Impact of HomeStyles-2 Intervention on Fruit and Vegetable Intake and Cognitions of Adults Participating in SNAP-Education

BackgroundAlthough chronic disease risk is inversely associated with fruit and vegetable (F/V) intake, only 12% and 9% of adults eat enough F/V, respectively. Teaching adults strategies for increasing F/V intake and targeting F/V-related cognitions are effective components of nutrition interventions. SNAP-Education (SNAP-Ed) is a federally funded nutrition education program that teaches SNAP-eligible families to make better food choices and utilizes such interventions.ObjectiveTo determine whether HomeStyles-2 (HS), a virtual nutrition education intervention delivered through SNAP-Ed for parents/caregivers of children ages 6 to 11 years, improves F/V intake and related cognitions of participants compared to a virtual attention control (AC).Study Design, Settings, ParticipantsThe study was a two-arm, cluster-randomized controlled trial. Participants were recruited and taught by SNAP-Ed nutrition educators who had been randomized to teach a six-lesson HS (N=102) or AC SNAP-Ed (N=64) curriculum.Measurable Outcome/AnalysisDemographic characteristics were analyzed using descriptive statistics. F/V intake and related cognitions were collected at baseline, post-intervention, and long-term follow up (LTFU). Differences were analyzed using a linear mixed effects model with fixed effects (eg, baseline value, group, language, gender, race, ethnicity, education, and age).ResultsParticipants were 39.6 ± 7.9 years old, primarily female (96.3%), had a post-secondary education (71.6%), and had overweight or obesity (82.1%). There were no within or between group differences in F/V intake or cognitions from baseline to post-intervention or post-intervention to LTFU (p>0.05).ConclusionThese results suggest that HS did not improve F/V intake or cognitions, which is likely a result of several uncontrollable factors. COVID required the adaptation of HS to a virtual format. COVID also negatively impacted recruitment and retention, which resulted in an underpowered study. Also, the SNAP-Ed contract changed scope during the intervention to no longer include adults, so recruitment was cut short. Future research should include a larger sample. Researchers need to be flexible when working with community members and organizations, which could potentially impact research protocols and outcomes but preserves relationships for future partnerships.FundingUSDA Although chronic disease risk is inversely associated with fruit and vegetable (F/V) intake, only 12% and 9% of adults eat enough F/V, respectively. Teaching adults strategies for increasing F/V intake and targeting F/V-related cognitions are effective components of nutrition interventions. SNAP-Education (SNAP-Ed) is a federally funded nutrition education program that teaches SNAP-eligible families to make better food choices and utilizes such interventions. To determine whether HomeStyles-2 (HS), a virtual nutrition education intervention delivered through SNAP-Ed for parents/caregivers of children ages 6 to 11 years, improves F/V intake and related cognitions of participants compared to a virtual attention control (AC). The study was a two-arm, cluster-randomized controlled trial. Participants were recruited and taught by SNAP-Ed nutrition educators who had been randomized to teach a six-lesson HS (N=102) or AC SNAP-Ed (N=64) curriculum. Demographic characteristics were analyzed using descriptive statistics. F/V intake and related cognitions were collected at baseline, post-intervention, and long-term follow up (LTFU). Differences were analyzed using a linear mixed effects model with fixed effects (eg, baseline value, group, language, gender, race, ethnicity, education, and age). Participants were 39.6 ± 7.9 years old, primarily female (96.3%), had a post-secondary education (71.6%), and had overweight or obesity (82.1%). There were no within or between group differences in F/V intake or cognitions from baseline to post-intervention or post-intervention to LTFU (p>0.05). These results suggest that HS did not improve F/V intake or cognitions, which is likely a result of several uncontrollable factors. COVID required the adaptation of HS to a virtual format. COVID also negatively impacted recruitment and retention, which resulted in an underpowered study. Also, the SNAP-Ed contract changed scope during the intervention to no longer include adults, so recruitment was cut short. Future research should include a larger sample. Researchers need to be flexible when working with community members and organizations, which could potentially impact research protocols and outcomes but preserves relationships for future partnerships.