2005 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 goals through developing and transferring effective nutrition intervention strategies. 2.List the milestones (indicators of progress) from your Project Plan. Year 2005 Develop nutrition interventions in Franklin Parish, Louisiana, 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. Year 2006 Design the nutrition intervention research for Franklin Parish, Louisiana, 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. Year 2007 Initiate the implementation and evaluation of nutrition intervention strategies in Franklin Parish, Louisiana: 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 2008 Implement and evaluate nutrition intervention strategies in Franklin Parish, Louisiana: 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 2009 Initiate the process of adapting the successful nutrition intervention strategies to other Lower Mississippi Delta communities. 1) Evaluate interventions for adaptability 2) Identify potential communities for additional research 3) Prepare manuscripts and develop symposia 4a.What was the single most significant accomplishment this past year? PUSH Feasibility Study Interventions targeting healthy food choices, healthier preparation methods, and availability of fruits and vegetables are needed in the Franklin Parish, LA, community. The People United to Sustain Health (PUSH) Feasibility Study was completed in Franklin Parish through the cooperation of the Franklin NIRI, Southern University and A&M College, Pennington Biomedical Research Center. This intervention addressed the issues of healthy weight, healthy food choices, food security, and physical activity in a rural setting. Ten participants completed the 8-week study and received nutrition education (taught by Peer Educator weekly) including cooking demonstrations; increased physical activity (measured by pedometers daily); record keeping (Food & Fitness Diaries recorded twice in a 7-day period); height measured at start-up only; weight measured weekly; blood pressure measured weekly; blood work analysis (measured once to determine acceptance of procedure); and a "Rolling Store" (rolled one day per week, parked for three hours at the study-site to allow participants to pick-up fresh fruits and vegetables). The feasibility study demonstrated that this nutrition and economic model can be implemented in underserved rural populations. 4b.List other significant accomplishments, if any. None 4c.List any 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. Southern University assisted in the implementation of the PUSH Feasibility Study in Franklin Parish, Louisiana. Southern University prepared the Food Security component of the PUSH Feasibility. The Nutrition and Health Survey Research Center can be utilized to collect food consumption data using the Delta Food Frequency Questionnaire. Conducted focus groups to evaluate the feasibility of the study from the perspective of the participants and staff involved in the study. The church and a food delivery medium, the "Rolling Store" was employed for providing healthy food choices (fruits and vegetables) to improve the diet and health in underserved rural residents. Southern University continues to participate in the USDA/ARS Food and Nutrition Summer Institute (FNSI). A Southern University scientist served as faculty participant and advisor for Southern University's student researchers. Southern University students designed a year long project, "Nutrition, Physical Activity and Diabetes: A Community Model," which focused on the community infrastructure and neighborhood characteristics with respect to opportunities for healthy eating and physical activity. Results were presented at the 6th annual FNSI conference, June 2004. at North Carolina Central University in Durham, NC. An abstract reporting the project was accepted for a poster presentation at the 2005 annual American Public Health Association. 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 Action Plans performance goals through developing and transferring effective nutrition intervention strategies. Accomplishments under this project 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). Johnson, G.S. 2005. Attitudes toward Diet and Dietary Intake of the Middle and Older Adults in the LMD. Experimental Biology 2005 meeting, April, 2005, San Diego, California. McGee, B.B. 2005. Diet quality, opinions and practices of adults in the Lower Mississippi Delta. Delta NIRI All Delta Conference, "Collaborating Communities: Creating a Healthy Climate for Change," June 6-8, 2005. Robinsonville, Mississippi. Richardson, V.A. 2005. Perception of Factors Influencing the Acquisition and Consumption of Healthy Food in the Lower Mississippi Delta: Focus Group Findings. Delta NIRI All Delta Conference, "Collaborating Communities: Creating a Healthy Climate for Change," June 6-8, 2005. Robinsonville, Mississippi. McGee, B.B. 2005. Alternate Approach to Training and Quality Control for Community-based Participatory Research in Rural Communities. Delta NIRI All Delta Conference, "Collaborating Communities: Creating a Healthy Climate for Change," June 6-8, 2005. Robinsonville, Mississippi. Eugene, J. 2005. Diet Habits among Residents in the Lower Mississippi Delta: FOODS 2000 Finding. Delta NIRI All Delta Conference, "Collaborating Communities: Creating a Healthy Climate for Change," June 6-8, 2005. Robinsonville, Mississippi. Laws, A. 2005. Assessing the Acceptability of a Lifestyle Modification Intervention Designed for African American Women in the Lower Mississippi Delta at High Risk for Type 2 Diabetes. Delta NIRI All Delta Conference, "Collaborating Communities: Creating a Healthy Climate for Change," June 6-8, 2005. Robinsonville, Mississippi. McGee, B.B., Johnson, G., Thornton, A., Harsha, D., Bogle, M.L., Stickland, E., McCabe-Sellers, B. 2005. Alternate Approach to Training and Quality Control for Community-based Participatory Research in Rural Communities. International Society for Behavioral Nutrition and Physical Activity meeting, June 2005, Amsterdam, The Netherlands.