I am doing a tongue-tie prevalence study for my practicum with the University of Utah Public Health Department.I recently completed the CITI training for this school in addition to UMass-Amherst CITI requirements which were completed in Nutrition Assessment class.The IRB process has been interesting and fun to see in action.I am still waiting to hear final approval from the IRB and for the evaluation of newborns for tongue-tie.I won’t be doing the actual evaluation of tongue-tie as lactation consultants had been arranged to do this evaluation prior to my involvement in the study.I will be doing follow up phone calls with parents after diagnoses and discharge from the hospital.
Part of this practicum is to do an extensive literature search on tongue-tie which I have done looking at references from 2010 to present time.I am in the process of reviewing articles I have pulled on this subject and putting them into an evidence-based summary table.Other deliverables for this practicum include developing an educational handout for parents and writing an article to be published!I thought I would share 2 slides from a lecture comparing chocolates and levels of evidence.They are part of a series of lectures on evidence-based research from the University of Utah Nursing Department. The source is Dr. Ellen Fineout-Overholt and Dr. Barbara Wilson.
My practicum has been in progress for a while, but this is my first blog entry to share the activities I have been involved with. For my practicum, I wanted to gain more experience with nutrition related research. I started working with two professors at a large local university (University of South Florida). Both are involved in very different and interesting research projects.
My work with Dr. Lauri Wright initially involved work with a Feeding America/Kid’s Café project. The purpose of the project was to develop a nutrition education program to promote fruit and vegetable intake in children from food insecure households. Prior to my starting work with this project, Dr. Wright had already designed the intervention and received a generous grant from Feeding America to cover the expenses. The project was conducted through a Boys and Girls Club in the Sulphur Springs community (a lower-income area) of Tampa, Florida during summer of 2012.
Upon my getting involved with this project, I designed educational materials on the importance of eating more fruits and vegetables which where used in the education of both children and parents involved in this program. On multiple occasions during the project, I assisted in the creation and distribution of fresh produce gift bags (donated by Feeding America) to the children and families participating in the intervention. I also had the opportunity to help with classroom based educational program (primarily focused on increasing intake of fruits and vegetables). We taught the children about the importance of eating a “rainbow” of different fruits and vegetables, and provided them with a healthy snack (ladybugs on a log: celery with peanut butter and dried cranberries).
As part of the research experience I gained from this community intervention, I helped gather data on anthropometric measures and estimates of reported fruit and vegetable intake via survey of the participating children. I then entered the data for approximately 50 pre and post surveys collected during the program into an excel spreadsheet. In meetings with Dr. Wright, we have already noticed trends in the data collected (for example, %ile of BMI was overwhelmingly high, suggesting a high prevalence of overweight and obesity in the subject group). The official statistical analysis of the data is currently being conducted by the department statistician. I look forward to sharing the results during my practicum presentation. Overall, it has been great to be involved in all aspects of this project, and to gain some experience with real hands-on public health nutrition related research.
Nutrition Class for Kid’s Café (all participants had given permission for photos to be taken)
Healthy snack provided to children during intervention
Bags of produce handed out during the Feeding American Project
My other area of work has been with Dr. Uusitalo and the TEDDY study (The Environmental Determinants of Diabetes in the Young Study). This is a large epidemiological study that is focusing on exposures early in life (particularly infant feeding practices) and later onset of Type 1 Diabetes. I am extremely impressed with the depth of this epidemiological data. The data collection has been ongoing for approximately 4 years, and will continue for an additional 11 years. The subjects are in 4 different countries, with a total of 8 sites of data collection total (4 in the U.S., 3 in Europe). The database is extensive and includes a wealth of information on the socio-demographic and nutritional habits of a cohort of mothers and newborns. Dr. Uusitalo is the main project coordinator; together we brainstormed ideas for small data analysis that she would like us to look at together. In order to better understand the data, I have also done a review of current literature on health outcomes related to infant feeding practices (especially duration of breastfeeding). Additionally, I have helped Dr. Uusitalo with coding some of the “missing” items in food database that the project utilizes.
My work with this project has allowed me to better understand the world of epidemiological research, and has given me more practice working with statistical analysis. I am hoping that my work with this research during my practicum will provide the foundation to possibly complete an independent study that would involve coming up with a research hypothesis and using the TEDDY database to test the hypothesis.
Hello Team! I just wanted to update you all on the progress of my nutrition initiative here in Germany. For my practicum work, I had a small idea of doing a nutrition intervention at our local on-post elementary school. The Commanding General of US Army Europe, LTG Hertling, caught wind of my ideas and turned this intervention into a large scale nutrition intervention that we hope will go Army wide! We are calling the intervention “Fueling the Future”.
LTG Hertling began an initiative called “Fueling the Team” a few years ago. The initiative is aimed at getting our soldiers to eat better and gain a better understanding of the right way to fuel their bodies. He started the “Go For Green” program in our Army dining facilities that labels the food as Red (not good for fueling), Yellow (use caution), and Green (good for fueling). The program has been a success. By creating “Fueling the Future” and sending the message of good nutrition to our military children, we hope to create stronger, healthier military families.
The children in our Department of Defense schools will be receiving monthly (twice per month or more) nutrition lessons in the class room. These lessons could be math, science, English, etc. lessons with a nutrition focus. Thus the lessons still meet a specific education standard but are about nutrition. There will also be monthly activities like commissary (grocery store) field trips, fitness classes (like Zumba), and physical training with soldiers that will reinforce the message of the importance of good nutrition and physical activity. The parents of the students received a Nutrition Parent Resource Guide at the start of the school year. The guide I created has specific nutrition information based on age, fun recipes, budget friendly shopping guides, and physical activity suggestions. The school year was kicked off in a big way with a Wellness Assembly attended by LTG Hertling. His wife, Sue Hertling, did a short fitness session with the children and then we headed out to the track for a “Walk with the General”. The local commissary provided fresh fruit and water for the children after the walk. Parents were invited to the assembly as well. It was a big success!
I distributed a Nutrition and Physical Activity Questionnaire at the start (well, kind of the start – October!) of the school year. It took a bit of time to get approval from the Department of Defense Education Activity and from the Army research branch. The school nurse also collected BMI data at the start of the school year. Our hope is that by increasing the amount of nutrition education the students receive and by repetitively hearing the message of the importance of good nutrition and physical activity, that the amount of fruit, vegetables, whole grains, and water the children consume will increase, intake of processed foods will decrease, and the amount of physical activity will increase. We also hope to see a change in BMI.
The “Fueling the Future” initiative has now spread to two more schools in the area and we hope that more will join in. Please see the links below for some of the media coverage that has followed our initiative.
Nicole Leth
Fueling the Future coverage:
Stars & Stripes story on page 4 and online
Also a news release to be published today. Both the article and release provided to garrisons for community papers.
Social media
Multiple posts on Facebook, Twitter, Flickr resulting in more than 100 likes, nearly 20 shares, and 110 photo views
Spotlight on USAREUR to begin airing tomorrow: https://portal.eur.army.mil/sites/ocpa/AudioVisualCenter/OCPA%20Spots%20For%20Review/FtF%20Spotlight_1.wmv
I’m writing this as a follow-up to my first blog about my experience with the Hartford School Food Services Department. It barely touches everything that I’d like to share with you, but I suppose you’ll just have to tune into my Practicum Presentation on Wednesday, December 14th.
Picking up from where I left off….
One of my first steps was to gather information that outlined the issues of poor nutrition and obesity of Hartford’s children. The Director and I decided there to be a statement of rationale that explained why we were doing the project and what exactly we were doing. We gathered as many statistics that we could to outline the issue. These included the following;
– Connecticut childhood obesity rates and higher among Hispanics (36.3%; 18.4% overweight, 17.9% obese) and non-Hispanic black teens (32.0%; 16.6% overweight, 15.4% obese), compared to Non-Hispanic white teens (22.9%); 13.7% overweight. 9.2% obese).
– Approximately 50% of Hartford’s 11 year old children are “at risk”, “obese”, or
“extremely obese” and 30% of Hartford’s 2 year old children are in the same categories
Community Food Show?
The Director and I were able to arrange for a meeting with a representative from the food vendor, Culinary Standards. He shared with us information on how one of his clients, Brownsville Independent School District organizes and promotes their annual “Kool Foods for Kool Schools: Food Show. It was after reviewing their Vendor Registration Form, Floor plan, agenda, and promotional materials, and hearing the vendor’s suggestions we decided we had to do our “homework” so the district could be ready for such an event.
Controlled Tasting
After meetings with other staff in the central office, kitchen managers who see what the children take, and evaluating production records, we decided if we should focus our energy on the food least taken or consumed in the district. We identified vegetables (particularly orange and dark green), fruit, and high protein vegetarian items for controlled taste tests. By starting with these priority types of food we’re able to start incorporating new menu items before the community food show in the spring.
In mid-October I attended the School Nutrition Association of Connecticut Fall Food Show to see, taste, and ask questions from food manufactures about new school foods on the market. It was interesting to see the vendor try to vie for the largest district in Connecticut’s time and ear. It was pretty well known that if the district decided to take on one of their product, there were would a lot of business and therefore, revenue for the company. It was at the moment that I really began to see the how running a food service department, with the ultimate goal of feeding kids, still needs to meet their bottom-line. And with the amount of money the federal government reimburses these programs, it takes a skilled and creative director to provide a diverse menu of fresh and healthy foods that (and this is key) the students will actually eat.
Not only is it an orange vegetable, a focus of the new Dietary Guidelines, but it’s easily prepared and suitable for the fast paced school food kitchen and it a good source of fiber with 100% of the daily value of vitamin A.
First thing was first in our challenge to do just this; we have to get students and kitchen staff acclimated to the practice of trying and tasting new foods. We thought it was best to keep them as controlled as possible so we can collect information on how best the tasting work i.e. how many staff does it take? Which tasting forms work best for what ages of students? Does nutritional messaging while tasting increase the likelihood to try something new? Or how does adult modeling influence tasting outcome?
These taste testings occurred in November during after school programming when students are participating in Hartford’s new Supper program. More on that on December 14th!
