VTechWorks Repository :: Browsing by Author "Misyak, Sarah A."

Browsing by Author "Misyak, Sarah A."

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Advancing Food as Medicine in the Retail Setting
Hollis, Sarah (Virginia Tech, 2024)
Over half of the American population, over 117 million individuals, have at least one or more preventable chronic diseases that are related to poor eating and exercise habits. This includes cardiovascular disease, type II diabetes, and poor bone health (Schap, 2016). The expansion of Food as Medicine programming in grocery stores is predicted to impact consumer food choices. Food retailers are trailing nutrition-related programs to understand how they can provide solutions to change eating habits (FMI, 2019) as more consumers shift their dietary habits and mindsets to be more focused on how food choices can affect health status. This project aimed to evaluate whether placing nutrition educational materials in ten Food City pharmacies in southwest Virginia and eastern Tennessee would provide consumer guidance in making food choices in the grocery store, specifically for populations looking to follow a low-carbohydrate diet or a heart-healthy diet. A pilot passive quasi-experimental design was created to determine if there was a product lift of the promoted products on the nutrition educational materials. Stores with both the resource racks and bag stuffers at the counters saw a 13.38% increase in carbohydrate-aware items and 1.04% in heart-healthy items. Stores that had bag stuffers only at the pharmacy counters saw a 10.55% increase in carbohydrate-aware items and a -0.11% decrease in heart-healthy items. Comparison stores saw a 11.19% increase in carbohydrate-aware items and a -0.48% decrease in heart-healthy items. This intervention was successful as it provided real world significance in product lift as well as it provided insight into future program development and modifications for future resources.
The Analysis of Food Recovery Organization Leadership: How Transformational and Servant Leaders Overcame a Time of Crisis
Nelson, Dalton Glenn (Virginia Tech, 2022-11-17)
The COVID-19 Pandemic exacerbated a multitude of systems in the United States in 2020 up to current day. The structure of non-profit organizations across the country weakened as demands escalated for free food resources with specific pressure placed on food banks and food recovery organizations. There were citizens who had not previously relied on free food services who found themselves in drive through pickups, waiting for pre-packaged food boxes or the occasional you-pick operation to feed their families and themselves. The increase in demand for free food services was reacted to by those leading and directing the free food distribution sites through a time of crisis. This qualitative study serves to analyze food recovery organization (FRO) leadership strategies and principles that guided their decision making and problem-solving skills in response to food shortages and supply chain issues. The merge of the eight pillars of transformational and servant leadership theory provided propositional pillars that were tested in practice through interviews with FRO leaders in Appalachia. The discovery of how these leadership strategies were enacted during a time of crisis will guide the development of a training curriculum for nonprofit leaders in the future.
Assessing the SNAP consumer environment at farmers markets
Young, Gabrielle; Misyak, Sarah A. (2022-01-20)
A Content Analysis of Implementation Strategies Chosen by Virginia School Nutrition Directors
Nelson, Rachel A.; Porter, Kathleen J.; Shomo, Kelly; Curwood, Sandra; Misyak, Sarah A. (Paris Scholar, 2021-11)
Objective: School-based interventions are common approaches to address childhood obesity; however, there is little understanding of strategies that can foster their implementation into schools. In this study, we aimed to identify goals and the specific strategies selected by school nutrition directors (SNDs) in Virginia to execute school-based interventions. Methods: Between 2018 and 2019, SNDs in Virginia participated in Team Nutrition workshops through which they created action plans. We carried out a content analysis of 132 action plans collected from 100 school divisions. We developed codes deductively and inductively. The codes captured plan completion, goals, and strategies. Each plan was independently coded by 2 coders. Results: Action plans included 1.2 goals (SD = 0.54) and 3.9 strategies per goal (SD = 2.1). Goals were most commonly related to improving menus or increasing participation in the school meal programs. The strategies varied based on the goals. However, obtaining buy-in from school personnel and students was the most commonly included goal (64.4%) across plans. The level of action plan completion decreased with each subsequent section of the worksheet. Conclusions: Emerging patterns identified in this study suggest SNDs' strategy selection is based on goals and that trainings should be tailored to promote the development of skills required to execute optimal strategies.
Cooperative Extension’s Capacity to Address Food Insecurity by Supporting Food Recovery Organizations
Schonberger, H. Lester; Yang, Lily; Chase, Melissa W.; Drape, Tiffany A.; Misyak, Sarah A.; Boyer, Renee R. (Clemson University, 2022-06-01)
Virginia Cooperative Extension (VCE) educators are uniquely positioned to support the food recovery organizations (FROs) which address hunger-related needs resulting from food insecurity. Based on an online survey to measure how VCE educators have engaged with FROs and their experiences, respondents who previously supported FROs did so across multiple programming areas, and those who had not indicated an interest while also experiencing barriers. Respondents also reported the need for context and audience-specific resources particular to the spectrum of food recovery. Addressing barriers and resource needs through a transdisciplinary eXtension Food Recovery Community of Practice may support educators in doing this work.
Cultivating a Healthy School Environment: Evaluation of a Virginia School Nutrition Training Program
Nelson, Rachel A. (Virginia Tech, 2020-05-18)
The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework was used to evaluate the impact of the Virginia Department of Education's (VDOE) implementation of the USDA's Team Nutrition training program on Virginia elementary schools from 2017-2020. The VDOE provided training for school nutrition directors (SNDs) at workshops in June 2018 and September 2019 and continued technical assistance to help SNDs improve the school food environment within their divisions. SNDs' perceived support, self-efficacy, and intention to implement changes to the school food environment was measured through pre- and post-training surveys and quarterly check-ins. Implementation was measured using lunchroom environment observations and strategic plans created at the workshops. SNDs representing 83.9% of Virginia elementary students (512,953 students) in 111 divisions attended at least one of the workshops. Within effectiveness, perceived support from cafeteria staff was highest among all stakeholders for both the 2018 and 2019 trainings, though it significantly decreased from before to after the training for both workshops. Average perceived support did not significantly change over time. Self-efficacy was significantly higher following the 2018 training workshop only. The intervention was adopted by 84% of divisions and both intention to implement and actual implementation were highest for strategies related to Farm to School, a VDOE priority. Effectiveness and implementation are expected to improve as it takes up to years for changes to occur in schools. Despite RE-AIM not being part of the initial evaluation plan, 62% of indicators were assessed. With some adaptations to improve effectiveness, the intervention should continue and be expanded.
Determination of the Capacity Building Framework that Support a Collaborative Fruit and Vegetable Prescription Program
Schwartz, Olivia Rae (Virginia Tech, 2017-05-22)
Over half of U.S. adults, roughly 117 million individuals, suffer from at least one preventable chronic disease, such as obesity, hypertension, coronary heart disease, and certain types of cancer. Epidemiological studies suggest that fruit and vegetable intake may be protective against these diseases, yet it is estimated that less than one-quarter of the population meets current fruit and vegetable recommendations. Low consumption rates may be attributed to lower income, food insecurity, and poor access and availability to fruits and vegetables. As a result, access to affordable and nutritious foods and beverages, particularly in underserved communities, such as “food deserts,” has become a national priority. An emerging strategy to address this is prescription programs, whereby physicians provide prescriptions or vouchers for fruit and vegetables to clients to encourage increased consumption, implemented in the form of the Farmacy Garden, which was the result of collaboration between multiple agencies. For collaborative efforts to be able to implement and sustain their shared goals, partnering individuals, agencies, and organizations need to first have the capacity or the potential to build capacity as a ‘unit.’ The purpose of this study was to concretely examine different factors and domains within Matachi’s Capacity Building Framework related to the Farmacy Garden in order to replicate the program in other locations. This framework conceptualizes organizational capacity building as dependent (and interdependent) on three different domains - individual, organizational, and environment. The study utilized semi-structured, openended interviews to ascertain concrete factors of organizational capacity building present at each level among Farmacy Garden collaborative project stakeholders (n=7). Interviews with six stakeholders (85.7% response rate) ranged in length from thirty-two minutes to one hour and twenty minutes. Common themes were coded separately by two members of the research team, first for overall recurring themes and second, to reveal connections between themes. Relevant quotes were identified and any discrepancies between researchers were resolved. Common themes often crossed over different levels, such as time, beliefs, values, and attitudes and inter-organizational linkages/partnerships, attitudes, and relationships, highlighting the inter-dependence of various factors across domains of capacity building. In addition to identifying specific factors that were necessary for the creation and sustainability of the Farmacy Program, the analysis revealed the importance of a “shared belief and value system.” In other words, individuals and organizations “valorized” this project in different ways than more traditional programs and/or interventions. The findings of this study can help guide leadership in cultivating relationships and new benchmarks to ensure transparency in project goals, in addition to time and physical resources, as well as inform the organizational capacity research area within nutrition and food systems fields.
Development and Evaluation of the Planetary Health Diet Index for the United States and Assessment of Dietary Constructs Associated with Sustainability
Parker, Molly Kathryn (Virginia Tech, 2023-05-09)
Dietary choices present an important avenue for promoting food system sustainability. Research suggests that plant-based dietary patterns can have positive health effects and reduce environmental impacts. The Planetary Health Diet was proposed by the EAT-Lancet Commission as a reference healthy and sustainable dietary pattern. A Planetary Health Diet Index (PHDI) was developed for Brazil to measure adherence to Planetary Health Diet recommendations; however, a PHDI has not been developed and evaluated for the United States (U.S.) population. Additionally, relatively few studies have assessed dietary constructs related to sustainability among U.S. adults, including the construct of meat attachment (i.e., a positive bond toward eating meat) and willingness to reduce meat intake. These gaps informed three primary research objectives. First, develop and evaluate the PHDI for the U.S. (PHDI-US). Second, use the PHDI-US to measure American adherence to the Planetary Health Diet. Third, analyze differences in meat attachment and willingness to reduce meat intake by sociodemographic and socioeconomic characteristics in a southern U.S. population. Cross-sectional data from 4,741 participants of the National Health and Nutrition Examination Survey 2017-2018 were used for analyses. Validity and reliability tests were acceptable, with total PHDI-US and Health Eating Index-2015 scores being positively associated; concurrent-criterion validity analyses identifying significantly lower scores among males, everyday smokers, and younger adults; and Cronbach's alpha equaling 0.51. The average PHDI-US score was 38.7 out of 150, indicating that American diets are far from meeting Planetary Health Diet recommendations. Using the Meat Attachment Questionnaire (MAQ), levels of meat attachment, meat intake frequency, and willingness to reduce meat intake and follow a more plant-based diet were compared by gender, educational attainment, income, and age among 328 American adults. The two characteristics most associated with differences in MAQ scores were age and educational attainment, with younger adults and those with higher educational attainment having lower MAQ scores and greater willingness to follow a more plant-based diet. The results of these studies can help improve the design of interventions by providing a tool to quantitatively measure American adherence to the Planetary Health Diet and identifying that younger adults and those with higher educational attainment may be more receptive to adopting sustainable dietary patterns.
Development of a SNP Assay for the Differentiation of Allelic Variations in the mdx Dystrophic Mouse Model
Misyak, Sarah A. (Virginia Tech, 2008-04-21)
The purpose of this study was to develop a SNaPshotÂ® assay to simultaneously discriminate between the dystrophic and wild type (wt) alleles in mdx mice. The mdx mouse is an animal model for Duchenne muscular dystrophy (DMD), a severe and fatal muscle wasting disease. To evaluate possible treatments and to carry out genetic studies, it is essential to distinguish between mice that carry the mutant dystrophic or wt allele(s). The current Amplification-Resistant Mutation System (ARMS) assay used to genotype mdx mice is labor intensive and sometimes fails to yield typing results, which reduce its efficiency as a screening tool. An alternative assay based on single nucleotide polymorphism (SNP) extension technology (i.e., SNaPshotÂ®) would be advantageous because its specificity and capability to be automated would reduce the labor involved and increase the fidelity of each assay. A SNaPshotÂ® assay has been developed that provides a robust and potentially automatable assay that discriminates between the wt and dystrophic alleles. The assay has been optimized to use: an undiluted DNA in the PCR, a 0.1 ÂµM PCR primer concentration, a full PCR product for the SNP extension reaction, a 50ÂºC annealing temperature for the SNP extension in accordance with standard SNaPshotÂ® conditions, and a 0.4 ÂµM concentration of the SNP extension primer. The advantages of the resultant SNaPshotÂ® assay over the ARMS assay include higher fidelity, robustness, and more consistent performance within and among laboratories, and reduced risk of human error.
Dietary Intake Changes in Response to a Sugar-Sweetened Beverage Reduction Trial for SNAP Participants and Nonparticipants
Bremer, Molly Catherine (Virginia Tech, 2017-06-13)
It is unknown if participation in the Supplemental Nutrition Assistance Program (SNAP) influences the magnitude of improvement in dietary intake in response to dietary interventions. Adults with low socioeconomic status (SES) tend to have lower overall dietary quality as compared to those with higher SES. However, low SES adults are more likely to receive benefits from SNAP, which gives nutrition assistance to millions of eligible Americans. The objective of this investigation is to examine differences in dietary intake between 1) SNAP participants, 2) those eligible for SNAP but not receiving (nonparticipants), and 3) those ineligible for SNAP, in response to an intervention targeting a reduction in sugar-sweetened beverage (SSB) consumption. Adult participants (n=146) from Southwest Virginia were enrolled in a 6-month, community-based trial, SIPsmartER. Participants provided SNAP enrollment status and 3 24-hour dietary recalls at baseline and 6-months. Dietary variables (SSB, macronutrients, etc.) and dietary quality data (Healthy Eating Index [HEI-2010]) were derived from nutritional analysis software (NDS-R 2011). Statistical analyses included descriptives and repeated-measures ANOVA. Although SNAP participation and eligibility status did not impact the overall effectiveness of this dietary intervention, the within group data suggests that those eligible for SNAP but not participating (n=30) may be at a disadvantage to improving their dietary intake as compared to those at a similar household income who receive SNAP benefits (n=56) or ineligible individuals at a higher income level (n=60). Future research is needed to explore if participant's ability to maintain long-term adherence to the dietary changes differs between groups.
Dietary Modulation of Inflammation-Induced Colorectal Cancer through PPAR
Carter, Ashlee B.; Misyak, Sarah A.; Hontecillas, Raquel; Bassaganya-Riera, Josep (Hindawi, 2009-04-22)
Mounting evidence suggests that the risk of developing colorectal cancer (CRC) is dramatically increased for patients with chronic inflammatory diseases. For instance, patients with Crohn's Disease (CD) or Ulcerative Colitis (UC) have a 12–20% increased risk for developing CRC. Preventive strategies utilizing nontoxic natural compounds that modulate immune responses could be successful in the suppression of inflammation-driven colorectal cancer in high-risk groups. The increase of peroxisome proliferator-activated receptor- (PPAR-) expression and its transcriptional activity has been identified as a target for anti-inflammatory efforts, and the suppression of inflammation-driven colon cancer. PPAR down-modulates inflammation and elicits antiproliferative and proapoptotic actions in epithelial cells. All of which may decrease the risk for inflammation-induced CRC. This review will focus on the use of orally active, naturally occurring chemopreventive approaches against inflammation-induced CRC that target PPAR and therefore down-modulate inflammation.
Differing Within-Household Food Security Statuses Are Associated with Varied Maternal Mental Health Outcomes
Liebe, Rachel A.; Holmes, Chanit’a; Misyak, Sarah A. (MDPI, 2024-05-18)
Household food insecurity is not necessarily equally experienced by all household members, with mothers often changing their intake first when food resources are limited. The purpose of this study was to understand the association between maternal mental health and intrahousehold differences in food security statuses. A cross-sectional survey was administered to Virginia mothers with low income (August–October 2021), assessing validated measures of food security, mental and physical health and related factors. Participants (n = 570) were grouped according to the food security status of adults and children within the household. Linear regression was used to assess the outcomes of interest by group and controlled for key demographic variables. Mothers in households with any food insecurity reported worse overall mental health and used 3–4 more food coping strategies than households experiencing food security (p < 0.05). Only mothers in households where adults experienced food insecurity reported significantly greater anxiety and depressive symptoms (61.5 and 58.1, respectively) compared to households experiencing food security (55.7 and 52.4, p < 0.001). While any experience of household food insecurity is associated with worse maternal mental health, there were differences by the within-household food security status. Future research should explore screening measures that capture specific household members’ food security to connect households with available resources.
Effect of Program Implementation Fidelity on Outcomes of the Lifestyle Change Program Conducted through Distance Learning by Cooperative Extension
Pourkhalili, Azin Rose (Virginia Tech, 2023-07-03)
The National Diabetes Prevention Program (National DPP) was established by Congress in 2010, with a focus on disseminating the evidence-based Lifestyle Change Program (LCP). This 12-month program consists of 26 lessons covering various topics related to goal setting, tracking food and physical activity, motivation, and support groups. Many organizations, including Cooperative Extension (CE), have adopted this program. In the first study conducted by the Virginia Cooperative Extension (VCE), the outcomes of the prediabetes LCP were examined across different age groups and delivery modalities. It was found that distance learning LCPs had slightly higher enrollment levels compared to in-person programs (51% vs. 49%). Moreover, participants aged 60 and older had a significantly higher attendance rate in the distance learning program. The VCE LCP resulted in 49 participants (35%) achieving at least a 5% weight loss, with 29 of them being 60 years or older. When considering the program delivery method, a higher percentage of individuals enrolled in distance learning programs (53%) achieved at least a 5% weight loss. Additionally, 86 participants (62%) engaged in an average of 150 minutes of physical activity per week, with a higher percentage in the in-person programs (64%) and among those aged 60 and older (67%). In Study 2, the distance learning LCP implementation fidelity was evaluated across five states, along with its association with program outcomes. The evaluation tool assessed structural and instructional implementation components. The results indicated that certain structural components directly influenced increased physical activity among participants. Additionally, the coaches' preparedness for the sessions directly impacted participants' weight loss. In addition to implementation fidelity, age was identified as an independent factor affecting weight loss percentage and attendance. Overall, the findings from both studies underscore the significance of effective implementation fidelity to program design in achieving desired health outcomes. The LCP shows promise as an intervention for individuals at risk of developing type 2 diabetes and can be effectively implemented through both in-person and distance learning methods by Cooperative Extension programs nationwide.
Examining Contributors and Solutions to Prevent and Manage Food Waste in Households with Low Incomes and the Emergency Food System within the U.S.
Chen, Susan (Virginia Tech, 2021-08-25)
In the United States (U.S.), up to 40% of the entire food supply is lost or wasted, which contributes to negative environmental, economic, and social outcomes, with the majority of food waste occurring in the retail and consumer sectors of the food supply chain. Concurrently, 10.5% of U.S. households experienced food insecurity in 2019. Food insecurity rates are higher among individuals with low income and disproportionately affects ethically and racially diverse people living in poverty. Diverting excess food from retail and institutional settings to people in need is one method to reduce food waste and enhance individual, household, and community food security. This PhD dissertation describes four studies that explored food waste management in the U.S. among households with low-income and within U.S. food pantries, which are a critical component of the emergency food system. Study 1 consisted of a systematic review that examined differences in food waste attitudes and practices among consumers of across income levels. Study 2 was a quantitative research methods approach to examine food waste attitudes and practices of SNAP-eligible households (n=17). Study 3 was a cross-sectional quantitative approach to examine the impact of the novel coronavirus disease (COVID-19) pandemic on food waste management within U.S. food pantries (n=290). Study 4 assessed the feasibility of food pantries in Virginia (n=68) to implement marketing-mix and choice-architecture (MMCA) strategies within their food pantries given the changes they had to make in their food distribution models in response to COVID-19 physical distancing requirements. Collectively, the studies described in this PhD dissertation address knowledge gaps and may be used to inform policies and initiatives to increase food security and decrease food waste among households with low-income and organizations aimed at serving them.
Exploring the Relationship Between Food Security Status and Mental Health Among SNAP-Eligible Virginia Mothers
Liebe, Rachel Antoinette (Virginia Tech, 2023-03-16)
Food insecurity is associated with increased stress, symptoms of mental illness, and persistent health disparities. Women caregivers (referred to as mothers) may be at an increased risk because they often compensate for food shortages by reducing their own intake and make household food decisions. The current literature on the relationship between food security status and mental health in the U.S. lacks a clear framework for the relationship between these two phenomena. This dissertation describes three studies that aimed to explore the relationship between food security and mental health for mothers with low income in Virginia: (1) understanding differences in mental health outcomes by food security status (n=1,029), (2) a path analysis of a conceptual framework of the relationship (n=1,029), and (3) a thematic analysis of mothers' lived experiences with this relationship (n=29). An explanatory, sequential mixed methods design was employed with a cross-sectional survey informing semi-structured interviews. The survey (administered August-October 2021) was developed with previously validated measures of food security status, physical and mental health, symptoms of mental illness, behavioral food coping strategies, and social support. The interview guide was developed based on the findings of the survey and administered in May and June 2022. Collective findings of this series of studies suggested lower food security status was associated with negative mental health outcomes. However, there were no direct pathways from food security status to mental health outcomes. Social support and behavioral food coping strategies mediated the relationship between food security status and mental health outcomes. Mothers reported experiencing managing a variety of stressors associated with food insecurity. Mothers also indicated that stressors and coping strategies associated with managing food insecurity impacted their mental health. Future research should explore additional factors impacting household resiliency and strategies to reduce stigma associated with resource utilization. These findings can be built upon to develop screening tools and interventions to help improve food security and mental health status mothers with low income.
Farmers Market Access by Snap-eligible Mothers of Young Children: Barriers and Impact on Nutrition Education Programming for Cooperative Extension
Misyak, Sarah A. (Virginia Tech, 2014-01-29)
Providing improved access to farmers markets and other local food outlets for low-income audiences is an increasingly popular nutrition intervention strategy to promote consumption of fresh fruits and vegetables and address obesity. The USDA encouraged more farm to fork initiatives and efforts to connect low-income populations with fresh and healthy, local foods through farmers markets through the implementation of the Supplemental Nutrition Assistance Program Nutrition Education (SNAP-Ed) provisions of the Healthy, Hunger-Free Kids Act of 2010. The purpose of this research was to assess the perceived barriers to farmers market access and strategies for overcoming those barriers for low-income individuals and families participating in Cooperative Extension nutrition programming. Data collection procedures included a survey of SNAP-Ed and the Expanded Food and Nutrition Education Program (EFNEP) program assistants, focus group discussions with SNAP-eligible individuals, and a photo elicitation study with mothers of young children. Results from these studies provide insight on how to structure program assistant trainings to encourage the inclusion of an optional farmers market orientation lesson in SNAP-Ed and EFNEP curricula; low-income individuals' perception of healthy food, access to and perception of local foods, benefits and barriers to shopping at farmers markets, and the impact of local foods on diet quality; and how to address perceived barriers through Cooperative Extension nutrition programming for the SNAP-Ed and ENFEP target population of SNAP-eligible mothers of young children. Working with farmers markets is an opportunity to form greater synergy between the arms of Extension (Family and Consumer Sciences, Community Viability, Agriculture and Natural Resources, and potentially 4-H) related to supporting local food systems while forming collaborative relationships with local farmers markets and community members.
A feasibility assessment for the use of the community health worker model for inclusive garden-based food systems programming for Virginia Cooperative Extension
DeNunzio, Maria Nicole (Virginia Tech, 2022-06-03)
Food systems include food production, processing, distribution, marketing, access, preparation, consumption, and disposal and influences of social, economic, and environmental conditions. Virginia Cooperative Extension (VCE) has professionals, paraprofessionals, and volunteers with expertise in food systems dimensions integrated into Virginia communities. Current VCE programming has unequal reach for Black, Indigenous, and people of color (BIPOC) communities. Community health workers (CHWs) are lay outreach workers who are from the communities they serve and can be effective health educators within BIPOC communities who experience health disparities. The CHW model is underexplored in food systems, despite the importance of food systems for health. A scoping review of United States CHW educational food systems interventions found CHW reach to BIPOC communities primarily through education on food preparation and consumption. Garden-based programming educated on the highest number of food system processes, highlighting a potential role of CHWs within food systems. These results guided development of a feasibility evaluation for the CHW model for garden-based food systems programming for VCE, emphasizing reach to BIPOC communities. Semi-structured interviews were conducted with 29 VCE stakeholders representing several disciplines. The CHW model is feasible for VCE within the current focus on food systems, diversity, and inclusion. Participatory approaches for programming should be used to incorporate the cultural knowledge of the CHW and to create a welcoming environment for BIPOC communities. The CHW model can connect disciplines to provide accessible and culturally relevant programming to BIPOC communities, thus extending the reach of VCE and potentially creating more inclusive community food systems.
Food retailer actions toward the National Strategy on Hunger, Nutrition, and Health to promote nutrition security: Applicability of the Business Impact Assessment-Obesity as a monitoring tool
DeNunzio, Maria; Houghtaling, Bailey; Kraak, Vivica; Gardezi, Maaz; Serrano, Elena L.; Misyak, Sarah A. (Society of Behavioral Medicine, 2024-10)
The White House National Strategy on Hunger, Nutrition, and Health (National Strategy) encourages actions across government and society to promote nutrition security. Nutrition security includes adequate food, diet quality, and equity, and food retail settings can promote these major concepts. Of all National Strategy whole-of-society calls to action, food retailers can contribute to 15 calls as key actors. However, there is currently no standardized monitoring tool to track food retailers’ commitments and actions toward the National Strategy to promote nutrition security. The Business Impact Assessment-Obesity and population-level nutrition (BIA-Obesity), a tool originally developed for corporate accountability monitoring, can be tailored for the National Strategy and nutrition security, given its standardized indicators and process to assess food company policies and commitments across six domains. We discuss the fit of the BIA-Obesity indicators for tracking food retailers’ commitments and actions across four pillars of the National Strategy. Existing indicators are appropriate to monitor components of Pillar 1: Improve Food Access and Affordability; Pillar 2: Integrate Nutrition and Health; Pillar 3: Empower All Consumers to Make and Have Access to Healthy Choices; and Pillar 5: Enhance Nutrition and Food Security Research. We suggest expanding current indicators to include equity, local foods, the digital food environment, and food waste reduction to improve alignment of the BIA-Obesity with the National Strategy. Application of the BIA-Obesity as an existing tool can facilitate data cohesion and more rapid assessment of the food retailer landscape to mutually meet nutrition security goals by 2030.
Food Safety Education Challenges and Opportunities in Virginia's Food Recovery Organizations
Schonberger, H. Lester (Virginia Tech, 2020-09-09)
There were an estimated 11.1% of households experiencing food insecurity in the U.S. in 2018, meaning that they did not have the adequate resources to access safe, nutritious food at some point in the year. In order to support people experiencing food insecurity and related-hunger, national organizations, regional food banks, and local programs operate to recover, organize, and distribute the food available to them. Food recovery work falls into a regulatory grey-area. Should anyone consuming donated food become ill, the food handlers would not be criminally or civilly liable if they distributed it in good faith. There are no federal regulations covering food handling in food recovery, though some states do have such regulations. As a result, safe food handling guidance, education, and training is offered through organized networks and Cooperative Extension. Participating in educational programs increases safe food handling knowledge, however volunteers and employees in food recovery organizations have also been observed to unsafely handle food. Additionally, these resources can be limited in their scope and some are only accessible through membership in pre-existing networks such as Feeding America. The purpose of this work is to further document how food is handled in food recovery and compliment that by collecting the experiences and perceptions of these food handlers as well as Cooperative Extension educators who support them. This work utilized a mixed-methods approach to quantify behaviors and experiences, which compliments qualitatively collected contextual information. Food handlers serving with a university-based student food recovery program, which works to distribute unserved and unsold food from on-campus dining centers, were observed improperly washing their hands, inconsistently keeping records, and using unclean or otherwise contaminated equipment. These behaviors could be addressed through rolespecific education representing their unique operations. Virginia Cooperative Extension (VCE) educators were used as a case study to measure their experiences when supporting food recovery, with 41% of respondents having previously supporting an organization or program. Topics covered ranged from safe food handling, network leadership, financial planning, and farming/gardening. VCE educators expressed a sense of altruism when supporting food recovery organizations, but also experienced challenges such as not having enough time to fully engage or the organization not having adequate equipment to enact their support. VCE educators who had not previously supported these organizations expressed wanting to learn more about food recovery work and how VCE can support them. Employees of food banks believe current food safety education could be improved by offering role-specific information in customizable formats so the food handlers can translate their knowledge into action. Future education should also focus on problemsolving, so food handlers feel empowered to react to expected challenges. Lastly, to account for challenges experienced while conducting this research, future projects within the context of food recovery should consider the limited time available of potential participants, offer compensation for their participation, and maximize pre-existing networks when connecting with them.
The Impact of Weight Bias and Stigma on Energy Misreporting in 24-Hour Dietary Recalls
Howes, Erica Marie (Virginia Tech, 2023-04-25)
Obesity research remains a high priority worldwide, given the sustained high levels of obesity (body mass index ≥30 kg/m2) and class III obesity (body mass index ≥40 kg/m2) across many demographic groups. One component of obesity research is the study of how diet can contribute to obesity, and thus it is crucial to evaluate how existing dietary assessment methods perform for people with obesity, and to develop or refine methods to enhance their accuracy. Researchers should be prepared to include more individuals with obesity and class III obesity, a growing demographic, in studies that assess dietary intake. With the inclusion of these groups, it is vital to consider the potential impact of weight bias and weight stigma on dietary research. Weight bias is negative attitudes and stereotypes about people with obesity, while weight stigma is how these attitudes collectively devalue people with obesity, which could result in acts of discrimination. This dissertation: 1) defined the issues of weight bias and weight stigma, and how they affect dietetics practice, including research, 2) determined the representation of participants with class III obesity in studies validating self-reported measures of dietary assessment using doubly-labeled water, and 3) explored how weight bias and weight stigma might impact misreporting of energy intake among people with overweight and obesity. Findings include that: 1) weight bias and weight stigma are important issues when working with people with obesity, and dietetics professionals can address these in many areas of practice; 2) in studies validating self-reported dietary assessment methods using doubly-labeled water, people with class III obesity are underrepresented, and thus the validity of existing methods to assess diet among people with class III obesity requires further research; 3) in a sample of participants with self-reported overweight and obesity, previous experiences of weight stigma were common, though internalized weight bias, weight bias toward others, and experiences of weight stigma were not predictive of the validity of energy intake reporting. Researchers should consider the potential impact of weight stigma on recruitment, retention, and participant experience when working with participants with obesity.

Browsing by Author "Misyak, Sarah A."

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