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As obesity rates continue to rise, comprehensive nutrition education for children needs to be further expanded and optimized. Due to the COVID-19 pandemic, more virtual nutrition programs emerged to bridge the gap of social distancing and continue health education endeavors remotely, but there is conflicting data on preferred formats and elements that make these innovative programs most impactful. To identify community and pedagogical factors that define successful virtual elementary school nutrition education partnerships between academic medical centers and elementary schools, an existing in-person nutrition program in Milwaukee County was adapted to a virtual format during the COVID-19 pandemic. The first virtual learning program was conducted wIth 3rd grade students ( N  = 109) at two urban Milwaukee County elementary schools during the school year, and the second was conducted with students and families ( N  = 7) from the same schools during the summer with live virtual cooking sessions and farmers market stipends. Focus group discussions from teachers ( N  = 7) and families ( N  = 8) and nutritional knowledge quizzes from students ( N  = 80) were obtained. Statistical analysis of student quizzes revealed significantly lower nutritional knowledge after lessons were completed as compared to previous in-person lessons. Content analysis of focus groups revealed three main themes surrounding successful nutrition program implementation: support, community, and engagement. Support, community, and engagement should be leveraged synergistically to increase participant interaction with nutrition topics and drive successful elementary school health education programs.

Although patients experiencing food insecurity commonly screen positive for a myriad of social determinants of health (SDOH) needs and chronic medical conditions influenced by diet, few studies have investigated associations within both uninsured and food insecure populations. We screened patients for food insecurity using the USDA six-item short form between October 2021 and April 2022. We then evaluated associations of food security status with nine separate SDOH needs and eight chronic medical conditions. In this cross-sectional study, of the 190 patients seen at a student-run free clinic serving patients without health insurance, 135 (71%) completed the SDOH survey. We identified chronic medical conditions via retrospective chart review and analyzed associations using multivariable logistic regressions adjusted for age and sex. Uninsured participants experiencing food insecurity (n = 22,16.3%) requested more support for: medications (adjusted odds ratio [AOR] = 7.28; 95% Confidence Interval [95% CI] = 2.33–23.2); p-value [ P ] =  < 0.001, housing (AOR = 9.99; 95% CI = 2.29–48.7; P  = 0.002), utilities (AOR = 3.94; 95% CI = 1.07–13.5; P  = 0.03), mental health resources (AOR = 4.54; 95% CI = 1.66–12.5; P  = 0.003), health insurance (AOR = 2.86; 95% CI = 1.09–8.22; P  = 0.04), and dental care (AOR = 3.65; 95% CI = 1.26–13.3; P  = 0.03). These participants were more likely to have anxiety (AOR = 3.26; 95% CI = 1.23–8.38; P  = 0.02) and depression (AOR = 2.88; 95% CI = 1.01–7.80; P  = 0.04) diagnoses or symptoms. We also discovered that individuals aged 18–50 experiencing food insecurity had a higher number of health conditions (AOR = 6.3455; 95% CI = 1.49–26.99; P  = 0.01), underscoring the profound impact of SDOH in younger populations. Understanding the interplay between food insecurity, SDOH needs, and medical conditions informs interventions, including food distribution programs and enhanced mental health resources.

OBJECTIVES/GOALS: At the Saturday Clinic for the Uninsured (SCU), a Milwaukee student-run free clinic affiliated with the Medical College of Wisconsin, we screened patients for food insecurity and evaluated associations of food security status with nine separate social determinants of health (SDOH) needs and eight chronic medical conditions influenced by diet. METHODS/STUDY POPULATION: This cross-sectional study took place from October 2021-April 2022 at SCU, which only sees uninsured patients. We added the USDA six-item food insecurity form to the clinic’s larger SDOH survey, which screens for medication financing, housing stability, energy assistance, legal issues, educational/work opportunities, substance use, mental health, health insurance options, and dental care needs. We then completed chart review for demographic, diagnostic, lab, and medication information pertaining to obesity, hypertension, diabetes, dyslipidemia, chronic kidney disease (CKD), gastroesophageal reflux disease (GERD), anxiety, and depression. We conducted descriptive statistics on demographics and measured associations using both Kendall’s tau correlation and odds ratios from binomial regression. RESULTS/ANTICIPATED RESULTS: Of the 157 patients seen during this time, most were middle-aged (mean age = 49.4 years ± 14.5 years), female (n = 98, 62.4%), Black or African American (n = 66, 42%) and resided in Milwaukee County (n = 144, 92.9%). 22 (16%) screened as food insecure and had greater odds and positively correlated with needing resources for medication financing (OR = 7.28, I 2 = 0.33), housing (OR = 129.99, I 2 = 0.28), energy assistance (OR = 3.94,I 2 = 0.2), mental health (OR = 4.54, I 2 = 0.28), insurance (OR = 2.86, I 2 = 0.18), and dental care (OR=3.65,I 2 = 0.28), but not legal concerns, education/work opportunities, or substance use. Food insecure patients had higher odds and positively correlated with having anxiety (OR = 3.26,I 2 = 0.23) or depression (OR = 2.88,I 2 = 0.19), but not obesity, hypertension, diabetes, dyslipidemia, CKD, or GERD. DISCUSSION/SIGNIFICANCE: Patients without health insurance and experiencing food insecurity were more likely to have multiple SDOH needs and mental health diagnoses. Risk factors separate from food security status may explain associations with other chronic medical conditions, including uninsured status, socioeconomic status, eating behaviors, or food accessibility.

The problem addressed in this study was university students with cognitive disabilities face accessibility barriers in e-learning courses resulting in lower academic achievement and decreased graduation rates compared to their non-disabled peers. The purpose of this qualitative case study was to highlight the lived experiences of university e-students with cognitive disabilities so that accessibility barriers can be reduced. The conceptual framework for this study was the Social Model of Disability. A qualitative case study method and design was used and the research environment was a medium-sized public university in Washington State. This study utilized semi-structured interviews and one focus group. Purposive sampling was used to gather a total of 10 participants. Interviews were recorded and manually transcribed. Member checking was used to ensure information accuracy and resonance. Data were manually coded and analyzed. Eleven themes and four subthemes were identified from the interview and focus group transcripts. Findings include that poor personal self-regulation skills, poor technology skills, disorganized learning management systems, inaccessible learning materials, poor student-professor communication, unclear expectations, and unsupportive professors are barriers to success. In addition, assignment and assessment flexibility, highly trained professors, embedded assistive technology, and accessible resources and learning tools support student success. Finally, inclusively designed and adaptable learning management systems, consistent usage of learning management systems, flexible assignments, multiple means of learning, and explicit expectations are strategies and supports for overcoming accessibility barriers. Recommendations for practice at the institutional level include hiring professors trained on supporting students with self-regulation skills, hiring staff that are committed to supporting students emotionally and academically, and exercising extreme care when choosing a learning management system. Recommendations for practice at the instructor or professor level include exclusively utilizing accessible learning tools and materials, providing multiple ways of learning course content, and being available and willing to support all students. The information gleaned from this study may inform teaching practices and institutional requirements for accessibility in university-level online courses. This study may also serve as a model for examining, valuing, and reporting the perceptions and opinions of students with cognitive disabilities as experts concerning accessibility in their own education.