KA 703. Nutrition Education and Behavior

Cindy Davies (Schlenker) has signed on to support KA 703. Nutrition Education and Behavior within Bernalillo County.

According to the ADA (American Diabetes Association)"hidden salt" may be the biggest source of sodium in our diets. Salt is used to increase storage life of canned food, frozen and boxed dinners, fast food, and restaurant foods to make them taste better. Salt should not be cut out of a diet completely, but people should try to reduce their salt intake. The Gallup Senior Jubilee welcomed 38 members on October 5, 2011 to their ninth senior jubilee a unique program designed to spotlight and celebrate the senior citizens who like in rural areas. The McKinley County CES home Economist provided nutrition education and her topic "Herbs and Spices Instead of Salt?" was well received. The participants learned which herbs have strong, medium and delicate flavors, which herbs can be combined to specific foods. As an added activity the were invited to prepare a poultry seasoning to take home and try on thanksgiving turkey. All 41 participants shared their knowledge about the use of certain herbs and they didn't hesitate in preparing their seasoning recipe to take home. Everyone noted that the seasoning had no salt, but the aroma was very appetizing.

Ideas for Cooking and Nutrition Program (ICAN) is the umbrella name used in New Mexico to refer to both the Supplemental Nutrition Assistance Program, (SNAP ED) and the Expanded Food and Nutrition Education programs. The primary goal of the ICAN program is to provide individuals with limited resources educational programs that increase the likelihood of all participants making healthy food choices consistent with the most recent dietary advice as reflected in the dietary advice as reflected in the Dietary Guidelines for Americans and the USDA MyPyramid.

The home economist has oversight and management of the Rio Arriba County ICAN program as one of her areas of responsibility. The ICAN program in Rio Arriba County now employs two three-quarter time nutrition educators, one of which was recently added due to the persistence of the home economist. These educators work under the supervision of the home economist and are charged with teaching and promoting nutrition classes to youth and adult audiences. As part of the home economist responsibilities, she provides training, guidance and supervision of the educators; manages the County ICAN budget; participates in yearly regional or state level conferences to learn of program updates; prepares reports related to program impacts; and evaluates the educator’s performance.
Goals of the newly reinvigorated County-based program include reaching 130 youth and 60 adult graduates. Participants in the program are considered graduates after completing a minimum of four hours of nutrition classes. For FY 10-11 the Rio Arriba County ICAN program exceeded their goals for youth by 273% by graduating 436 youth and exceeded adult goals by 9% by graduating 66 adults.

Adults programs have been delivered at various venues throughout the county. Including the NNMC GED program; NMSU NM Works Life Skills Program; Las Cumbre Child Care Program; Rio Arriba County DWI Juvenile program; and the Espanola County Senior Citizens program. Adult programming included classes to promote eating more fruits and vegetables, food safety, label reading, the importance of physical activity, adult and child serving sizes, and how to make the most of your food dollars.

Individual ICAN county impact results are not made available to counties, but rather are compiled into one state-wide report. However, please see the Just Be It! Healthy and Fit (JBI)section for specific results for youth, as a majority of the JBI participants were also reported for the ICAN program as well.


Just Be It! Healthy and Fit Program

Childhood obesity has been identified as a major health concern throughout the United States. Risk factors for childhood obesity include lack of nutritious food and physical activity, lack of support from the school and home environment to choose appropriate foods and make time to exercise along with too much “screen time”. Poor nutrition and limited physical activity are risk factors for chronic diseases and also play a role in a students’ ability to learn, thereby affecting scholastic success. Childhood obesity has a significant impact on health care costs and the ability to produce a well-educated, prepared work force.

Just Be It! Healthy and Fit (JBI) is a childhood obesity prevention program. Fifth grade students in Rio Arriba, Los Alamos, and Santa Fe County have been targeted to receive the program by providing them with knowledge regarding nutrition and physical activity.

In an effort to fight obesity and teach children about healthy lifestyles, Extension Agents from Rio Arriba, Los Alamos, and Santa Fe Counties have implemented the JBI nutrition and fitness field trip experience for fifth grade students. The 2010 field trip began with a JBI Trivia Game -setting the tone for the four - 45-minute workshops: MyPyramid, Vary Your Veggies Focus on Fruits,Power-Up with Exercise, and Fun With Food Facts. These workshops are also aligned to the New Mexico Health and Physical Education Standards and Benchmarks. The Extension agents from each respective county presented in each of three workshops, and the fourth workshop on physical activity was conducted by a PE teacher from Espanola Public Schools. Two field trips were conducted in Espanola, one in Moriarity, one in Santa Fe, and one in Los Alamos.

In Fall of 2010, over 285 students from eight schools in Rio Arriba County participated in the two field trips. In addition, students were provided with a student-parent booklet containing information and activities reinforcing the workshops. Teachers are also provided with a resource kit containing a nutrition curriculum, additional health and nutrition resources and each class received an exercise kit with a variety of fun, fitness items.

Each site was responsible for recruiting volunteers to assist with the field trip program. In the 2010 field trip over 15 volunteers were recruited for the Rio Arriba Program. These volunteers served as workshop presenters, workshop assistants and group leaders. An estimated volunteer contribution for Rio Arriba County was $1500.00. In addition to these volunteers, 15 classroom teachers assisted by supervising youth throughout the day.

Based on the average results from the field trip pre- and post-tests, students indicated an average knowledge gain of 39% by attending this one-day educational field trip. There was knowledge gain for these fifth grade students on nutrition guidelines, choosing healthy snacks, physical activity, food labels, how the media affects food choices, and goal setting after attending this field trip.

Selected results of a survey taken by 13 out of 15 teachers who attended the field trip are as follows: 87% felt that their students' knowledge about health and nutrition definitely increased, and the other 13% felt that it somewhat increased. All but one teacher rated the workshops excellent or good, as well as students perceiving health and nutrition in a more positive light than before the field trip. Comments included: "Loved it!" The students really enjoyed the exercise workshop." "Thank you for informing myself and my students about nutrition and exercise. I learned a lot myself."

Other components of the JBI program include follow-up classroom instruction which includes curriculum development, evaluation regarding behavior change, parent education and evaluation and community awareness of childhood obesity issues. Classroom instruction ran from October through March/April in each county. The agent worked with a total of four classes at Carinos Charter School and Fairview Elementaries and oversaw 11 other classes that attended the field trip. In addition, five other JBI classes were taught throughout the county as well.

In 2010-11, JBI classrooms in Rio Arriba County were taught either by the home economist, nutrition educator, or outside nutrition contractors hired through the USDA CYFAR grant, which was initially received due to the overall success from the first field trip. Over 436 students have been reached during the 2010-2011 school year. Classroom instruction included intense activities to learn about the five food groups, fats, fast food consumer decision making, goal setting, fun ways to exercise including dance pads and numerous other physical fitness activities, as well as food safety, label reading, serving sizes, and healthy snacks.

Knowledge gain is one of the medium-term objectives of the JBI program. In the 2010-2011 school year 286 students participated in the main program, and 243 completed the pre and post tests and increased their nutrition knowledge as a result of receiving nutrition classes during the school year. The 2010-2011 pre-test average score was 9.08% (57%) and the post-test average score was 14.30 (out of a possible 16 points) (89%) showing a 5.22 point gain, or 56% average knowledge gain. The difference in scores was statistically significant (p<.0001).
In addition, pre- and post-tests were administered to students who participated in the in-class instruction at five other schools who were not involved in the field trip. The pre-test average score was 56% and the post test average score was 93% showing a 66% knowledge gain. The agent conducted over 43 JBI classes throughout the school year, and an additional 178 JBI/ICAN classes were conducted by other nutritional educators throughout the school year, and to include summer programs.

Another medium term objective for students to increase their fruit intake was not met, but for vegetable intake, it was met. Students increased their vegetable intake after receiving nutrition classes during the school year. In Rio Arriba County, 240 students completed pre and post surveys on the intake of fruits and vegetables. The pre-test average score for fruit intake was 3.4 and the post-test average score was 3.57. The difference in scores was not statistically significant (p≤.1060). The pre-test average score for eating vegetables was 2.70 and the post-test average score was 3.13. The difference in scores was statistically significant (p≤ .0005) based on a paired t-test.

A third medium term objective was for students to increase their amount of physical activity. This goal was met as well. There was a statistically significant difference for physical activity for the year. In Rio Arriba County, 239 students completed pre and post surveys on physical activity. The pre-test average score was 3.23 and the post-test average score was 3.51. The difference in scores was statistically significant (p≤.0210).

The medium term objective for parents to increase their nutrition knowledge was also met. A set of 11 newsletters were developed by the agent and the other three JBI committee members and sent out to parents of students in the JBI program. Impacts of the newsletter through a survey conducted with parents showed a pre-test score average of 75% and the post-test score average of 94%. There was a 25% average knowledge gain for parents. The return rate for newsletter evaluations was 16% (n=243). (This average gain is the average of newsletters from all three participating counties.) Numerous positive comments were received from families on the program evaluation such as "Because of the JBI program my child learned to eat more fruit and vegetables." My child has learned how to stay healthy and it would be nice to have this program offered in every grade." "My child took this program very serious and lost five pounds by eating better and exercising more." "Learning about how to eat portions was very helpful." "As a result of this program my family is eating better and exercising more."

Further, the long term objective of developing a new JBI childhood obesity curriculum was completed by the JBI committee after five years of research and development in the three participating counties. The committee met numerous times to review, edit, and add additional lesson plans during the past five years. Meetings also included development of workshops and poster sessions, and meetings and communications with the JBI editor, printer and program manager.

Expanding the program to other New Mexico counties also showed progress. Currently one county agent, in addition to the 3 agents working on the project, is using the program. The Just Be It! plan of work appears at http://pow.nmsu.edu/view_template.php?plan_id=31, the New Mexico Extension website and on the web site www.nmcyfar.org. County agents can sign on to participate in the program. The Just Be It! Healthy and Fit curriculum, is now available on DVD and in print form. This curriculum was recently sent to every county in New Mexico who has nutrition programs, as an additional resource. As more Extension agents are trained to deliver the program, more youth and their family members will reduce risk factors for obesity and develop a healthy lifestyle. National presentations on the curriculum and other program components have been made. These presentations assist in providing interest on a national level.

“Healthy Eating For Those With Diabetes”

Nine seniors and staff from the Springer Senior Citizen’s Center participated in an education program delivered by the home economist to address the dietary needs of diabetics serviced by the center. Discussion topics included label reading, identifying low and high carbohydrate foods, counting carbohydrates, and choosing foods low in saturated and trans fats as well as sodium. Numerous educational materials were available to the participants to further enhance their knowledge of healthy eating habits. Over half of those attending were diabetics themselves. As a result of the training, staff were better able to recognize dietary changes they may need to make when preparing meals for seniors so that meal choices are healthier overall.

“Nutritional Needs of Head Start Youth”

Each year the home economist works with Mora/Colfax Head Start site directors in order to provide nutritional programs to the parents of students enrolled in the program. Over 100, parents, teachers and site directors in Raton and Springer received materials focusing on the 2-5 year old Kid’s MyPyramid; the new MyPlate; healthy eating habits, including picky eating behaviors; and ways parents and children can incorporate more physical activity into their daily lives. Parents also requested basic information on budgeting for family meals and cutting costs while still providing nutritious meals for their families. These efforts have resulted in an increased awareness of basic nutrition concepts by the parents and teaching staff, thereby benefiting the children involved.

The home economist was also asked to serve as a community member on the Mora/Colfax Head Start Policy Council, which meets monthly to discuss policies and procedures, hiring of staff, budgets and other issues pertinent to the overall program.