KA 703. Nutrition Education and Behavior (Grant County)

Home Economist collaborates closely with local agencies and supports the Grant County Health Council with the Robert Woods Johnson Healthy Kids, Healthy Communities Childhood Obesity Grant. This entailed working with the local La Vida group (Hidalgo Medical Services) and their Registered Dietician whereby she and one of their promotoras, and myself and another promotora would be in one of the local IGA stores one Saturday each month of the grower's season and we prepared and offered "tastes" of recipes from the Loving Your Family, or the Kitchen Creations New Mexico Favorites cookbook. These were every second Saturday beginning in May and ending in October 2011. Generally the Bayard Food Basket, where Home Economist was stationed, we talked to 120 - 150 people as we were stationed right by the check out counters. They had to pass by us to check out. We generally were handing out 80 - 100 samples, depending on the recipe. The Bayard area is reluctant about squash and pumpkins, but most were at least willing to give it a try!

Home Economist participated along with ICAN Educators in Hidalgo Medical Services annual "Jump into Summer" event held downtown Silver City in Gough Park, mid June. We have an area for "critter cuts" whereby familes stop by and we help them create "critters" from season vegetables. They all enjoy playing and creating with the foods such as carrots, squashes, radishes, etc.

Home Economist and ICAN crew also are requested every year for the annual "squash derby" at the local farmer's market. We get participants from 2 - 82 stop by and try their hand at making a derby car from yellow squash or zucchini's and tire cut from parsnips or carrots and racing them down a slide and thier "landing" is recorded and awards are given to the top three places.

Home Economist developed the 2010 Holiday Program around the value of nuts in our diet. "Nuts for the Holidays" incorporated nutcracker decorations and various recipes including the various nuts. Gifts and packaging ideas along the theme were shared with the two audiences (morning program and evening program) of about 35 participants.

Newspaper columns: Home Economist has a news column entitled "Family Matters" and also is in a rotating group with the local health entities and writes for them under "Wishing you Well". Nutrition Topcs included, Yams vs Sweet Potatoes, Turkey Talk, New Dietary Guideline My Plate, Salad Month, Listeriois and Meat Temps.

Food Safety: Home Economist delivered the food safety message of Fighting Bac to all Grant County Senior Centers and their staff (4 different locations and 14 employees). They received new thermometers and instruction on their calibration and proper use were discussed as well as the new meat internal temperatures and MyPlate.
Home Economist also set up a display booth for a local safety fair held in April 2011 with the Food Safety posters from the Agro Terrorism office.
Home Economist also participated in the Food Vulnerability Training held in March 2011, as well as the Food Preservation Workshop held in April 2011 on campus.
Home Economist conducted a two day Food Preservation workshop offered through Western New Mexico's WILL program (Western Institue for Lifelong Learning). 8 Participants broke into four groups and each group of two prepared either water bathed, pressure canner, freezing and drying. Apples and green beans were the items preserved.

ICAN Program is supervised by Home Economist, one full time educator, one 3/4 time educator and one 1/2 assistant. The 2011 ICAN Nutrition Program for Grant County netted 65 adult graduates and 736 youth graduates. Enrolled participants, not graduated adults were 120 (unduplicated), 392 enrolled adult contacts (duplicated), 105 adults one time session, 83 adults recruited, 62 contacts at community events/fairs. Youth: 776 enrolled participants (unduplicated), 4,448 enrolled contacts (duplicated), 230 youth in one time sessions, and 164 reached through community event/fair.

Grant County Home Economist conducted several nutrition workshops during the 2010 fiscal year. Two sessions of Eat Food, Lose Weight were conducted to participants expressing an interest in losing weight and keeping it off. This was a collaborative effort with the Dept. of Health's nurse Melvyn Gelb. Both groups were a good cross section of Grant county's demographics. Total attending 26. At least 4 of these participants went on to join weight watchers and have since dropped dress sizes!
A basic nutrition and some 50/50 plate instruction were given to a group of Promotora's from Sierra, Grant, and Dona Ana counties in March. Some instruction on adding 8 minutes of physical activity a day was also given.

The 2010 ICAN Nutrition Program for Grant County 2010 proved very successful and far reaching. The Two Nutrition Educators had 899 youth graduates by the third quarter, and 327 Adult graduates by the same quarter. These numbers exceed their goals for fiscal year 2010. In addition, 31,999 indirect contacts were reached via recipes, take home packets from school youth, calendars, ICAN brochures, curriculum pieces, etc. The program is following the ICAN County Action plan and continues to reach new eligible audiences and continues to make differences in youth and adults eating habits and household food budgets. Research shows that 4 or more lessons are necessary to change behavior and the above numbers attest to both educators dedication to their positions. The ICAN program assistant continues to stretch the ICAN budget as far as possible when procuring groceries and is accurate in entering data from the two educators.

Grant County conducted one Kitchen Creations session for 2010. This was held in the mining community of Bayard, NM at the junior high school home economics kitchen. 38 enrolled, 36 completed the two saturday, 6 hour sessions. of these, 9 were diabetic, 3 were pre-diabetic, and the remainder were caregivers to diabetics. 32 of the 38 participants prepare the food eaten in the home. Ages of participants were 24 aged 45-65, 2 participants were in the 18 - 29 age group and 6 were aged 30 -44. Ethnicity was primarily hispanic (58%), American indian(5%), white non-hispanic (37%). 31 females and 7 males attended the class and 18% considered themselves to be in excellent health, while 68% marked Good health, nearly 11% marked Fair health and one person marked Poor health. On final evaluations, 54% reported that they could use the Diabetes Food Guide Pyramid to plan a day's meal, 73% reported using the 50/50 method to control carbs eaten at meals, 65% reported that they could read food labels to find the amount of carbohydrates in a serving, 73% reported that they could now measure food portions, 58% reported eating at least 2 servings of whole grains per day, 65% eat at least 2 servings of non-starchy vegetables at dinner, and 58% said they would use more herbs and spices to flavor foods instead of salt and fat. Many favorable comments were received after each session and overall.

Kitchen Creations
A total of 785 individuals (White 41%, Hispanic 39%, Native American 17%, African American 1%, Asian American 1%, Other 1%) participated in 45 Kitchen Creations cooking schools in 26 counties during 2009. Classes were team taught by local Extension Home Economists and a health care professional. Four bilingual cooking schools were held during FY09, one in Bernalillo, Dona Ana, Lea, and Luna Counties.

Kitchen Creations cooking schools consist of four, three-hour long lessons. The cooking schools feature current nutrition recommendations for people with diabetes and hands-on food preparation and cooking experiences. Participants completed demographics and knowledge questionnaire and program evaluations at the completion of the cooking school.

Funding for Kitchen Creations is provided in part through a grant from the New Mexico Department of Health ($197,000).


ICAN
Ideas for Cooking and Nutrition Program (ICAN) is the umbrella name used in New Mexico to refer to both the Supplemental Nutrition Assistance Program Education (SNAP ED) and Expanded Food and Nutrition Education Program (EFNEP) 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 Guidelines for Americans and the MyPyramid.

During FY09 SNAP ED reached 24,964 adults (White 25.1%, African American 2.1%, Native American 14.4%, Asian 0.9%, Hawaiian/Pacific Islander 0.3%, Hispanic 57.2%) and 37,461 youth (White 16.1%, African American 2.3%, Native American 12.3%, Asian 0.3%, Hawaiian/Pacific Islander 0.1%, Hispanic 58.9%) in 474 sites in New Mexico, including the Zuni Reservation with the following results:

The Adult Behavior Survey is administered in a pre/post format. During FY09 participants indicated a positive change in behaviors on each of the 16 questions.
• 30% increase in comparing prices at the grocery store
• 130% increase in using nutrition labels when deciding what foods to buy
• 66% increase in purchasing healthy items at the grocery store
• 55% increase in preparing healthy meals at home each day
• 71% increase in involving their child in meal preparation each day
• 19% increase in sitting down for family meals
• 48% increase in eating breakfast daily
• 92% increase in eating fruits and vegetables for snacks each day
• 30% increase in drinking water
• 60% increase in performing 30 minutes of physical activity each day
• 44% increase in watching less than 2 hours of television each day
• 122% increase in paying attention to portion size
• 100% increase in eating at least 3 ounces of whole grains each day
• 105% increase in eating at least 4 cups of fruits and vegetable each day
• 80% increase in drinking at least 3 cups from the dairy group each day
• 56% increase in drinking less than one cup of sugary beverages each day

Every item on the adult behavior survey showed substantial change from pre to post. The lowest amount of change was 19%, and the highest was 130%. Some of the items which showed the least change are those that are least emphasized by many of our educators, such as involving children in meal preparation and watching less television. In general, items related directly to nutrition scored highest, except for comparing prices.

Youth Evaluation Results
The Youth Behavior Survey is administered in a pre/post format. During FY09 youth participants indicated a positive change in 11 of the 12 behavior questions. The 12th question remained unchanged.
• 6% increase in eating breakfast each day
• 8% increase in drinking water when thirsty
• 2% increase in performing 30 minutes of physical activity each day
• 9% increase in eating fruits or vegetables for snacks each day
• 0% change in watching less than 2 hours of television each day
• 13% increase in paying attention to portion size
• 23% increase in knowledge about how much to eat from each group of MyPyramid
• 20% increase in knowledge about the importance of calcium
• 100% increase in knowledge about how to properly wash hands
• 133% increase in knowledge about how physical activity improves health
• 21% increase in knowledge about identifying dark green vegetables
• 49% increase in knowledge about calories

Every item on the youth behavior survey showed change from pre to post. The knowledge questions all had higher rates of change than the behavior questions. Among the behavior questions, change was greater on the four nutrition questions than on the two questions related to physical activity. The knowledge questions all show substantial spread.

During FY09 EFNEP reached 929 adults and 2,053 youth in Bernalillo and Dona Ana counties. Fifteen educators provided 16,872 hours of education to graduate 801 adults (White 9%, African American 1%, Native American 3%, Hispanic 86%) and 2,053 youth (White 14%, African American 6%, Native American 3%, Hispanic 75%).

Two evaluation tools are used with the adult EFNEP population – a 24-hour food recall and a 10-question Behavior Change questionnaire. The following results were reported using the 24-hour food recall:
• 11.1% increase in intake of grains
• 33.3% increase in intake of fruits
• 18.2% increase in intake of vegetables
• 30.8% increase in intake of milk
• 12.1% increase in intake of meats & beans

A summary of the nutrient adequacy ratio or protein, iron, calcium, vitamin A, C, and B6 show an increase of 16.7%.

The 10-question Behavior Change Questionnaire shows the following results:
• 47% improved in the area of planning meals
• 41% improved in the area of comparing prices
• 41% improved in having food o the month
• 47% improved in using a grocery list
• 40% improved in following recommended guidelines for letting foods sit out
• 57% improved in thawing foods properly
• 41% improved in providing health food choices for their families
• 41% improved in preparing foods without adding salt
• 55% improved in using the Nutrition Facts label to make food choices
• 41% improved in providing breakfast for their children

Funding for SNAP ED is provided from USDA/FNS through New Mexico Human Services Department, Income Support division for $2,022,785. An equal dollar amount of math comes from New Mexico State University.

Funding for EFNEP is provided through a grant from USDA/CSREES for $589,841.

Funding for these programs is also provided through the New Mexico Legislature for $200,000.

General Nutrition
In addition to the funded series of nutrition education classes, home economist around the state conducted a variety of programs to meet the needs of the individuals in their counties. Classes included both one-time programs and mini-series classes that were taught in schools, senior centers, activity centers, and churches. Topics included: snacks, gifts, nutrition and health, food safety, grilling, feeding your newborn, feeding your young child, and food preservation.

Food preservation and food safety remain the most consistently taught courses in the state. The need for families to have safe food at affordable cost will continue to be a priority for teaching and training in the coming year.

Funding for some of these programs is provided by two grants through the New Mexico Department of Health ($50,000)