Objective: The aim of this study was to examine caregiver perceptions of summertime neighborhood-level environmental barriers and facilitators to healthy eating and active living in their elementary-age racial minority children. Methods: Caregivers with students in the prekindergarten–fifth grade were recruited from two schools located in low-income urban neighborhoods of Columbus, OH, with a predominantly Black population. Participants engaged in the research portion of the Healthy Eating Active Living: Mapping Attribute using Participatory Photographic Surveys (HEALth MAPPSTM) protocol, which included (1) orientation; (2) photographing and geotagging facilitators and barriers to HEALth on daily routes; (3) in-depth interview (IDI) discussing images and routes taken; (4) focus groups (FG). IDIs and FGs were transcribed verbatim. Analyses were guided by grounded theory and interpretive phenomenology and were coded by researchers (n = 3), who used comparative analysis to develop a codebook and determine major themes. Results: A total of 10 caregivers enrolled and 9 completed the IDIs. Five caregivers participated in focus groups. A majority (77.8%, n = 7) of caregivers identified as Black, female (88.9%, n = 8), and low income (55.6%, n = 5). IDI and FG themes included (1) walkway infrastructure crucial for healthy eating and active living; (2) scarce accessibility to healthy, affordable foods; (3) multiple abandoned properties; (4) unsafe activity near common neighborhood routes. Conclusions: Caregivers perceived multiple neighborhood-level barriers to healthy eating and activity during the summer months when school is closed. Findings from this study provide initial insights into environmental determinants of unhealthy summer weight gain in a sample of predominantly racial minority school-age children from low-income households.

BackgroundThe most efficacious childhood obesity prevention interventions have involved caregivers directly or indirectly. Due to the high reliance on technology, research examining technological intervention approaches is warranted, particularly during the summer when parents may be more difficult to engage and the risk for excess weight gain among children is high.MethodsThe feasibility and acceptability of a multi-component childhood obesity prevention intervention incorporating a caregiver component utilizing technology-based approaches—texting and social media—was explored. This was an internal pilot of the Camp Nutrition Education Recreation and Fitness (NERF) study, a group RCT for school-age children coupled to the USDA Summer Food Service Program. Feasibility and acceptability of the technology caregiver engagement component were assessed via process outcomes (participation rates) and in-depth interviews.ResultsParticipants (n = 37) were 91.9% female, 91.8% Black, 58.7% low-income, and 75.0% overweight/obese. Participation rates in texting and social media were 62.2% and < 3%, respectively. Themes emerged from the in-depth interviews were texting provides connection; desire more involvement with program; fear social media privacy intrusion.ConclusionsResults will be used to inform changes to technology-based caregiver engagement strategies to be tested in future interventions.Trial registrationClinical Trials, NCT02908230/09-19-2016. Registered 20 September 2016

Objectives Adapt and pilot Simple Suppers (SS)—a site-based 8-week family meals program for Head Start (HS) families offered in fall, winter, and spring—to an online platform using a community-based participatory approach, in response to COVID-19. Methods Researchers collaborated with community partners and HS families to adapt the core components (caregiver education; child education; family meal) of SS to an online format. Feasibility outcomes (demand: response rate, attendance, retention; acceptability: satisfaction; implementation: fidelity, cost; limited effectiveness: diet, weight status) were measured: pre, post, or throughout programming via count, survey, focus group, or direct measure. Baseline demographic data were also collected. Results The research-community team came to consensus on: a) utilizing e-methods families were accustomed to in local HS programs and elementary schools (Google Classroom; Zoom; YouTube videos) for the educational components; b) enhancing the educational components with a supplemental program-specific weekly magazine (“SS Digest”); c) creating a weekly meal kit delivery for the family meal component (“SS Chef's Crate”); and d) adding an additional week to programming (8 to 9) to orient families to the new online format. 13 of 40 families enrolled in HS participated in the fall session of SS-GO programming (32.5% response rate) and mean (SD) weekly attendance was 4.0 (0.86). 11 of the 13 families engaged in the research, and 10 of 11 completed pre- and post-test data collection (91% retention). Survey and focus group data revealed high levels of satisfaction for SS-GO. Weekly lessons were delivered as intended 92.8% of the time, and Chef's Crates were received by families 100% of the time. Mean (SD) food cost of programming was $212.33 (66.06) or $16.33 per family. Limited effectiveness data are forthcoming. Baseline mean (SD) caregiver age was 32.5 (9.32) years (n = 11), 100% (n = 11) female, 72.7% (n = 11) Black, mean (SD) BMI 36.3 (9.31), 36.4% (n = 4) low income, and 36.4% (n = 11) had low or very low food insecurity. Mean (SD) child age was 3.45 (0.69) (n = 11), 45.5% (n = 5) were female, and had a mean (SD) BMI z-score 0.63 (0.76) (n = 11). Conclusions SS-GO demonstrates feasibility utilizing a community-based participatory approach. Data will guide future iterations of the program—in COVID-19 and after. Funding Sources USDA NIFA CYFAR

Objectives To determine caregiver perceptions of neighborhood-level environmental barriers and facilitators to healthy eating and active living (HEAL) among children living in low-income, urban neighborhoods during the summer. Methods The current study was a part of a prospective observational study - Project SWEAT - which investigated determinants of unhealthy weight gain during the summer months in economically disadvantaged school-age children. Caregivers with students in grades preK–5th attending 2 Columbus, OH elementary schools were recruited. Participants completed a demographic survey. To explore neighborhood-level environmental barriers and facilitators to HEAL, participants engaged in a modified HEAL MAPPS (Healthy Eating Active Living Mapping Attributes using Participatory Photographic Surveys) protocol, which included 5 phases: 1) orientation; 2) photographing and geotagging facilitators and barriers to HEAL on daily routes using a Garmin Oregon 650 device; 3) in-depth interview (IDI) discussing images and routes taken; 4) focus group per school site; and 5) culminating local community stakeholder meeting. Results Ten families enrolled; 9 families completed photographing, geotagging and IDIs; 5 families participated in focus groups. A majority (77.8%, n = 7) of caregivers were African-American, female (88.9%, n = 8), and low-income (55.6%, n = 5). Preliminary analyses of photograph and IDI themes include: 1) walkway infrastructure crucial for healthy eating and active living; 2) scarce accessibility to healthy, affordable foods; 3) multiple abandoned properties; and 4) unsafe activity near common neighborhood routes. Conclusions Results from this pilot indicate caregivers perceive both environmental barriers and facilitators to healthy eating and active living during the summer. Additional research should be conducted to confirm findings from this study and compare findings to different settings (e.g., rural and suburban). Funding Sources USDA North Central Nutrition Education Center for Excellence.

BackgroundData indicate that school‐age children, particularly underserved children, experience unhealthy gains in BMI more than twice as fast during the summer months. Few efforts have been directed at implementing evidence‐based programming to prevent this negative trend. Because caregivers help children establish and reinforce diet and physical activity behaviors through role modeling, their involvement, either directly or indirectly, in child‐targeted behavioral interventions is essential.Study DesignCamp NERF 2015 was a citywide scale up of an 8‐week, multi‐component (nutrition, physical activity (PA), and mental health), theory‐based program for underserved school‐age children in grades K‐5 coupled with the USDA Summer Food Service Program. Twelve eligible elementary school sites were randomized to 1 of 3 programming groups: 1) Active Control (non‐nutrition, PA, or mental health); 2) Standard Care (nutrition and PA); or 3) Enhanced Care (nutrition, PA, mental health, and caregiver engagement) programming. Caregiver engagement strategies were: 1) Traditional print materials sent home weekly with children; 2) Text messaging; and 3) Social media.MethodsCaregiver outcomes included self‐efficacy (SE) for healthy behaviors, physical activity level, and weight status (or BMI) and were assessed at baseline and post‐intervention. Among all caregiver participants, change outcomes were assessed utilizing hierarchical linear model analyses. Among Enhanced Care group caregiver participants, text messaging exposure – none, low, high – was added to the model to assess the effect of the texting intervention. To determine acceptability of caregiver engagement strategies, in‐depth interviews were completed with a subset of participating caregivers, transcribed verbatim, and analyzed qualitatively utilizing interpretive phenomenology and grounded theory.ResultsCaregiver retention rate was 93% (n=81). Approximately 87.4% (n=76) were female and 75.7% (n=66) were Black. At baseline, 80.5% (n=70) were overweight or obese. No significant differences in caregiver SE for healthy behaviors, PA, or BMI were demonstrated between groups from baseline to post‐intervention (p‐values > 0.10). Among the Enhanced Care group, texting participation rate was 62.2% and social media participation rate was less than 3%. When texting exposure was included in the models, mean physical activity score significantly decreased among the low‐exposure group compared to the no‐exposure group (p=0.02); there were no significant changes for the high‐exposure group. Three main themes emerged from the in‐depth interviews: 1) Texting Provided a Means of Connection; 2) Desired More Involvement with Program; and 3) Feared Privacy Intrusion with Social Media.ConclusionsResults from this study will be utilized to improve caregiver engagement strategies in the delivery of this and other similar health behavior interventions for underserved school‐age children during the summer months.Support or Funding InformationAcknowledgements: The Camp NERF research team would like to thank the Aetna Foundation and The Ohio State University Office of Outreach and Engagement for funding this study.