Title: Evidence Translation for Childhood Obesity Prevention in Minnesota
Sarah Gollust (Public Health) and Marilyn (Susie) Nanney (Family Medicine and Community Health)
Co-Investigators: Karen Cadigan (Children, Youth, & Family Consortium), Rachel Callanan (American Heart Association), Susan Weisman (Public Health Law Center, William Mitchell College of Law)
Amount Awarded: $93,306
Timeframe: March 2011 - March 2013
Abstract: Preventing childhood obesity is an urgent public health challenge that demands innovative policy approaches. Critically missing in current obesity prevention efforts is a quick and efficient system for translating the best available evidence from research to policy. Little is known about how childhood obesity evidence is used to influence the policymaking process or the barriers and facilitators for getting research evidence translated to, and used by, policymakers. In this project, we will convene a faculty-community collaborative to analyze the process of childhood obesity policymaking in Minnesota, with the objective of developing a system for communicating timely and relevant evidence to policymakers. In the first task, we will use content analysis methods to examine the types and sources of research evidence and other persuasive information (e.g., anecdotes, values, norms, public opinion polls) that Minnesota legislators and advocates have used to frame the policy problem of childhood obesity over a 5-year period (2006-2011) in policy-relevant documents and news reports. In the second task, we will conduct semi-structured interviews with a sample (n=30) of Minnesota political actors to examine the barriers and facilitators to use of research evidence and the types, sources, and formats of research evidence that political actors wish to use in the policymaking process. In the third task, we will integrate the data collected in the first two aims to inform the creation of a model system for communicating research evidence to an existing intermediary community-based policy center and then to relevant advocates, media contacts, and state policymakers. A pilot evaluation of the system using interviews and media tracking will indicate whether findings from a targeted University of Minnesota research initiative were successfully disseminated, laying the groundwork for a larger systematic evaluation of the policy impact of our evidence-translation system.
Title: State Level Food System Indicators
Robert P. King (Department of Applied Economics), Molly D. Anderson (Food Systems Integrity, Arlington, MA), David Mulla (Department of Soil, Water and Climate), Mary Story (Epidemiology and Community Health, School of Public Health)
Amount Awarded: $99,050
Timeframe: January 2010 – June 2012
Abstract: Today's food system is complex and multifaceted. It affects human health, the environment, and the economy. It is also closely linked to culture and our sense of community. Sound food policy formation requires a robust understanding of the current food system status as well as of the linkages between policy initiatives and changes in the food system. The Wallace Center has recently developed basic framework and set of national indicators for understanding and monitoring the status and performance of the U.S. food system. These indicators are built around the concepts of "healthy, fair, green, and affordable." However, national indicators have two significant shortcomings. First, they may mask important heterogeneity across regions, states, and communities. Second, with indicators for only a single geographic area, it is not possible to use statistical procedures to assess the reliability and validity of the food system indicators and the conceptual framework that underlies them. In this study we will develop a set of state-level food system indicators and collect data on them for all 50 states for the period 1997 – 2007. We hypothesize that there will be significant variation in food system status across states and over time. We also hypothesize that the "healthy, fair, green, and affordable" framework developed by the Wallace Center is a valid construct for assessing food system status at the state level. After collecting data on 20 to 30 indicators for 50 states over 11 years, we will conduct a confirmatory factor analysis designed to assess the validity of the Wallace Center's "healthy, fair, green, and affordable" framework. We will also assess the stability of the factors and the associated factor loadings that emerge from the analysis. Project outcomes will serve as a valuable resource for policy makers and planners at the state and national levels.
Title: Computing an Appropriate School Lunch Price Index for Federal Reimbursements for the National School Lunch Program
Ben Senauer (Applied Economics)
Co-Investigators: Marla Reicks (Food Science and Nutrition), Mary Story (School of Public Health), Len Marquart (Food Science and Nutrition)
Timeframe: January 2009 - December 2009
Abstract: The National School Lunch Program (NSLP), instituted under the Richard B. Russell National School Lunch Act and the Child Nutrition Act of 1966, is a federally assisted meal program operating in over 101,000 schools that provides nutritionally balanced, low-cost or free lunches to many children each school day (30.5 million in 2007). Cash reimbursements (currently $2.57 for free lunches, $ 2.17 for reduced price lunches, and $0.24 for paid lunches) provided by United States Department of Agriculture (USDA) for each school lunch meal served form the bulk of the federal support provided to schools to enable them to achieve the policy goal of delivering adequate food and nutrition to children. However, the amount of reimbursement provided to schools is deemed inadequate (as reported by school food authorities/school districts and the major professional association – the School Nutrition Association) for truly achieving the NSLP goal of adequate nutrition delivery. This is particularly so in times of high food costs, which interfere with school food services' ability to improve the healthfulness of the meals served to the children, impeding the way the NSLP can be used as a means for countering the epidemic of childhood obesity, as well as preventing hunger among children from low income families. Investigation reveals that USDA's NSLP reimbursement rate adjustments reflect changes in the Food Away from Home Series of the Consumer Price Index for all Urban Consumers (FAFH-CPI-UC) provided by the U.S. Bureau of Labor Statistics (BLS). FAFH-CPI-UC primarily uses price data from commercial food establishments which typically tend to be very different from school food services both in the food that is served and the distribution of the cost of meal production over various cost components like food and labor. The FAFH-CPI-UC clearly does not provide an appropriate basis for determining adjustments in reimbursement rates for school lunches. The inadequacy of federal support in the face of the assistance needs as stated by school food authorities (school districts) demands a different basis for reimbursement adjustments that adequately reflects changes in school lunch prices and enables improved achievement of the child nutrition policy goals. The overall objective of the proposed research is to aid child nutrition food policy in achieving its policy goals by identifying, developing, and evaluating the right metrics needed to inform and formulate the school meal food policy.
Title: The Effects of Federal Food Assistance Programs on Food Insecurity and the Healthy Development of Young Children
Judy Temple (Humphrey Institute)
Co-Investigators: Jayne Fulkerson (Nursing), Elton Mykerezi (Applied Economics), Arthur Reynolds (Child Development)
Timeframe: January 2009 - December 2009
Abstract: In this proposed research we investigate the relationship between two major types of federal food assistance programs, household food insecurity and the subsequent health and well-being of young children up to age 5. Specifically, we estimate the effects of household participation in Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and the Food Stamp Program on food insecurity using a new nationally-representative data set of U.S. children born in 2001. We also investigate the effects of WIC and Food Stamp receipt on food insecurity and various measures of child health and cognitive development. Recent reports indicate that the prevalence of severe food insecurity or hunger is growing among U.S. children. At the same time, relatively little evidence exists of the effects of WIC and Food Stamps on young children. In this interdisciplinary research project we seek to understand the mechanisms through which food assistance can promote healthy child development.
Title: Institutional and Consumer Decision-Making in the Hospital Setting: An Evaluation of a Healthy Food Practices Model
Jennifer Schultz (Department of Economics, UMD)
Co-Investigators: Jill Klingner (Health Care Management and Operations Management, UMD), Lara LaCaille (Department of Psychology, UMD), Rick LaCaille (Department of Psychology, UMD), Kim Nichols (Health, PhysEd, and Recreation, UMD), John Strange (St. Luke's Hospital, Duluth), Marilyn Odean (Medical School, UMD)
Timeframe: January 2009 - December 2009
Abstract: The health care industry is establishing itself as a leader in creating a model of healthy food practices by implementing an approach that involves working with local farmers, purchasing food grown without pesticides and hormone additives, offering sustainably produced and healthy food choices, and minimizing food waste. Hospitals are also identifying a link between a healthy food system and healthy patients and communities in hospitals' policies and programs. To study this innovation in health care we propose to (1) document processes associated with food selection, purchasing and pricing in a hospital setting and document the cost associated with offering local, sustainably produced and healthy food; (2) investigate the role of demographic characteristics, health behaviors, and psychosocial motivations on reported and actual food selection in a hospital cafeteria; and (3) investigate whether food selection behavior changes as a result of changes in food prices and labeling food as organic, sustainably produced or made from locally grown ingredients. Documenting the processes and costs associated with this shift in food systems will provide a model for other hospitals and health care systems interested in modifying their food systems. Ultimately the adoption of healthy food systems in health care may lead to a change in agricultural production that promotes health and reduces obesity and chronic disease. In addition, knowing the determinants of food selection behavior can allow for the development of interventions to increase the consumption of healthy food in the hospital (worksite) setting. Identifying factors in food selection is important in shaping food policy and can ultimately improve the health of many individuals at risk for poor food choice and consumption.