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1.
Silvia Lepe Jennifer Goodwin Katie T. Mulligan Kate Balestracci Linda Sebelia Geoffrey Greene 《Journal of nutrition education and behavior》2019,51(3):307-317
Objective
To conduct a comprehensive process evaluation of a policy, systems, and environmental (PSE) change intervention.Design
Quasi-experimental, mixed methods.Setting
Low-income urban school district.Participants
Fifth-grade students in 4 schools assigned to 2 intervention and 2 comparison schools (intervention, n?=?142; comparison, n?=?170).Intervention
Both groups received a nutrition curriculum delivered by classroom teachers. Intervention schools also received 10 PSE lessons taught by paraprofessional educators.Main Outcome Measures
Quantitative data were obtained from fidelity and observation checklists, grading rubrics and self-reported student surveys. Focus group and interviews provided qualitative data. Quantitative measures included assessments of PSE and fruit and vegetable knowledge, as well as assessment of times fruits and vegetables (FV) were consumed yesterday.Analyses
Qualitative data were analyzed using inductive content analysis. Quantitative data were analyzed using repeated measures analysis of variance and analysis of co-variance.Results
Fidelity, dose, reach, and acceptance of PSE intervention were high; students felt more empowered, although PSE lessons were considered lengthy and complicated. Intervention PSE and FV knowledge scores were significantly higher than comparison scores (F37.56, P < .001; and F3.94, P < .05, respectively). However, issues in communication were identified between school staff and researchers.Conclusions and Implications
Policy, systems, and environmental classroom interventions commented on the differences between quantitative and qualitative assessments, and this suggests the need for more sensitive quantitative assessments. Future research should look at long-term outcomes as this study only looked at short-term outcomes. 相似文献2.
Pamela Ann Koch Isobel R. Contento Heewon L. Gray Marissa Burgermaster Lorraine Bandelli Emily Abrams Jennifer Di Noia 《Journal of nutrition education and behavior》2019,51(4):440-455
Objective
To evaluate Food, Health, & Choices, two 10-month interventions.Design
Cluster-randomized, controlled study with 4 groups: curriculum, wellness, curriculum plus wellness, and control.Setting
Twenty elementary schools (5/group) in New York City.Participants
Fifth-grade students (n?=?1,159). At baseline, 44.6% were at the ≥85th body mass index (BMI) percentile for age and 86% qualified for free or reduced-price lunch.Intervention
Curriculum was 23 science lessons based on social cognitive and self-determination theories, replacing 2 mandated units. Wellness was classroom food policy and physical activity bouts of Dance Breaks.Main Outcome Measures
For obesity, age- and sex-specific BMI percentiles were used (anthropometric measures). The researchers also employed 6 energy balance-related behaviors and 8 theory-based determinants of behavior change (by questionnaire).Analysis
Pairwise adjusted odds in hierarchical logistic regression models were determined for >85th BMI percentile. Behaviors and theory-based determinants were examined in a 2-level hierarchical linear model with a 2?×?2 design for intervention effects and interactions.Results
Obesity showed no change. For behaviors, there was a negative curriculum intervention change in physical activity (P?=?.04). The wellness intervention resulted in positive changes for sweetened beverages frequency (P?=?.05) and size (P?=?.006); processed packaged snacks size (P?=?.01); candy frequency (P?=?.04); baked good frequency (P?=?.05); and fast food frequency (P?=?.003), size (P?=?.01), and combo meals (P?=?.002). Theory-based determinants demonstrated no change.Conclusions and Implications
The findings of the lack of a decrease in obesity, behavior changes only for the wellness intervention, and no changes in theory-based determinants warrant further research. 相似文献3.
Carrie M. Durward Mateja Savoie-Roskos Abiodun Atoloye Patrice Isabella Melanie D. Jewkes Brenda Ralls Kathleen Riggs Heidi LeBlanc 《Journal of nutrition education and behavior》2019,51(3):342-347
Objective
To evaluate the effect of the Utah Double Up Food Bucks (DUFB) program on fruit and vegetable (F&V) intake and food security status among Supplemental Nutrition Assistance Program (SNAP) recipients.Methods
Data were collected in 2015, using a before-and-after study design. At the farmers’ market, a convenience sample of SNAP recipients was recruited for a survey and a 4-week telephone follow-up survey. Differences between the 2 surveys in food security and F&V intake were tested using the Wilcoxon signed-rank test.Results
Follow-up surveys were completed with 138 (40%) of the 339 baseline participants. Median F&V consumption increased from 2.82 times per day to 3.29 times per day (median, interquartile range 1.48–3.99 and 3.28–5.02, respectively, P?=?.002). The percentage of DUFB participants who were food secure increased by 15% (P?=?.001).Conclusions and Implications
The present results add to the growing literature indicating farmers’ market incentives are associated with increased F&V consumption and decreased food insecurity. Although more research is needed, farmers’ market incentives may be an effective area of policy intervention. 相似文献4.
José Azevedo Patrícia Padrão Maria J. Gregório Carla Almeida Nuno Moutinho Nanna Lien Renata Barros 《Journal of nutrition education and behavior》2019,51(3):326-334
Objective
Assess the impact of a web-based gamification program on nutrition literacy of families and explore differences in impact by socioeconomic status.Design
Quasi-experimental.Setting
Thirty-seven kindergartens from Portugal.Participants
Eight hundred seventy-seven families.Intervention
Web-based social network of participants' interactions, educational materials, apps and nutritional challenges, focused on fruit, vegetables, sugar, and salt.Main Outcome Measures
Parental nutrition literacy (self-reported survey – 4 dimensions: Nutrients, Food portions, Portuguese food wheel groups, Food labeling).Analysis
General linear model – Repeated measures was used to analyze the effect on the nutrition literacy score.Results
Families uploaded 1267 items (recipes, photographs of challenges) and educators uploaded 327 items (photographs, videos) onto the interactive platform. For the intervention group (n?=?106), the final mean (SD) score of nutrition literacy was significantly higher than the baseline: 78.8% (15.6) vs 72.7% (16.2); P < .001, regardless of parental education and perceived income status. No significant differences in the scores of the control group (n?=?83) were observed (final 67.8% [16.1] vs initial 66.4% [15.6]; P?=?.364).Conclusions and Implications
Gamified digital interactive platform seems to be a useful, easily adapted educational tool for the healthy eating learning process. Future implementations of the program will benefit from longer time intervention and assessment of the eating habits of families before and after intervention. 相似文献5.
Bijou R. Hunt Maureen R. Benjamins Sabena Khan Jana L. Hirschtick 《Journal of nutrition education and behavior》2019,51(3):287-299
Objective
Examine associations between food insecurity and multiple demographic, socioeconomic, acculturation, social risk factor, and food access variables.Design
Data are from Sinai Community Health Survey 2.0, a cross-sectional, population-based probability survey of adults.Setting
Ten selected community areas in Chicago.Participants
Adults aged 18 years and over who completed the Household Food Security Scale (HFSS) portion of the survey were included in the analysis (n?=?1,041).Main Outcome Measures
Food insecurity as defined by the HFSS was the dependent variable. Independent variables included multiple demographic, socioeconomic, acculturation, social risk factor, and food access variables.Analysis
Multivariate logistic regression, along with a manual backward selection process, was used to examine predictors of food insecurity. A P of .05 was used to determine statistical significance.Results
Respondents reporting English as their primary language (odds ratio [OR]?=?0.31; P?=?.002) had significantly lower odds of experiencing food insecurity. Respondents who reported feeling lonely (OR?=?1.86; P?=?.024) had significantly higher odds of experiencing food insecurity. Emergency food use (OR?=?3.89; P?=?.001) and food stamp benefit receipt (OR?=?2.79; P?=?.001) were also associated with food insecurity. Race/ethnicity demonstrated a strong relationship with food insecurity in early models, but this relationship appeared to be mediated by language and social risk factors. In the final adjusted model, most demographic and socioeconomic variables, including race/ethnicity, gender, and education were not significantly associated with food insecurity.Conclusions and Implications
The burden of food insecurity was not shared equally across populations. This analysis sheds light on significant predictors of food insecurity in several diverse communities in Chicago. Findings can help inform tailored interventions by guiding food assistance programs to those most in need. 相似文献6.
Valarie K. Frigge Marilyn S. Nanney Lisa Harnack Margaret Haggenmiller Rebekah Pratt 《Journal of nutrition education and behavior》2019,51(3):277-286
Objective
Use Normalization Process Theory to evaluate the implementation and integration of the expanded School Breakfast Program (SBP).Design
Interviews were conducted during the 2014–2015 school year. Normalization Process Theory guided the interview questions.Setting
Rural high schools in Minnesota.Participants
Interviews were conducted with 12 foodservice directors and 11 principals from the Project Break–Fueling Academics and Strengthening Teens intervention. Four of the 12 schools were in their first year of providing the expanded SBP program to their students whereas 8 were in their second year.Phenomenon of Interest
Normalization Process Theory was used to evaluate the implementation and integration of the expanded SBP into rural Midwestern high schools.Analysis
Three members of the research team used NVivo 10 software to code and analyze the interviews. Emerged themes were reported.Results
Modifying the SBP aligned with values of the study participants (coherence). Support was obtained from staff, students, and community members (cognitive participation). Operational work occurred in each school to establish and integrate the modified SBP (collective action). The SBP expansion was assessed through student participation rates (reflexive monitoring).Conclusions and Implications
Normalization Process Theory can be used to evaluate the implementation, embedding, and integration of a modified SBP into a school program. This evaluation can support other schools in modifying and embedding their SBPs into their school environment. 相似文献7.
Christine M. Olson Myla S. Strawderman Meredith L. Graham 《Journal of nutrition education and behavior》2019,51(4):391-399
Objectives
To describe (1) the use of a diet goal-setting tool in a self-directed online intervention aimed at promoting a healthy lifestyle, and (2) the association of tool use with gestational weight gain (GWG).Design
Cross-sectional analysis of data from the intervention group in a randomized effectiveness trial.Setting
An urban county in the northeastern US.Participants
A total of 898 healthy pregnant women aged 18–35 years with body mass indexes of (BMI) ≥18.5 and <35; 39.1% were low-income.Main Outcome Measures
Physical, sociodemographic, and psychosocial characteristics; use of tool features; and GWG.Analysis
Frequencies, chi-square tests of independence, and regression analysis.Results
Use of the online dietary tool was 45.1% completed the assessment, 35.3% set a goal, and 22.6% engaged in self-monitoring. Among women with normal BMI, setting ≥2 goals and engaging in self-monitoring were significantly (P < .05) associated with less GWG. Among women with higher BMI, setting ≥2 goals was significantly associated with greater GWG.Conclusions and Implications
Although online diet goal setting is a potentially effective weight management tool for pregnant women with normal BMI, findings suggest that it may not be for higher-BMI women. Additional research is needed to explain this finding. 相似文献8.
Alyssa J. Moran Neha Khandpur Michele Polacsek Anne N. Thorndike Rebecca L. Franckle Rebecca Boulos Sally Sampson Julie C. Greene Dan G. Blue Eric B. Rimm 《Journal of nutrition education and behavior》2019,51(4):400-408
Objective
To evaluate the effects of a supermarket meal bundling and electronic reminder intervention on food choices of families with children.Design
Quasi-experimental (meal bundling) and randomized, controlled trial (electronic reminders).Setting
Large supermarket in Maine during 40-week baseline and 16-week intervention periods in 2015–2016.Participants
English-speaking adults living with at least 1 child aged ≤18 years (n?=?300) with 25% of households participating in the Supplemental Nutrition Assistance Program.Intervention(s)
(1) Four bundles of ingredients needed to make 8 low-cost healthful meals were promoted in the store through displays and point-of-purchase messaging for 4 weeks each; (2) weekly electronic messages based on principles from behavioral psychology were sent to study participants reminding them to look for meal bundles in the store.Main Outcome Measures
(1) Difference in storewide sales and individual purchases of bundled items (measured using supermarket loyalty card data) from baseline to intervention in intervention vs control groups.Analysis
Regressions controlling for total food spending and accounting for repeated measures.Results
There were no differences in spending on bundled items resulting from the meal bundling intervention or the electronic reminders.Conclusions and Implications
Overall, there was little impact of healthful meal bundles and electronic reminders on storewide sales or purchases of promoted items in a large supermarket. 相似文献9.
Linda L. Knol Cliff A. Robb Erin M. McKinley Mary Wood 《Journal of nutrition education and behavior》2019,51(3):357-363
Objective
Investigate the relationships between food security status and cooking self-efficacy and food preparation behaviors among college students.Methods
Students living off campus while attending the University of Alabama completed an online survey between February and April 2016. Food security status was assessed using the Adult Food Security Survey Module. Cooking self-efficacy and food preparation behaviors were assessed using validated questionnaires. Multiple regression analysis was used to test for significant differences in cooking self-efficacy and food preparation scores by food security status.Results
Among respondents (n?=?368), 38.3% were food insecure. Very low food secure students had significantly lower cooking self-efficacy scores and food preparation scores than food secure students (P?=?.001).Conclusions and Implications
Preparing meals at home is less common for very low food secure students, and these students demonstrate less confidence in cooking ability. Further study of food-related decisions and trade-offs under resource constraints are needed. 相似文献10.
Karen M. Jetter Jennymae Adkins Susie Cortez Gesford Kane Hopper Vicki Shively Dennis M. Styne 《Journal of nutrition education and behavior》2019,51(3):268-276
Objective
This study determined how people who live in low-income households can consume an affordable, nutritious diet.Design
A community-based participatory research (CBPR) project was completed that developed and priced 2 weeks of healthy menus that met US Department of Agriculture Dietary Guidelines for Americans. Prices were collected from a market basket survey of 13 stores in the city of Chico during October, 2010. Initial menu development began in 2011–2012. Menus were reviewed in 2017 and reflect current guidelines.Setting
Chico, CA.Main Outcome Measures
Macro dietary objectives including the caloric content and servings of fat, sugar, whole grains, and fruits and vegetables. The cost of purchasing the market basket of goods for a family of 4 that achieved those objectives was determined.Results
The 2 weeks of menus all met dietary objectives on average. The daily cost varied from $19 to $31 when food was purchased from a bulk supermarket, with an average daily cost of $25. Average monthly cost was $756 in 2010 dollars, or $838 in 2015 dollars.Conclusions and Implications
People living in low-income households can afford to eat healthily. Using CBPR principles, daily targets, and technical support, public health partners can partner with community members for member-defined solutions that are affordable and meet dietary guidelines. Access to stores that sell low-price bulk items is important to being able to afford a healthy diet. 相似文献11.
12.
Amanda Walch Philip Loring Rhonda Johnson Melissa Tholl Andrea Bersamin 《Journal of nutrition education and behavior》2019,51(3):318-325
Objective
To identify practices, attitudes, and beliefs associated with intake of traditional foods among Alaska Native women.Design
Cross-sectional study that measured traditional food intake; participation in food-sharing networks; presence of a hunter or fisherman in the home; the preference, healthfulness, and economic value of traditional foods; and financial barriers to obtaining these foods.Participants
Purposive sample of 71 low-income Alaska Native women receiving Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) assistance in Anchorage, AK.Analysis
Bivariate and multivariate regression analyses.Results
Traditional foods contributed 4% of total daily calories. Given a choice, 63% of participants indicated that they would prefer half or more of the foods they ate to be traditional (ie, not store-bought). The majority of participants (64%) believed that traditional foods were healthier than store-bought foods. Of all participants, 72% relied on food-sharing networks for traditional foods; only 21% acquired traditional foods themselves. Participants who ate more traditional foods preferred traditional foods (B?=?.011 P?=?.02).Implications for Research and Practice
Traditional food intake was low and findings suggested that Alaska Native women living in an urban setting prefer to consume more but are unable to do so. Future research might examine the effect of enhancing social networks and implementing policies that support traditional food intake. 相似文献13.
Jerica M. Berge Susan Telke Allan Tate Amanda Trofholz 《Journal of nutrition education and behavior》2019,51(4):419-431
Objective
To describe a direct observational approach (ie, interactive family board game) to measure familyfunctioning and parenting behaviors of relevance to child weight and weight-related behaviors and to examine family functioning and parenting factors from multiple family dyads (eg, siblings, parent–child) and their associations with child weight and weight-related behaviors.Design
Cross-sectional, mixed-methods study.Setting
Two home visits were conducted with families 10days apart with a 7-day observational period between home visits.Participants
Children (n?=?150) aged 5–7years and their families from 1 of 6 racial and ethnic or immigrant and refugee groups, including African American, Hispanic, Hmong, Native American, Somali, and white, participated in the Family Matters study between 2014 and 2016.Main Outcome Measure
Child weight status and weight-related behaviors (ie, diet quality, physical activity).Analysis
Adjusted logistic and linear regression models with robust SEs were used in analysis.Results
Higher family functioning scores across the majority of family dyads were significantly associated with lower child weight status (P < .05). In addition, some family functioning scores were associated with child diet and physical activity, but not consistently. Parenting behavior scores were inconsistently associated with child weight and weight-related outcomes.Conclusions and Implications
Results suggest that the interactive family board game task is a direct observational approach that researchers can use with family members to measure family functioning and parenting behaviors related to childhood obesity. Future interventions may want to consider including multiple family members in both measurement and intervention development to target childhood obesity. 相似文献14.
Madeline Travers Deborah O&#x;Uhuru Trisha Mueller Jane Bedell 《The Journal of adolescent health》2019,64(3):376-381
Purpose
Inequitable access to quality adolescent sexual and reproductive health (ASRH) care may contribute to the high rate of teen pregnancy in the Bronx, New York. Bronx Teens Connection (BxTC), a community-wide intervention, sought to increase the number of ASRH best practices implemented and the number of females 12–19 years old receiving services by health centers in the Bronx.Methods
To promote best practices, BxTC provided training and technical assistance to partnering health centers from 2011 to 2014. Health center staff completed a 26-item survey annually to document clinic practices and service utilization. Significance of changes was assessed with paired t tests.Results
BxTC provided 285 hours of training and technical assistance to 12 partnering health centers. Eight health centers consistently completed the survey. Of the possible 31 ASRH best practices, the average number implemented increased from 23 in 2011 to 28 in 2014. Increases in unduplicated female adolescent patients were observed among Hispanics/Latinas (p?=?.026) and all females aged 15–17 (p?=?.035). Contraceptive coverage reported by six of the eight health centers increased among Hispanic/Latinas (32%–55%, p?=?.006), patients ages 15–17 (33%–53%, p?=?.005), and patients 18–19 (38%–56%, p?=?.036). The total number of hormonal implants provided to teens increased from two in 2011 to 173 in 2014.Conclusions
Other jurisdictions may consider prioritizing clinical linkages in order to improve ASRH outcomes by supporting best practices and expanding access to services in the most disinvested neighborhoods. 相似文献15.
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Emily Rogers Lucinda Bell Kaye Mehta 《Journal of nutrition education and behavior》2019,51(3):300-306
Objective
Early childhood is a crucial time for the development of eating behaviors and food preferences. With increased labor force participation by Australian mothers of young children, grandparents are acting as the main informal carers of grandchildren. Therefore, grandparents have the capacity to influence the feeding of young children and thus their eating behaviors.Design
Eleven semistructured qualitative interviews.Setting
Suburban Adelaide, South Australia.Participants
Grandparents (n?=?11; 9 grandmothers and 2 grandfathers).Phenomenon of Interest
To gain insight into grandparental perspectives, beliefs, and opinions regarding the feeding of grandchildren aged 1–5 years.Analysis
Interviews were manually transcribed and coded, and codes were synthesized into common themes.Results
Four major themes emerged: (1) intergenerational differences (between grandparents and parents); (2) maintaining familial relationships; (3) treating grandchildren with food, and (4) nutritional efficacy. Grandparents thoughtfully managed familial relations, including intergenerational differences, in relation to feeding grandchildren. They showed some cognitive dissonance with regard to provision of treat foods (defined as discretionary foods) in which grandparents simultaneously prioritized healthy foods and treats.Conclusions and Implications
Grandparents’ social role in the complex psychosocial space of child feeding warrants serious recognition and deeper understanding to engage them fully as stakeholders in children's nutritional health. 相似文献17.
Sarah A. Amin Megan Lehnerd Sean B. Cash Christina D. Economos Jennifer M. Sacheck 《Journal of nutrition education and behavior》2019,51(3):364-369
Objective
Food literacy provides a framework for food-related knowledge, skills, and behaviors. The aim of this study was to develop a Tool for Food Literacy Assessment in Children (TFLAC), grades 4–5.Methods
Development of the TFLAC consisted of 3 phases: (1) content validity using a 2-round modified Delphi panel (n?=?16) and content validity ratios (CVR); (2) pilot-testing (n?=?38); and (3) assessment of internal consistency and test-retest reliability (n?=?706) using Cronbach α and intraclass correlation coefficients, respectively. Statistical significance was set at P < .05.Results
Round 1 (CVR?=?0.40) and 2 (CVR?=?0.70) Delphi panel feedback and the pilot test informed modifications to the TFLAC question format, wording, and difficulty. Food literacy domain-specific Cronbach α values were acceptable (range, .80–.98) except for cooking knowledge (.63), and intraclass correlation coefficients were 0.64–0.70 (P < .001).Conclusions and Implications
The TFLAC meets basic psychometric standards and may serve as a foundation for nutrition education intervention design and evaluation. Further testing with a broader geographic audience may be warranted. 相似文献18.
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Morgan Bahl Sarah L. Francis LeLee Yap Doris Montgomery Catherine Lillehoj 《Journal of nutrition education and behavior》2019,51(4):486-491