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 Experience: Building Empathy in Future Food and Nutrition Professionals(Elsevier, 2017-03) Harmon, Alison; Landolfi, Kara; Shanks, Carmen Byker; Hansen, Leanna; Iverson, Laura; Anacker, MelodyOBJECTIVE To assess changes in empathy in students completing a food insecurity experience. DESIGN Mixed methods; quantitative data from survey in years 1 and 2; qualitative data extracted from students\' workbooks in years 2-5. This study was conducted over 10 weeks annually for 5 years. SETTING Northwest US land-grant university. PARTICIPANTS Students enrolled in a community nutrition course who chose to complete the food insecurity exercise. Total included 58 students in quantitative analysis in years 1 and 2 and 119 in qualitative analysis, years 2-5. INTERVENTION(S) The intervention was a food insecurity experience in which participants spent no more than $3/d on food for 5 days ($15 total) while striving for a nutritious diet and reflecting on their experience. MAIN OUTCOME MEASURES Empathy scores measured by Likert scales; participant responses and reflections recorded in workbook journals. ANALYSIS Comparison of means across time using paired t tests (P < .05); coding and sorting themes from workbook journals. RESULTS Quantitative findings indicated that both classroom content and experiential exercises were important for enhancing empathy about food insecurity. Empathy scores increased from time I to time II and from time I to time III. Qualitative reflections among participants included terms such as guilt, empathy, compassion, and raised consciousness about food insecurity. CONCLUSIONS AND IMPLICATIONS Experiential and transformational learning to develop empathy can take place in a 5-day food insecurity experience during a typical university-level community nutrition course. This intervention can be tested for applications in other contexts.Item Public health restrictions, directives, and measures in Arctic countries in the first year of the COVID-19 pandemic(Informa UK Limited, 2023-12) Peterson, Malory; Akearok, Gwen Healey; Cueva, Katie; Lavoie, Josée G.; Larsen, Christina V. L.; Jóhannsdóttir, Lára; Cook, David; Nilsson, Lena Maria; Rautio, Arja; Timlin, Ulla; San Sebastián, Miguel; Gladun, Elena; Rink, Elizabeth; Broderstadt, Ann Ragnhild; Dagsvold, Inger; Siri, Susanna; Ottendahl, Charlotte Brandstrup; Olesen, Ingelise; Zatseva, Larisa; Young, Rebecca Ipiaqruk; Chaliak, Ay’aqulluk Jim; Ophus, Emily; Stoor, Jon Petter A.Beginning January of 2020, COVID-19 cases detected in Arctic countries triggered government policy responses to stop transmission and limit caseloads beneath levels that would overwhelm existing healthcare systems. This review details the various restrictions, health mandates, and transmission mitigation strategies imposed by governments in eight Arctic countries (the United States, Canada, Greenland, Norway, Finland, Sweden, Iceland, and Russia) during the first year of the COVID-19 pandemic, through 31 January 2021s31 January 2021. We highlight formal protocols and informal initiatives adopted by local communities in each country, beyond what was mandated by regional or national governments. This review documents travel restrictions, communications, testing strategies, and use of health technology to track and monitor COVID-19 cases. We provide geographical and sociocultural background and draw on local media and communications to contextualise the impact of COVID-19 emergence and prevention measures in Indigenous communities in the Arctic. Countries saw varied case rates associated with local protocols, governance, and population. Still, almost all regions maintained low COVID-19 case rates until November of 2020. This review was produced as part of an international collaboration to identify community-driven, evidence-based promising practices and recommendations to inform pan-Arctic collaboration and decision making in public health during global emergencies.Item “Death by a Thousand Cuts”: Agriculture Producer Resiliency in the Western United States(Informa UK Limited, 2023-11) Freeman, Brenda; Grocke-Dewey, Michelle U.; Chichester, Lindsay; Breeding, Katherine; Stallones, Lorann; Minter, MonicaObjective: Agricultural producers face a wide array of stress triggers, shocks, and long-term pressures such as drought, flooding, fire, government policies, financial insecurity, and physical injuries. Extant research has revealed that mental health stigma, lack of access to care in rural areas, and negative coping responses (alcohol abuse, suicide, prescription drugs use) exacerbate the challenge of producer responses to short and long-term adversity. Resilience, the traits, processes, and capacities of producers to adapt and transform their approach to farming or ranching, when necessary, in response to stress triggers or long-term pressures, has received less research attention, particularly in the Western United States. The purpose of the study was to apply an interactionist occupational resilience theoretical perspective to the investigation of contextual factors contributing to resilience in Western United States agricultural producers. Methods: Qualitative interviews (45 to 90 minutes) were conducted with agricultural producers (n=51) from Western states and territories. Applied thematic analysis with a phenomenological lens was utilized to analyze interview transcriptions. First and second level coding were conducted to derive themes. Results: The analysis revealed that resilience is based upon the interactions between traits of producers and the context of agriculture. Four themes were generated (Agricultural Life, External Stressors, Traits and Adaptations, and Supports and Resources), supported by subthemes. The themes and subthemes are depicted in an agricultural producer resiliency model. The findings shed light on the equivocal role of neighbors in providing support for each other and the double- edged sword of co-working with family. Conclusions: The findings underscore that social capital is an important mechanism for supporting farmers and ranchers, as those with stronger social resources are more resilient. We recommend more funding to tailor stress and mental health programming to the specifics of agriculture, integration of behavioral health in primary care as a mechanism to increase access to care, and more intentional technical assistance for farmers and ranchers on strategic planning and problem solving.Item The need and development for a value-added toolkit—A case study with Montana specialty fruit growers(Frontiers Media SA, 2023-04) Garg, Sumedha; Jha, Gaurav; Kim, Sun-Hwa; Miller, Zachariah; Kuo, Wan-YuanIntroduction: Cold-hardy small fruits and berries have the potential for specialty fruit growers in the Intermountain West, where the climate is not suited for conventional fruit crops. In the last seven years, approximately 50 varieties of cold-hardy, bush fruit types have been researched in western Montana. Method: Hence with the increased small fruit and berry production, and interest of specialty fruit growers in value-added product development, this paper utilized participatory action research (PAR) to develop a value-added product development toolkit with specialty fruit growers and used an integrated logic model to discuss creating and implementing the toolkit. Firstly, we used an online survey to identify the needs and challenges of specialty fruit growers. Next, a value added toolkit is drafted using the principles of design thinking and involving a student-grower partnership. Thirdly, the specialty fruit grower's interest in and feedback on the drafted toolkit is evaluated using focus group discussions and individuals interviews, and the results are used to revise the toolkit. Lastly, the short, medium and long-term outcomes for this toolkit are discussed using the logic model. Results: From the survey, 61% of specialty fruit growers indicated an interest in value-added opportunities. Yet, focus group discussions and individual interviews found the biggest barriers to value-added product development are cost, resources, and environment. This indicated a co-created toolkit will be a beneficial solution. During focus group and individual interviews, the growers suggested including the toolkit as part of coursework in semester-long classes. This will address issues of continuity and funding. Discussion: Overall, this study deployed PAR methods to propose with Montana specialty fruit growers a solution to their increasing needs in value-added pursuits, implying short-term economic benefits but also long-term socio-ecological benefits. The participatory model of creating value-added resources presented by this paper can benefit other small-scale specialty crop growers in underserved regions.Item Improving Chronic Illness Self-Management with the Apsáalooke Nation: The Báa nnilah Project, a cluster randomized trial protocol(MDPI, 2023-10) Keene, Shannen; Allen, Sarah; Knows His Gun McCormick, Alma; Trottier, Coleen; Bull Shows, Brianna; Hallet, John; Deernose, Rae; Held, SuzanneTreatment fidelity remains underreported in health intervention research, particularly among Indigenous communities. One explanation for this gap is the lack of culturally consonant strategies listed in the National Institutes of Health (NIH) Behavior Change Consortium (BCC) treatment fidelity framework, the gold standard for understanding and measuring fidelity. This paper focuses on the development and implementation of a culturally consonant treatment fidelity support plan across two of the five BCC fidelity areas, provider training and treatment delivery, within a chronic illness self-management program for the Apsáalooke (Crow) Nation. Our team selected and adapted strategies from, and added strategies to, the BCC framework, that centered on relational accountability and the Apsáalooke culture. To be culturally consonant, we approached treatment fidelity as supporting Aakbaabaaniilea (Apsáalooke program facilitators) rather than monitoring them. This resulted in the development of a fifth treatment fidelity area: building and fostering relationships. We propose that fidelity to relational accountability is the foundation of successful programs in Indigenous communities. This suggests an important shift from tracking what was conducted in an intervention to prioritizing how things were conducted. We encourage others to view the BCC framework as a starting point in developing fidelity strategies that are consonant with local cultures.Item Built environment approaches: Extension personnel's preferences, barriers, and facilitators(Frontiers Media SA, 2022-10) Balis, Laura E.; Grocke-Dewey, Michelle U.Introduction: Interventions that modify the built environment can increase population physical activity levels and prevent chronic disease. The national Cooperative Extension System is poised to implement built environment approaches (i.e., pedestrian/bicycle infrastructure and enhanced access to physical activity spaces), but implementation strategies (i.e., methods or techniques to move research to practice) are needed to improve uptake. Effective implementation strategies address relevant barriers and capitalize on facilitators. The purpose of this study was to understand 1) barriers and facilitators to implementing built environment approaches in two state Extension systems, 2) preferences for built environment approaches, and 3) preferences for implementation strategies. Methods: A cross-sectional online survey was used to understand Extension personnel's preferences for and barriers and facilitators to built environment approaches through a mixed-methods study design. This work was informed by anthropological inquiry as the overall research philosophy, and by the Health Impact Pyramid, Leeman et al.'s classification of implementation strategies, and the Consolidated Framework for Implementation Research as the theoretical frameworks. The survey was distributed to eligible Extension personnel (n = 42) in two states. Quantitative data analysis consisted of numbers/proportions and Friedman tests. Qualitative analysis was completed through a rapid deductive approach to quickly produce actionable results. Results: Fourteen respondents (33%) completed the survey. Most had not implemented physical activity interventions in their communities or had implemented only individual-level interventions, though were interested in implementing built environment approaches. Benches, playground improvements, and crosswalks were the most desired approaches, while facilitation, assessing community strengths and needs, and technical assistance were desired implementation strategies. The most common barriers were relative priority and available resources; facilitators were external policy and incentives and implementation climate. Discussion: Extension personnel are receptive to built environment approaches and engaged with community coalitions. Yet, invested parties prefer individual-level interventions, and agents perceive a lack of resources for implementation. Implementation strategies that build capacity in both the Extension system and community coalitions may address these barriers through increasing relative priority and sharing existing resources. This work is a first step toward compiling implementation strategies to address relevant barriers to built environment approaches in community settings.Item Individual Muscle Contributions to the Acceleration of the Center of Mass During the Barbell Back Squat in Trained Female Subjects(Wolters Kluwer, 2023-08) Goodman, William W.; Helms, Eric; Graham, David F.Goodman, WW, Helms, E, and Graham, DF. Individual muscle contributions to the acceleration of the centre of mass during the barbell back squat in trained females. J Strength Cond Res XX(X): 000–000, 2023—The squat is used to enhance performance and rehabilitate the lower body. However, muscle forces and how muscles accelerate the center of mass (CoM) are not well understood. The purpose was to determine how lower extremity muscles contribute to the vertical acceleration of the CoM when squatting to parallel using 85% one-repetition maximum. Thirteen female subjects performed squats in a randomized fashion. Musculoskeletal modeling was used to obtain muscle forces and muscle-induced accelerations. The vasti, soleus, and gluteus maximus generated the largest upward accelerations of the CoM, whereas the muscles that produced the largest downward acceleration about the CoM were the hamstrings, iliopsoas, adductors, and tibialis anterior. Our findings indicate that a muscle's function is task and posture specific. That is, muscle function depends on both joint position and how an individual is interacting with the environment.Item Perceived stress, stressors, and preferred stress management strategies among western agricultural producers(American Psychological Association, 2023-05) Grocke-Dewey, Michelle U.; Brennan, Alison; Freeman, Brenda; Weas, Heather; Gutheil, Jessica; Stallones, Lorann; McMoran, DonChronic stress is associated with adverse physical, emotional, and social health outcomes such as increased rates of chronic disease, anxiety, behavioral inhibition, and well-being. In the United States, farmers and ranchers experience some of the highest levels of these adverse health outcomes. This study presents data from the Western Region Agricultural Producer Stress Survey, a survey tool designed to better understand these stressors and desired mitigation techniques. A sample of 767 agricultural producers participated in a survey that gauged their perceived stress levels, sources of stress, desired stress management topics, and preferred methods of receiving information. Workload, financial worries, and lack of time presented as the top stressors. Women averaged higher levels of both perceived stress and stressor pileup than men. Interest in stress management topics also differed significantly by gender and age, with men more interested in parenting classes and support groups, and younger producers more interested in nutrition/cooking classes. The most preferred methods for receiving information were online options. Data suggest that, on average, producers across the Western region of the United States are experiencing a medium level of stress. While this is concerning, producers expressed interest in learning more about a variety of topics to help them manage their stress and improve their well-being. Better understanding of agricultural producers’ preferences for stress management topics, as well as their preferred dissemination methods, is critical in terms of providing this often underserved population with appropriate mental health assistance.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 Scaffolding collective agency curriculum within food-systems education programs(Frontiers Media SA, 2023-05) Jordan, Nicholas R.; Valley, Will; Donovan, Dennis; Clegg, Daniel J.; Grossman, Julie; Hunt, Natalie; Michaels, Thomas; Peterson, Hikaru; Rogers, Mary A.; Sames, Amanda; Stein, MaryCollective agency (CA) can be defined as the shared understanding, will, and ability of a heterogenous group to take action and work together toward a common goal. We are motivated by the premise that CA is central to meeting the challenges inherent to 21st century food systems. These challenges include maintaining sustainable agricultural production and meeting nutritional needs of a growing population while protecting the climate, wildlife, soil, air and water quality, and enhancing equity, inclusion and justice for those who work in or engage with these systems. Given the importance of CA in food systems, university programs focused on food systems must address it. To date, despite many calls for higher education to build skills in CA, implementation has been minimal. Single courses addressing CA exist in some program-level curricula, but we know of no previous efforts in food-systems degree programs to systematically cultivate CA across their curriculum through scaffolding, i.e., interconnection and integration of learning activities across courses, so as to enhance their complementarity and impact. We (a consortium of university faculty building food systems curricula, located at University of British Columbia, Montana State University, and University of Minnesota) developed our approach to teaching CA through an action-research process, conducted during 2019–2022. In this paper, we report on our process and outline an emergent conceptual model of a curriculum for CA that can be embedded within broader, program-level food systems curricula. We describe its elements and share our experiences in implementing these elements. We conclude by describing current efforts to further develop CA curricula in the context of food-systems degree programs.