Blood Pressure, Diabetes Mellitus Risk, Diet, Healthy, Health Behavior, Utilization, Health Care
Conditions
Brief summary
Increasing fruit and vegetable (FV) intake, and reducing saturated fat, salt, and added sugar are central lifestyle recommendations in the Dietary Guidelines for Americans to prevent chronic disease. Yet, while diet is modifiable, numerous barriers exist for lower-resourced families to engage in healthy dietary behaviors. In particular, rural families face structural and systemic disparities, such as inadequate access to affordable healthy food. Thus, this project. Thus, this study, PhytoRx Families, an innovative produce prescription (Prx) program, addresses health disparities in rural North Carolina (NC). This project will pilot test and explore the impact of PhytoRx Families (PhtyoRxF) on nutrition-related, health-related, and healthcare utilization outcomes.
Detailed description
Increasing fruit and vegetable (FV) intake, and reducing saturated fat, salt, and added sugar are central lifestyle recommendations in the Dietary Guidelines for Americans to prevent chronic disease. Yet, while diet is modifiable, numerous barriers exist for lower-resourced families to engage in healthy dietary behaviors. In particular, rural families face structural and systemic inequities, such as inadequate access to affordable healthy food. Thus, this project, PhytoRx Families, an innovative produce prescription (Prx) program, will address health disparities in rural North Carolina (NC). This project will pilot test and explore the impact of PhytoRx Families (PhtyoRxF) on nutrition-related outcomes. This study will define impact on FV intake using the ASA24 dietary recall (primary outcome) among n=30 adults and school-aged children (adult-child dyads; children 8-14 year olds, 2nd-9th grade). The study will also explore the impact of PhytoRxF on cardiovascular health-related outcomes (blood pressure, glycated hemoglobin (HbA1C), height, weight (BMI calculated)). Finally the study will examine the change in healthcare utilization among PhytoRxF participants.
Interventions
OTHERPhytoRx Families: A Pilot Test to Address Food Security in Rural North Carolina
This project will pilot test and explore the impact of PhytoRx Families (PhtyoRxF) on nutrition-related, health-related, and healthcare utilization outcomes among n=30 adults and school-aged children (adult-child dyads; children 8-14 year olds, 2nd-9th grade).
Sponsors
East Carolina University
North Carolina State University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
8 Years to 64 Years
Healthy volunteers
Yes
Inclusion criteria
* Fluent in English or Spanish (speaking, reading, writing) * An adult (18 years of age or older) who's a parent or caregiver of a child ages 8 to 14 years old or a child ages 8 to 14 years old * Served at participating clinic in a county where the program is being implemented (Goldsboro Pediatrics, Bertie County Rural Health Association, and Roanoke Chowan Community Health in Bertie, Halifax, Lenoir, Northampton, or Wayne Counties) * Living in a county where the program is being implemented (Bertie, Halifax, Lenoir, Northampton, or Wayne Counties) * Free living to the extent they are able to receive and use a box of fresh produce and participate in direct nutrition education classes * Willing and able to provide written consent and participate in all study activities.
Exclusion criteria
* Adults not at risk of food insecurity * Adults, who are not parents nor caregivers of a child 8 to 14 years * Adults who do not want to or could not fully participate (e.g., an adult family member with advanced kidney disease with severe dietary restrictions).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fruit and vegetable intake | Baseline and end of study at 16 weeks | Measured by ASA24 dietary recall |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Diet quality | Baseline and end of study at 16 weeks | Measured by ASA24 dietary recall |
| Food security status | Baseline and end of study at 16 weeks | USDA 6-Item Food Security Survey. Score range is 0 to 6. Responses of often or sometimes on questions HH3 and HH4, and yes on AD1, AD2, and AD3 are coded as affirmative (yes). Responses of almost every month and some months but not every month on AD1a are coded as affirmative (yes). The sum of affirmative responses to the six questions in the module is the household's raw score on the scale. Food security status is assigned as follows: Raw score 0-1-High or marginal food security; Raw score 2-4-Low food security; Raw score 5-6-Very low food security |
| Nutrition security status | Baseline and end of study at 16 weeks | 4-Item Household Nutrition Security Screener (Gretchen Swanson/Center for Nutrition & Health Impact), Score range is 0 (if the participant selects Always) to 4 (if the participant selects Never), with higher scores indicating a greater degree of Household Nutrition Security |
| Blood pressure | Baseline and end of study at 16 weeks | Measured by automated monitor; Omron HEM-907XL, Vernon Hills |
| Hemoglobin A1C | Baseline and end of study at 16 weeks | Measured by point-of-care (PoC) testing via A1C+ Now Analyzer, PTS Diagnostics |
| Skin carotenoids | Baseline and end of study at 16 weeks | Objective measure of fruit and vegetable intake measured by skin carotenoids, derived from a validated reflection spectroscopy device, Veggie Meter® |
| Self-efficacy for Healthy Eating | Baseline and end of study at 16 weeks | Self-efficacy for Eating Behaviors Scale. Score range from 1 (participant responds strongly disagree) to 5 (participant responds strongly agree), with higher scores indicating higher self efficacy for choosing healthy foods |
| Food-related Parenting Practices | Baseline and end of study at 16 weeks | Comprehensive Home Environment Survey (CHES). Measurement of social and physical home environment to assess food-related parenting practices. Scale from 1 (participant responds Never) to 5 (participant responds Always), with higher scores indicating positive food-related parenting practices (ie eating meals together as a family, modeling healthy behaviors, cooking at home, involving children in the meal planning/cooking process). |
| Barriers and Facilitators to Fruit and Vegetable Consumption | Baseline to end of study at 16 weeks | Adapted instruments from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Parent Module and the Singleton et al 2018 study to assess barriers and facilitators to fruit and vegetable consumption. Score range from 1 (participant responds Strongly Disagree) to 5 (participant responds Strongly Agree), with higher scores representing more barriers to eating fruits and vegetables. |
| Body Mass Index-For-Age Percentile | Baseline and end of study at 16 weeks | Weight in kilograms and height in meters (collected at baseline only) will be assessed by electronic scale with stadiometer, SECA 874dr scale. BMI will be calculated by dividing weight (kg) by height (m) squared, then plotted on a growth chart. |
| Body Mass Index | Baseline and end of study at 16 weeks | Weight in kilograms and height in meters (collected at baseline only) will be assessed by electronic scale with stadiometer, SECA 874dr scale. BMI will be calculated by dividing weight (kg) by height (m) squared |
Countries
United States
Contacts
Primary ContactBasheerah Enahora, PhD
Outcome results
None listed