2006 Annual Report 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? Why 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 Hollandale Nutrition Intervention Research Initiative (Hollandale NIRI) is aligned with the National Program 107 - Human Nutrition, and addresses ARS Strategic Plan performance goal 4.1.1 through developing and transferring effective nutrition intervention strategies. 2.List by year the currently approved milestones (indicators of research progress) Year 2005: Objective 1. Develop nutrition interventions in Hollandale, MS, through community-based participatory research. Milestone a) The Hollandale NIRI community-based research team will be in place in MS. Milestone b) The Hollandale NIRI research worksite will provide a neutral site in Hollandale, MS, and enhance visibility of the Delta NIRI. Milestone c) An assessment of community resources and environmental conditions in Hollandale, MS, relevant to nutrition interventions will be complete. Objective 2. Design the nutrition intervention research for Hollandale NIRI using a Comprehensive Participatory Planning and Evaluation (CPPE) process. Milestone a) Potential interventions and strategies will be identified and evaluated. Milestone b) A research protocol for each of the selected interventions in Hollandale, MS, will be written. Milestone c) New and modified data collection instruments will be developed as needed for each intervention. Milestone d) Manuscripts will be completed and include input from the Hollandale NIRI community members describing the CBPR/CPPE processes, development of the Hollandale research worksite, community readiness, resource assessment, and other elements of the pilot testing and preparation for each intervention. Milestone e) Hollandale NIRI will participate in the planning and implementation of one regional conference of scientific and lay communities. Objective 3A. Implement nutrition intervention strategies in Hollandale, MS. Milestone a) A well-written research protocol for a nutrition intervention in Hollandale, MS, will be finalized. Milestone b) Appropriate data collection instruments and procedures necessary for the intervention research will be pre-tested if necessary. Milestone c) Hollandale residents will be trained to collect data and to monitor data collection. Milestone d) A detailed operational plan for the implementation process for the intervention in Hollandale will be completed. Milestone e) Appropriate institutional review board approval for human subject's participation will be in place. Milestone f) Manuscripts describing pilot testing intervention strategies, data collection procedures, and training of data collectors will be completed for peer reviewed journals and will include input and participation from Hollandale NIRI community members. Year 2006 Objective 3A. Implement nutrition intervention strategies in Hollandale, MS. Milestone a) Implement nutrition intervention strategies specific to Hollandale. Milestone b) Monitor data collection and progress of intervention strategies. Milestone c) Evaluate process variables associated with nutrition interventions in Hollandale. Milestone d) Hollandale NIRI will assist in preparation and submission of manuscripts to peer reviewed journals for publication. Year 2007 Objective 3B. Evaluate nutrition intervention strategies implemented in Hollandale, MS. Milestone a) Evaluate nutrition intervention strategies in place in Hollandale, MS. Milestone b) Develop measures to evaluate the impact of the CBPR/CPPE processes on the community of Hollandale, MS. Milestone c) Monitor the effects of other activities within Hollandale on the nutrition intervention. Milestone d) Utilize appropriate qualitative and quantitative statistical techniques to evaluate objectives and test hypotheses of the interventions in Hollandale. Milestone e) The participation of the Hollandale NIRI (community group) in the analytical process will be documented. Milestone f) A data monitoring and evaluation system will be in place for continuous monitoring of data collection and quality of processes used. Milestone g) Manuscripts describing the status of interventions in Hollandale with regards to process and outcome variables will be completed with input from the Hollandale NIRI community members and submitted to peer reviewed journals for publication. Milestone h) Hollandale NIRI will participate in the convening of a Delta NIRI national symposia for scientific and lay communities on CBPR/CPPE and nutrition intervention strategies targeting high risk populations in rural communities. Year 2008. Objective 4. Initiate the process of adapting the successful nutrition intervention strategies from Hollandale, MS, to other Lower Mississippi Delta communities. Milestone a) At least one additional community in MS will be targeted and recruited for community-based nutrition intervention research to duplicate the successful strategies and interventions. Milestone b) Manuscripts describing the research process and intervention outcomes will be prepared with input from the Hollandale NIRI and submitted to peer reviewed journals for publication. Milestone c) Hollandale NIRI will participate in the convening of a national Delta NIRI symposia for scientific and lay communities on CBPR, CPPE, and nutrition intervention strategies targeting high risk populations in rural communities. 4a.List the single most significant research accomplishment during FY 2006. This accomplishment is aligned with National Program 107 – Human Nutrition: Component 7. Health Promoting Intervention Strategies for Targeted Populations. Action Plan Problem Statements: Identify, implement and test nutrition and physical activity interventions in low-income communities. Hollandale NIRI Fit for Life Steps: The development of the Hollandale NIRI walking trail led to the implementation of a nutrition and physical activity intervention, "Hollandale NIRI Fit for Life Steps", for the community of Hollandale. This intervention consisted of trained volunteers and coaches from the community, to lead walking groups followed by the implementation of walking groups and monthly educational and motivational sessions intended to impact behavioral factors that have been shown to influence health. "Hollandale NIRI Fit for Life Steps" was implemented in three phases:. 1)training of coaches, including coaches' recruitment of walking group participants;. 2)participant enrollment and walking group intervention activities, lasting 6 months; and. 3)follow-up on coaches and participants, at 12 months from participant enrollment, with phase one completed and currently at month 4 of phase two. The potential impact of these accomplishments will lead to healthier lifestyles of Hollandale residents, reducing the prevalence of diabetes, hypertension, and other chronic health diseases, as well as serving as a model for implementing successful interventions in other rural communities. 4b.List other significant research accomplishment(s), if any. Expansion of Hollandale NIRI Research Worksite: Hollandale NIRI expanded the office and established a research worksite in Hollandale to implement community-based efforts to further address the community's needs related to nutrition interventions and lifestyle changes. Mississippi State University Cooperative Extension (MSU EXT) has served as Community Coordinator for this office and research worksite. MSU EXT provided several programs that had a direct impact on the community and included residents that are not participating in the "Hollandale NIRI Fit for Life Steps" Research Intervention. These include the following: Summer Youth Soccer Nutrition Education, Summer Youth Intern Program, Community-Wide Health Fairs, Breast Cancer Awareness Program, and the rise of public awareness. Summer Youth Soccer Nutrition Education, Summer Youth Intern Program, and the participation in Community-Wide Health Fairs directly concentrate on food choices, health problems, and behavioral and lifestyle factors. The impact of these programs includes raising the awareness with publicity and diversity within the Hollandale community, and serving as foundation for future interventions; and provided recruitment of community participants for the research activities. 4c.List significant activities that support special target populations. None. 5.Describe the major accomplishments to date and their predicted or actual impact. The Hollandale NIRI has fully organized the community into a formal working group, namely the Hollandale NIRI, with committees and subcommittees to ensure that the community is fully engaged with planning, developing, and implementing nutrition intervention research. Hollandale NIRI has an organized structure and by-laws to govern the nutrition intervention and research work in the community. An official office is designated with 3 full-time staff to fulfill the research, outreach, and intervention goals/objectives of the Hollandale NIRI. The staff includes: Community Coordinator, Intervention Coordinator and Outreach Worker. Each of the partners provides the necessary technical assistance and guidance for the research and interventions in the community. The Hollandale NIRI staff is trained in research methodology and data collection techniques and is an integral part of the research and intervention team. The Hollandale NIRI collaborates with the University of Southern Mississippi (USM), Alcorn State University (ASU), Mississippi State Cooperative Extension (MS EXT), and the Delta NIRI Partners to plan, develop, and implement the "Fit for Life Steps" nutrition and physical activity research intervention. A six-month pilot nutrition and walking intervention is presently being conducted in the community of Hollandale. This pilot research intervention consisted of 8 walking teams with a total of 83 community participants. Researchers and data collectors were trained to collect biological and physical data and in interviewing techniques, using a variety of data collections instruments. Data analysis is in progress and reviewed for publication purposes. The teams are trained and equipped with the necessary skills to become self-sufficient and self-sustaining at the end of the intervention. Hollandale NIRI community members were involved with the planning and implementation of the All Delta Conference; and were an integral part of the program as speakers/presenters and exhibitor. They have participated in local, state and national conferences associated with nutrition and health and those conferences focusing on Community-Based Participatory Research. 6.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? In the Hollandale NIRI Summer Youth Intern Program, students completed training on Workforce Preparedness under the direction of MSU EXT. In these workshops students used training computers from MSU EXT and developed resumes and PowerPoint presentations. 7.List your most important publications in the popular press and presentations to organizations and articles written about your work. (NOTE: List your peer reviewed publications below). Delta Democrat Times, Greenville, MS. Completion of the 12 month followup of the Fit for Life Steps Study. May 23, 2006. WABG Television Station. Discuss the Soccer and the Will Try Research Study in the Hollandale NIRI Community. June 2006.