Health & Human Development
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The Department of Health and Human Development is a group of dedicated faculty and staff whose interests, while diverse, center on one central theme: human beings. HHD works to help individuals from early childhood to mature adults though teaching, research, and service programs in both the public and private sectors.
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Item Food insecurity among households with children during the early months of the COVID-19 pandemic(Lyson Center for Civic Agriculture and Food Systems, 2023-06) Houghtaling, Bailey; Haynes-Maslow, Lindsey; Andress, Lauri; Hardison-Moody, Amnie; Grocke-Dewey, Michelle U.; Holston, Denise; Patton-Lopez, Megan; Pradhananga, Nila; Prewitt, T.; Shanks, Justin; Webber, Eliza; Byker Shanks, CarmenUnderstanding impacts of the COVID-19 pandemic among households with children is necessary to design appropriate public health responses that protect food and nutrition security. The objective of this research was to understand predictors of food insecurity during the COVID-19 pandemic among households with at least one child (<18 years), including whether foods reported as out-of-stock were associated with the likelihood of food insecurity. An online survey using validated measures and open-ended questions was distributed to a convenience sample in five states—Louisiana, Montana, North Carolina, Oregon, and West Virginia—during the early months of the COVID-19 pandemic (April through September of 2020). Predictors of food insecurity (race/ethnicity, age, marital status, education, federal nutrition assistance program participation, number of adults and children in the household, rurality, and missing foods when shopping) among households with children during the COVID-19 pandemic were modeled using logistic regression (p < 0.05, a priori). To further illuminate household experiences during this time, two researchers independently coded open-ended survey question data using inductive and deductive approaches to construct themes. Households with children had increased odds of experiencing food insecurity during the COVID-19 pandemic if they had the following characteristics: Hispanic ethnicity; age between 25 and 44 years; additional adult household members; economic hardship; SNAP/WIC participation; being widowed, divorced, or separated; and reporting foods not available when shopping. Participants described mainly negative changes to dietary patterns and practices as a result of the COVID-19 pandemic. They also described food security challenges and ideas for improving food security. Consistent with other data collected and analyzed during the height of the COVID-19 pandemic, this study contributes findings that emphasize the need for enhanced public health responses and emergency preparedness measures that protect food and nutrition security. Because of the increased short- and long-term consequences including exposure to adverse circumstances, impaired learning, risks to mental health, and poor health outcomes, ensuring an adequate food supply is especially important for households with children.Item Co-design of Adaptable Learning Outcomes for Sustainable Food Systems Undergraduate Education(2020-09) Ebel, Roland; Ahmed, Selena; Valley, Will; Jordan, Nicholas; Grossman, Julie; Byker Shanks, Carmen; Stein, Mary; Rogers, Mary; Dring, ColinHigher education institutions are increasingly offering Sustainable Food Systems (SFS) degree programs in response to societal demand for training a professional food systems workforce. As a relatively young field, there is a need for clearly articulated learning outcomes (LOs) for SFS education to define student learning through degree programs, design new programs, and evaluate and modify existing programs. New and established SFS programs are often fragmented over multiple academic departments which impedes the development of a coherent and holistic curriculum for approaching the complexity of food topics. Here, we address these needs through the co-creation of adaptable LOs for Baccalaureate degree-level SFS programs which are aligned to a SFS Signature Pedagogy and based on outcomes-based education toward contributing to a solid conceptual basis for SFS education. The SFS Signature Pedagogy is a framework that can be applied to develop students' systemic capacities, including holistic, and pluralistic ways of understanding sustainability challenges, multi-, inter- and trans-disciplinarity, experiential learning, and collective action projects. Our co-design of LOs was based on qualitative content analysis of existing LOs of established SFS programs, a cross-sectional survey with SFS educators and refinement of LOs from feedback in an expert panel. This process resulted in the eight adaptable LOs: (1) systems thinking, (2) critical reflection, (3) diverse ways of knowing, (4) practical application, (5) multi-context communication, (6) teamwork, (7) collective action, and, (8) advocacy for SFS. We anticipate the adaptable LOs proposed here to be applicable for diverse student communities and geographic respectively cultural contexts as well as to provide insight for sustainability-related academic programs toward developing professionals equipped with skills and capacities to address complex challenges.Item The effects of foods available through the Food Distribution Program on Indian Reservations (FDPIR) on inflammation response, appetite, and energy intake(2020-09) Smith, Melinda S.; Held, Suzanne; Rink, Elizabeth; Byker Shanks, Carmen; Miles, Mary P.Objective: To compare the effects of a typical Food Distribution Program on Indian Reservations (FDPIR) diet with an FDPIR diet that meets Dietary Guidelines for Americans (DGA) on inflammation response, appetite and energy intake on a combination of American Indian (AI) and non-AI individuals. Design: A within-subjects, randomised, crossover design was used to compare two dietary conditions: (1) a FDPIR diet that met DGA and (2) a FDPIR diet that did not meet DGA. Each participant served as their own control and was exposed to both dietary conditions. Repeated-measures ANOVA and t tests assessed significance between the two dietary conditions. Setting: This took place in the Montana State University Nutrition Research Laboratory in the USA. Participants: Female and male participants (n 13) aged 18–55 years from the university and local community. Results: There were no significant differences in inflammatory response and appetite sensations between the two dietary conditions. Findings indicated that participants ate 14 % more (P < 0·01) kcal on a typical FDPIR diet compared with a FDPIR diet that met DGA. Conclusions: Higher energy intake during a typical FDPIR diet compared with a FDPIR diet that meets DGA may increase risk for obesity and nutrition-related diseases, including type 2 diabetes and other chronic inflammatory conditions.Item Intended and Unintended Consequences of a Community-Based Fresh Fruit and Vegetable Dietary Intervention on the Flathead Reservation of the Confederated Salish and Kootenai Tribes(2020-08) Ahmed, Selena; Dupuis, Virgil; Tyron, Michael; Running Crane, MaryAnn; Gavin, Teresa; Pierre, Micheal; Byker Shanks, CarmenTribal communities in the United States face disparities to accessing healthy foods including high-quality produce. A six-week fresh fruit and vegetable (FV) dietary intervention, Eat Fresh, was co-designed with a Community Advisory Board of local food and nutrition stakeholders on the Flathead Reservation of the Confederated Salish and Kootenai Tribes in Montana. Eat Fresh was implemented as a pilot study with low-income participants (n = 19) enrolled in the Food Distribution Program on Indian Reservations toward improving dietary quality and perceptions of well-being. We evaluated Eat Fresh at pre- and post-intervention on the basis on food procurement practices, dietary quality using the Healthy Eating Index (HEI), Body Mass Index (BMI), blood pressure, and participant perceptions of health. Participants reported consuming a greater number of types of FVs daily during the intervention (p < 0.005 for fruits and p > 0.19 for vegetables). Overall, participants found Eat Fresh moderately challenging to adhere to with the main barriers being access to ingredients in recipes (39.51% of responses), time constraints to cook (35.80%), and lack of financial resources (33.33%). Dietary quality improved during the intervention from a mean HEI score of 48.82 (± 11.88) out of 100–56.92 (± 11.88; (p > 0.12). HEI scores for fruit consumption significantly increased (p < 0.05) from 1.69 (out of 5 points) during the pre-intervention to 2.96 during the post-intervention. BMI and blood pressure increased for several participants, highlighting an unintended consequence. Most participants responded that FV consumption made them feel either very good (51.16%) or good about their health (43.02%) with the majority (83%) perceiving an improvement in energy. Findings of this pilot study highlight both intended and unintended consequences of a dietary intervention that provide lessons in co-designing community-based programs.Item Co-design of Adaptable Learning Outcomes for Sustainable Food Systems Undergraduate Education(2020-09) Ebel, Roland; Ahmed, Selena; Valley, Will; Jordan, Nicholas; Grossman, Julie; Byker Shanks, Carmen; Stein, Mary; Rogers, Mary; Dring, ColinHigher education institutions are increasingly offering Sustainable Food Systems (SFS) degree programs in response to societal demand for training a professional food systems workforce. As a relatively young field, there is a need for clearly articulated learning outcomes (LOs) for SFS education to define student learning through degree programs, design new programs, and evaluate and modify existing programs. New and established SFS programs are often fragmented over multiple academic departments which impedes the development of a coherent and holistic curriculum for approaching the complexity of food topics. Here, we address these needs through the co-creation of adaptable LOs for Baccalaureate degree-level SFS programs which are aligned to a SFS Signature Pedagogy and based on outcomes-based education toward contributing to a solid conceptual basis for SFS education. The SFS Signature Pedagogy is a framework that can be applied to develop students' systemic capacities, including holistic, and pluralistic ways of understanding sustainability challenges, multi-, inter- and trans-disciplinarity, experiential learning, and collective action projects. Our co-design of LOs was based on qualitative content analysis of existing LOs of established SFS programs, a cross-sectional survey with SFS educators and refinement of LOs from feedback in an expert panel. This process resulted in the eight adaptable LOs: (1) systems thinking, (2) critical reflection, (3) diverse ways of knowing, (4) practical application, (5) multi-context communication, (6) teamwork, (7) collective action, and, (8) advocacy for SFS. We anticipate the adaptable LOs proposed here to be applicable for diverse student communities and geographic respectively cultural contexts as well as to provide insight for sustainability-related academic programs toward developing professionals equipped with skills and capacities to address complex challenges.Item Perceptions of food environments and nutrition among residents of the Flathead Indian Reservation(2020-10) Byker Shanks, Carmen; Ahmed, Selena; Dupuis, Virgil; Houghtaling, Bailey; Running Crane, MaryAnn; Tryon, Mike; Pierre, MikeBackground Indigenous food systems have been displaced with the emergence of colonization, industrialization, and cultural, economic, political, and environmental changes. This disruption can be seen in marked health and food environment disparities that contribute to high obesity and diabetes mellitus prevalence among Native American peoples. Methods A Community-Based Participatory Research (CBPR) approach was used to document food environment experiences among residents of the Flathead Reservation in rural Montana. Participants were identified using purposive sampling techniques to participate in a survey and a semi-structured interview. Descriptive statistics helped to describe participant demographics, food access variables, and household food security status. Food environment perceptions were analyzed using the constant comparison method among trained researchers. Results Participants completed surveys (n = 79) and interviews (n = 76). A large number participated in federal nutrition assistance programs. Many self-reported experiencing diet-related chronic diseases. Major themes included the community food environment, dietary norms, and food-health connections. Subthemes were represented by perceptions of food environment transitions and the important role of food in familial life. Further, opportunities and challenges were identified for improving community food environments. Conclusions Perceptions of the food environment were linked to strategies that could be targeted to improve dietary quality along a social-ecological model continuum. There is need for skill-based education that directly addresses the time and monetary constraints that were commonly experienced by residents. Coinciding food environment interventions to promote dietary quality that engage community members, store management, and government policy stakeholders are also needed to reestablish healthy Native American food systems and environments within this community.Item Contribution of wild foods to diet, food security, and cultural values amidst climate change(2019-11) Smith, Erin; Ahmed, Selena; Running Crane, MaryAnn; Eggers, Margaret J.; Pierre, Mike; Flagg, Kenneth A.; Byker Shanks, CarmenWild foods are recognized to contribute to diet and food security through enhancing the availability of local, diverse, and nonmarket food sources. We investigated the contribution of wild foods to diet, food security, and cultural identity in a Native American[1] community in the context of climate change. Structured interviews were conducted with low-income residents of the Flathead Indian Reservation[2] in Northwestern Montana who participate in the federal Food Distribution Program on Indian Reservations, also known by participants as ‘Commodities.’ Responses to structured questions were analyzed for frequency, and open-ended responses were coded and analyzed to identify prevalent themes. Our analysis indicated that half of participants were food insecure. Approximately 28% of participants engaged in at least one wild food procurement activity, including hunting, fishing, and harvesting. On average, participants who engaged in one or more wild food procurement activities were more food secure than those who did not. Results highlight the multidimensional valuation of wild foods by participants including taste, freshness, nutritional quality, being a traditional community practice, and providing a sense of self-sufficiency. Climate change is perceived by participants to be adversely impacting wild food systems due to increased variability in seasonality and precipitation and increased incidences of wild fire. Findings point to the need for community-based strategies to strengthen wild food knowledge toward enhancing food sovereignty in Native American communities, in the context of climate change. [1] The term ‘Native American’ was determined to be the preferred term for referencing the Native American community in this study, based on consultation from our community advisory board. [2] The term ‘Flathead Indian Reservation’ was determined to be the preferred term for referencing the location in which this study was held, based on consultation from our community advisory board.Item Sustainability Dimensions of a North American Lentil System in a Changing World(2019-10) Warne, Teresa; Ahmed, Selena; Byker Shanks, Carmen; Miller, Perry R.Food production and consumption are among the largest drivers of global change. The adoption of lentil in production systems and in plant-based diets is a food system solution that can support the environmental, socio-economic, and human health dimensions of sustainability. The purpose of this study is to evaluate producer and consumer perceptions of the sustainability profile of the lentil system in Montana (USA), and the surrounding region that includes Idaho (USA), North Dakota (USA), Washington (USA), and Canada, in the context of global change. Surveys were conducted with lentil producers (n = 63; conventional n = 42, organic n = 15, and mixed management n = 6) and consumers (n = 138) in the rural state of Montana (USA). The most prevalent agronomic reason for including lentil in production systems reported by producers is to diversify crop rotation (92%). The most prevalent economic reasons for including lentil in rotation reported by producers is to capitalize on dryland production (95%) and to serve as a cash crop (87%). With respect to lentil consumption, the most prevalent health-related perceptions were that eating lentils helps to improve nutrition (88%), feel satiated or full (85%), and support a plant-based diet (81%). Consumers and non-consumers of lentils alike reported they would increase lentil consumption based on environmental (78%), economic (75%), and health and nutrition (72%) information contrasting lentils and animal-based protein sources. Overall, findings highlight how the lentil system supports multiple dimensions of sustainability based on the perspectives of study informants. Additionally, findings elucidate barriers and opportunities for promoting lentil in agricultural systems and diets. Impacts of market, policy, and climate change on lentil production, and lack of consumer knowledge on benefits of lentils to help meet food security through a sustainable diet, challenge sustainability dimensions of lentil in the food system.Item The UnProcessed Pantry Project Framework to Address Nutrition in the Emergency Food System(2019-09) Byker Shanks, Carmen; Weinmann, Emma; Holder, Jill; McCormick, Michael; Parks, Courtney A.; Vanderwood, Karl; Coburn, Christopher; Johnson, Nick; Yaroch, Amy L.Low-income populations suffer a greater burden of chronic diseases and food insecurity, are more likely to consume ultraprocessed food, and are less likely to meet dietary recommendations than the general population.1,2 Ultraprocessed food is manipulated with artificial ingredients and can be high in sodium, caloric sweeteners, and saturated fats and, thus, has deleterious health effects.3 The NOVA framework, created by Monteiro and colleagues,3 is commonly applied to public health research to characterize food processing at different levels (unprocessed, minimally processed, processed culinary ingredients, processed, ultraprocessed).3 In the United States, ultraprocessed food typically is accessible, affordable, and convenient, whereas minimally processed food typically is more difficult to access, expensive, and less convenient.1,4 Over time, the availability of ultraprocessed food has increased across the global food supply and in the diets of individuals worldwide, especially among low-income popualations.Item Variation of Adolescent Snack Food Choices and Preferences along a Continuum of Processing Levels: The Case of Apples(2019) Svisco, Elizabeth; Byker Shanks, Carmen; Ahmed, Selena; Bark, KatieFood processing is used for transforming whole food ingredients into food commodities or edible products. The level of food processing occurs along a continuum from unprocessed to minimally processed, processed, and ultra-processed. Unprocessed foods use little to no processing and have zero additives. Minimally processed foods use finite processing techniques, including drying, freezing, etc., to make whole food ingredients more edible. Processed foods combine culinary ingredients with whole foods using processing and preservation techniques. Ultra-processed foods are manufactured using limited whole food ingredients and a large number of additives. Ultra-processed snack foods are increasing in food environments globally with detrimental implications for human health. This research characterizes the choices, consumption, and taste preferences of adolescents who were offered apple snack food items that varied along a processing level continuum (unprocessed, minimally processed, processed, and ultra-processed). A cross-sectional study was implemented in four elementary school classrooms utilizing a buffet of apple snack food items from the aforementioned four food processing categories. A survey was administered to measure students’ taste acceptance of the snacks. The study found that the students selected significantly (p < 0.0001) greater quantities of ultra-processed snack foods (M = 2.20 servings, SD = 1.23) compared to minimally processed (M = 0.56 servings, SD = 0.43) and unprocessed (M = 0.70 servings, SD = 0.37) snack foods. The students enjoyed the taste of ultra-processed snack foods (M = 2.72, SD = 0.66) significantly more (p < 0.0001) than minimally processed (M = 1.92, SD = 1.0) and unprocessed (M = 2.32, SD = 0.9) snack foods. A linear relationship was found between the selection and consumption quantities for each snack food item (R2 = 0.88). In conclusion, it was found that as processing levels increase in apple snack foods, they become more appealing and more heavily consumed by elementary school students. If applied broadly to snack foods, this conclusion presents one possible explanation regarding the high level of diet-related diseases and nutrient deficiencies across adolescents in America. Food and nutrition education, food product development, and marketing efforts are called upon to improve adolescent food choices and make less-processed snack food options more appealing and accessible to diverse consumers.