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Appalachians Together Restoring the Eating Environment

Not Applicable
Completed
Conditions
Dietary Habits
Interventions
Behavioral: School-Based Healthy Snacking Campaign
Behavioral: Community Cooking Classes
Registration Number
NCT02399436
Lead Sponsor
Mark Swanson, PhD
Brief Summary

Most of the nation's serious chronic health challenges and causes of death, including diabetes, heart disease, cancer, and obesity, are directly linked to sub-optimal diet. Both poor diets and associated disease are disproportionately common in the Appalachian counties of eastern Kentucky, a region with stark health inequities, including elevated rates of obesity, overweight, and premature mortality. The purpose of this pilot study is to evaluate a multi-component intervention developed through community-based participatory research methods for improving access to healthy foods and enhancing dietary intake in eastern Kentucky. The intervention components evaluated in this study consist of a social marketing campaign delivered to middle and high schools to promote healthy snacking and water consumption, and a series of group cooking classes for adults.

Detailed Description

This pilot study evaluates two principal components of a community-based intervention to improve dietary habits and access to healthy foods: a school-based healthy snacking campaign and a series of community cooking classes for adults. The primary outcome assessed within each intervention component is dietary intake as measured by self-reported beverage and food consumption in pre-post surveys. Secondary outcome variables include attitudes, preferences, confidence, self-efficacy and other psychosocial variables related to healthy eating behaviors, perceptions of healthy food availability, food purchasing and preparation habits, and perceived barriers to healthy eating.

The school-based intervention component employs a nonequivalent control group research design. A subset of middle- and high-schools within a single county in eastern KY will receive a healthy snacking campaign intervention, and students from randomly selected classrooms within these schools will be invited to enroll in the study. Students from middle- and high-school classrooms in a comparison county that receives no intervention will serve as nonequivalent controls. The investigators specific aims for this component are to improve the availability of healthy snack foods that students may purchase at school, increase student consumption of healthy snacks over unhealthy snacks, and increase the consumption of water over sugar-sweetened beverages. Following baseline, posttest surveys will be administered at 3, 6 and 14 months.

Community cooking classes will be delivered to a non-random sample of adults who will complete pretest-posttest measures at baseline and 8 weeks. The specific aims of this component are to increase the consumption of healthy foods at home, and increase participant knowledge, skills, and self-efficacy around healthy home cooking.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
720
Inclusion Criteria
  • For School-Based Component: 6th-12th grade students enrolled in a participating school and classroom in the intervention or comparison county.
  • For Cooking Classes: Adults aged 18 years and older residing in intervention county who have at least one juvenile in household.
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
School-Based Healthy Snacking CampaignSchool-Based Healthy Snacking CampaignStudents who attend middle and high schools in the experimental county that participate in the healthy snacking campaign intervention.
Community Cooking ClassesCommunity Cooking ClassesAdults in the intervention county who enroll in group cooking classes (single-group pretest-posttest)
Primary Outcome Measures
NameTimeMethod
Change in Beverage Consumption (Students)Baseline, 3 months, 6 months, and 14 months

Frequency and quantity of beverages consumed in past month. Includes water, 100% fruit juice, sugar-sweetened beverages, sugar-free beverages and milk.

Change in Dietary intake (Adults)Baseline to 8 weeks

Frequency of consumption of fruits, vegetables, beans, candy, pastries, desserts, and salty snacks in the past month.

Change in Snack Consumption (Students)Baseline, 3 months, 6 months, and 14 months

Frequency and quantity of snacks consumed in past month. Includes chips (regular and low-fat), salty snacks, candy, desserts, vegetables, fruit, nuts and seeds, vegetable dips, yogurt, and popcorn.

Secondary Outcome Measures
NameTimeMethod
Change in Healthy Snacking Confidence and Self-efficacy (Students)Baseline, 3 months, 6 months, and 14 months
Change in Food Purchasing Habits (Adults)Baseline to 8 weeks

Frequency of purchasing food at work, grocery/convenience stores, restaurants and produce stands

Change in Snack Food Purchasing Habits (Students)Baseline, 3 months, 6 months, and 14 months

Frequency of purchasing snack foods and beverages at fast food restaurants, convenience stores, and school venues and events

Change in Snacking Attitudes and Preferences (Students)Baseline, 3 months, 6 months, and 14 months

Survey items address taste preferences, attitudes about healthy eating behaviors and body image

Change in Availability of Healthy Snack Foods (Students)Baseline, 3 months, 6 months, and 14 months

Frequency of availability of healthy and unhealthy snack foods at school

Change in Food Preparation Habits (Adults)Baseline to 8 weeks

Likelihood of performing healthy food preparation behaviors; survey items address meal planning and preparation

Change in Barriers to Healthy Eating (Adults)Baseline to 8 weeks

Survey items address physical, psychosocial, emotional, and financial barriers to healthy eating

Change in Perceptions of Availability of Healthy Foods (Adults)Baseline to 8 weeks

Survey items address availability of high quality fruits and vegetables and low-fat foods

Trial Locations

Locations (1)

University of Kentucky

🇺🇸

Lexington, Kentucky, United States

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