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) Manuscripts will be completed by UAPB scientists 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) UAPB 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 UAPB 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 UAPB. Milestone f) Manuscripts describing pilot testing intervention strategies, data collection procedures, and training of data collectors will be completed for peer reviewed journals by UAPB scientists. 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) UAPB will prepare and submit 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) Manuscripts describing the status of interventions in Marvell, AR,with regards to process and outcome variables will be completed by UAPB scientists and submitted to peer reviewed journals for publication. Milestone h) UAPB 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. Year 2008 Objective 4. Initiate the process of adapting the successful nutrition intervention strategies from Marvell, AR, public school district to other Lower Mississippi Delta communities. Milestone a) At least one additional community in AR 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 by UAPB scientists and submitted to peer reviewed journals for publication. Milestone c) UAPB will participate in the convening of a Delta NIRI 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. 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. Marvell NIRI Walking Club Research Intervention: Previous research studies have documented that residents in the Delta region have poorer health than the nation regardless of their income level or race. To address the high rates of nutrition-related chronic diseases in the region, the University of Arkansas at Pine Bluff in collaboration with other Delta NIRI partners, assisted in implementing the Marvell NIRI Walking Club Research Intervention. The intervention combines physical activity and nutrition education to improve the fitness and well-being of adults in the Marvell Community. This intervention will increase individuals' knowledge and attitudes about the importance of regular physical activity and eating healthy to improve overall health and well-being. 4b.List other significant research accomplishment(s), if any. Delta NIRI Adult Food Frequency Questionnaire Manual: There was a need to develop a procesures manual for the Delta NIRI Adult Food Frequency Questionnaire (FFQ) inorder to train community partners and other groups to utilize the FFQ in rural communities. The manual was developed in collaboration with the ARS, USDA Community Nutrition Research Group. This accomplishment is significant in that it provides instructions and procedures for training and administering the Delta NIRI Food Frequency in diverse communities. It will be field tested prior to implementation. 4c.List significant activities that support special target populations. The collaborative efforts of the Delta NIRI partners in responding to nutrition problems identified by residents in the Marvell, AR, public school district are impacting nutrition-related chronic diseases in the Lower Mississippi Delta. The development and implementation of the Walking Trail Service Intervention and the Walking Club Research Intervention will improve knowledge and attitudes about the role of nutrition and physical activity in maintaining a healthy lifestyle and disease prevention. 5.Describe the major accomplishments to date and their predicted or actual impact. Implementation of service interventions and development of research protocols for community-based interventions in the Marvell NIRI Community. The University of Arkansas at Pine Bluff, in collaboration with researchers from Arkansas Children's Hospital Research Institute, UAMS College of Public Health, Arkansas Cooperative Extension, individuals from the Marvell public school district, and ARS implemented three service interventions: a walking club for Marvell adults, a Food Demonstration project, and a garden project called, Garden of Eden. These interventions were developed to emphasize to the participants the importance of walking as physical activity, modifying recipes to develop low sodium and low fat meals to encourage eating healthy, and developing skills to grow vegetables and herbs by planting raised gardens utilizing limited space. The impact of these interventions will lead to maintaining healthy lifestyles, combining physical activity with healthy eating by employing acceptable food preparation methods, and increasing fruit and vegetable consumption, that leads to a reduction in obesity, hypertension, diabetes, and chronic heart diseases in the Marvell NIRI Community. The Community Readiness Survey, directed by UAPB, provided information to determine the level of readiness of communities to plan and participate in nutrition and physical activity interventions. Results were used to develop strategies to build capacity to generate community participation in each phase of nutrition and physical activity interventions. 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). Bradley, B. 2006. Assessing resources to address the needs of children and families. 50th Rural Life Conference, University of Arkansas at Pine Bluff, February 10, 2006. Stigger, F., Bradley, B. 2006. Fast food facts and eating out tips. Marvell NIRI Incentive Breakfast, April 8, 2006. Hyman, E.G., Strickland, E., McCabe-Sellers, B., Bogle, M.L., Prewitt, T., Staggs, C., Hyman, E., Strickland, E. McCabe, B. 2006. Community readiness: Key to developing sustainable nutrition and physical activity interventions in rural communities. National Obesity Action Forum, June 5-6, 2006, Bethesda, Maryland.