Identifying specific beliefs to target to improve restaurant employees' intentions for performing three important food safety behaviors

Current national food safety training programs appear ineffective at improving food safety practices in foodservice operations, given the substantial number of Americans affected by foodborne illnesses after eating in restaurants each year. The Theory of Planned Behavior (TpB) was used to identify important beliefs that may be targeted to improve foodservice employees' intentions for three food safety behaviors that have the most substantial affect on public health: hand washing, using thermometers, and proper handling of food contact surfaces. In a cross-sectional design, foodservice employees (n=190) across three midwestern states completed a survey assessing TpB components and knowledge for the three food safety behaviors. Multiple regression analyses were performed on the TpB components for each behavior. Independent-samples t tests identified TpB beliefs that discriminated between participants who absolutely intend to perform the behaviors and those with lower intention. Employees' attitudes were the one consistent predictor of intentions for performing all three behaviors. However, a unique combination of important predictors existed for each separate behavior. Interventions for improving employees' behavioral intentions for food safety should focus on TpB components that predict intentions for each behavior and should bring all employees' beliefs in line with those of the employees who already intend to perform the food safety behaviors. Registered dietitians; dietetic technicians, registered; and foodservice managers can use these results to enhance training sessions and motivational programs to improve employees' food safety behaviors. Results also assist these professionals in recognizing their responsibility for enforcing and providing adequate resources for proper food safety behaviors.     

Predicting intentions to adopt safe home food handling practices. Applying the theory of planned behavior

While most home cooks know about safe home food handling procedures, compliance is generally low and has not been much improved by campaigns. Foodborne disease is a common cause of illness, hospitalization and even death, and many of these illnesses are caused by unsafe home food practices. Using the theory of planned behavior as a model, survey data were analyzed. Perceived behavioral control was the strongest predictor of behavioral intentions for both hand washing and food thermometer use. Subjective norm was the next strongest predictor for thermometer use, while attitude towards the behavior was the next strongest predictor for hand washing. This is consistent with earlier focus group results for thermometer use and suggests some possible strategies for designing future home food safety messages.     

Elementary school teachers' involvement in firearm safety education

This national study assessed elementary school teachers' (n = 352) firearm safety education activities and perceptions using a 3-wave mailing survey. One percent of the teachers reported receiving undergraduate training regarding firearm safety. Yet, 12% claimed to be well prepared or very well prepared to teach firearm safety. Most teachers had high perceived self-efficacy regarding teaching firearm safety and perceived firearm safety education as important. Ten percent were currently teaching firearm safety. Teachers perceived 3 main barriers to teaching firearm safety: not enough expertise (66%), not sure what topics should be taught (58%), and not enough time to include firearm safety in the curriculum (54%). About one third (35%) desired further information regarding teaching firearm safety.     

Motivational techniques of dietitians counseling individuals with type II diabetes

A survey was conducted to ascertain to what extent dietitians use techniques cited in the literature considered to affect adherence by patients with non-insulin dependent (Type II) diabetes. A survey instrument listing techniques related to changing behavior, the counseling process, and content of teaching was developed and mailed to 500 members of the ADA Diabetes Care and Education Practice Group. Responses were received from 39% of the sample. For a majority of techniques, data analysis showed statistical association between frequency of use, perceived importance, and adequacy of practitioner training. Dietitians regularly used only 40% of the cited techniques related to changing behavior and the counseling process, but they said most of the items were important. Only half of the items related to the content of teaching were rated as important, and dietitians felt prepared to use only 70% of them. Most dietitians did not teach concepts related to glucose utilization, energy metabolism, and the metabolic role of insulin in diabetes. Those findings suggest that dietitians do not regularly use many techniques considered effective in obtaining dietary adherence of patients with diabetes. Since other studies show compliance is directly influenced by skills of the provider, dietitians could improve cost-effective health care by developing further professional expertise in the area of counseling patients with diabetes.     

The relationship between diet and perceived and objective access to supermarkets among low-income housing residents

In the U.S., supermarkets serve as an important source of year-round produce (Chung & Myers, 1999), and yet access to supermarkets may be scarce in "food deserts," or poor, urban areas that lack sources of healthy, affordable food (Cummins & Macintyre, 2002). This study examined objective distance to the nearest supermarket and participant-report of supermarket access in relation to fruit and vegetable intake. Street-network distance to the closest supermarket was calculated using GIS mapping. Perceived access was assessed by a survey question asking whether participants had a supermarket within walking distance of home. Cross-sectional survey data were collected from 828 low-income housing residents in three urban areas in greater-Boston. Generalized estimating equations were used to estimate the association between perceived and objective supermarket access and diet. Fruit and vegetable consumption was low (2.63 servings/day). Results suggest that most low-income housing residents in greater-Boston do not live in "food deserts," as the average distance to a supermarket was 0.76 km (range 0.13-1.22 km). Distance to a supermarket was not associated with fruit and vegetable intake (p = 0.22). Perceived supermarket access was strongly associated with increased fruit and vegetable intake (0.5 servings/day) after controlling for socio-demographic covariates (p < 0.0001). Patterns of mismatch between perceived and objective measures revealed that mismatch between the two measures were high (31.45%). Those who did not report a supermarket within walking distance from home despite the objective presence of a supermarket within 1 km consumed significantly fewer fruits and vegetables (0.56 servings/day) than those with a supermarket who reported one, even after controlling for socio-demographic variables (p = 0.0008). Perceived measures of the food environment may be more strongly related to dietary behaviors than objective ones, and may incorporate components of food access not captured in objective measures.     

Fruit, vegetable, and fat intake among non-Hispanic black and non-Hispanic white adolescents: associations with home availability and food consumption settings

OBJECTIVE: This study sought to explore home food availability and common settings of food consumption as correlates of fruit, vegetable, and fat intake among a sample of non-Hispanic black and non-Hispanic white adolescents. PARTICIPANTS AND DESIGN: Adolescents (n=144 black, 84 white) and their parents completed a cross-sectional survey in an urban adolescent health clinic. The adolescent survey included screening measures for fruit, vegetable, and fat intake and items on frequency of eating meals with family, while watching television, and at three types of restaurants. Parents provided information on home availability of foods. MAIN OUTCOMES: Correlates of fruit, vegetable, and fat consumption. STATISTICAL ANALYSIS: Spearman correlations for associations among variables, t tests for mean comparisons, and multiple stepwise regression conducted separately for black and white adolescents. RESULTS: In multiple regression, home availability was not significantly associated with fruit, vegetable, or fat intake except for fruit intake among white adolescents only. Use of non-fast-food restaurants was the strongest positive predictor of vegetable intake. For both black and white adolescents, fast-food and buffet restaurant use and eating while watching television were the strongest predictors of fat intake. CONCLUSIONS: Compared with restaurant use and eating while watching television, home availability had a relatively small impact on fruit, vegetable, and fat consumption for both black and white adolescents. Intervention programs on adolescent nutrition should target not just availability of healthful foods, but also ease of access, such as the preparation of fruits and vegetables so that they are flavorful and ready to eat.     

Influence of mother's educational level on food parenting practices and food habits of young children

The main purpose of the present study is to examine whether differences in mothers' food parenting practices by educational level could explain differences in food consumption in Flemish preschool children. Three hundred and sixteen mothers of children aged 2.5-7 years, completed a self-administered questionnaire. Differences by educational level were found in children's and mothers' consumption frequencies of fruit, vegetables and soft drinks, and in the use of restrictions, verbal praise, negotiation, discouragement of sweets and restraining from negative modelling behaviour. Multiple logistic regression analyses revealed that mothers' consumption was an independent predictor for all four outcome variables; verbal praise was a significant predictor for children's vegetable consumption, permissiveness for regular consumption of soft drinks and sweets, and, using food as a reward for regular sweet consumption. Differences in children's food consumption by mothers' educational level were completely explained by mother's consumption and other food parenting practices for fruit and vegetables but not for soft drinks.     

Determining the food irradiation beliefs of community nutrition educators: do beliefs influence educational outreach?

OBJECTIVE: To develop an instrument to measure the food irradiation beliefs of community nutrition educators and to determine the influence of those beliefs on food irradiation educational outreach. DESIGN: Survey development, cross-sectional telephone survey. SETTING: Cooperative Extension Program. PARTICIPANTS: All Family and Consumer Sciences (FCS) county extension agents serving in the most populated counties in Texas (n = 134, response rate = 99%). These participants may not be representative of all FCS extension agents. VARIABLES MEASURED: Food irradiation beliefs and educational outreach as well as selected demographic variables. ANALYSIS: To determine validity and reliability of the instrument, factor analysis and Cronbach's alpha were conducted, respectively. To determine if food irradiation beliefs influenced food irradiation educational outreach, logistic and multiple regression analyses were conducted, with significance set at P < .05. RESULTS: The instrument had adequate reliability; two belief scales were identified through factor analysis, referred to as Safety Beliefs and Understanding Beliefs. Additionally, regression analysis suggested that educators' beliefs about food irradiation influenced the amount of food irradiation education they provided. CONCLUSIONS AND IMPLICATIONS: Results suggest that educators' beliefs about the safety and their understanding of food irradiation are predictors of the educational outreach they provide about it, indicating the potential value of professional development regarding food irradiation.     

The role of attitudes, intentions and habit in predicting actual consumption of fat containing foods in Italy

OBJECTIVE: To explore which were the most important predictors of the actual consumption of foods containing fat and to test if there were different profiles of beliefs and attitudes. DESIGN: A total of 1200 households participated in a food consumption survey for 7 days. A questionnaire, containing questions on belief, attitude and intention items based on Ajzen and Fishbein's model, was completed on the first day of the survey. SETTING: The study was conducted at the beginning of 1994 in Italy. Subjects: In all, 860 subjects, randomly selected for each household participating in the food consumption survey, were included in this study. RESULTS: A cluster analysis based on average daily intake per capita of nine types of food containing fats was carried out on 860 subjects. The three clusters represented people with different criteria of preference for milk. The relationship between the variables was tested using the forward selection method in multiple regression. The attitude entered sequentially into the model assessing the intention of consuming, after the habit component. Habit was found to be the most the most important predictor of the actual consumption of each type of food. The intention entered into the equation as predictor of the consumption only for butter and olive oil. Habit has been found more important than intention in influencing the consumption of all types of food, whereas the intention did not enter into the model as determinant of the consumption with exception of butter and olive oil in which it remains as a significant predictor. CONCLUSIONS: The results of the cluster analysis suggested that subjects of cluster 1 might be more concerned about fat intake. The findings of the regressions showed that the subjective measure of habit entered in the model as the most important predictor of the actual consumption of each type of food. The low prediction of the actual consumption indicated that there could be other important variables influencing the consumption not included in this study.     

Teachers' Beliefs Concerning Teaching about Testicular Cancer and Testicular Self-Examination

ABSTRACT: This study compared high school health teachers' beliefs concerning teaching about testicular cancer (TC) and testicular self-examination (TSE) to actual instruction. The Teachers' Testicular Cancer Beliefs Survey was developed, using the Health Belief Model (HBM) as a theoretical framework. Multiple regression analysis of HBM subscales determined perceived seriousness of TC was the most significant predictor (p < .05) of TC instruction. Perceived barriers to teaching about TSE was the most significant predictor (p < .05) of TSE instruction. Male health educators were more likely (p < .001) than females to teach about TC and TSE. Teachers having previous preparation in TC and TSE provided more instruction (p < .001) than those without. Less than half of respondents provided TC instruction, while TSE instruction was provided by less than one-third. Comprehensive cancer prevention and early detection education, including strategies for teaching about TC and TSE, should be part of each health teacher's training.     

Selected predictors of health promotion counseling by three groups of allied health professionals

Three groups of allied health professionals, including dental hygienists, dietitians, and certified nurse-midwives, were surveyed to determine current practice, beliefs, and attitudes regarding health promotion and disease prevention. The study aimed to explore the power of selected variables drawn from social learning theory in predicting self-reported level of counseling. We conducted separate analyses for 10 areas of health promotion and disease prevention: high blood pressure, smoking, lack of exercise, overweight, high-fat diet, alcohol abuse, illicit drug use, stress, isolation and loneliness, and nonuse of safety belts. The predictor variables were respondents' professional group membership, confidence that they possess appropriate skills and knowledge to counsel patients (self-efficacy), belief that patients will follow through on recommendations (adherence expectation), and belief that reduction of risk will improve patients' health status (expectation of health impact). The level of counseling activity varied markedly across the risk areas, with blood pressure and weight receiving the most emphasis on average and isolation and loneliness and nonuse of safety belts receiving markedly less attention. There also was variation across the professional groups. Certified nurse-midwives had higher mean counseling scores in all topics except those related to diet, where the dietitians' mean scores were approximately the same. Of all the areas about which counseling might be increased, use of safety belts stands out as having the lowest reported prevalence, the least complexity in terms of implementation, and the most relevance to at least two of the professional groups. These findings suggest the importance of skills training, including the provision of actual or simulated counseling experience and modeling by others in the same professional group.(ABSTRACT TRUNCATED AT 250 WORDS)     

Social support is a primary influence on home fruit, 100% juice, and vegetable availability

Children tend to eat more fruit and vegetables when more are available in the home. We proposed and tested a model that predicts the availability at home (hereinafter termed "home availability") of fruit, 100% juice, and vegetables, using new measures of frequency of food shopping, purchase, and comparative purchase outcome expectancies (ie, the perceived benefits and costs of purchasing fruit and vegetables), home food pantry management practices, family social support for purchasing fruit and vegetables, food shopping practices, and body mass index (BMI). Participants (N=98) were recruited in 2004 in front of grocery stores and completed two telephone interviews. Cross-sectional hierarchical regression was employed with backward deletion of nonsignificant variables. Despite many statistically significant bivariate correlations between the new variables and home fruit, 100% juice, and vegetable availability, social support was the primary predictor of home fruit availability in multivariate regression. BMI and home 100% juice pantry management were the primary predictors of home 100% juice availability. Social support, BMI, and shopping practices were the primary predictors of home vegetable availability. Social support for purchasing fruit, 100% juice, and vegetables was an important, consistent predictor of home availability. These findings need to be replicated in larger samples.     

Attitudes and behaviors about pesticide residues,susceptibility to cancer,and consumption of fruits and vegetables

Nutrition educators are encouraging increased consumption of fruits and vegetables as a source of fiber, nutrients and anti-carcinogens. However, media messages about the health effects of pesticide residues have created fear about consuming fresh produce. A survey was sent to 2,000 Washington state residents to assess attitudes and behaviors related to concern about pesticide residues, perceived susceptibility to cancer, and consumption of fruits and vegetables. The survey included questions that were developed to assess each of the attitude and behavior variables. Multiple regression analysis indicated that 41% of the residue-reducing behavior and 44% of the health concern about pesticides was explained by the variables. Individuals with health concerns regarding pesticides had higher scores for residue-reducing behaviors, environmental concern, and perceived susceptibility to cancer. Respondents with low concerns about pesticides had a higher trust in regulation and saw greater benefits for pesticide use. Concerns beyond personal health, such as environmental concern, appear to contribute to concerns about pesticide residues. Fear of pesticide residues does not appear to diminish nutrition behaviors related to fruit and vegetable consumption.     

Associations between perceived parent behaviors and middle school student fruit and vegetable consumption

OBJECTIVE: To examine whether (1) student perceptions of parent behaviors explain variations in fruit and vegetable consumption, (2) self-efficacy mediates this relationship, and (3) perceived home fruit and vegetable availability moderates this relationship. DESIGN: A cross-sectional survey. SETTING: Classrooms in 3 middle schools in 2 northeast Georgia counties. PARTICIPANTS: 366 middle school students. The response and participation rates were 59% and 56%, respectively. VARIABLES MEASURED: Perceived authoritative parenting, perceived parent control, perceived parent modeling, perceived parent support, self-efficacy, perceived fruit and vegetable availability, and fruit and vegetable consumption. ANALYSIS: Hierarchical multiple regression; P <.05. RESULTS: Perceived parent modeling, perceived parent support, self-efficacy, and perceived fruit and vegetable availability were significant predictors of fruit and vegetable consumption. The relationship between perceived parent support and fruit and vegetable consumption was mediated by self-efficacy. The relationship between fruit and vegetable consumption and both perceived parent modeling and support was moderated by perceived fruit and vegetable availability. CONCLUSIONS AND IMPLICATIONS: Parents appear to moderately influence middle school student fruit and vegetable consumption. Educators might focus on improving home fruit and vegetable availability and student self-efficacy, as well as parent support and modeling. The level of availability might indicate where efforts should focus for enhancing parent behaviors.     

Predictors and consequences of food neophobia and pickiness in young girls

OBJECTIVE: Vegetable intake among children is well below recommended levels. We assessed whether food neophobia and pickiness contribute to low vegetable intake in school-aged girls and if there are distinct predictors for neophobia and pickiness. Children with food neophobia are reluctant to eat new foods whereas picky children resist eating many familiar foods. Design/subjects Participants were 192 7-year-old girls and their parents, recruited for a study of girls' nutrition and development. We examined relationships between food neophobia and pickiness and assessed whether these variables predicted girls' vegetable consumption and predictors of food neophobia and pickiness. ANALYSES: The data were analyzed using a two-step process. First, we used a two-way analysis of variance to assess whether girls who scored high or low on food neophobia and pickiness measures had different levels of vegetable consumption. We used multiple regression analysis to determine predictors of food neophobia and pickiness in the girls. RESULTS: Girls with both food neophobia and pickiness consumed fewer vegetables (1.1+/-0.1) than girls with neither neophobia nor pickiness (1.6+/-0.1). Neophobia and pickiness were modestly related in this sample, but had different predictors. Girls with food neophobia were more anxious and had mothers with food neophobia. Picky girls had mothers with less variety in their vegetable intake (r=-0.22) and mothers who perceived their family to have little time to eat healthful foods (r=0.36). In addition, picky eaters were breastfed for fewer than 6 months (r=-0.25). Pickiness was predicted primarily by environmental or experiential factors subject to changes; neophobia was predicted by more enduring and dispositional factors. APPLICATIONS: Because food neophobia and pickiness negatively influence vegetable intake, intervention strategies to increase vegetable intake should focus on predictors of neophobia and pickiness, especially those subject to change.     

Purchasing habits of senior farmers' market shoppers: utilizing the theory of planned behavior

The purpose of this study was to understand fresh fruit and vegetable purchasing habits among senior farmers' market shoppers using the theory of planned behavior. A survey instrument was developed to collect information on seniors' fruit and vegetable purchasing habits. A convenience sample of seniors shopping at farmers' markets was employed. A total of 184 surveys were collected. Respondents were divided into two groups based on response to a question of whether they received Senior Farmers' Market Nutritional Program (SFMNP) checks: 35 were on the SFMNP and 149 were not. Results indicated attitudes, subjective norms (SN), and perceived behavioral control (PBC) were all significantly correlated with intentions at the p?相似文献   

Teaching medical students the subjective global assessment

OBJECTIVE: Clinical nutrition assessment is a clinical skill not taught in many medical schools in North America. The purpose of this study is to determine whether second-year medical students can be taught to perform a nutritional Subjective Global Assessment (SGA). METHODS: In this study, second-year medical students were given a didactic session and a bedside demonstration of the SGA. Subsequently, they performed an SGA on unknown patients and classified those patients into one of three categories: A) well nourished, B) moderately malnourished, or C) severely malnourished. This was compared with the assessments of clinical dietitians and a physician. RESULTS: After this instruction, medical students correctly identified malnourished individuals. They were less accurate in their subclassification between mildly and severely malnourished individuals. The degree of agreement with clinical dietitians and a physician was fair (kappa = 0.34). CONCLUSIONS: With a multidisciplinary team of physicians and clinical dietitians, medical students can be taught the SGA in a 3h format. This is an important clinical skill that emphasizes the importance of clinical nutrition and may help identify malnourished individuals early in the course of their hospitalization.     

Nephnologists’ and Internal Medicine Physicians’ Expectations of Renal Dietitians and General Dlinical Dietitians

Objective To document and compare nephrologists’ and internal medicine physicians’ expectations of renal dietitians and general clinical dietitians.

Design Subjects completed a mailed survey. Respondents provided demographic information and used a 5-point Likert scale to note whether each of 14 job functions was appropriate for general clinical dietitians, renal dietitians, or both.

Subjects Five hundred forty-one physicians registered with the Ohio State Medical Board (OSMB) were surveyed. Within this group were 283 nephrologists (the population of nephrologists registered with the OSMB) and 258 internal medicine physicians (selected randomly by the OSMB). A total of 133 physicians (25%) returned the survey; 119 surveys were usable: 70 from nephrologists and 49 from internists.

Statistical analyses performed A composite variable was created by coding and summing physicians’ responses regarding dietitian job functions. This variable was averaged for both physician categories. A t test was conducted to compare composite variable results between the two physician groups.

Results At least 50% of nephrologists and internists agreed that both types of dietitians should conduct nutrition assessments, determine patients’ energy needs, evaluate medication-nutrient interactions, recommend diet and tube-feeding orders, instruct patients about physician-ordered diets, and teach nutrition concepts to hospital interns. Few physicians agreed that either type of dietitian should order diets, tube feedings, or diet instructions.

Applications/conclusions Clinical dietitians can educate physicians about dietitians’ roles informally in their institutions and formally by supporting programs like The American Dietetic Association Physician Nutrition Education Program. In addition, dietetics educators can hone their students’ communication and problem-solving skills to promote positive physician-dietitian interaction. J Am Diet Assoc. 1997;97:1389-1393.