Design, protocol and baseline data of Nurturing Healthy Teachers, a cluster non-randomized controlled trial to improve the health, well-being, and food security of preschool and elementary school teachers in Houston, Texas

Shreela V Sharma; Mackenzie Senn; Angela Zieba; Miao Tang; Ru-Jye Chuang; Courtney Byrd-Williams; Mike Pomeroy; Azar Gaminian; Jill Cox; Katherine French; Nalini Ranjit

doi:10.1016/j.pmedr.2024.102674

Design, protocol and baseline data of Nurturing Healthy Teachers, a cluster non-randomized controlled trial to improve the health, well-being, and food security of preschool and elementary school teachers in Houston, Texas

Prev Med Rep. 2024 Mar 1:40:102674. doi: 10.1016/j.pmedr.2024.102674. eCollection 2024 Apr.

Authors

Affiliations

¹ Department of Epidemiology, Center for Health Equity, The University of Texas Health Science Center at Houston, School of Public Health, 1200 Pressler St, Houston, TX 77030, USA.
² Department of Health Promotion and Behavioral Sciences, Center for Health Equity, The University of Texas Health Science Center at Houston, School of Public Health, 1200 Pressler St, Houston, TX 77030, USA.
³ Department of Health Promotion and Behavioral Sciences, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health, 1616 Guadalupe St., Austin, TX, USA.
⁴ Brighter Bites Houston, TX, USA.
⁵ Penn State Extension Better Kid Care, 103 Innovation Blvd., Suite 214, State College, PA 16803, USA.

Abstract

Background: We present the conceptual framework, design, and study measures of Nurturing Healthy Teachers, a quasi-experimental study to examine the short- and long-term effectiveness of the Nurturing Healthy Teachers (NHT) nutrition intervention on food insecurity, dietary behaviors, mental health and cardiometabolic health among preschool and elementary school teachers.

Methods: A convenience sample of 28 elementary schools with pre-kindergarten and elementary classrooms were recruited in Houston, Texas. Nurturing Healthy Teacher intervention includes Brighter Bites, an evidence-based coordinated school health program that combines access to fresh produce and nutrition education, and Create Healthy Futures, a web-based nutrition education program that targets nutrition knowledge, self-efficacy, mindfulness, and social support to create healthy habits among teachers. The primary outcome is food insecurity. Secondary outcomes include diet quality, mental health, and cardiometabolic health. Metabolic markers and skin carotenoid levels were assessed using in-person assessments, while all other measures were obtained via questionnaire.

Results: At baseline, most of the participants were female, 63 % identified as Hispanic, were highly educated, and had a mean age of 42.6 years. Overall, 50 % of teachers were classified as being obese and 20 % had high cholesterol. At baseline teachers had a mean HbA1c (%) of 5.6 %. Moderate to severe depression was experienced by 18 % of teachers and 23 % of teachers experienced moderate to severe anxiety.

Conclusions: The results of this study will inform next steps towards future implementation and evaluation of teacher-focused interventions.

Keywords: Cardiometabolic health; Food Insecurity; Mental health; School-based; Teachers, diet.