Caitlin N Hawley1, Corrine M Huber2, Lyle G Best2, Barbara V Howard3,4, Jason Umans3, Shirley A A Beresford5, Barbara McKnight6, Arlette Hager7, Marcia O'Leary2, Anne N Thorndike8, India J Ornelas9, Meagan C Brown5, Amanda M Fretts10. 1. Department of Medicine, University of Washington, 1410 NE Campus Parkway, Seattle, WA, 98195, USA. 2. Missouri Breaks Industries Research Inc, 118 S Willow St, Eagle Butte, SD, 57625, USA. 3. Medstar Health Research Institute, 6525 Belcrest Rd #700c, Hyattsville, MD, 20785, USA. 4. Georgetown and Howard Universities Center for Clinical and Translational Science, 4000 Reservoir Road NW, Washington, DC, 20007, USA. 5. Department of Epidemiology, University of Washington, 1410 NE Campus Parkway, Seattle, WA, 98195, USA. 6. Department of Biostatistics, University of Washington, 1410 NE Campus Parkway, Seattle, WA, 98195, USA. 7. Cheyenne River Sioux Tribe Adult Diabetes Program, 24276 Airport Rd, Eagle Butte, SD, 57625, USA. 8. Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA. 9. Department of Health Services, 1410 NE Campus Parkway, Seattle, WA, 98195, USA. 10. Department of Epidemiology, University of Washington, 1410 NE Campus Parkway, Seattle, WA, 98195, USA. amfretts@uw.edu.
Abstract
BACKGROUND: The prevalence of poor diet quality and type 2 diabetes are exceedingly high in many rural American Indian (AI) communities. Because of limited resources and infrastructure in some communities, implementation of interventions to promote a healthy diet is challenging-which may exacerbate health disparities by region (urban/rural) and ethnicity (AIs/other populations). It is critical to adapt existing evidence-based healthy food budgeting, purchasing, and cooking programs to be relevant to underserved populations with a high burden of diabetes and related complications. The Cooking for Health Study will work in partnership with an AI community in South Dakota to develop a culturally-adapted 12-month distance-learning-based healthy food budgeting, purchasing, and cooking intervention to improve diet among AI adults with type 2 diabetes. METHODS: The study will enroll 165 AIs with physician-diagnosed type 2 diabetes who reside on the reservation. Participants will be randomized to an intervention or control arm. The intervention arm will receive a 12-month distance-learning curriculum adapted from Cooking Matters® that focuses on healthy food budgeting, purchasing, and cooking skills. In-person assessments at baseline, month 6 and month 12 will include completion of the Nutrition Assessment Shared Resources Food Frequency Questionnaire and a survey to assess frequency of healthy and unhealthy food purchases. Primary outcomes of interest are: (1) change in self-reported intake of sugar-sweetened beverages (SSBs); and (2) change in the frequency of healthy and unhealthy food purchases. Secondary outcomes include: (1) change in self-reported food budgeting skills; (2) change in self-reported cooking skills; and (3) a mixed-methods process evaluation to assess intervention reach, fidelity, satisfaction, and dose delivered/received. DISCUSSION: Targeted and sustainable interventions are needed to promote optimal health in rural AI communities. If effective, this intervention will reduce intake of SSBs and the purchase of unhealthy foods; increase the purchase of healthy foods; and improve healthy food budgeting and cooking skills among AIs with type 2 diabetes - a population at high risk of poor health outcomes. This work will help inform future health promotion efforts in resource-limited settings. TRIAL REGISTRATION: This study was registered on ClinicalTrials.gov on October 9, 2018 with Identifier NCT03699709 .
BACKGROUND: The prevalence of poor diet quality and type 2 diabetes are exceedingly high in many rural American Indian (AI) communities. Because of limited resources and infrastructure in some communities, implementation of interventions to promote a healthy diet is challenging-which may exacerbate health disparities by region (urban/rural) and ethnicity (AIs/other populations). It is critical to adapt existing evidence-based healthy food budgeting, purchasing, and cooking programs to be relevant to underserved populations with a high burden of diabetes and related complications. The Cooking for Health Study will work in partnership with an AI community in South Dakota to develop a culturally-adapted 12-month distance-learning-based healthy food budgeting, purchasing, and cooking intervention to improve diet among AI adults with type 2 diabetes. METHODS: The study will enroll 165 AIs with physician-diagnosed type 2 diabetes who reside on the reservation. Participants will be randomized to an intervention or control arm. The intervention arm will receive a 12-month distance-learning curriculum adapted from Cooking Matters® that focuses on healthy food budgeting, purchasing, and cooking skills. In-person assessments at baseline, month 6 and month 12 will include completion of the Nutrition Assessment Shared Resources Food Frequency Questionnaire and a survey to assess frequency of healthy and unhealthy food purchases. Primary outcomes of interest are: (1) change in self-reported intake of sugar-sweetened beverages (SSBs); and (2) change in the frequency of healthy and unhealthy food purchases. Secondary outcomes include: (1) change in self-reported food budgeting skills; (2) change in self-reported cooking skills; and (3) a mixed-methods process evaluation to assess intervention reach, fidelity, satisfaction, and dose delivered/received. DISCUSSION: Targeted and sustainable interventions are needed to promote optimal health in rural AI communities. If effective, this intervention will reduce intake of SSBs and the purchase of unhealthy foods; increase the purchase of healthy foods; and improve healthy food budgeting and cooking skills among AIs with type 2 diabetes - a population at high risk of poor health outcomes. This work will help inform future health promotion efforts in resource-limited settings. TRIAL REGISTRATION: This study was registered on ClinicalTrials.gov on October 9, 2018 with Identifier NCT03699709 .
Entities:
Keywords:
Budgeting; Cooking; Curriculum; Diabetes mellitus, type 2; Diet, food, and nutrition; Education, distance; Indians, north American; Randomized controlled trial; Rural population
Authors: E T Lee; T K Welty; R Fabsitz; L D Cowan; N A Le; A J Oopik; A J Cucchiara; P J Savage; B V Howard Journal: Am J Epidemiol Date: 1990-12 Impact factor: 4.897
Authors: Vicky A Newman; Cynthia A Thomson; Cheryl L Rock; Shirley W Flatt; Sheila Kealey; Wayne A Bardwell; Bette J Caan; John P Pierce Journal: J Am Diet Assoc Date: 2005-03