KA 703. Nutrition Education and Behavior

Kitchen Creations
The agent successfully planned and implemented one Kitchen Creations class in April 2010. This class was a partnership between NMSU Cooperative Extension Service, San Juan Regional Medical Center Diabetes Education, and New Mexico Public Health. The class consisted of four weekly sessions. Each session was four hours long. In this time, participants were exposed to diabetes education such as factors that increase or decrease insulin levels, the 50/50 plate method of diet management, understanding food labels, the Diabetic Food Guide Pyramid, and more presented by a Certified Diabetes Educator from San Juan Regional Medical Center and to shopping tips, cooking skills and portion control ideas and diabetic recipes provided by the Kitchen Creations Grant and presented by the San Juan County Home Economist. This class resulted in 15 graduates. Reports from class participants indicate that the Kitchen Creations class format is conducive to learning and that the information presented is easy to understand and is being used by the participants at home.

ICAN and KidsCAN
In 2010 the agent facilitated various ICAN and KidsCAN programs in San Juan County. These programs presented nutrition and cooking information to more than 3,400 residents of San Juan County. The KidsCAN program worked with seven public schools and one private school in four school districts to provided nutrition and cooking education to youth in San Juan County. The ICAN program worked with seven agencies in San Juan County to provide nutrition, cooking and food budgeting information to Supplemental Nutrition Assistance Program (SNAP) eligible adults and seniors in San Juan County. The 2010 ICAN and KidsCAN programs resulted in more than 500 youth and adult graduates for San Juan County. Education was provided through posters, brochures, demonstrations, and weekly classes throughout the county. In addition to partnerships with public and private schools, ICAN and KidsCAN curriculum was presented at the New Mexico Senior Olympics health fair, Sycamore Park Community Center, Bloomfield Multicultural Center, Apple Ridge Assisted Living Center, Headstart, Kidz First Child Care Center, Family Crisis Domestic Abuse Center, Income Support Office, Farmington Growers Markets, the San Juan County Fair, and multiple other agencies and locations in San Juan County. Based on comparisons from pre surveys and post surveys, it has been determined that participants of these programs have increased their knowledge in food and nutrition related topics such as MyPyramid, USDA Dietary Guidelines for Americans, food preparation skills, portion and serving sizes, understanding of nutrition facts labels, food safety, food dollar budgeting, use of SNAP benefits etc. Participants have returned to classes stating that they are using the knowledge they gain in class at home and are passing the knowledge on to friends and family members.

Organ Wise Guys
In the spring of 2010 Organ Wise Guys nutrition education the Kellogg Company announced the opportunity for organizations interested in nutrition education materials to apply for mini-grants to use for summer nutrition programming. At the urging and with the assistance of the agent, two organizations in San Juan County, the Sycamore Park Community Center and the Kidz First Daycare and Preschool Summer Day camp program, applied for the $750 mini-grants. Through this collaboration between the organizations and the Extension Service each organization was awarded the grant consisting of $750 dollars in monies and educational materials to be used for nutrition programming efforts including nutrition posters, worksheets, display materials, puppets, and story books. The directors of each organization then attended a training and planning session planned and implemented by the agent to organize a curriculum for their summer programs. Nutrition and health education focusing on choosing healthy foods and physical activity using the Organ Wise Guys and Kellogg materials was then implemented by both the employees of each organization and the San Juan County Extension Home Economist throughout the summer and has continued into the school year at both locations.

Other components of the JBI program include follow-up classroom instruction, intensive evaluation regarding behavior change, parent education, and community awareness of childhood obesity issues. Classroom instruction runs from October through April/May in each county. The agent worked with a total of 4 classes and oversaw five other classes conducted by either the ICAN educator or an outside contractor. Approximately 186 students participated in the classroom program. JBI classroom instruction included intense activities to learn about the major 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, how the media influences our food choices and healthy snacks. Approximately 88 JBI workshops were delivered during the 2009-2010 school year, with most classes receiving a minimum of 9 classes each.

Knowledge gain is one of the medium-term objectives of the JBI program. Students increased their nutrition knowledge as a result of receiving nutrition classes during the school year. Approximately 186 students in Rio Arriba county participated in the program and 92 completed both the pre and post tests on nutrition knowledge. The pre-survey average score was 8.65 (54%) and the post test average score was 14.64 (out of a possible 16 points) (92%) showing a 5.98 point gain, or 69% knowledge gain. The difference in scores was statistically significant (p=.0001).

In addition, pre and post tests were administered to students who participated in in-class instruction at tive other schools who were not involved in the field trip. The pretest average score was 56% and post test average scores were 93% showing a 66% knowledge gain.

Another medium term objective for students to increase their fruit and vegetable intake was met. Students increased their fruit and vegetable intake after receiving nutrition classes during the school year. The pretest average score for fruits was 2.49 and the post test average score was 3.04 There was a 22% increase in scores and the difference in and the difference in scores was statistically significant (P=.05). The scores for increased vegetable intake was 2.06 for pre tests and the post score was 2.22. The difference in scores was not statistically significant.

Almost all parents and families wrote comments about what they liked best about the program, such as "I was really impressed that she learned so much, that it inspired her to really think about the issues, and that she was moved to discuss, debate, and encourage us to eat better. What an inspiring field trip that must have been! Thanks.

The nutrition educator, under the supervision of the agent conducted the JBI/ICAN program at San Juan, Ojo Caliente, ElRito, Chama, and Gallina Elementary Schools. The agent also hired an outside contractor with grant funds to conduct ICAN/JBI at James H. Rodriguez Elementary School. Impact results are noted in short term goals. Summer programs conducted by the educator included Chama, Canjilon, Dulce, Rio Arriba Cloverbud Day Camp and the Abiquiu Boys and Girls Club. A total of 17 classrooms received the ICAN/JBI programs, and 5 summer programs resulted in reaching 405 youth in ICAN/JBI programs throughout the 2009-2010 year, with 346 ICAN youth graduates. ICAN only programs provided food safety, MyPyramid, milk group, fruit group, vegetable group and information on physical activity.

ICAN and Just Be It! Healthy and Fit Program (combination program in Rio Arriba county)

The ICAN/Just Be It! Healthy and Fit Program (JBI) promotes healthy lifestyles by reducing risk factors for 5th grade students in 3 counties – Rio Arriba, Santa Fe and Los Alamos.

To kick off the program for the 2009-2010 school year, Extension Agents from Los Alamos, Rio Arriba and Santa Fe counties, as well as staff from Espanola Hospital and Espanola School District, conducted the Just Be it! Healthy and Fit field trip, a tri-county, educational nutrition and fitness school enrichment program offered to fifth graders in each of the named counties. The 2009 field trip began with a JBI Trivia game - setting the tone for the 4 workshops that students attend. The field trip consists of four, 45 minute workshops: MyPyramid, Vary Your Veggies and Focus on Fruits, Power up With Exercise, and Fun with Food Facts. Workshops are aligned to the NM Health Education Standards and Benchmarks. The extension agents from each county presented in each of three workshops, and the 4th workshop on physical activity was conducted by a PE teacher from Espanola Public Schools. Four field trips were conducted at the beginning of the 2009-2010 school year. In Los Alamos County - 249 students from five elementary schools participated, 163 W, 5 NA, 63 H, 17 A, 1 B. 126 females and 123 males. In Rio Arriba: 106 students from two elementary schools participated, 2 WH, 13 AI, 92 H, 50 male, 56 female. Santa Fe County 106 students participated from one elementary school, 7 w, 2 B, 10 NA, 77 H, 4 Asian. 43 male, 63 female. An additional field triip was offered to schools in southern Santa Fe County and the event was held in Moriarty. Students from this school were comprised of 12H, 2NA, and 40 , 31F, 21M.for a total of 52 students . Students and teachers participating in the field trip also received a student/parent handout developed by Extension agents, containing information and activities about healthy eating, food safety, goal setting and physical fitness. Twenty four teachers from the 3 counties participated in the field trips and received a classroom exercise kit consisting of a variety of physical activity equipment. Teacher classroom resource kits included USDA MyPyramid lessons for grades 5-6, CDC Health Stores, MyPyramid handouts for each student, 4-H pamphlets and other health and nutrition information. A total of 513 students participated in the field trip. Based on the average results from the pre and post tests in participating counties, students indicated an average knowledge gain of 52% by attending this one-day educational field trip. Individual results for Espanola showed a 60% knowledge gain.

The long term objective of expanding the program to other New Mexico counties showed progress. The JBI curriculum is in the final stages of being produced and disseminated to counties. It is expected that county agents will offer the program in their county and show positive results for youth. Presentations on the curriculum were made at the CYFAR conference in San Francisco, the Priester Conference in Alabama, and the NAEFCS conference in Portland,Maine. These presentations assist in providing interest on a national level. The agent took the main responsibility for writing, and organizing the JBI curriculum, although everyone on the JBI committee has contributed. The editing process is almost complete, and will soon progress to the printing stage.

Additionally, the agent hired one JBI nutrition educator as a contractor to reach more schools. This individual reached four additional classes that would not otherwise have been provided. The agent also sought and received approval to hire a new ICAN nutrition educator to further assist in providing programs to such a large county.

Other KidsCan Programs

The program assistant, under the supervision of the agent conducted the JBI program at San Juan,Ojo Caliente, El Rito, Chama, and Gallina Elementary Schools. The agent also hired an outside contractor with grant funds to conduct JBI/ICAN at James H. Rodriguez Elementary school. Impact results are noted above. Summer programs conducted by the nutrition educator included Chama, Canjilon, Dulce, the Cloverbud Day Camp and the Abiquiu Boys and Girls Club. A total 17 classrooms received the JBI/ICAN programs, and 5 summer programs resulted in reaching 405 youth in JBI/ICAN programs throughout the 2009-2010 program year, with 346 ICAN graduates. ICAN only programs provided were food safety, Mypyramid, milk group, fruit group and vegetable group .

ICAN Adult Programs

The agent and nutrition educator provided various adult and senior ICAN programs throughout the year. In the Fall of 2009 five participants received nutrition programs from the Eating Right Is Basic curriculum conducted at the City of Espanola Recreation Center. Through a partnership with New Mexico Works, a program to help provide workforce skils to citizens, the agent conducted three classes in the fall and winter of 2009-2010, with 43 participants. Two classes were conducted with the GED classes at the Northern New Mexico College with three participants. The agent utizilized the Eating Right Is Basic and Loving Your Family Feeding Their Future Curriculum. In the summer of 2010 the nutrition educator conducted classes at the Senior Citizens Center in Chama utilzing the "Eat Smart Live Strong" program for 30 participants. Finally the agent conducted the same program at the Chama Senior Citizens Center for 13 people. A total of 94 adults participated in the Adult ICAN program this year, with 57 graduates.

Health Fairs

The agent and nutrition educator attended the Las Cumbres Health Fair and set up a display with a variety of health and nutrition information in Espanola, approximately 125 people attended.

The nutrition educator attended a health fair conducted by the Embudo Health Center and set up a display about the ICAN program, and provided health and nutrition information to approximately 115 people.

The nutrition educator set up an ICAN/JBI booth at the Rio Arriba County Fair reaching approximately 250 adults and 250 youth..

The nutrition eductor set up the ICAN/JBI display at the Alcalde Field Day. Approximately 175 adults and 10 youth attended.

KITCHEN CREATIONS

The Home Economist organized the Kitchen Creations Diabetic Cooking Schools. 69 diabetics, family members, and other interested individuals gained skills in reading nutrition facts labels, adjusting portion sizes, and planning and preparing meals lower in sodium, fat, and carbohydrates. A Certified Diabetic Educator co-taught each class. The Home Economist taught participants about safe food handling and portion sizes. The Diabetic Educator taught participants about using the 50/50 plate method and counting carbohydrates.

At the end of the four weeks 60% of the participants said they use the 50/50 method to control the amount of carbohydrates they eat and use the Diabetes Food Guide Pyramid to plan a day’s meal. 100% of participants stated Kitchen Creations has helped them manage their diabetes. Participant’s comments included: “This has been one of the best things I have done for myself in a long time.,” “The class encourages me to try new things.,” “This is by far the most informative session on carbohydrates I have ever been to.” and “Keeping guidelines has helped bring my sugar down. 197 to 106 this morning. Thank you so much for your help.”

Ten participants from the 2009 class requested a reunion. Food safety was reinforced through presentation and bingo games.

COOKING WITH KIDS

Cooking With Kids curriculum was used by the 4-H Home Economist to teach 25 students in two classrooms. This curriculum is designed to introduce youth to plant science & local farmers by using their 5 senses to hear the farmers story, smell, taste, touch and recognize uncommonly used fruits and vegetables. Youth gained life skills such as: healthy choices, communication and importance of community.