VERMONT AGRICULTURAL EXPERIMENT STATION AND UNIVERSITY OF VERMONT EXTENSION
Annual Report 2017

Program Goal Area: Childhood Obesity

Project Descriptions

Harvey, Jean    What do Men Really Want?:  A Crowdsourcing Approach to Understand Weight Loss Behavior in Men National Institute of Food and Agriculture/Department of Agriculture    

Currently men are underrepresented in the weight loss treatment literature.  Men are less likely to participate in obesity treatment interventions, are less likely to engage fully when they do and are less likely to lose clinically significant amounts of weight.  Men however, have nearly the same prevalence of overweight and obesity as women and suffer the same degree of morbidity and mortality because of it.  There is a clear and urgent need to identify evidence based approaches and program components that can effectively engage men in initial weight loss and successful long-term weight loss maintenance.  Therefore, the objective of this study is to use an innovative technique called crowdsourcing to understand why men do not seek out and participate in weight loss interventions.   Web-based crowdsourcing is a rather anonymous, fast and inexpensive method to generate new hypotheses and discover unexpected issues that might have been overlooked by professionals. Crowdsourcing may therefore, help to detect possible unexpected beliefs about obesity and may identify unpredicted barriers to weight loss in men.  Ultimately, the information gathered will be used to develop and launch new targeted obesity treatment programs for men.            

Rounds, R., Harvey, J. What do men really want: A crowdsourcing approach to understand weight loss in men. (2015) The Obesity Society, Los Angeles, CA 

Johnson, Rachel           Web-based training in digital imaging to measure fruit and vegetable consumption in schools National Institute of Food and Agriculture/Department of Agriculture    

The USDA National School Lunch Program recently implemented regulations requiring children to select a fruit or vegetable (FV) with their lunch meal. Moreover Farm to School and school garden programs are flourishing and provide fresh and local produce to schools. Assessing whether these efforts result in children's increased consumption of FV or simply lead to increased waste is vital to evaluating their impact. In the PIs previous Hatch project, our research team tested digital imaging against weighed plate waste and determined it is a feasible, reliable and valid method to assess school children's FV intake. Digital imaging is less time and resource intensive compared to other dietary assessment tools. Our goal is to expand digital imaging in schools with the ultimate goal of assessing FV consumption nationwide. Since it is impractical for our UVM research team to collect data nationally, we aim to develop, pilot and launch a Web-based training tool to train school-based staff in digital imaging. We will compare the feasibility of digital imaging data collected and transmitted by school staff to those previously collected by our research team.

Kolodinsky, Jane M.     Innovative Community Supported Agriculture Cost-Offset Intervention to Prevent Childhood Obesity      Cornell University       

This project, Innovative Community Supported Agriculture Cost-Offset Intervention to Prevent Childhood Obesity and Strengthen Local Agricultural Economies, examines whether subsidizing the cost of community supported agriculture (CSA) shares (herein referred to as cost-offset CSA, or CO-CSA), for low-income families combined with CSA-tailored education: 1) increases consumption of fruits and vegetables, 2) substitutes fruits and vegetables for more energy-dense foods, and 3) improves overall diet quality and energy balance, thus helping children maintain healthy body weights.

The study is a randomized intervention trial, meaning that families will be randomly assigned to either the intervention group or the control group (which will receive an identical intervention one year later). The grant funds will provide 50% of the price of the CSA share for CO-CSA participants, with the remaining cost paid by the participant through SNAP/EBT benefits and/or cash.  The tailored nutrition education curriculum will be delivered by extension educators on consecutive weeks in three-lesson clusters during early, mid-, and late CSA season, for a total of nine classes.  This is a multistate project with CSA farmer representation from NY, NC, VT, and WA.

Publications

1.Seguin RA, Morgan E, Hanson K, Ammerman A, Jilcott Pitts SB, Kolodinsky JM, Sitaker M, Becot F, Connor LM, Garner J, McGuirt J. Study protocol: Innovative community supported agriculture cost-offset intervention to prevent childhood obesity and strengthen local agricultural economies. BMC Public Health. 2017; 17(306): 1-20.

2. Hanson KL, Kolodinsky JM, Wang W, Morgan EH, Jilcott Pitts SB, Ammerman AS, Seguin RA. Adults and Children in Low-Income Households That Participate in Cost-Offset Community Supported Agriculture Have High Fruit and Vegetable Consumption. Nutrients. 2017; 9(726): 1-10.

3. Kolodinsky JM, Sitaker M, Morgan EH, Connor LM, Hanson KL, Becot F, Jilcott Pitts SB, Ammerman AS, Seguin RA,. Can CSA cost-offset programs improve diet quality for limited resource families? Choices. 2017; 32(1): 1-10.

4. McGuirt JT, Jilcott Pitts SB, Seguin RA, Bentley P, DeMarco M, Becot F, Ammerman AS. Perspectives on a local food access and nutrition education program from cooperative extension nutrition educators. In review.

5. McGuirt JT, Jilcott Pitts SB, Hanson K, DeMarco M, Seguin RA, Kolodinsky JM, Becot F, Ammerman AS.áA choice experiment to examine factors influencing willingness to participate in a Community Supported Agriculture (CSA) program among low-income parents. In review.

6. Seguin RA, McGuirt JT, Jilcott Pitts SB, Garner J, Hanson KL, Kolodinsky J, Sitaker M. Knowledge and experience related to community supported agriculture and local foods among nutrition educators in three regions of the United States: a qualitative study. In review.

7. Hanson KL, Garner J, Connor LM, Jilcott Pitts SB, Harris R, Kolodinsky JM, McGuirt J, Wang W, Ammerman AS, Sitaker M, Seguin RA. Community Supported Agriculture: Appealing produce, payment options, convenience, and choice may be important to facilitating participation among low-income households. In review.

Presentations

1. McGuirt JT, Jilcott Pitts SB, Hanson KL, DeMarco M, Seguin RA, Kolodinsky JM, Ammerman AS.áA Choice Experiment to examine factors influencing willingness to participate in a Community Supported Agriculture (CSA) program among low-income parents. American Public Health Association (APHA). November 2017.

2. Garner JA, Olujide M, Ammerman AS, Jilcott Pitts SB, Kolodinsky JM, Sitaker MH, Seguin RA. Educators  Experiences with a Local Foods Curriculum for Low-Income Households in a Subsidized Community Supported Agriculture Program. Food and Nutrition Conference and Expo (FNCE).  October 2017.á

3. Seguin RA, Ammerman AS, Hanson KL, Kolodinsky JM, Jilcott Pitts SB, Sitaker MH. Farm Fresh Foods for Healthy Kids: Innovative Cost-Offset Community Supported AgricultureáIntervention to Prevent Childhood Obesity and Strengthen Local Agricultural Economies. Society for Nutrition Education and Behavior (SNEB). July 2017.

4. Kolodinsky JM, Ammerman A, Hanson K, Jilcott Pitts SB, Sitaker M, Morgan EH, Seguin RA. Resonance Raman Spectroscopy (RRS): Does this Innovative Technology to Measure Fruit and Vegetable Consumption have Relevance for Applied Economics? Agriculture and Applied Economics Association (AAEA). July 2017.

5. Becot F, Wang W, Sitaker M, Kolodinsky JM, Ammerman AS, Seguin RA. Increasing low-income households  access to fresh produce through a cost offset CSA: How does that work for the farmers? Agriculture, Food and Human Values. June 2017.

6. Wang W, Kolodinsky JM, Seguin RA, Sitaker M, Hanson KL. Understanding duration of rural low income membership in subsidized Community Supported Agriculture. Food and Human Values. June 2017.

7. Garner JA, Jilcott Pitts SB, Hanson KL, Ammerman AS, Kolodinsky JM, Sitaker MH, Connor LM, Seguin RA. A Mixed Methods Process Evaluation of the Farm Fresh Foods for Healthy Kids (F3HK) Intervention. International Society of Behavioral Nutrition and Physical Activity (ISBNPA). June 2017.

8. Seguin RA, Ammerman AS, Hanson KL, Jilcott Pitts SB, Kolodinsky JM, Sitaker MH. Innovative community supported agriculture cost-offset intervention to prevent childhood obesity and strengthen local agricultural economies. Society for Nutrition Education and Behavior (SNEB). August 2016.

9. Kolodinsky JM and Seguin RA. Challenges and benefits of implementing and sustaining a cost-offset community supported agriculture (CO-CSA) model: Overview of the project. Agriculture and Applied Economics Association (AAEA). July 2016.

10. Seguin RA and Kolodinsky JM. Challenges and benefits of implementing and sustaining a cost-offset community supported agriculture (CO-CSA) model from the perspective of farmers and extension educators. National Association of Community Development Extension Professionals (NACDEP). June 2016.

11. Wang W, Kolodinsky JM, Seguin RA. Identifying reasons for attrition from subsidized community supported agriculture membership among limited resource populations. Agriculture, Food and Human Values. June 2016.

12. Hanson KL, Kolodinsky JM, Gauger M, Ammerman A, Jilcott Pitts SB, Sitaker M, Seguin RA. Fruit and vegetable intake among adults and children from low-income households that participate in a cost-offset CSA.áAmerican Public Health Association. November 2016.

13.Morgan EH, Hanson K, Jilcott Pitts SB, Kolodinsky JM, Sitaker M, Ammerman A, Seguin RA. Evaluating the relationship between the National Cancer Institute's Fruit and Vegetable Screener, repeat 24-hour recalls, and skin carotenoids as measures of fruit and vegetable intake in children. American Public Health Association. November 2016.

Curricula

Farm Fresh Foods for Healthy Kids. Cornell University, 128 pages, 2016.          

Kolodinsky, Jane M.     Expanding the Impact of the Cornell Center for Behavioral Economics in Child Nutrition Programs        Cornell University                   

Publications

Becot, Florence, Jane Kolodinsky, Erin Roche, Alexandra Zipparo, Linda Berlin, Erin Buckwalter, and Janet McLaughlin (2017). Economic impact of Farm to School Programs: What we know and where are the gaps?  Choices, A journal of the Agricultural and Applied Economics Association. http://www.choicesmagazine.org/choices-magazine/theme-articles/transformations-in-the-food-system-nutritional-and-economic-impacts/do-farm-to-school-programs-create-local-economic-impacts                                                                                                                                                                          

Roche, E, J. Kolodinsky, R.N. Johnson, M. Pharis, and Jenna Banning (2017). Transforming the school environment leads to kids with good intentions. Choices Special Issue on Transformations in Food Systems.  http://www.choicesmagazine.org/choices-magazine/theme-articles/transformations-in-the-food-system-nutritional-and-economic-impacts/school-gardens-may-combat-childhood-obesity

Kolodinsky, Jane M.     VT Paid Family Medical Leave

IMPAQ International, LLC

The Implementation Feasibility Analysis integrated research on possible implementation models for the PFML program along with a public opinion survey that examined public views toward a PFML program via a sample of 500 Vermont adults. Notable Public Opinion Survey Findings include:  Most Vermont adults surveyed believed that establishing a program to guarantee access to paid family and medical leave in Vermont is very important (80 percent favored without a contextual explanation of a PFML program, and 71 percent favored when provided with a contextual explanation).   A majority of adults (54 percent) believed that Vermont should have a statewide paid family and medical leave program, but over a third chose to leave things as they are now, with employers choosing whether to provide paid leave.  A leave period of 8 weeks was about right to a plurality of adults (39 percent), with 29 percent saying it was too long, and 22 percent saying it was too short. Six weeks was about right for a plurality (45 percent), but 34 percent said that it was too short. About half (49 percent) said 12 weeks was too long, and 68 percent said 16 weeks was too long.  o  Solid majorities favor all the funding options tested: employer- and employee-funded (75 percent), employee-funded (69 percent favor funding of less than 1 percent of an employee’s paycheck, while 63 percent favor a funding rate of about $5.40 per week per average worker), and employer-funded (68 percent).   Adults are split on the appropriate level of wage replacement for a PFML program. Replacing 100 percent of wages is either too much (43 percent) or about right (44 percent); replacing 90 percent of wages is about right to a plurality (43 percent), but 36 percent said this amount was too much; replacing 66 percent of wages is split between not enough (41 percent) and about right (38 percent).  4. Education, Outreach, and Marketing Analysis for Implementation Purposes: This analysis combined a statewide survey of 427 business owners along with 4 focus groups with Vermont’s business owners and leaders. The survey and focus groups provide a comprehensive understanding of current business practices and views regarding options for developing a program that serves the needs of employees and employers. Notable findings include:  Business Survey Findings: o Almost half (46.9 percent) of surveyed businesses supported a statewide PFML program, while 40.4 percent were opposed.  A combination of employer and employee funding was the financing mechanism with the most support (32 percent favored).  The level of wage replacement with the most support was 60 percent of salary (27 percent favored).   While 89 percent of surveyed businesses offered some type of paid short-term leave, 64 percent of surveyed businesses offered paid long-term leave (including general paid time off, paid leave provided on a case-by-case basis, paid maternity or paternity leave, or long-term leave for a serious illness or injury).  For over 90 percent of the businesses that offered paid long-term leave, fewer than a quarter of their eligible employees had utilized the benefit within the past year.  Focus Group Findings:  When asked about their level of support for a state-administered PFML policy, focus group participants demonstrated a high level of support with the majority stating that they were supportive to strongly supportive (while a plurality stated that they were neutral).  When asked about their concerns regarding the implementation of a state-administered PFML policy, most participants focused on how the state would administer and fund the policy.  Most participants indicated that their business did not provide paid family or medical leave to their employees. Many participants indicated that cost was the main factor that prevented them from providing paid leave, while a plurality noted that their business was already providing generous paid leave benefits.  Participants were asked to share recommendations regarding the development of a PFML program. Participants suggested that the state examine the impacts on other states and countries that have implemented a PFML program and consider diverse perspectives (including business and non-business perspectives) throughout the development of a program.  Together, these study components provide a detailed understanding of the feasibility of implementing a PFML program in Vermont. The study examines multiple aspects of implementing a state-wide PFML program, including assessing the views and support for a PFML program among Vermont’s families and businesses; detailing the personal experiences of families that faced life events that impacted their ability to balance work and family obligations; estimating the potential increase in paid leaves under different program scenarios and the associated cost implications; and estimating the potential economic benefits for Vermont. This study presents a comprehensive set of research that supports the development of an informed and effective PFML program.

Kolodinsky, Jane M.     Community and Public Safety Dashboard

Michigan State University

Chittenden County has experienced significant community impacts from a growing heroin epidemic, increased mental health crises, crime stemming from substance abuse, and increased emergency department utilization. Recognizing the complexity and interconnectedness of these community behavioral health challenges, former Burlington Police Chief Michael Schirling convened a group of local service agencies and community organizations for a monthly meeting to facilitate information sharing across the organizations. This group identified the need for a data dashboard that would facilitate the sharing of data across sectors that would enable them to dedicate their efforts to identifying and implementing shared actions, rather than solely sharing anecdotal information. Chittenden County became a pilot site of the CAPE Project with funding to support a partnership between CRS, the Chittenden County Regional Planning Commission, and the Burlington Police Department's Service Executives Committee to explore the development of a shared dashboard to monitor behavioral health concerns. The pilot revealed significant challenges inherent to this effort including the difficulties of sharing data about individuals across agencies due to privacy and data quality concerns, organizational capacity to support such efforts both internal and external to participating organizations, and sustainablity of maintaining regular and timely updates.        

Cuthbertson, A., DembΘlΘ, A., Leatherman, J., Loveridge, S., Tess, J., Lo, S., Stephens, B., Kolodinsky, J., Hamshaw, K, Lesko, H.L., Dunkenberger, M.B., White, N., Sherrard, A., & MacFarlane, C. (2016). Community-Responsive Behavioral Health Research: Translating Data for Public Consumption and Decision Making. Community Development Practice, 20: 36-48.      

Kolodinsky, Jane M.     Youth Resource Mapping

Stone Environmental, Inc.

To effectively support positive youth development at all levels, it is essential for young people, their families, and their allies to have information on the array of services and resources that are available to them at the state and local levels. In an effort to promote and expand needed youth services, the Children and Family Council for Prevention Programs and other youth-work systems must know what services are available and where, and identify where gaps exist. This project is working to collate and aggregate information on all available resources for youth (age 14 - 22). The Center for Rural Studies at the University of Vermont is currently conducting a survey of all known resources to develop a fuller understanding of the areas in which they are focused and how they operate. A web mapping application will be developed for youth, families, service providers, and policy makers to easily locate available programs and resources in Vermont. An additional benefit of this effort, will be the ability to evaluate areas of saturation or gaps in resource availability in the state. Survey data collection will be completed in the spring of 2018, with mapping of the collected data to commence in the spring and summer of 2018.

Pope, Elizabeth Incentivizing Physical Activity Using Gamification, a Pilot Study

National Institute of Food and Agriculture/Department of Agriculture

Seventy-five percent of high school students in Vermont are not physically active for 60 minutes/day, the guideline from the Centers for Disease Control and Prevention.  Physical activity is an important behavior for weight control and optimal health.  Establishing a physically active lifestyle during adolescence is desirable, as adolescence is a critical period for obesity development.  Very few physical activity interventions have focused on adolescents and even fewer have been effective, indicating that new strategies are needed.  As many high school students are familiar with and enjoy games on either their mobile devices, tablets, or gaming systems, incentivizing physical activity within a gaming context may be a novel and age- appropriate way to encourage high school students to meet physical activity goals.  The proposed study intends to nudge junior and senior high school students to meet physical activity goals by using a mobile gaming app to incentivize 60 minutes of physical activity throughout the entire day and 30 minutes throughout the school day.  A mixed-methods approach will be used to design and carryout the intervention.  Year one will involve youth participatory development of the gaming intervention, which will take place as a randomized-controlled trial with 100 students in year two.          

Pope, L., Garnett, B., Dibble, M. (2017). Engaging adolescents in inform the development of a mobile gaming app to incentivize physical activity. JMIR Research Protocols.6(8): doi: 10.2196/resprot.8113.