in the LMD and with the Jackson Heart Study in Mississippi to provide validation of this adult food frequency instrument, allowing it to be used widely in nutrition research. A similar collaborative effort is underway with the CNRC in Houston, with Baylor scientists assisting in the development of a child food frequency questionnaire. These are examples of additional collaboration within the ARS Human Nutrition Program. We continue to collaborate with USDA, Economic Research Service (ERS) to develop a measure of community food security that will assist in nutrition interventions for the targeted population of the LMD. 4. What was your most significant accomplishment this past year? A. Single Most Significant Accomplishment during FY 2002: Obtaining community-level information on perceptions of the problems associated with healthy food consumption, food security, grocery shopping, and barriers associated with acquisition of healthy foods, is critical to community-based nutrition interventions. The Southern University Coordinating Center for the Delta NIRI Focus Group Study recruited participants and conducted 36 focus groups in 9 counties of LMD and prepared the Focus Group Study Technical Report. Data were analyzed with the development of the Summaries and Emerging Themes for the areas of behavioral change, shopping, food security, and healthy food. The impact of this study will guide future decisions on the types of nutrition interventions that are acceptable and sustainable for Delta residents. B. Other Signifiant Accomplishments: None. C. Significant Accomplishments/Activities that Support Special Target Populations: Community readiness activities were conducted in three Delta NIRI parishes in Louisiana. The Louisiana investigators held meetings with state liaisons and key community leaders in three Louisiana parishes to provide an update on Delta NIRI activities and to solicit support and cooperation for ongoing and future Delta NIRI research activities. The community of Winnsboro in Franklin parish has been selected for the first nutrition intervention in Louisiana. 5. Describe your major accomplishments over the life of the project, including their predicted or actual impact? Southern University scientists contributed two chapters to the monograph entitled "Nutrition and Health Status in the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi: A Review of Existing Data." G. Harrison, Editor, Westat, Rockville, MD, 1997. The monograph provides information on the existing nutritional health of lower Delta residents. Southern University scientists participated in the planning, implementation and completion of the Key Informant Survey in 1997. A sample of 500 people from Arkansas, Louisiana, and Mississippi participated in the survey. SU staff interviewed and collected data from one half of the LA participants. The study provided information on the perceptions of the nutrition and health concerns and problems in Delta counties and parishes. The top nutrition concern in all three states was consumption of high-fat foods. The top health problem in Louisiana was high blood pressure. Southern University scientists participated in the planning and implementation of the Foods of Our Delta Study (FOODS) in 1998. A sample of 409 adults and children from 313 households with telephones and 144 households without telephones were surveyed. The study validated the telephone methodology for rural areas. SU scientists participated in the develop and pre-testing of an adult food frequency questionnaire for the LMD. SU Scientists contributed to the develoment of FOODS 2000 to assesss the nutrition and health status of a representative sample of the population in the 36 Delta counties in Arkansas, Louisiana, and Mississippi. FOODS 2000 was designed as a baseline cross sectional telephone survey of a representative sample of the population 3 years of age and older. These data are being used to design and implement nutrition intervention in Winnsboro, LA. Scientists from Southern University participated in the planning, pre- testing of instruments, and implementation of the Community Assessment Survey, which included: a survey of approximately 360 food stores was conducted in 18 Delta counties/ parishes in Arkansas, Louisiana and Mississippi to learn more about the food choices available to people, as well as the food choices they make. Southern University staff screened all stores in Louisiana prior to the Survey. 6. What do you expect to accomplish, year by year, over the next 3 years? 2003: Design interventions to improve the nutritional well-being of adolescents and young adults in Winnsboro, LA. Implement a lifestyle intervention to control diabetes in Delta residents. Design and scientifically test methods for disseminating nutrition and health information and education materials explicitly designed for limited resource individuals. Complete the Nutrition and Health Survey Research Center. 2004: Operate the Nutrition and Health Survey Research Center to support dietary intake and food consumption assessments related to the implementation and monitoring of interventions in Arkansas, Louisiana, and Mississippi. 2005: Implement interventions to improve the nutritional well-being of residents in Winnsboro, LA. Assess the impact of interventions on the health and well-being of residents. 7. What technologies have been transferred and to whom? When is the technology likely to become available to the end user (industry, farmer other scientist)? What are the constraints, if known, to the adoption durability of the technology? A Manual of Operations for conducting focus groups in rural areas was developed and tested by SU scientists. It is being made available to communities and other scientists who are working in rural areas or with low income, minority groups.

Impacts
(N/A)

Publications

  • Thornton, A., McGee, B.B, Mellad, K., Fomby, B., Eubanks, G.E., Paeratakul, S. The influence of sociodemographic factors on psychosocial beliefs and food security in rural lower Mississippi Delta residents. Journal of the American Dietetic Association. 2001(Supplement). v. 101. Abstract p. A40.


Progress 10/01/00 to 09/30/01

Outputs
1. What major problem or issue is being resolved and how are you resolving it? The Lower Mississippi Delta (LMD) area of Arkansas, Louisiana, and Mississippi is characterized by high rates of poverty, low education attainment, and food insecurity. There is a high prevalence of hypertension, diabetes, obesity, anemia, and heart disease, all of which are influenced by nutrition. We are attempting to resolve these problems through the efforts of the Lower Mississippi Delta Nutrition Intervention Research Initiative (Delta NIRI). The Delta NIRI consortium consists of scientists from Alcorn State University, Alcorn State, MS (ASU); Arkansas Children's Hospital Research Institute, Little Rock, AR (ACHRI); Pennington Biomedical Research Center, Baton Rouge, LA (PBRC); Southern University and A&M College, Baton Rouge, LA (SU); The University of Arkansas at Pine Bluff, Pine Bluff, AR (UAPB); The University of Southern Mississippi, Hattiesburg, MS (USM); and The Agricultural Research Service (ARS) of USDA, Little Rock, AR. The ARS has initiated agreements with other scientists with needed expertise for specific research requirements. For example: the Children's Nutrition Research Center (CNRC) in Houston is collaborating by providing a Baylor Medical Center scientist with nutrition epidemiology skills; the Human Nutrition Research Center (HNRC) at Tufts University in Boston is providing expertise on the development of an original adult food frequency questionnaire; and the Iowa State University at Ames contributes through a rural sociologist with specific skills in community development. These scientists participate fully in the Delta NIRI Consortium. The Consortium is diverse, including minorities, many disciplines (nutrition, food science, family economics, sociology, medicine, agriculture, etc.), and a variety of professionals (nutritionists, pediatricians, nurses, food scientists, sociologists, agriculture economists, etc.). This diversity is necessary because of the complexity of the food problems, poverty, isolation, and low educational attainment in the Delta. The Consortium is evaluating the nutritional health in the Lower Delta, to identify nutritionally responsive problems, and to design and evaluate interventions which may be sustained at the community level and implemented on a larger scale in similar areas of the United States. In addition, a capacity building goal is to increase and continue expertise within each Partner to enhance their teaching and research skills in the areas of food, nutrition and health in order to sustain successful interventions in this high-risk population. 2. How serious is the problem? Why does it matter? Rates of rural poverty and nutrition-related chronic diseases in the LMD are among the nation's highest. Arkansas, Mississippi, and Louisiana rank 50th, 49th, and 48th, respectively, in health rankings of the United States and continue to worsen compared with the other states. Food insecurity is higher in each of these states than the average for the US and 2 1/2 times the national average in the LMD. The area is underserved by food and nutrition and other health professionals. National surveys have not included this area in their sampling of the US. Therefore, information on the food intake, nutrition-related health problems, and food access and security within the area is scarce to nonexistent. The burden of food- related health problems is carried by minority, low-income, and educationally disadvantaged individuals and families in the communities of the Delta. The presence of these problems severely limits the quality of life, productivity, and the future of this at-risk population and at the same time propels them into the high user category for nutrition assistance programs and high cost health care and treatment of nutrition- related disease. 3. How does it relate to the National Program(s) and National Component(s)? The National Program in Human Nutrition, #107, has five specific program components that are being addressed by this research: nutrition monitoring; composition of the diet; nutritional needs of a diverse population; diet, genetics, lifestyle, and the prevention of obesity and chronic disease; and health-promoting intervention strategies for targeted populations. The Delta NIRI provides the USDA, ARS with a unique opportunity to strengthen existing efforts to improve the nutritional health of disadvantaged and at-risk populations through nutrition intervention research. The participation of the Partners allows scientists to evaluate and generate knowledge about nutrition and health needs, food habits, and food consumption in the thirty-six counties in the LMD. The Initiative will enable the Consortium to design and evaluate nutrition interventions that will be sustainable in the LMD. Delta NIRI surveys have determined the composition of the diet and nutritional needs of the diverse population of the Delta. The telephone methodology for obtaining food and nutrition information is important to nutrition monitoring in the LMD as well as the rest of the US. We are collaborating with Tufts Human Nutrition Research Center to develop an adult food frequency questionnaire based on what adults are eating in the LMD and with the Jackson Heart Study in Mississippi to provide validation of this adult food frequency instrument, allowing it to be used widely in nutrition research. A similar collaborative effort is underway with the CNRC in Houston with Baylor scientists assisting in the development of a child food frequency questionnaire. These are examples of additional collaboration within the ARS Human Nutrition Program. We continue to collaborate with USDA, Economic Research Service (ERS) to develop a measure of community food security which will assist in nutrition interventions for the targeted population of the LMD. 4. What were the most significant accomplishments this past year? A. Single Most Significant Accomplishment during FY 2001: Obtaining community level information on perceptions of the problems associated with healthy food consumption, food security, grocery shopping, and barriers associated with acquisition of healthy foods, is critical to community-based nutrition interventions. Southern University served as the Coordinating Center for a series of 36 focus groups considering four topics in 9 counties of AR, LA, and MS. A Manual of Operations was developed by Southern for conducting focus groups in rural areas. This manual is available for other scientists and the Delta NIRI to use in similar rural areas, where none existed. B. Other Significant Accomplishments: None C. Significant Accomplishments/Activities that Support Special Target Populations: None 5. Describe the major accomplishments over the life of the project including their predicted or actual impact. Southern University scientists contributed to the monograph entitled "Nutrition and Health Status in the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi: A Review of Existing Data". G. Harrison, Editor, Westat, Rockville, MD, 1997. Southern University scientists participated in the planning, implementation and completion of the Key Informant Survey of 500 people in Arkansas, Louisiana, and Mississippi. The study provided information on the perceptions of the nutrition and health concerns and problems in Delta counties and parishes. Southern University scientists participated in the planning and implementation of the Foods of Our Delta Study (FOODS) in 1998, sampling 409 adults and 313 children from households with telephones and households without telephones. The study validated the telephone methodology for rural areas. Foods of Our Delta Study 2000(FOODS 2000) assessed the nutrition and health status of a representative sample of the population in the 36 Delta counties in Arkansas, Louisiana, and Mississippi. FOODS 2000 was designed as a baseline cross-sectional telephone survey of a representative sample of the population 3 years of age and older, conducted between January and June 2000. A total of 2162 households were interviewed by telephone. Scientists from Southern University have participated in the planning, pre-testing of instruments and implementation of a Community Assessment Survey, which includes a grocery store survey, and an nutrition and health environment profile for the LMD. 6. What do you expect to accomplish, year by year, over the next 3 years? 2002: Designing interventions to improve the nutritional well-being of adolescents and young adults in the Delta. Implement Summer Feeding Study in collaboration with the University of Southern Mississippi. 2003: Implement a lifestyle intervention to control diabetes in Delta residents. Design and scientifically test methods for disseminating nutrition and health information and education materials explicitly designed for limited resource individuals. 2004: Southern University will complete the Nutrition and Health Survey Research Center. The role of the Center will be to support dietary intake and food consumption assessments proposed for the Nutrition Assessment Survey and for related research activities associated with implementation of interventions in LMD. 7. What science and/or technologies have been transferred and to whom? When is the science and/or technology likely to become available to the end user (industry, farmer, other scientists)? What are the constraints if known, to the adoption & durability of the technology product? Findings from the Key Informant Survey and the Foods Of Our Delta Study have been provided to survey participants, interviewers, and key individuals at the local and state level through two newsletters. Peer reviewed manuscripts have contributed new knowledge about the lower Delta region to scientists, educators and policy makers. 8. List your most important publications in the popular press (no abstracts) and presentations to non-scientific organizations and articles written about your work (NOTE: this does not replace your peer-reviewed publications which are listed below) None.

Impacts
(N/A)

Publications

  • Thornton, A., McGee, B.B., Mellad, K., Fomby, B., Eubanks, G.E., Paeratakul, S. The influence of socio-demographic factors on psychosocial beliefs and food security in rural lower Mississippi Delta residents. Journal of the American Dietetic Association. 2001. v. 101S: Abstract p. 92.
  • Dawkins, N., McGee, B.B., Thornton, A., Fomby, B., Eubanks, G.E., Simpson, P. Perceptions of key informants of diabetes as a health problem in the lower Mississippi Delta: ethnicity effect. Journal of the American Dietetic Association. 2001. v. 100S: Abstract p. 90.


Progress 10/01/99 to 09/30/00

Outputs
1. What major problem or issue is being resolved and how are you resolving it? Nutrition is a major environmental factor that is key to maximizing human potential. Nutrition problems of overnutrition and undernutrition are prevalent in the Lower Mississippi Delta region of Arkansas, Louisiana and Mississippi. Identifying nutritional responsive problems in the most vulnerable segment of the country and evaluating nutritional interventions will provide solutions to improve the health and well-being of residents in this region. The purpose of this initiative is to evaluate the nutritional health of residents in the Lower Mississippi Delta states of Arkansas, Louisiana and Mississippi and to design and evaluate interventions that may be applied to other areas of the United States. In designing the interventions, primary consideration will be given to their scientific excellence, effectiveness, and potential sustainability. 2. How serious is the problem? Why does it matter? The Lower Mississippi Delta region of Arkansas, Louisiana and Mississippi is plagued by a large number of health problems that are linked to a lack of nutrition and health education. Poverty, infant mortality, low birth- weight infants and births to teen mothers in this region are the highest in the nation. The incidence of cardiovascular disease, diabetes and cancer are also higher than the national average. The burden of diet- related disease is carried by many minority, low-income and educationally disadvantaged individuals, families and communities in the Delta. The presence of these problems seriously limits the capacity of this population to be fully productive citizens. 3. How does it relate to the National Program(s) and National Component(s)? The National Program in Human Nutrition, #107 has five specific program components that are being addressed by this research:nutrition monitoring, composition of the diet, nutritional needs of a diverse population, diet, genetics, lifestyle and the prevention of obesity and chronic disease, and health promoting intervention strategies for targeted populations. The Delta NIRI provides the USDA/ARS with a unique opportunity to strengthen existing efforts to improve the nutritional health of disadvantaged and at risk populations. This research allows scientists to generate knowledge about the nutrition and health needs, food consumption patterns of residents in the Delta region and design and evaluate nutrition interventions that enable people to improve their nutritional status. 4. What were the most significant accomplishments this past year? A. Single most significant accomplishment during FY 2000 year: Southern University serves as the Coordinating Center for the Focus Group Pilot Study which was conducted during March - May, 2000. Individuals were trained from partner institutions to conduct the focus group sessions. The pilot study was conducted to evaluate the study protocol for collecting information about the perceptions of Delta residents in one parish/county in Arkansas, Louisiana and Mississippi. The overall goal of the larger Focus Group Study is to obtain information on perceptions of the problems associated with fruit and vegetable consumption, food security, grocery shopping and barriers associated with acquisition of fruits and vegetables in order to guide intervention decisions. Results from the pilot will guide the implementation of the larger study. B. Other significant accomplishment(s), if any: None. C. Significant accomplishments/activities that support special target populations: The work of the Delta NIRI Consortium is impacting one of the most socially disadvantaged/limited resource populations in the US. The burden of food related health problems is carried by minority, low income, and educationally disadvantaged individuals and families in the communities of the Delta. The presence of these problems severely limits the quality of life, productivity, and the future of this at risk population and at the same time propels them into the high user category for nutrition assistance programs and treatment of disease. Individuals from the local areas have been employed by Delta NIRI to collect data, contact agencies and assist with focus groups. Interventions to increase consumption of fruits and vegetables may cause minority small farm owners to establish farmers markets and food cooperatives. Sustainable interventions could reduce the incidence of nutrition related diseases and decrease the need for nutrition assistance programs. 5. Describe the major accomplishments over the life of the project including their predicted or actual impact. 1.) Southern University scientists contributed to the monograph entitled Nutrition and Health Status in the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi: A Review of Existing Data. G. Harrison, Editor, Westat, Rockville, MD, 1997. The monograph provides information on the existing nutritional health of lower Delta residents. The area is characterized by a limited transportation infrastructure, high rates of adolescent pregnancy, deaths from heart disease, stroke, cancer, and diabetes, low birth weight babies, high rates of obesity, and limited access to grocery stores. 2.) Southern University scientists participated in the planning, implementation and completion of the Key Informant Survey in 1997. A sample of 500 people from Arkansas, Louisiana, and Mississippi participated in the survey. The study provided information on the perceptions of the nutrition and health concerns and problems in Delta counties and parishes. The top nutrition concern in all three states was consumption of high fat foods. The top health problem in Arkansas was teen pregnancy, and in Louisiana and Mississippi was high blood pressure. 3.)Southern University scientists participated in the planning and implementation of the Foods of Our Delta Study (FOODS) in 1998. A sample of 409 adults and children from 313 households with telephones and 144 households without telephones were surveyed. The study validated the telephone methodology for rural areas. Decreased consumption of fruits and vegetables was found. A food frequency questionnaire was developed. 6. What do you expect to accomplish, year by year, over the next 3 years? 2001.Southern University will establish a Nutrition and Health Survey Research Center. The role of the Center will be to support dietary intake and food consumption assessments proposed for the Nutrition Assessment Survey and for related research activities associated with implementation of interventions. Designing interventions to improve the nutritional well-being of adolescents and young adults in the Delta based on findings of the Nutritional Assessment Survey, Part I; implementation of a lifestyle intervention to control diabetes in Delta residents;.Southern University scientists will assist in the implementation of the Food Store Survey, Community Nutrition and Health Profile, and the Focus Group Study components of the Community Assessment Study. 2002. Designing and scientifically testing methods for disseminating nutrition and health information and education materials explicitly designed for limited resource individuals; 2003. Contributing to new knowledge through the generation of research products. 7. What science and/or technologies have been transferred and to whom? When is the science and/or technology likely to become available to the end user (industry, farmer, other scientists)? What are the constraints if known, to the adoption & durability of the technology product? Findings from the Key Informant Survey and the Food Of Our Delta Study have been provided to survey participants, interviewers and key individuals at the local and state level through two newsletters. Peer reviewed manuscripts have contributed new knowledge about the lower Delta region. 8. List your most important publications in the popular press (no abstracts) and presentations to non-scientific organizations and articles written about your work (NOTE: this does not replace your peer-reviewed publications which are listed below) McGee, B.B. Evolution of a Health and Nutrition Intervention Process: Community Assets Evaluation and Food Security. Health Status of Minorities: Present Issues and Future Actions. March 30-31, 2000. Florida State University. Tallahassee, FL.

Impacts
(N/A)

Publications

  • Dawkins, N.L., McGee, B.B., Tubb, T., Simpson, P., Fomby, B., Thornton, A., Eubanks, G.E. Perceptions of Key Informants of Diabetes as a Major Health Problem in the Lower Mississippi Delta. Journal of The American Dietetic Association. 2000. v. 100(9S) p. A-90. Abstract.