Reducing the summer health gap: Evaluation of a community-based child nutrition assistance program

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PROJECT SUMMARY The K23 award will support the career development of candidate, Jiwoo Lee, PhD, RN, LSN, to become an independent researcher with expertise in evaluation of public health nutrition programs that will guide future development of childhood obesity prevention interventions designed to reduce weight-related disparities. Dr. Lee will achieve this goal by conducting an innovative research project and career development activities that are aligned with her career goals. The proposed research will evaluate a summertime, community-based child nutrition assistance program, the Summer Food Service Program (SFSP), funded by the United States Department of Agriculture. This program addresses the nutritional gap of increased food insecurity that low- income children experience during the summer months by providing meals to children at program sites. However, nutritional guidelines of the program are not as comprehensive as other nutrition assistance programs, which may contribute to weight gain among children from low-income households who are disproportionately affected by childhood obesity. Additionally, the program sites vary in operation length and the extent to which there is additional healthy programming beyond the provision of foods. Lastly, characteristics of program participants as well as the program’s impact on child diet quality and weight are not well documented. Without this knowledge, it is challenging to characterize what works and for whom and identify targets for optimizing the SFSP and for future interventions. The proposed research will conduct a prospective observational study to describe program site and participant characteristics at baseline to evaluate the current program implementation (Aim 1) and determine if the site and participant characteristics are associated with child program attendance and changes in food insecurity, diet quality and weight gain (Aims 2 and 3). Two cohorts of elementary school-aged children and their parents (n=210) recruited through SFSP sites in Twin Cities metropolitan area of Minnesota will participate in data collection before and in the final weeks of the program (spring and end of summer, respectively). Data collection components include an online psychosocial survey, three 24-hour dietary recalls, and measurement of height, weight and percent body fat. Additionally, parents will report program usage weekly during the program. A multi-disciplinary team of mentors at the University of Minnesota will guide the proposed project and career development activities. Training areas include: a) health equity approaches in reducing food insecurity and weight gain (Drs. Jayne Fulkerson and Lisa Harnack), b) advanced statistical skills for use in evaluation of the long-term impacts of public health programs (Dr. Weihua Guan), c) implementation science and intervention development (Dr. Nancy Sherwood) and d) collaborations with community partners (Drs. Jayne Fulkerson and Lisa Harnack). The project and training plan will position Dr. Lee to advance her career as an independent investigator while contributing to the mission of the NIH by reducing weight-related health disparities of children living in low-income households.