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Article ; Online: Using the R = MC

Craig, Derek W / Walker, Timothy J / Cuccaro, Paula / Sharma, Shreela V / Heredia, Natalia I / Robertson, Michael C / Fernandez, Maria E

BMC public health

2024 Volume 24, Issue 1, Page(s) 207

Abstract: Background: Schools are a key setting for supporting youth physical activity, given their broad reach and diverse student populations. Organizational readiness is a precursor to the successful implementation of school-based physical activity ... ...

Abstract	Background: Schools are a key setting for supporting youth physical activity, given their broad reach and diverse student populations. Organizational readiness is a precursor to the successful implementation of school-based physical activity opportunities. The R = MC Methods: We analyzed interview data from 15 elementary school staff (principals, assistant principals, physical education teachers, and classroom teachers) from a school district in Texas. We focused on factors related to adopting, implementing, and sustaining a variety of school-based physical activity opportunities. We used the Framework Method to guide the analysis and coded data using deductive (informed by the R = MC Results: Four themes emerged from the data: (1) implementation is aided by the presence of internal and external relationships; (2) physical activity opportunities compete with other school priorities; (3) seeing the benefits of physical activity opportunities motivates school staff toward implementation; and (4) staff buy-in is critical to the implementation process. Themes 1-3 aligned with subcomponents of the R = MC Conclusion: Our results highlight and explain how key readiness constructs impact the implementation of school-based physical activity opportunities. They also highlight the importance of obtaining staff buy-in when implementing in the school setting. This information is critical to developing readiness-building strategies that help schools improve their capacity to deliver physical activity opportunities effectively. Trial registration: Not applicable.
MeSH term(s)	Adolescent ; Humans ; Heuristics ; Exercise ; Qualitative Research ; Students ; Motivation
Language	English
Publishing date	2024-01-17
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-024-17744-2
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Development of a Culinary Medicine Toolkit to Improve Implementation of Virtual Cooking Classes for Low-Income Adults with Type 2 Diabetes.

Ai, David / Heredia, Natalia I / Cruz, Vanessa / Guevara, Diana C / Sharma, Shreela V / Woods, Dolores / Danho, Melisa / McWhorter, John Wesley

Healthcare (Basel, Switzerland)

2024 Volume 12, Issue 3

Abstract: Culinary medicine (CM) addresses diseases through nutrition and culinary education. To promote access to educational material for people with diabetes and engagement in virtual classes, we created a virtual culinary medicine toolkit (VCMT) sensitive to ... ...

Abstract	Culinary medicine (CM) addresses diseases through nutrition and culinary education. To promote access to educational material for people with diabetes and engagement in virtual classes, we created a virtual culinary medicine toolkit (VCMT) sensitive to literacy levels and language preferences. The VCMT was developed to accompany existing virtual CM programs and help improve participant interaction and retention, offering educational materials for providers and participants. The provider VCMT offers level-setting education to reduce mixed nutrition messaging, including educational resources discussing inclusive nutrition and mindful eating topics. Each handout has a QR code and link to engaging, animated videos that provide further explanation. The participant VCMT offers a range of fundamental cooking skill videos and infographics, including knife skills and preparing whole grains and healthy beverages. Participant handouts and animated videos, which are played during the virtual CM class, allow participants to learn more about diabetes management and food literacy topics, including interpreting nutrition labels, and are employed during a CM to facilitate discussion and reflection. The animated videos replace a traditional slide-based lecture, allowing space for patient-centered facilitated discussions during virtual cooking sessions. The VCMT could guide the development of virtual CM interventions to shift learning from lecture-based to patient-centered discussions via a visual and inclusive medium.
Language	English
Publishing date	2024-01-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2721009-1
ISSN	2227-9032
ISSN	2227-9032
DOI	10.3390/healthcare12030343
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Article ; Online: An Increase in Food Insecurity Correlated with an Increase in Plasma Triglycerides among Latinx Children.

Haushalter, Keally / Burgermaster, Marissa / Hudson, Erin / Landry, Matthew J / Sharma, Shreela V / Davis, Jaimie N

The Journal of nutrition

2023 Volume 154, Issue 2, Page(s) 565–573

Abstract: Background: Food insecurity and metabolic diseases both disproportionately affect Hispanic children. Cross-sectional studies have linked food insecurity with adverse cardiometabolic markers, including elevated plasma triglycerides and glucose ... ...

Abstract	Background: Food insecurity and metabolic diseases both disproportionately affect Hispanic children. Cross-sectional studies have linked food insecurity with adverse cardiometabolic markers, including elevated plasma triglycerides and glucose concentrations. However, the association between changes in food insecurity and changes in cardiometabolic markers in children remains to be explored. Furthermore, few studies have assessed the impact of school-based nutrition interventions on household food insecurity. Objective: The objectives of this study are to assess the effect of the TX Sprouts intervention on household food insecurity and to examine the association between changes in household food insecurity and changes in cardiometabolic markers over 1 academic year. Methods: This secondary analysis used data from TX Sprouts, a cluster-randomized school-based gardening, cooking, and nutrition trial. The study enrolled 3rd-5th-grade students from 16 schools that served primarily (>50%) Hispanic families with low income in Austin, TX. Participants (n = 619) provided household food insecurity data and fasting lipid panels at both baseline and postintervention, ∼9 mo following. Results: There was no intervention effect on household food insecurity. Independent of the intervention, a 1-point increase in food insecurity, indicative of becoming more food insecure, was associated with a 2.61 mg/dL increase in triglycerides (P = 0.001; 95% CI: 1.04, 4.19) at follow-up. Children who were food insecure at baseline and became food secure at follow-up had a mean 5.05 mg/dL decrease in triglycerides compared with a 7.50 mg/dL increase in triglycerides in children who remained food insecure throughout (95% CI: -23.40, -1.71, P = 0.023). There were no other associations between changes in food insecurity and cardiometabolic markers. Conclusion: Although the intervention did not improve food insecurity, reductions in food insecurity over 9 mo were associated with improved cardiometabolic markers in high-risk children, emphasizing the need for interventions targeting food insecurity. The study is registered at clinicaltrials.gov under NCT02668744 (https://classic. Clinicaltrials: gov/ct2/show/NCT02668744).
MeSH term(s)	Child ; Humans ; Cross-Sectional Studies ; Food Supply ; Food Insecurity ; Hispanic or Latino ; Cardiovascular Diseases
Language	English
Publishing date	2023-12-17
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	218373-0
ISSN	1541-6100 ; 0022-3166
ISSN (online)	1541-6100
ISSN	0022-3166
DOI	10.1016/j.tjnut.2023.12.024
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Article: A cluster-randomized controlled trial to assess the impact of a nutrition intervention on dietary behaviors among early care and education providers: The Create Healthy Futures study.

Mofleh, Dania / Chuang, Ru-Jye / Ranjit, Nalini / Cox, Jill N / Anthony, Christine / Sharma, Shreela V

Preventive medicine reports

2022 Volume 28, Page(s) 101873

Abstract: Create Healthy Futures is a self-paced, web-based intervention on improving healthy eating behaviors among Early Care and Education (ECE) providers. We examined the impact of web-based Create Healthy Futures on diet quality measured by the Alternative ... ...

Abstract	Create Healthy Futures is a self-paced, web-based intervention on improving healthy eating behaviors among Early Care and Education (ECE) providers. We examined the impact of web-based Create Healthy Futures on diet quality measured by the Alternative Healthy Eating Index (AHEI) 2010, dietary behaviors, and related psychosocial and environmental factors among ECE providers. A cluster randomized controlled trial (CRCT) was implemented with baseline surveys administered from October 2019-January 2020, intervention implementation from April-May 2020, and post-intervention from May 2020-August 2020. Centered-based ECE programs under the Pennsylvania Head Start Association (n = 12) were recruited and randomized to intervention (n = 5) or comparison (n = 7) groups. A total of 186 ECE providers completed the post-intervention surveys (retention rate: 86.1%). At baseline, 31.5% of ECE providers were food insecure. Pre-to-post intervention demonstrated no significant within-or-between-group changes in the AHEI-2010 diet quality scores. ECE providers in the intervention group reported a significant decrease from baseline to post-intervention in the number of days eating out (aMD = -0.8, CI:-1.6, -0.1,
Language	English
Publishing date	2022-06-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2785569-7
ISSN	2211-3355
ISSN	2211-3355
DOI	10.1016/j.pmedr.2022.101873
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Article: Evaluation of the kitchen microbiome and food safety behaviors of predominantly low-income families.

Carstens, Christina K / Salazar, Joelle K / Sharma, Shreela V / Chan, Wenyaw / Darkoh, Charles

Frontiers in microbiology

2022 Volume 13, Page(s) 987925

Abstract: Bacterial pathogens in the domestic environment present a risk to residents, particularly among susceptible populations. However, the impact of consumer demographic characteristics and food handling methods on kitchen microbiomes is not fully understood. ...

Abstract	Bacterial pathogens in the domestic environment present a risk to residents, particularly among susceptible populations. However, the impact of consumer demographic characteristics and food handling methods on kitchen microbiomes is not fully understood. The domestic kitchen bacterial communities of ten predominantly low-income families in Houston, TX, were assessed in conjunction with a cross-sectional food safety survey to evaluate differences in household and surface-specific microbiomes and bacterial foodborne pathogen presence. Three kitchen surfaces within each household, including the sink drain, the refrigerator handle, and the counter, were environmentally sampled and metataxonomically evaluated via targeted 16S rRNA sequencing. Disposable dish sponges were also acquired and examined. Results indicated that alpha diversity did not vary by the households, sampling locations, or demographic characteristics evaluated. Significant differences in beta diversity were observed among the bacterial communities of five pairs of households and between refrigerator handle and disposable dish sponge microbiomes. A total of 89 unique bacterial foodborne pathogens were identified across surface types. Each household contained at least one contaminated surface, and the most common bacterial foodborne pathogens identified were
Language	English
Publishing date	2022-09-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2587354-4
ISSN	1664-302X
ISSN	1664-302X
DOI	10.3389/fmicb.2022.987925
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Article ; Online: Food Safety Attitudes, Behaviors, and Hygiene Measures among Predominantly Low-Income Parents in Houston, Texas.

Carstens, Christina K / Salazar, Joelle K / Sharma, Shreela V / Chan, Wenyaw / Darkoh, Charles

Journal of food protection

2022 Volume 85, Issue 12, Page(s) 1745–1755

MeSH term(s)	Animals ; Humans ; Female ; United States ; Male ; Consumer Product Safety ; Ethnicity ; Texas ; Cross-Sectional Studies ; Health Knowledge, Attitudes, Practice ; Minority Groups ; Food Safety ; Hygiene ; Food Handling/methods ; Poverty ; Food Contamination/analysis ; Food Microbiology
Language	English
Publishing date	2022-09-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	243284-5
ISSN	1944-9097 ; 0362-028X
ISSN (online)	1944-9097
ISSN	0362-028X
DOI	10.4315/JFP-22-179
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Article ; Online: Fruit and Vegetable Intake and Home Nutrition Environment among Low-Income Minority Households with Elementary-Aged Children.

Naylor Metoyer, Brittni / Chuang, Ru-Jye / Lee, MinJae / Markham, Christine / Brown, Eric L / Almohamad, Maha / Dave, Jayna M / Sharma, Shreela V

Nutrients

2023 Volume 15, Issue 8

Abstract: Racial/ethnic and socioeconomic differences were shown to have an influence on child fruit and vegetable intake. This study examined the associations between parent and child fruit and vegetable intake and the home nutrition environment among Hispanic/ ... ...

Abstract	Racial/ethnic and socioeconomic differences were shown to have an influence on child fruit and vegetable intake. This study examined the associations between parent and child fruit and vegetable intake and the home nutrition environment among Hispanic/Latino and African American families. Through a cross-sectional study design, self-reported surveys (
MeSH term(s)	Adult ; Humans ; Aged ; Fruit ; Vegetables ; Cross-Sectional Studies ; Feeding Behavior ; Nutritional Status ; Diet
Language	English
Publishing date	2023-04-10
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu15081819
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Article ; Online: Clinical outcomes of a large-scale, partnership-based regional food prescription program: results of a quasi-experimental study.

Ranjit, Nalini / Aiyer, Jennifer N / Toups, Jack D / Liew, Esther / Way, Kenia / Brown, Henry Shelton / McWhorter, John Wesley / Sharma, Shreela V

BMC research notes

2023 Volume 16, Issue 1, Page(s) 13

Abstract: Background: Food prescription programs are gaining interest from funders, policy makers, and healthcare payers as a way to provide value-based care. A small body of research suggests that such programs effectively impact health outcomes; however, the ... ...

Abstract	Background: Food prescription programs are gaining interest from funders, policy makers, and healthcare payers as a way to provide value-based care. A small body of research suggests that such programs effectively impact health outcomes; however, the quality of existing studies is variable, and most studies use small samples. This study attempts to address these gaps by utilizing a quasi-experimental design with non-equivalent controls, to evaluate clinical outcomes among participants enrolled in a food prescription program implemented at scale. Methods: We completed a secondary analysis of participant enrollment and utilization data collected between May 2018 and March 2021, by the Houston Food Bank as part of its multi-institution food prescription program. Enrollment data was obtained from 16 health care partners and redemption data from across 40 food pantries in Houston, Texas. Our objective was to assess if program participation impacted multiple cardio-metabolic markers. Exposure was defined as any visit to a food pantry after receipt of prescription. Linear and logistic regression models were used to estimate change in outcomes by exposure status and number of food pantry visits. Results: Exposed patients experienced a -0.28% (p = 0.007) greater change in HbA1c than unexposed patients, over six months. Differences across exposure categories were seen with systolic blood pressure (-3.2, p < 0.001) and diastolic blood pressure (-2.5, p = 0.028), over four months. The odds of any decline in HbA1c (OR = 1.06 per visit, p < 0.001) and clinically meaningful decline in HbA1c (OR = 1.04 per visit, p = 0.007) showed a linear association with visit frequency. Conclusions: Our study of a large food prescription program involving multiple health care and food pantry sites provides robust evidence of a modest decline in HbA1c levels among participants. These results confirm that food prescription programs can continue to be effective at scale, and portend well for institutionalization of such programs.
MeSH term(s)	Humans ; Glycated Hemoglobin ; Food Supply ; Food ; Texas ; Prescriptions
Chemical Substances	Glycated Hemoglobin
Language	English
Publishing date	2023-02-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2413336-X
ISSN	1756-0500 ; 1756-0500
ISSN (online)	1756-0500
ISSN	1756-0500
DOI	10.1186/s13104-023-06280-8
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Article ; Online: A coalition-driven examination of organization capacity to address food insecurity in Greater Houston: a qualitative research study.

John, Jemima C / Gonzalez, Jennifer / Chan, Sara-Grace / McPherson, Heidi / Aiyer, Jennifer N / Galvan, Esperanza / Browning, Nicole / Sharma, Shreela V

Frontiers in public health

2023 Volume 11, Page(s) 1167100

Abstract: Background: Economic and social hardships have worsened food insecurity, particularly among low income and racial-ethnic minority groups. Given the core goal of the 150+ member Houston Health Equity Collective (HEC) to reduce food insecurity by 5% in ... ...

Abstract	Background: Economic and social hardships have worsened food insecurity, particularly among low income and racial-ethnic minority groups. Given the core goal of the 150+ member Houston Health Equity Collective (HEC) to reduce food insecurity by 5% in 2025, we explored member organizations' capacity and challenges faced in screening and responding to food insecurity through care coordination efforts. Methods: A twice-administered Qualtrics XM survey (Provo, Utah) with 76 organizations, followed by five focus groups with 22 of these organizations, explored reach and response efforts to food insecurity. Qualitative assessments lasted between 0.5 to 1.5 h, were audio-recorded, cleaned, coded, and thematically analyzed using NVivo, version 11 (Burlington, Massachusetts). The qualitative study was guided by a general inductive approach. In total, over 6 h of audiovisual recording were extracted, and over 100 pages of text exported to NVivo for data analysis. The research team read and coded transcripts independently using the codebook, and met routinely to discuss and resolve codes -resulting in numerous revisions to the codebook. Coding structure was discussed at multiple meetings and differences were addressed through consensus. Predominant qualitative themes impacting food insecurity screening were "stigma and cultural-related barriers", "clinic capacity and attitudes", "need to focus on upstream influences of food insecurity and SDOH needs", "impact of COVID-19", and "need for HEC system responses". Main recommendations to enhance screening and reach included improving staff culture, enhancing cultural sensitivity across organizational practices, and using shared technology to coordinate care. Respondents stated that the HEC can drive these recommendations through networking opportunities, use of shared resource directory, and placing focus on upstream factors. Conclusions: Recommendations to target food insecurity must focus on organizational staff responsiveness and sensitivity to patients' needs. Of equal importance is the need for increased attention to the upstream influencers and integration of systems-level interventions to holistically target the barriers impacting food insecurity.
MeSH term(s)	Humans ; Ethnicity ; COVID-19/epidemiology ; Minority Groups ; Qualitative Research ; Focus Groups
Language	English
Publishing date	2023-08-15
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2023.1167100
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Article ; Online: Perspectives of Health Care Staff on Predictors of Success in a Food Prescription Program: A Qualitative Study.

McWhorter, John Wesley / Aiyer, Jennifer N / Ranjit, Nalini / Toups, Jack / Liew, Esther / John, Jemima C / Sharma, Shreela V

Preventing chronic disease

2023 Volume 20, Page(s) E02

Abstract: Partnerships between food prescription programs and food banks can address food insecurity and support health; however, few studies have examined the experience and perceptions of health care partners about these programs. Our objective was to analyze ... ...

Abstract	Partnerships between food prescription programs and food banks can address food insecurity and support health; however, few studies have examined the experience and perceptions of health care partners about these programs. Our objective was to analyze secondary qualitative data from clinicians and clinic staff involved in implementing a food prescription program in Houston, Texas. We collected data from 17 health care clinics from May 2018 through March 2021 to learn how implementation of the food prescription program was perceived, and we received 252 responses. Principal themes were the importance of a value-based care strategy, patient and food pantry barriers to success, the importance of interorganizational care coordination, and the need to integrate food prescriptions into clinic workflow. Insights of clinicians and clinic staff on implementation of food prescription programs can inform program development and dissemination.
MeSH term(s)	Humans ; Delivery of Health Care ; Food ; Qualitative Research ; Ambulatory Care Facilities ; Prescriptions
Language	English
Publishing date	2023-01-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2135684-1
ISSN	1545-1151 ; 1545-1151
ISSN (online)	1545-1151
ISSN	1545-1151
DOI	10.5888/pcd20.220178
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