Danielle Berman

Evaluating the Impact of Six Supplemental Nutrition Assistance Program Education Interventions on Children’s At-Home Diets

Background. Nutrition education in the Supplemental Nutrition Assistance Program Education (SNAP-Ed) is designed to promote healthy eating behaviors in a low-income target population. Purpose. To evaluate the effectiveness of six SNAP-Ed interventions delivered in child care centers or elementary school settings in increasing participating children’s at-home fruit and vegetable (F/V) consumption by 0.3 cups per day and use of fat-free or low-fat milk instead of whole or reduced-fat milk during the prior week. Method. Clustered randomized or quasi-experimental clustered trials took place in child care centers or elementary schools between 2010 and 2012. Parents of children at intervention and control sites completed baseline and follow-up surveys about their child’s at home F/V consumption and other dietary behaviors. Results. One of the six interventions was successful in meeting the objective of increasing children’s F/V consumption by 0.3 cups per day. For three of the six interventions, there was a small but statistically significant increase in F/V consumption and/or use of low-fat or fat-free milk. Conclusion. Although not all interventions were effective, these findings suggest that it is possible for some SNAP-Ed interventions to improve dietary habits among low-income children among some families. The effective interventions appear to have benefited from implementation experience and sustained efforts at intervention refinement and improvement.

Eat Smart, Live Strong Intervention Increases Fruit and Vegetable Consumption Among Low-Income Older Adults

This study evaluated the impact of a four-session interactive nutrition education program—Eat Smart, Live Strong (ESLS)—on the consumption of fruit and vegetables by low-income older adults. A pre–post quasi-experimental design study was conducted with a longitudinal sample of 614 low-income Supplemental Nutrition Assistance Program (SNAP) participants and those eligible for SNAP, aged 60 to 80 years, in 17 intervention and 16 comparison senior centers in Michigan. The study compared participants’ self-reports of their consumption of fruit and vegetables using a modified version of the University of California Cooperative Extension Food Behavior Checklist. ESLS increased participants’ average daily consumption of fruit by 0.2 cups (P < 0.05) and vegetables by 0.31 cups (P < 0.01). ESLS, a four-session, cognitive-behavioral nutrition education program is an effective curriculum for helping low-income older adults eat more fruit and vegetables.

A Patient and Provider Research Agenda on Diabetes and Hypertension Management

INTRODUCTION A demonstration project in Richmond, Virginia involved patients and other stakeholders in the creation of a research agenda on dietary and behavioral management of diabetes and hypertension. Given the impact of these diseases on morbidity and mortality, considerable research has been directed at the challenges patients face in chronic disease management. The continuing need to understand disparities and find evidence-based interventions to improve outcomes has been fruitful, but disparities and unmet needs persist. METHODS The Stakeholder Engagement in Question Development (SEED) method is a stakeholder engagement methodology that combines engagement with a review of available evidence to generate research questions that address current research gaps and are important to patients and other stakeholders. Using the SEED method, patients and other stakeholders participated in research question development through a combination of collaborative, participatory, and consultative engagement. Steps in the process included: (1) identifying the topic and recruiting participants; (2) conducting focus groups and interviews; (3) developing conceptual models; (4) developing research questions; and (5) prioritizing research questions. RESULTS Stakeholders were involved in the SEED process from February to August 2015. Eighteen questions were prioritized for inclusion in the research agenda, covering diverse domains, from healthcare provision to social and environmental factors. Data analysis took place September to May 2016. During this time, researchers conducted a literature review to target research gaps. CONCLUSIONS The stakeholder-prioritized, novel research questions developed through the SEED process can directly inform future research and guide the development of evidence that translates more directly to clinical practice.

Accounting for Job Quality in Women’s and Men’s Commute Time to Work: An Update to the “Household Responsibility” Thesis

Women often face trade-offs in fulfilling both employment and household responsibilities. One indicator of this is commute time, a compromise between the stresses of longer work journeys and potentially expanded job options. Women spend less time commuting than men and thus may have fewer work opportunities. While prior research finds a link between commute time and womens disproportionate household responsibilities, it does not examine in detail the potential role of job quality. Using employee data from the 2008 National Study of the Changing Workforce, this study examines how fringe benefits, scheduling flexibility, wages, and full-time hours relate to commute time and mediate relationships between sex, household responsibilities, and commute time. This study finds that for women, orientation toward traditional gender roles is associated with shorter commute times, though access to benefits is related to longer commutes. The association between wages and commute time is similar between women and men, and men’s commute times are not tied to their household roles or attitudes.

Employment Opportunity for Workers Without a College Degree Across the Public, Nonprofit, and For-Profit Sectors

The public and nonprofit sectors are known for providing enhanced employment opportunity to women, persons of color, and parents. The authors ask whether the same is true for workers without college degrees, examining sectoral differences in access to jobs offering fringe benefits, full-time hours, and schedule flexibility. The authors find that the influence of sector and union representation on job quality varies by type of benefit. For example, among public and for-profit employees, union representation is positively associated with benefits availability. Nonprofit employees of either union status have less access to full-time hours, and schedule flexibility is comparably available to all but unionized for-profit workers.