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Completed

NCT Number: NCT02399436

Appalachians Together Restoring the Eating Environment

Most of the nation's serious chronic health challenges and causes of death, including diabetes, heart disease, cancer, and obesity, are directly linked to sub-optimal diet. Both poor diets and associated disease are disproportionately common in the Appalachian counties of eastern Kentucky, a region with stark health inequities, including elevated rates of obesity, overweight, and premature mortality. The purpose of this pilot study is to evaluate a multi-component intervention developed through community-based participatory research methods for improving access to healthy foods and enhancing dietary intake in eastern Kentucky. The intervention components evaluated in this study consist of a social marketing campaign delivered to middle and high schools to promote healthy snacking and water consumption, and a series of group cooking classes for adults.

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Key information

Conditions

Dietary Habits Behavior Behavior, Animal Feeding Behavior

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Kentucky

Lexington, Kentucky, 40506, United States

About this study

This pilot study evaluates two principal components of a community-based intervention to improve dietary habits and access to healthy foods: a school-based healthy snacking campaign and a series of community cooking classes for adults. The primary outcome assessed within each intervention component is dietary intake as measured by self-reported beverage and food consumption in pre-post surveys. Secondary outcome variables include attitudes, preferences, confidence, self-efficacy and other psychosocial variables related to healthy eating behaviors, perceptions of healthy food availability, food purchasing and preparation habits, and perceived barriers to healthy eating.

The school-based intervention component employs a nonequivalent control group research design. A subset of middle- and high-schools within a single county in eastern KY will receive a healthy snacking campaign intervention, and students from randomly selected classrooms within these schools will be invited to enroll in the study. Students from middle- and high-school classrooms in a comparison county that receives no intervention will serve as nonequivalent controls. The investigators specific aims for this component are to improve the availability of healthy snack foods that students may purchase at school, increase student consumption of healthy snacks over unhealthy snacks, and increase the consumption of water over sugar-sweetened beverages. Following baseline, posttest surveys will be administered at 3, 6 and 14 months.

Community cooking classes will be delivered to a non-random sample of adults who will complete pretest-posttest measures at baseline and 8 weeks. The specific aims of this component are to increase the consumption of healthy foods at home, and increase participant knowledge, skills, and self-efficacy around healthy home cooking.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • For School-Based Component: 6th-12th grade students enrolled in a participating school and classroom in the intervention or comparison county.
  • For Cooking Classes: Adults aged 18 years and older residing in intervention county who have at least one juvenile in household.

Treatment and study plan

School-Based Healthy Snacking Campaign

Behavioral

The school-based healthy snacking campaign includes the following activities:

  • Sales promotion of snack choices that meet federal Smart Snack guidelines during the school day and at school events, such as snack bars and after-school events;
  • The installation of new filtered water fountains outfitted with water-filling stations;
  • The distribution of re-usable water bottles to students at participating schools; and
  • A social marketing campaign to support adoption of the healthy snacks and water consumption by students.

Community Cooking Classes

Behavioral

Cooking classes will be delivered to groups of 8-12 adult participants as a series of 8 weekly classes in community venues. The content of each class is driven by topics and themes identified and prioritized by community members, namely cooking healthy on tight budget.

Primary outcomes

  1. Change in Beverage Consumption (Students)

    Time frame: Baseline, 3 months, 6 months, and 14 months

    Frequency and quantity of beverages consumed in past month. Includes water, 100% fruit juice, sugar-sweetened beverages, sugar-free beverages and milk.

  2. Change in Snack Consumption (Students)

    Time frame: Baseline, 3 months, 6 months, and 14 months

    Frequency and quantity of snacks consumed in past month. Includes chips (regular and low-fat), salty snacks, candy, desserts, vegetables, fruit, nuts and seeds, vegetable dips, yogurt, and popcorn.

  3. Change in Dietary intake (Adults)

    Time frame: Baseline to 8 weeks

    Frequency of consumption of fruits, vegetables, beans, candy, pastries, desserts, and salty snacks in the past month.

Secondary outcomes

  1. Change in Snacking Attitudes and Preferences (Students)

    Time frame: Baseline, 3 months, 6 months, and 14 months

    Survey items address taste preferences, attitudes about healthy eating behaviors and body image

  2. Change in Healthy Snacking Confidence and Self-efficacy (Students)

    Time frame: Baseline, 3 months, 6 months, and 14 months

  3. Change in Availability of Healthy Snack Foods (Students)

    Time frame: Baseline, 3 months, 6 months, and 14 months

    Frequency of availability of healthy and unhealthy snack foods at school

  4. Change in Snack Food Purchasing Habits (Students)

    Time frame: Baseline, 3 months, 6 months, and 14 months

    Frequency of purchasing snack foods and beverages at fast food restaurants, convenience stores, and school venues and events

  5. Change in Food Preparation Habits (Adults)

    Time frame: Baseline to 8 weeks

    Likelihood of performing healthy food preparation behaviors; survey items address meal planning and preparation

  6. Change in Food Purchasing Habits (Adults)

    Time frame: Baseline to 8 weeks

    Frequency of purchasing food at work, grocery/convenience stores, restaurants and produce stands

  7. Change in Perceptions of Availability of Healthy Foods (Adults)

    Time frame: Baseline to 8 weeks

    Survey items address availability of high quality fruits and vegetables and low-fat foods

  8. Change in Barriers to Healthy Eating (Adults)

    Time frame: Baseline to 8 weeks

    Survey items address physical, psychosocial, emotional, and financial barriers to healthy eating

Sponsors and collaborators

Lead sponsor

Mark Swanson, PhD

Other

Collaborators

  • Community Farm Alliance

Registry information

Acronym: Appal-TREE

Important dates

Study start
2015
Primary completion
2016
Study completion
2016
First posted
Mar 26, 2015
Registry last updated
Apr 19, 2017

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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