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 Lower Mississippi Delta Nutrition Intervention Research Initiative falls under 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 Marvell, AR, public school district through community-based participatory research. Milestone a) The Marvell NIRI community-based research team will be in place in AR. Milestone b) The Marvell research worksite will provide a neutral site in Marvell, AR, and enhance visibility of the Delta NIRI. Milestone c) An assessment of community resources and environmental conditions in Marvell, AR, relevant to nutrition interventions will be complete. Objective 2. Design the nutrition intervention research for Marvell, AR, public school district 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 Marvell, AR, will be written. Milestone c) New and modified data collection instruments will be developed as needed for each intervention. Milestone d) The University of Arkansas Cooperative Extension (UA EXT) will assist in the preparation of manuscripts describing the CBPR/CPPE processes, development of the Marvell NIRI research worksite, community readiness, resource assessment, and other elements of the pilot testing and preparation for each intervention. Milestone e) The UA EXT will participate in the planning and implementation of one regional conference of scientific and lay communities. Objective 3A. Implement nutrition intervention strategies in Marvell, AR, public school district. Milestone a) A well-written research protocol for a nutrition intervention in Marvell, AR, will be finalized. Milestone b) Appropriate data collection instruments and procedures necessary for the intervention research will be pre-tested if necessary. Milestone c) Marvell residents and individuals from UA EXT 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 Marvell, AR, will be completed. Milestone e) Appropriate institutional review board approval for human subject's participation will be in place for UA EXT. Milestone f) UA EXT will assist in the preparation of manuscripts describing pilot testing intervention strategies, data collection procedures, and training of data collection to be submitted to peer reviewed journals. Year 2006 Objective 3A. Implement nutrition intervention strategies in Marvell, AR, public school district. Milestone a) Implement nutrition intervention strategies specific to Marvell, AR. Milestone b) Monitor data collection and progress of intervention strategies. Milestone c) Evaluate process variables associated with nutrition interventions Marvell, AR. Milestone d) UA EXT will assist in the preparation and submission of manuscripts to peer reviewed journals for publication. Year 2007 Objective 3B. Evaluate nutrition intervention strategies implemented in Marvell, AR, public school district. Milestone a) Evaluate nutrition intervention strategies in place in Marvell, AR, public school district. Milestone b) Develop measures to evaluate the impact of the CBPR/CPPE processes on the community of Marvell, AR. Milestone c) Monitor the effects of other activities within the Marvell, AR, public school district on the nutrition intervention. Milestone d) Utilize appropriate qualitative and quantitative statistical techniques to evaluate objectives and test hypotheses of the interventions in Marvell, AR. Milestone e) The participation of the Marvell 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) UA EXT will assist in the preparation of manuscripts describing the status of interventions in Marvell, AR, with regards to process and outcome variables will submit to peer reviewed journals for publication. Milestone h) UA EXT will participate in the convening of a national symposia for scientific and lay communities on CBPR/CPPE, and nutrition intervention strategies for at-risk populations in rural communities. 4a.List the single most significant research accomplishment during FY 2006. Healthy Eating Intervention: The Healthy Eating intervention research group of the Marvell NIRI collaborated with the Food Panty in the Marvell Community. The Pantry provides food boxes to 300 plus families on a monthly basis. Summer honor students under the supervision of UA EXT gathered information and data collected from the Food Pantry participants. These data were used to design a nutritional intervention to aid the participants in using food items from the food pantry that might otherwise just be stored and/or discarded. A Tasting Event was held on July 21, 2006, using items in the boxes from the Food Pantry. A recipe for each dish was provided as well. Results from the Healthy Eating project will be used for the implementation of the Delta DASH Intervention which will replicate the DASH Diet in the Marvell community. 4b.List other significant research accomplishment(s), if any. The Walking Club Intervention: The Walking Club Research Intervention has conducted the six month data collection. Thirty-four of the 39 participants who participated in baseline data collection were measured. On the third Saturday of each month an awards breakfast was held at the Haven Apartment Complex for participants. They were served a nutritious breakfast and given small tokens for meeting-established goals. The breakfast session also included educational topics such as healthy eating habits (home and restaurants), appropriate clothing for walking (shoes, socks, etc.), and exercise/physical activity tips. The group also shared their accomplishments, questions, and concerns during this time. Dianne Sims, Community Outreach Technician from U A Cooperative Extension, took the lead role in organizing the monthly breakfast sessions and reminding participants of Walking Club activities as well as times and locations for data collection. The Marvell NIRI Garden (service project) The Marvell NIRI Spring Garden was planted at the Marvell Research site and at the Senior Haven Center. Members of the community planted sweet corn, peppers, tomatoes, beets, carrots, squash and zucchini, okra, lettuce, and various herbs in raised boxes with assistance from the UA EXT. The garden produced vegetables and herbs during the summer months, and the Community was encouraged to pick what was grown. The group learned that some vegetables were planted too thickly; corn can be grown in a raised bed garden with plenty of water and fertilizer; and clipping the leaves from the okra stalks enabled the sunlight to be absorbed better, leading to better produce. The honor students and Marvell NIRI office staff have been tending the garden. A fall garden will be planted in mid-September at both the Senior Haven Center and the Research Worksite and will include greens (mustard, turnip, spinach, and collard). 4c.List significant activities that support special target populations. None. 5.Describe the major accomplishments to date and their predicted or actual impact. The implementations of service projects prior to research projects have made the community more receptive to the goals of the NIRI program and willing to participate. Training is an ongoing process with the community as they want to learn more about Community Based Participatory Research and the avenues in which they have to travel to make their community healthier and worthy of living in once again. The Marvell NIRI is a member of the Chamber of Commerce and has used this mechanism to gain full support of the entire community, and to motivate participation from all segments of the community and support for sustainability. All accomplishments made under this project are fully consistent with relevant milestones listed in the Project Plan, and with the relevant research components as defined in the National Program 107 – Human Nutrition Action Plan. Accomplishments under this project also contribute to the achievement of ARS Strategic Plan Goal 4, Objective 1, Performance Measure 1, in that project accomplishments contribute substantially to attainment of the Agency FY 2007 target of executing and reporting nutritional interventions. 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. (NOTE: List your peer reviewed publications below). Feature news story, Channel 4 TV News (KATV). The segment that aired in March featured NIRI partners, community members, and the Mayor of Marvell discussing the Nutritional Intervention Program in Marvell, AR. Core, J. 2006. Changing Lifestyles To Fight Obesity in the Delta – A Tale of Three Communities. Agricultural Research, March 2006. p. 16-18.