2004 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? 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 (2004) Establish a cooperative partnership with Marvell NIRI consortium partners. Support Marvell NIRI in coordinating, assisting, designing, organizing, conducting, interpreting, and evaluating community participatory based nutritional interventions in Marvell, AR. Year 2 (2005) Develop nutrition interventions in Marvell, AR, through community-based participatory research (CBPR): 1) Establish Community Groups and Research Teams. 2) Identify community-specific nutritional problems/concerns. 3) Identify community resources/environmental conditions. Design the nutrition intervention research for Marvell, AR, using Comprehensive Participatory Planning and Evaluation (CPPE): 1) Evaluate proposed intervention strategies. 2) Develop community-specific research plans/protocols. 3) Modify and develop new data collection instruments. Implement and evaluate nutrition intervention strategies in Marvell, AR: 1) Complete training on data collection/intervention strategies. 2) Pre-test data collection instruments/procedures. 3) Complete operational plan/research protocol. 4) Implement community-specific nutrition interventions. Year 3 (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 Marvell, AR. 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. 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. Establish a cooperative partnership with Marvell NIRI consortium partners. This objective has been fully met. Support Marvell NIRI in coordinating, assisting, designing, organizing, conducting, interpreting, and evaluating community participatory-based nutritional interventions in Marvell, AR. 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? Year 2005 Develop nutrition interventions in Marvell, AR, 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 Marvell, AR, 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 Marvell, AR: 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 Marvell, AR. 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. 4.What were the most significant accomplishments this past year? A. Single most significant accomplishment during FY 2004: An individual was hired to serve as the Marvell NIRI Community Coordinator and took a lead in establishing a functionally operative Marvell NIRI worksite in Marvell, AR. This accomplishment is important since the Lower Mississippi Delta NIRI becomes a permanent fixture in the Marvell community through the Marvell NIRI. The Arkansas Cooperative Extension, in collaboration with the Lower Mississippi Delta NIRI and Delta NIRI cooperators (Arkansas Children's Hospital Research Institute and University of Arkansas at Pine Bluff), employed a Marvell NIRI Community Coordinator to oversee Marvell NIRI operations and nutritional projects. The potential impact of these accomplishments will lead to healthier lifestyles of Marvell 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 like communities. B. Other significant accomplishment(s), if any. With the assistance of the Marvell NIRI Community Coordinator, the Marvell NIRI component of the Lower Mississippi Delta NIRI Consortium initiated a comprehensive nutrition and physical activity intervention to be implemented in Phillips County, AR. This accomplishment is important since the intervention is designed to improve the nutritional health of the residents in Marvell, AR and twelve (12) unincorporated communities. The Marvell NIRI, in collaboration with researchers at the Lower Mississippi Delta NIRI and Delta NIRI cooperators (University of Arkansas at Pine Bluff, Arkansas Children's Hospital Research Institute, and the Arkansas Cooperative Extension) designed, developed, and have initiated multiple nutrition and physical activity interventions including: a) walking club; b) walking trail; c) school-based intervention; and d) food preparation using modified recipes. The potential impact of these interventions would lead to healthier lifestyles of Marvell 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 like communities. 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. The Marvell NIRI has established an administrative and program office in the Marvell community, and uses a Cooperative Extension Community Coordinator as the lead staff person. The Marvell NIRI is a member of the Chamber of Commerce and uses this mechanism to gain full support of the entire community, and to motivate participation from all segments of the community and support for sustainability. 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? None. 7.List your most important publications in the popular press and presentations to organizations and articles written about your work. None.