2003 Annual Report 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 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 2½ 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: The Marvell NIRI Community Research Group did not have funds to conduct the nutrition intervention research planning. The Group came up with some local funds and identified a not-for-profit organization in Marvell, AR, through which the USDA, ARS agreed to supply additional funds utilizing a cooperative agreement. The Community Research Group is moving forward with planning the interventions. This has allowed the intervention implementation phase to move ahead in a shorter time frame. B. Other Signifiant Accomplishments: None. C. Significant Accomplishment/Activities that support special target populations: The population in Marvell, AR, is largely African-American families with low incomes and low educational attainment without resources or skills to interact with agencies, universities, or others to accomplish a common goal. The Marvell NIRI Community Research Group (which includes the university partners as well as various community agencies, programs and individuals) brought the citizens together for a workshop on Comprehensive Participatory Planning and Evaluation. Thirty-six individuals were trained in the process. The Community Research Group is now using this process to plan interventions and to participate with other groups in the community about other problems or processes. 5.Describe the major accomplishments over the life of the project, including their predicted or actual impact. The Marvell NIRI Community Research Group has formed a working group to plan, implement, and evaluate nutrition intervention strategies in Marvell, AR. This group consists of University partners, scientists from USDA, ARS, and individuals from the community. They meet regularly in the community and through conference calls. The group has officers and procedures for meetings. They identified a local not-for-profit organization, the Mid Delta Community Consortium, which could receive and disburse funds more efficiently than the University partners. This has empowered the Community Group to move forward with the planning and evaluation of the nutrition interventions. Through the use of the Comprehensive Participatory Planning and Evaluation Workshop the Group has identified the food- and nutrition-related problems in Marvell, AR, that can be focused for intervention. In addition, the Group can use this participatory process in their work with other groups in the community. 6.What do you expect to accomplish, year by year, over the next 3 years? 2004: Complete the research protocol for the nutrition intervention. Develop an operational and training plan for the implementation of the intervention. Recruit participants from the community. Initiate the collection of baseline data. 2005: Monitor and evaluate the intervention in Marvell. Continue recruitment and training if necessary. Prepare progress reports to share with communities in LA and MS and with scientists in the US. 2006: Continue monitoring and evaluation of the intervention in Marvell. Publish information about progress of intervention to date. 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 and durability of the technology products? The community and university partners were trained in the process of community-based research and in the comprehensive participatory planning and evaluation process. These are techniques that can be used in the community with other agencies and programs by these partners and others. 8.List your most important publications in the popular press and presentations to organizations and articles written about your work. (NOTE: This does not replace your peer-reviewed publications listed below). None.