Elizabeth Anderson Steeves

• PhD, RD
• Johns Hopkins University

This mixed methods study explored online grocery shopping perceptions by surveying individuals who do and do not receive SNAP benefits (n = 129) and by conducting interviews with SNAP recipients (n = 26) who have grocery shopped online. T-tests assessed survey findings, codebook thematic analysis was used to identify qualitative themes, and results...

Introduction: Maternal and Child Health (MCH) Nutrition Training Programs aim to train graduate-level registered dietitian/nutritionists (RDNs) to improve the health of MCH populations. Metrics exist to evaluate the production and success of skilled graduates; however, metrics are needed regarding the reach of MCH professionals. This study aimed t...

College students are a vulnerable population to food insecurity (FI), which has significant implications for academic and health outcomes. The aims of this study were to explore the meaning of FI and its impact on students' lived experiences and food decisions, facilitators and barriers to food access as a student, and students' proposed solutions...

Ecological theories suggest that environmental, social, and individual factors interact to cause obesity. Yet, many analytic techniques, such as multilevel modeling, require manual specification of interacting factors, making them inept in their ability to search for interactions. This paper shows evidence that an explainable artificial intelligenc...

Background: There is increasing evidence of problematic rates of food insecurity among college students, yet few studies have gone beyond this to examine housing insecurity rates or rates of basic need insecurity (BNI), which is defined as having both food and housing insecurity, among the postsecondary population. BNI may have significant impacts...

Background Food skills are defined as meal planning, preparation, shopping, budgeting, resourcefulness, and label reading/consumer awareness. To date, food skills have not been tested in intervention-based studies. Objective To evaluate the feasibility of implementing a food skills intervention. Design This was an eight-week prospective food skil...

Online grocery shopping has the potential to improve access to food, particularly among low-income households located in urban food deserts and rural communities. The primary aim of this pilot intervention was to test whether a three-armed online grocery trial improved fruit and vegetable (F&V) purchases. Rural and urban adults across seven countie...

Objective To determine the effectiveness of adapting healthy food retail components for online delivery. Use of Theory or Research Small food retail stores that accept SNAP/EBT are important food sources for low-income Americans, especially in areas where traditional grocery stores are difficult to access. SNAP-Ed recognizes healthy food retail in...

Objective To describe food shopping frequency across 7 store types in a rural context and compare food shopping frequency between federal nutrition assistance recipients and nonrecipients. Methods This cross-sectional study was conducted at county fairs in rural Tennessee. Results Reported overall mean food shopping frequency was 18.4 (SD, 13.9)...

Objective To test the feasibility of implementing and evaluating a healthier checkout pilot study in a convenience store chain. Design A quasi-experimental study was conducted comparing a 3-month “healthier checkouts” intervention in 10 convenience stores which stocked eight healthier items in the checkout space and 10 comparison stores assigned t...

Objectives (1) To describe facilitators and barriers to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food shopping via electronic benefits transfer (eWIC) compared with paper vouchers. (2) To explore suggestions that WIC participants had for modifying the program to enhance their overall WIC experience. Design...

The retail food environment (RFE) has important implications for dietary intake and health, and dramatic changes in RFEs have been observed over the past few decades and years. Prior conceptual models of the RFE and its relationships with health and behavior have played an important role in guiding research; yet, the convergence of RFE changes and...

Objective To describe process evaluation findings for a pilot sustainable food systems course. Use of Theory or Research The Value-Belief-Norm Theory, a pro-environmental behavior theory used to describe socially responsible behavior, was used. Process evaluation ensured theory-based learning outcomes were properly implemented and participants wer...

Objective: To evaluate the impact of a youth-led nutrition intervention on youth-leaders themselves Design: Mixed methods, including: in-depth interviews and a quasi-experimental quantitative study comparing youth-leaders and nonparticipant comparison youth Analysis: Qualitative analysis using direct content analysis. Difference-in-differences anal...

Objectives: The objective of this cross-sectional, exploratory study was to understand the perceptions of healthy food retail programs (HFRP) by Extension professionals in low-income communities to determine strategies for successful implementation of HFRP. Methods: Thirty Extension agents and county directors from one state in the southeastern...

The purpose of this convergent, multiphase, mixed methods study was to better understand the perceptions of adolescents’ food environments and related food behaviors using grounded visualization and story mapping. Adolescents from one high school (13–16 years) in the southeastern United States were evaluated via data from health behavior surveys (n...

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) redemption rates have been declining in many low-income urban settings, potentially related to aspects of the food environment. B’more Healthy Corner Stores for Moms and Kids was a feasibility trial in Baltimore City that aimed to test multiple behavioral economic (BE) st...

Objective To evaluate the secondary impact of a multilevel, child-focused, obesity intervention on food-related behaviours (acquisition, preparation, fruit and vegetable (FV) consumption) on youths’ primary caregivers. Design B’More Healthy Communities for Kids (BHCK) group-randomized controlled trial promoted access to healthy foods and food-rela...

Introduction Peer‐led interventions may be an effective means of addressing the childhood obesity epidemic, particularly as part of multi‐level interventions. Thus, we aimed to expand and sustain the youth‐leader program for the second wave of the B'more Healthy Communities for Kids (BHCK) trial using a combined policy, systems and environmental (P...

Background: Psychosocial factors are important determinants of health behaviors and diet-related outcomes, yet relatively little work has explored their relation to food-purchasing and preparation behaviors in low-income populations. Aim: To evaluate the psychosocial factors associated with food-related behaviors. Methods: Cross-sectional data...

The multifactorial causes of obesity require multilevel and multicomponent solutions, but such combined strategies have not been tested to improve the community food environment. We evaluated the impact of a multilevel (operating at different levels of the food environment) multicomponent (interventions occurring at the same level) community interv...

Peer-led interventions may be an effective means of addressing the childhood obesity epidemic; however, few studies have looked at the long-term sustainability of such programs. As part of a multilevel obesity prevention intervention, B’More Healthy Communities for Kids, 16 Baltimore college students were trained as youth-leaders (YLs) to deliver a...

The aim of this study was to describe the relationship of breakfast frequency to diet quality and BMI among low-income, predominantly African American adolescents aged 9–15 (n = 239). Mean frequency of breakfast consumption was 5.0 ± 0.15 times per week. A significant, positive relationship was seen between HEI scores and frequency of breakfast con...

Higher rates of obesity and obesity-related chronic disease are prevalent in communities where there is limited access to affordable, healthy food. The B?More Healthy Communities for Kids (BHCK) trial worked at multiple levels of the food environment including food wholesalers and corner stores to improve the surrounding community?s access to healt...

Sex Differences in the Baseline Demographics of the Study Participants. (DOCX)

Background To prevent obesity, it is important to assess dietary habits through self-reported energy intake (EI) in children. We investigated how EI is associated with body mass index and which elements of dietary habits and status are associated with EI among African-American (AA) children. Methods We assessed and included data from 218 10–14-yea...

This study adapted Photovoice methodology for younger participants to better understand the perceptions of urban African American youth on their food environments and diets. Youth (n = 17, ages 10–13 years) photographed and described, using novel narrative-based activities, the myriad places they regularly acquired “junk food” from environments sat...

Background Childhood obesity, one of the greatest challenges to public health, disproportionately affects low-income urban minority populations. Fruits and vegetables (FV) are nutrient dense foods that may be inversely associated with excessive weight gain. We aimed to identify the individual characteristic, psychosocial, and household factors infl...

Objective Social relationships can impact youths’ eating and physical activity behaviours; however, the best strategies for intervening in the social environment are unknown. The objectives of the present study were to provide in-depth information on the social roles that youths’ parents and friends play related to eating and physical activity beha...

Peer‐led interventions may be an effective means of addressing the childhood obesity epidemic, however few studies have looked at long‐term sustainability of such programs. In July 2014, we initiated wave 1 of a multi‐level, multi‐component obesity prevention intervention in Baltimore, USA ‐B'More Healthy Communities for Kids (BHCK). We trained 16...

B’More Healthy Community for Kids (BHCK) is an ongoing multi-level intervention to prevent childhood obesity in African-American low-income neighborhoods in Baltimore city, MD. Although previous nutrition interventions involving peer mentoring of youth have been successful, there is a lack of studies evaluating the influence of cross-age peers with...

Objective: Evidence of associations between social support and dietary intake among adolescents is mixed. This study examines relationships between social support for healthy and unhealthy eating from friends and parents, and associations with diet quality. Design: Cross-sectional analysis of survey data. Setting: Baltimore, MD. Participants:...

Objective This study aims to examine the extent to which low‐income African‐American children's weight status, psychosocial characteristics and food‐related behaviours are associated with that of their adult caregivers. Methods Cross‐sectional data from baseline evaluation of B'More Healthy Communities for Kids obesity prevention trial were used....

Supporting info item

Objective: To examine associations between food insecurity, excess body weight, psychosocial factors and food behaviours among low-income African-American families. Design: Cross-sectional survey of participants in the baseline evaluation of the B'More Healthy Communities for Kids (BHCK) obesity prevention trial. We collected data on socio-econo...

Early adolescents perceive peers as credible and relatable. Peers therefore have a unique conduit to engage early adolescents in positive health behaviors through nutrition learning such as that recommended by the U.S. Institute of Medicine (IOM). We developed an online, peer leader component to an existing in-person preventive nutrition interventi...

The Maryland Healthy Stores pilot-study tested the feasibility of a small food store intervention in rural Maryland. Eight small stores were randomized to receive a 4-month intervention to increase healthy food availability (n = 4) or serve as comparison stores (n = 4). Changes in stocking of 12 healthier items promoted in the intervention were mea...

Multilevel, multicomponent (MLMC) interventions are needed to address the complex, multifactorial obesity epidemic. Such interventions work in several settings simultaneously, including schools, food stores, restaurants and households. However, limited work has been done to use MLMC program implementation data to guide program delivery. In July 201...

B'More Healthy Communities for Kids (BHCK) is a multi‐level, multi‐component obesity prevention trial directed toward low‐income African American youth in Baltimore. BHCK works with small food stores, recreation centers, carryout restaurants, wholesalers, policymakers and families. Process evaluation is conducted by monitoring 88 implementation sta...

This study explores food preparation behaviors, including types of food prepared, methods of preparation, and frequency of preparation of low-income urban African American youth ages 9-15 in Baltimore City (n = 289) and analyzes a potential association to diet quality as measured through Healthy Eating Index 2010 (HEI) scores. Overall, the youth pr...

Our objective was to pilot collaborations between two urban farms with two corner stores to increase access to fresh produce in low-income neighbourhoods. We conducted a pre-post evaluation of two farm-store collaborations using quantitative distribution and sales data. Using semi-structured interviews, we qualitatively assessed feasibility of impl...

The food environment has a great impact on the nutritional health of the population. Food environment interventions have become a popular strategy to address the obesity epidemic. However, there are still significant gaps in our understanding of the most effective strategies to modify the food environment to improve health. In this review, we exami...

Background Childhood obesity rates in the U.S. have reached epidemic proportions, and an urgent need remains to identify evidence-based strategies for prevention and treatment. Multi-level, multi-component interventions are needed due to the multi-factorial nature of obesity, and its proven links to both the social and built environment. However, t...

Developing nutrition-focused environmental interventions for youth requires accurate assessment of where they purchase food. We have developed an innovative, technology-based method to improve the accuracy of food source recall among children using a tablet PC and ground-truthing methodologies. As part of the B’more Healthy Communties for Kids stud...

Caloric menu labeling is currently used as a strategy to promote healthier dietary choices. However, because caloric menu labels may be challenging to interpret, providing information about the amount of time it would take to burn off the calories consumed has been suggested. Unfortunately, children may interpret this information in an unintended w...

Multi‐component interventions are needed in low income urban settings to address the complex environmental, economic, and social issues driving obesity. Low income neighborhoods in Baltimore can be described as “food swamps,” with few supermarkets and many small food outlets stocking unhealthy foods. After a decade of focused work in specific food...

Purpose: The purpose of our study was to examine the monitoring capabilities of the Omron HJ-720ITC pedometer and determine the feasibility of using it in physical activity interventions. Methods: Using data from an 8-week lifestyle-intervention study, we tested the capabilities of the pedometer for recording physical activity data. Data from a...

The more time adults spend being sedentary, the greater the risk of obesity. The effect of reducing television (TV) watching, a prominent sedentary behavior, on weight loss has not been tested in an adult standard behavioral obesity intervention, and the mechanisms by which reducing TV watching influences energy balance behaviors are not well under...

Objective: To determine whether daily self-weighing (DSW) is associated with disordered eating (DE) symptoms within an adult lifestyle intervention (LI), and to examine changes in DE symptoms during the 18-month trial. Method: One-hundred and seventy-eight adults (53% female, 90% White, 52.0 ± 8.6 years, BMI = 35.0 ± 4.4 kg/m2) were enrolled in...

Developing nutrition‐focused environmental interventions for youth requires accurate assessment of their food sources. We developed an innovative, technology‐based method to improve the accuracy of food source usage reporting among youth using a tablet PC and ground‐truthing methodologies. As part of the B'More Healthy Communities for Kids study, w...

African‐American adolescents living in low‐SES neighborhoods in Baltimore, MD face many obstacles to consuming a healthful diet, which contribute to high rates of obesity in this population. In‐depth interviews were conducted with low‐SES Baltimore youth ages 10–14 (n=15) and their adult caregivers (n=15) to investigate potential strategies to prom...

Objectives: This study was designed to evaluate the feasibility of testing the hypothesis that differences in neighborhood level food access may be associated with consumer exposure to food borne microbial contamination. Methods: This study was carried out in Baltimore MD in 2011 among selected neighborhoods defined as high or low food access. In e...

Soaring obesity rates in the United States demand comprehensive health intervention strategies that simultaneously address dietary patterns, physical activity, psychosocial factors and the food environment. Healthy Bodies, Healthy Souls (HBHS) is a church-based, community-participatory, cluster-randomized health intervention trial conducted in Balt...

There are an estimated 9.4 million cases of foodborne illness each year. Consumers have a key role in preventing foodborne illness, but differences in the practice of food safety behaviors exist, increasing risk for certain groups in the population. Identifying groups who are more likely to practice risky food safety behaviors can assist in develop...

Dietary goals specific for lowering energy density (ED) may promote a nutrient-dense diet and weight loss. This pilot study examined the effects of ED-based diet prescriptions on diet quality and weight loss during a 3-month behavior-based obesity intervention conducted in a research setting. Forty-four adults with overweight/obesity (age 52.1±7.6...

Dietary variety is a factor that influences consumption but has received little attention in obesity treatment. This study examined the effect of limiting the variety of different non-nutrient-dense, energy-dense foods (NND-EDFs) (i.e., chips, ice cream, cookies) on dietary intake and weight loss during an 18-mo lifestyle intervention. Two hundred...