Community Nutrition Programs

Department of Population , Family and Reproductive

Health Noon Hour Seminar September 16, 2015

Scope of Program

Community Nutrition Supplemental Feeding Programs

Breastfeeding promotion Peer Counselling

Obesity Maternal Nutrition

Post Partum Weight Retention Schools Feeding Programs

Nutrition Education Healthy Food Choices

Food Preparation Shopping Choices

SNAP Food Deserts

Early Life Origins of Adult Disease Chronic Disease and Dietary Patterns

Collaboration and Partnerships

Center for Adolescent Health Center for Human Nutrition

JHH Department of Pediatrics JHH Department of Obstetrics & Gynecology

Johns Hopkins Bayview Medical Center Morgan State University

Baltimore City Health Department Baltimore Food Policy Advisory Committee Maryland Dept. Health & Mental Hygiene

Family League of Baltimore Food Bank for New York City

NYC Dept. of Education Share our Strength

National WIC Association CDC

MCHB UCLA

University of Maryland MD American Academy of Pediatrics MD Academy of Nutrition & Dietetics

Current Programs/ Projects

Supplemental Nutrition Program (WIC)

Obesity/Post-partum Weight retention

Community Nutrition Partnerships to Reduce Chronic Disease

Breast Feeding Peer Counselors

School Lunch Selection/ Environment

Virtual Shopping tours

Cooking Matters

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is funded by the United States Department of Agriculture (USDA)

Provides – Healthy Supplemental Foods – Nutrition assessment and education – Referrals to health and other social services to participants

The prototype for the National WIC Program was designed and piloted at this School and adopted nationally by Congress in 1974

The WIC Program

Promotes the health and nutritional well being of low-income pregnant, postpartum and breastfeeding women, infants and children under five years of age living in Baltimore through practice, research and community engagement.

Johns Hopkins WIC Program

Program serves over 10,000 Pregnant, breast feeding and post partum women, infants and children up to age five Operates in twelve sites, Head Start, Shelters for the homeless and domestically abused women and children in Baltimore Over 75% of all infants participate in the program Peer counselors provide supportive services to breast feeding women

Hopkins Baltimore City WIC

Integrating obstetrical care and WIC to address maternal obesity and postpartum weight retention

• Primary Goal: obese women (BMI >30) return to pre-pregnancy weight within 6 months of delivery

• Collaborating Partners: Hopkins Hospital Outpatient Center, Nutrition in Pregnancy Clinic

• Design (Randomized Clinical Trial): randomized to receive standard service of care or enrolled in a targeted program to promote weight loss (WICNIP)

• Methodology: within 24 hours of delivery all participants received WIC standard of care

• WICNIP groups received targeted periodic : weight loss counseling, postnatal nutrition education, exercise instruction, and family health and nutrition information. They also received timed text messages reinforcing and expanding on above and social media engagement.

• Data:

– OBGYN clinic (standard prenatal care assessments, weight and nutrition history)

– JHU WIC Clinic (demographics, anthropometrics, health status, and nutrition history)

CDC/National WIC Association Grant

Increase access to healthy foods and beverages thereby reducing obesity and chronic disease risk.

Components

• Needs Assessment of Baltimore City

• Coalition Building: Baltimore Food PAC

– network of Baltimore City community partners

– health organizations; social service agencies; advocacy groups; faith based entities; breastfeeding consortia and educational institutions.

• Community Action Plan

– A multi-pronged effort to maximize healthy food choice, increase fresh food purchases, improve health education and coordinate efforts between agencies serving the Baltimore WIC population.

Community Partnerships

to Reduce Chronic Disease

Share our Strength: Cooking Matters at the Store

Mission Empower low income families with the skills to stretch their food budgets and cook nutritious meal for their families

In JHU WIC clinics: • Nutrition education for low-income mothers (in English and

Spanish) • Pop-up grocery store tour • Focus: Identifying WIC foods and whole grains, comparing unit

prices, reading nutrition labels, buying seasonal produce

At Community Events: • Similar focus but aimed at all community members

*CookShop What is CookShop?

• CookShop teaches nutrition information and cooking skills.

• New York City Public Schools

• Implemented by the Food Bank for New York City.

Cafeteria Observations

• Cafeteria Observation • 10 public elementary schools in

New York City • 274 Kindergarten-2nd grade

students • Digital Data Collection using iPad • Selection • Consumption • Cafeteria environment • School nutrition policies

• Kristin Mmari, Principal Investigator

PFRH Community Nutrition Program

THE TEAM

Faculty and Senior Staff

Aderonke Adegbite

Marycatherine Augustyn

Patricia Bell Waddy

Anna Bondy

Dina Gorlin

Susan Gross

Linda Kelly

Maureen Nathanson

David M. Paige

Claudette Welch

Erin Wicks

Jasina Wise

Clinic Staff

Lashawn Darian

Annette Duval

Yadira Foley

Lauren Forte

Ali Foster

Tara James

Brenda Nock

Jennifer Poynot

Dawnetta Robinson

Deborah Robinson

Rhonda Wicks

Shannon Winston

Student Team

Current/Recent

Khrysta Baig

Poongothai Belaji

Amanda Belknap

Erin Biehl

Anna Bondy (current WIC Staff)

Stephanie Brown

Kate Cessnun

Yue Che

Caitlin Cross-Barnet

Victoria Elliot

Jenna Fahle

Stephany Gabaud

Laina Gagliardi

Danielle Gilbert

Matthew Goldshore

Emily Gregory

Caitlin Murphy

Titilope Oduyebo

Julia Quam

Lauren Rogers-Bell

Mona Sobhani

Angie Wong

Virgilia Zabala

Student Opportunities and Internships

• Project Evaluation

• Community engagement

• Participant and Community nutrition education

• Study tool development

• Study participant recruitment

• Data collection

• Data Analysis

• Assist with manuscript development

• Please contact

– Susan Gross – sgross@jhu.edu

– Marycatherine Augustyn – maugust1@jhu.edu

– David Paige – dpaige@jhu.edu

For more Information

Selected Publications

Gregory EF, Butz AM, Ghazarian SR, Gross SM, Johnson SB. (2015). Met Expectations and Satisfaction

with Duration: A Patient-Centered Evaluation of Breastfeeding Outcomes in the Infant Feeding Practices

Study II. Journal of Human Lactation, 31, 444-51.

Gregory EF, Butz AM, Ghazarian SR, Gross SM, and Johnson SB. (2014). Are unmet breastfeeding

expectations associated with maternal depressive symptoms? Academic Pediatrics, 15, 319-25.

Wang G, Divall S, Radovick S, Paige D, Ning Y, Chen Z, Ji Y, Hong X, Walker S, Caruso D, Pearson C,

Wang MC, Zuckerman B, Cheng TL, Wang X. Preterm Birth and Random Plasma Insulin Levels at Birth

and in Early Childhood. Journal of the American Medical Association. 311 (6) 587-596.

doi.10.1001/jama.2014.1.2014

Gilbert D, Nanda J, Paige DM. Securing the Safety Net: Concurrent Participation in Income Eligible

Assistance Programs. Maternal and Child Health Journal. Vol. 17 No 5. doi. 10. 1007/s10995-013-1281-2.

2013.

Paige, DM, “Lactose Intolerance” in Encyclopedia of Human Nutrition (Third Edition): Ed. Caballero B.

Elsevier B. V. 2013, http://dx.doi.org/10.1016/B978-0-12-375083-9.00169-0

Cross-Barnet, C., Augustyn, M., Gross, S., Resnik, A., and Paige, D. (2012). Long-term breastfeeding

support: failing mothers in need. Maternal and Child Health Journal, 16, 1926-32.

Moore-Greene, G.M., Gross, S.M., Silver, K.D., and Perrino, C.S. (2012).Chronic stress and decreased

physical exercise: impact on weight for African American women. Ethnicity and Disease, 22, 185-91.

Gross, S.M., Resnik, A.K., Nanda, J.P., Cross-Barnet, C., Augustyn, M., Kelly, L., and Paige, D.M. (2011).

Early postpartum: a critical period in setting the path for breastfeeding success. Breastfeeding Medicine, 6,

407-12

Selected Publications Continued

Paige DM, Remarks on WIC Research Agenda: Planning WIC Research Agenda. Institute of Medicine. The National Academies Press, Washington DC 2011

Gross, S.M., Resnik, A.K., Nanda, J.P., Cross-Barnet, C., Augustyn, M., Kelly, L., and Paige, D.M. (2011). Early postpartum: a critical period in setting the path for breastfeeding success. Breastfeeding Medicine, 6, 407-12

Paige DM, Remarks on WIC Research Agenda: Planning WIC Research Agenda. Institute of Medicine. The National Academies Press, Washington DC 2011

Paige DM. Lactose Intolerance II Encyclopedia of Human Nutrition. Ed Caballero, B. Elsevier Press. 2011.

Grutzmacher, S. and Gross, S.M. (2011). Household Food Security and Fruit and Vegetable Intake among Low-income 4th Graders. Journal of Nutrition Education and Behavior, 43, 455-63.

Gross, S.M., Resnik, A.K., Nanda, J.P., Cross-Barnet, C., Augustyn, M., Kelly, L. and Paige, D.M. (2011). Early Postpartum: A Critical Period in Setting the Path for Breastfeeding Success. Breastfeed Med. 6, 407-12.

Cross-Barnet, C, Augustyn, M, Paige, DM. Constructing the Broken Body: Breast Pumps and the Mechanization of Infant Feeding among Low-Income Mothers. Gender & Society, 2010.

Gross, S.M., Pollock, E.D. & Braun, B. (2010). Family influence: Key to fruit and vegetable consumption among fourth- and fifth-grade students. Journal of Nutrition Education and Behavior. 42, 235-41.

Scott-Johnson, P.E., Gross, S.M., and Browne, D.C. (2010). Web-based data collection: an effective strategy for increasing African Americans' participation in health-related research. Ethnicity and Disease, 20, S1-201-6.

Scott-Johnson, P.E., Gross, S.M., Gray, L.M., Zhu, S., and Browne, D.C. (2010). Sex differences in perceived weight-based stigmatization among African Americans. Ethnicity and Disease, 20, S1-196-200.

Wang G, Johnson S, Gong Y, Polk S, Divall S, Radovick S, Moon M, Paige DM…Wang X. “Weight gain in early life and overweight/obesity across the gestational age spectrum: prospective birth cohort study”. International Journal of Obesity, 2014. Under Review