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 uner 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 the Marvell, AR, community, 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 the Marvell, AR, community, 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 the Marvell, AR Community: 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 the Marvell, AR, community: 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? Marvell NIRI Walking Club The problem of cardiovascular disease risk, including obesity, hypertension, and diabetes exists in the rural community of Marvell, Arkansas and methods to alleviate these risks are needed. Researchers from the Arkansas Children's Hospital Research Institute, University of Arkansas at Pine Bluff, Arkansas Cooperative Extension, University of Arkansas for Medical Sciences College of Public Health and the USDA,ARS developed and implemented a walking club project to test the feasibility of establishing a rural community walking program in Marvell, AR. Researchers were able to recruit and retain (over a 6-month period) 74 participants, including 62 adults and 12 youths/children. Each participant received a Marvell Walking Club t-shirt and a pedometer, which they were shown how to use to monitor the number of steps they walked on a daily and weekly basis. Monthly awards breakfasts were held to reward participants for meeting their weekly and monthly goals and small incentive prizes were given for their accomplishments, while guest speakers provided health education sessions. The result is that Marvell NIRI is using the information gained from the service project to begin a full research study that will last for one year, and will be lead by group leaders from the Marvell community. Outcome data (e.g., minutes/steps walked, blood pressure, fitness level, body composition, and self-efficacy data) will be collected at regular intervals throughout the one-year study and the anticipated impact is the collection of data necessary to promote walking programs in other Delta communities. 4b.List other significant accomplishments, if any. Marvell Community Garden’s Sprout Success Additional partnerships are necessary for the Marvell NIRI in order to increase their capacity and become a sustainable and viable organization. The Marvell NIRI, through the support of the Arkansas Children’s Hospital Research Institute, University of Arkansas at Pine Bluff, Arkansas Cooperative Extension, University of Arkansas for Medical Sciences College of Public Health, and the USDA,ARS, entered into a partnership with Heifer International to design and established several community vegetable gardens in the Marvell. This project promoted a method for growing fresh fruits and vegetables without having a lot of land or space. Raised beds were built by a local farmer, and space for the gardens was provided by the Marvell School District and the Haven Manor Senior Center. Seeds were planted, and plants were maintained and harvested by local community residents. This project provided the feasibility data needed to move the project to a full research intervention, and the community is seeking additional support From Heifer International to expand the garden program throughout the Marvell community because of its success. 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. An ACHRI investigator is serving as the Co-chair of the food security and nutrients writing group. This group has had several face-to-face meetings, and monthly conference calls, during the 2005 fiscal year (and earlier) to fully investigate potential relationships in the FOODS 2000 data set between food secure/insecure households in the Delta and Delta residents' food intake, perceived health status, and quality of life. The impact of this writing group has been to submit one manuscript to the Journal of Nutrition and develop three additional manuscripts that will be ready for journal submission in August – December 2005. All staff from ACHRI participated in the All Delta conference, Robinsonville, MS, in June 2005. ACHRI investigators chaired the session on Food Security and presented numerous papers and posters. Two research staff attended a two-day workshop on Community-Based Participatory Research through the UCLA Center for Vulnerable Populations. ACHRI researchers participated in the development of a causal model to predict obesity, health status and chronic illness with indicators of nutritional status with the Food Security and Nutrients Writing Group. 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? The type of science and technology transfers that have occurred, or will occur, through Delta NIRI are primarily related to capacity building in the Marvell community for designing, conducting, and evaluating health interventions specific to their population. Active community members have been trained, or are being trained, to perform tasks such as grant writing, recruitment, program development, physiologic measurement techniques (e.g., blood pressure, fitness testing), raised bed gardening, to ensure long-term sustainability of community-based health interventions. 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). Dr. Patrick Casey was the lead author on Child and Household Food Insecurity is Associated with Childhood Overweight Status, presented at the 4th International Society for Behavioral Nutrition and Physical Activity meeting in Amsterdam, The Netherlands, June 2005. Dr. Judith Weber presented Economic Analysis of Replacing High Fat Vending Snacks with Healthier Choices at the 4th International Society for Behavioral Nutrition and Physical Activity meeting in Amsterdam, The Netherlands, June 2005. Dr. Patrick Casey presented Delta NIRI food security data to the staff of the US Senate Hunger Caucus at Senator Blanche Lincoln's office in Washington, DC, in May 2005. Dr. Patrick Casey coordinated the production of the Delta NIRI video presentation by Senator Dale Bumpers for the All Delta meeting in June 2005. Dr. Judith Weber presented the Delta NIRI study as one component of her seminar titled Increasing Physical Activity in Schools, Worksites and Communities to Decrease Obesity in Arkansas at the Dean's Research Forum, UAMS College of Medicine, May 2005. This was an invited presentation.