Addressing Disparities in Food Access Among Young Children in Louisiana: A Farm to ECE Approach

Study Overview
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Brief Summary
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The goal of this pilot project is to increase access to healthy food, improve diets, and reduce food insecurity and, in turn, reduce health disparities among low-income, minority children under the age of five attending early childcare centers. Specific aims are to: 1) examine the feasibility of a six-month Farm to ECE intervention and 2) collect preliminary data to evaluate the efficacy of the program to 2.1) improve the ECE nutrition environment from baseline to follow-up; 2.2) increase access to local fruits and vegetables among children at ECEs from baseline to follow-up; and 2.3) increase parent knowledge and use of community food resources. The investigators will use this preliminary data to develop a larger scale project to test intervention efficacy.

Detailed Description
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The pilot study will take place at four centers within a network of Catholic Charities Early Head Start and Head Start Centers in New Orleans, Louisiana. Two centers will serve as intervention sites and two as comparison sites. Over 90% of the network centers' students identify as Black, and all qualify for federally funded free meals and snacks. The intervention will include: (1) assisting ECEs with conducting self-assessments; (2) connecting ECEs with local farmers and food producers; (3) providing technical assistance for menu changes, procuring healthy food, identifying and implementing best feeding practices and policies for the environment; (4) delivering nutrition education; and (5) connecting parents/guardians with local food resources and affordable fresh food to be consumed at home. The intervention will be implemented for 6 months. Aim 1 uses a cross-sectional mixed methods design, collecting both quantitative and qualitative data in intervention centers. Aim 2 uses a pre-post design with a comparison group, collecting quantitative survey data at the center and parent level. At baseline and six-month follow-up, the investigators will conduct short surveys with staff and parents/caregivers of children attending ECEs.

Official Title
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Addressing Disparities in Food Access Among Young Children in Louisiana: A Farm to ECE Approach

Conditions
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Food Insecurity, Health Knowledge, Attitudes, Practice, Nutrition, Healthy

Intervention / Treatment
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* Behavioral: Farm to ECE programming


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria (Key informant interviews and center assessments): Director or staff of participating center 18 years of age minimum Exclusion Criteria (Key informant interviews and center assessments): • Staff not involved with educational programming Inclusion Criteria (Parent/guardian surveys): Parent or guardian of current student at participating center 18 years of age minimum Exclusion Criteria (Parent/guardian surveys): • None

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: intervention and comparison
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention Center<br>The intervention will include: (1) assisting ECEs with conducting self-assessments; (2) connecting ECEs with local farmers and food producers; (3) providing technical assistance for menu changes, procuring healthy food, identifying and implementing best feeding practices and policies for the environment; (4) delivering nutrition education; and (5) connecting parents/guardians with local food resources and affordable fresh food to be consumed at home | Behavioral: Farm to ECE programming<br>* Students and parents at this center will receive program elements described in arm descriptions.<br>|
| No Intervention: Comparison<br>No programming at center, only surveys | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| incidence of parent/guardian use of community food resources | Parent/guardian surveys will ask questions about use of community food resources. Frequencies will be calculated based on results. | 6 months | 
| nutrition environment score measured by NAPSACC | Environmental assessments and pre/post staff surveys using validated tools (Nutrition and Physical Activity Self-Assessment for Child Care NAPSACC) will be used to determine changes in the nutrition environment and healthy options. Nutrition environment scores will be calculated using the tool scoring guide. | 6 months | 
| percent completion of program components (fidelity) | Staff will be asked to complete tracking records of all executed program components. Percent completion will be calculated by dividing program components executed by total program components. | 6 months | 
| satisfaction score with program implementation | Staff will be asked to complete a post intervention survey to indicate their satisfaction (scale of 1-5) with the program implementation and its components. | 6 months |