Delta Healthy Sprouts: Participants' Diet and Food Environment at Baseline
Authors: Goodman Melissa H , Thomson Jessica L , Landry Alicia S , Tussing‐Humphreys Lisa M 
Published: June 2021

Local food environments influence the nutrition and health of area residents. This baseline analysis focuses on the food environments of women who participated in the Delta Healthy Sprouts project, a randomized, controlled, comparative trial designed to test the efficacy of two Maternal, Infant, and Early Childhood Home Visiting programs on weight status and health behaviors of mothers and their infants residing in the rural Mississippi Delta. Participants resided in Washington, Bolivar, or Humphreys County and were visited in their homes thus precise geographical location data was available.At baseline, participants were in the early second trimester of pregnancy. The majority were African American (96.3%), single (92.7%), received Medicaid (91.5%), enrolled in SNAP (75.6%), enrolled in WIC (84.1%), and owned or had access to a car (90.2%). Two‐thirds of the participants were classified as overweight or obese based on self‐reported pre‐pregnancy body weight and measured height.Over an 18 month period, dietary data was gathered from participants using multiple pass 24‐hour dietary recalls via the Nutrition Data System for Research software. Diet quality was calculated from this data using Healthy Eating Index‐2010 which measures adherence to the 2010 Dietary Guidelines for Americans. The Healthy Eating Index‐2010 total score ranges from 0 to 100 points. At baseline, the participants' mean Healthy Eating Index score was 43.1 with a range of 21.5 to 72.0.Participants also completed surveys asking about food practices, including the name and address of the store where most of the household food was purchased. All grocery and convenience stores in the towns where more than two participants lived were enumerated and evaluated for availability of healthy options, price, and quality using the Nutrition Environment Measures Survey for grocery stores (NEMS‐S) and convenience stores (NEMS‐CS). The 12 measured grocery stores had a mean score of 30.6 with a range of 23 to 41 (57 possible points). The 84 measured convenience stores had a mean score of 8.1 with a range from 2 to 14 (58 possible points).Focusing on the store where most of the household food was purchased, all but two participants reported grocery shopping at a store in their county. In Washington County, all residents of the largest town (n=42) reported shopping in town. For the two smaller towns in Washington County, about half (46.1%) reported commuting to the largest neighboring town for food shopping. In Bolivar County, all but one resident (n=16) reported shopping in in the largest town, regardless of town residency.Results suggest that grocery stores rated adequately for provision of healthy items while convenience store ratings were insufficient. Additionally rural participants reported grocery shopping in larger towns rather than stores closer to their residence. Future research will investigate the impact of food environments on nutrition intake and overall health.Support or Funding InformationSupported by the USDA Agricultural Research Service with in kind support from the Delta Health Alliance.