In-House Pureed Food Production in Long-Term Care: Perspectives of Dietary Staff and Implications for Improvement

Texture modification of foods to a pureed consistency is a common management approach for older adults with dysphagia. Long-term care (LTC) facilities commonly produce some pureed food in-house. This study investigated challenges and preferred practices associated with the production of pureed food in LTC facilities. Nutrition Managers (n = 27) and cooks (n = 26) from 25 Ontario LTC facilities were recruited for one-on-one, semistructured interviews. Interviews were digitally recorded, transcribed, and analyzed using inductive thematic analysis. Four themes arose from the data to exemplify challenges in production, including (a) difficulty in using standardized recipes, (b) varied interpretation of governmental guidelines, (c) lack of consistency in terminology and texture, and (d) wanting to improve the visual appeal. These challenges were reported to reduce the quality of in-house produced pureed food. Preferred practices to overcome these challenges were also provided by participants, such as involving cooks in pureed recipe improvements and tailoring to the specific needs of residents. Incorporation of these practices into pureed food production may help to shape and improve future practice and pureed food products.     

Psychosocial and organizational determinants of safe food handling at retail and food service establishments: a systematic review and meta-analysis

Various psychosocial and organizational factors have been investigated as determinants of food handlers’ food safety behaviours. A systematic review and meta-analysis of studies in this area was conducted to identify and synthesize the key behavioural determinants. Standard systematic review steps were followed: comprehensive search strategy; relevance screening; article characterization; risk of bias assessment; data extraction; and random-effects meta-analysis. Sixty-two relevant studies were identified, and knowledge was the most commonly investigated behavioural determinant (n = 51). Increased knowledge was consistently associated with safe food handing behaviours across both correlation (r = 0.30; 95% confidence interval [CI]: 0.12, 0.46; n = 24 studies; I² = 98%) and odds ratio (OR) measures (adjusted OR = 1.85; 95% CI: 1.27, 2.70; n = 3; I² = 0%). Seven other behavioural determinant categories were also consistently associated with various food safety behaviour outcomes. In contrast, no association was found between food handler experience and behaviour. The findings can inform the development of targeted training initiatives for food handlers.     

Food Anxiety Is Associated with Poor Health Status Among Recently Hospital-Discharged Older Adults

Older adults returning home from the hospital may encounter health issues that cause anxiety about their ability to obtain enough food. Home-delivered meal (HDM) programs support nutritional needs and improve food security of those who cannot provide for themselves. A study conducted in six states examined feelings of anxiety about getting enough food in older adults (aged 60 years and older), comparing three time points: prior to hospitalization, at hospitalization (n = 566) and after receiving HDMs for two months posthospitalization (n = 377). Food anxiety during hospitalization was significantly higher among Hispanic ethnicity, current and former smokers, diabetics, and those who eat alone or have difficulty shopping. Food anxiety was significantly lower from baseline to two months follow-up (P < 0.0001), and participants showed improvements in certain coping strategies they used to get their meals. Indicators of food anxiety can help the health care system and community nutrition programs target those at highest risk of negative health outcomes.     

Challenges and opportunities for measuring the impact of a nutrition programme amongst young people at risk of food insecurity: A pilot study

Food insecurity in Australia is increasing. Organisations within the charitable food sector aim to manage, and in some cases are implementing strategies to prevent, food insecurity, such as food literacy programmes. This pilot study describes the challenges and opportunities for evaluating the impact of a food literacy programme, FoodMate by SecondBite^?, which aims to reduce food insecurity amongst ‘at risk’ young people. Three community agencies working with ‘at risk’ young people delivered an 8‐week food literacy programme in Melbourne, Australia. A pre‐test/post‐test design was used and outcome measures included: (i) food intake, (ii) diet quality, (iii) cooking confidence and (iv) food independence. These were assessed via questionnaires and 24‐hour recalls at three time points: pre‐programme (T1), post‐programme (T2) and at 4 to 6‐week follow‐up (T3). Twenty‐one young people aged 16–25 years participated in this pilot study. The response rate for the questionnaire and 24‐hour recalls declined across the study: T1 (n = 21), T2 (n = 11) and T3 (n = 9). Some positive effects were associated with the programme but attrition rates were high and the majority of participants did not complete all measures. Although results were inconclusive, this study describes some common challenges of conducting a food literacy intervention with vulnerable young people and highlights the benefit of nutrition researchers and practitioners working together to conduct evaluation of such programmes.     

A Theory-Based Newsletter Nutrition Education Program Reduces Nutritional Risk and Improves Dietary Intake for Congregate Meal Participants

At-risk older adults need community-based nutrition programs that improve nutritional status and practices. This 6-month study assessed the impact of the traditional Chef Charles (CC) program (Control) compared to a theory-based CC program (Treatment) on nutritional risk (NR), dietary intakes, self-efficacy (SE), food security (FS), and program satisfaction for congregate meal participants. Participants were mostly educated, single, “food secure” White females. NR change for the treatment group was significantly higher (P = 0.042) than the control group. No differences were noted for SE or FS change and program satisfaction between groups. The overall distribution classification levels of FS changed significantly (P &#60; .001) from pre to post. Over half (n = 46, 76.7%) reported making dietary changes and the majority (n = 52, 86.7%) rated CC as good to excellent. Results suggest the theory-based CC program (treatment) is more effective in reducing NR and dietary practices than the traditional CC program (control).     

Perceptions of Food Advertising and Association With Consumption of Energy-Dense Nutrient-Poor Foods Among Adolescents in the United States: Results From a National Survey

The advertising and marketing of energy-dense, nutrient-poor (EDNP) food and drink has been cited as one contributor to unhealthy eating behaviors in adolescents. The present study examines perceptions about and trust in food advertising and their association with consumption of EDNP foods and drinks among adolescents in the United States. Data (n = 1,384) come from the U.S. National Cancer Institute’s Family Life, Activity, Sun, Health, and Eating Survey. One way ANOVAs were conducted to assess differences between population subgroups in advertising perceptions. Bivariate and multivariable linear regression models were used to examine the associations between perceptions toward and trust in food advertising and consumption of EDNP foods and drinks, controlling for sociodemographic factors. Results show that there are significant differences between racial/ethnic groups on advertising perceptions (F = 16.32, p = < .0001). As positive perceptions toward food advertising increase among adolescents, there is an associated increase in daily frequency of consumption of EDNP foods and drinks (β = 0.10, p < .01). Similarly, the more adolescents agreed that they trusted food advertising, the higher the reported daily frequency of EDNP food and drink consumption (β = 0.08, p = .01). Targeting perceptions about food advertising may be a worthy intervention strategy to reduce the impact of food marketing and the consumption of heavily advertised EDNP foods and drinks among adolescents.     

Going Beyond Exposure to Local News Media: An Information-Processing Examination of Public Perceptions of Food Safety

The relationship between local news media and public perceptions of food safety was examined in a statewide telephone survey (n = 524). The theoretical framework of the study was based on a review of the social and psychological factors that affect public concerns about food safety, the relationship between mass communication and risk perception, and the thesis of information-processing strategies and its impact on learning from the news. The results show that information-processing strategies substantially mediated the relationship between local news media and public perceptions of food safety, with elaborative processing being more influential than active reflection in people's learning from the news media. Attention to local television had an independent effect, after demographics, awareness of food safety problems, and perceived safety of local food supply were statistically controlled. Other important predictors included gender, education, ethnicity, and perceived safety of local food supply.     

A culturally tailored research ethics training curriculum for American Indian and Alaska Native communities: a randomized comparison trial

The primary aim of this study was to develop an American Indian and Alaska Native (AIAN) tailored research with human subjects curriculum that would increase the participation of AIAN members in research affecting their communities. We used a community-engaged research approach to co-design and evaluate a culturally tailored online human subjects curriculum among a national sample of AIAN community members (n = 244) with a standard nationally used online curriculum (n = 246). We evaluated pre- and post-test measures to assess group differences in ethics knowledge, perceived self-efficacy to apply such knowledge to protocol review, and trust in research. Analysis of regional tribal differences assessed curriculum generalizability. Using an 80% correct item cut-off at first attempt as passing criterion, the tailored curriculum achieved a 59.3% passing rate versus 28.1% in the standard curriculum (p < .001). For both arms, participants reported a significant increase in trust in research and in research review efficacy. Participants took less time to complete the training and reported significantly higher acceptability, satisfaction, and understandability of the curriculum for the tailored curriculum. This culturally tailored research ethics curriculum has the potential to increase participation in AIAN communities in research affecting tribal members. The AIAN curriculum achieved significantly higher levels of participants’ research ethics knowledge, self-efficacy in reviewing research protocols, trust in research, and completion of the training requirements. Culturally grounded training curricula may help remedy the impact of historical research ethics abuses involving AIAN communities that have contributed to mistrust of research and lack of community engagement in research.     

Food Safety Knowledge and Practices among Older Adults: Identifying Causes and Solutions for Risky Behaviors

Adults aged 60 years and older are more likely than younger adults to experience complications, hospitalization, and death because of food-borne infections. Recognizing this risk, we conducted a nationally representative survey (n = 1,140) to characterize older adults’ food safety knowledge, attitudes, and practices as well as the demographic characteristics of older adults with risky food handling practices. The survey was conducted using a Web-enabled panel. We found that although older adults consider themselves to be knowledgeable about food safety, many are not following recommended food safety practices. Areas for improvement include the following: reheating deli meats to steaming hot, not eating store-bought deli salads, cooking eggs properly, monitoring refrigerator temperature using a thermometer, using a food thermometer to check doneness of meat/poultry/egg dishes, and storing leftovers properly. The survey results also suggest that food safety education targeting older adults is needed and that such initiatives should emphasize practices to prevent listeriosis, a potentially fatal illness among older adults. Our findings suggest that, in particular, men, individuals with higher incomes, and college-educated individuals would benefit from food safety education.     

Video observation of hand-hygiene compliance in a manufacturer of ready-to-eat pie and pastry products

ABSTRACT

Food-handler hand-hygiene can be a contributory factor for food-borne illness. Cognitive data (knowledge/attitudes/self-reported practices), while informative, are not indicative of behaviour, and are subject to biases. Consequently, observation of behaviour is superior to survey data. However, researcher presence in direct observation increases reactivity, whereas video observation gives comprehensive analysis over a longer period, furthermore, familiarity reduces reactivity. Although video observation has been used to assess food safety at retail/foodservice, this valuable method is under-utilized in food-manufacturing environments. For the study, footage (24 h) was reviewed to assess compliance in a food-manufacturing site with company protocol. Video observation of food-handlers entering production (n = 674) was assessed; upon 70 occasions no attempt to implement hand-hygiene was observed. Of attempted hand-hygiene practices (n = 604), only 2% implemented compliant practices. Although 78% of attempts utilized soap, only 42% included sanitizer. Duration ranged from 1 to 69 s (Median 17 s). The study provides hand-hygiene data in an area that observational data is seldom captured.     

Retaining Traditional Dietary Practices among Greek Immigrants to Australia: The Role of Ethnic Identity

This article explores why some Greek immigrants to Australia continue to adhere to a traditional Mediterranean diet whereas others have adopted eating behaviors characteristic of a less healthy “Australian” diet. Twelve qualitative interviews were conducted and comparisons made between individuals consuming more (n = 6) and less traditional diets (n = 6). The level of adherence to the diet was previously assessed by a diet score in a separate quantitative study (MEDIS-Australia) from which the subset of 12 participants for the present study was recruited. Analysis revealed that maintenance of a strong ethnic identity offers a pathway through which individuals retain dietary practices of their homeland.     

Occlusion of sight,sound and smell during Green Exercise influences mood,perceived exertion and heart rate

This study’s aim was to identify the relative contribution of sight, sound and smell to the Green Exercise effect. It was hypothesised that visual occlusion while exercising in a natural environment would have the greatest diminishing effect on perceived exertion and mood compared to auditory and olfactory occlusion. Twenty-nine healthy participants were randomly assigned to one of the three groups: visual (n = 10), auditory (n = 9) and olfactory occlusion (n = 10). Each performed six, 5-min bouts of exercise alternating between full sensory and occlusion. Rate of perceived exertion (RPE), heart rate (HR) and mood were recorded at the end of each bout. Sensory-occlusion increased mood, RPE and HR; effects were strongest when sounds were blocked but virtually absent when vision was blocked. During sensory occlusion, mood changes were characterised by increased Fatigue and Confusion, and reduced Vigour. Reductions in Tension and Vigour and increases in Fatigue were found during full sensory exercise, consistent with previous research findings.     

Globalization and Food Prestige among Indian Adolescents

This study provides a foundation for understanding how globalization and changing food environments are linked to cultural models of food prestige in adolescents. We used methods from cognitive anthropology, including free lists, pile sorts, and consensus modeling, to explore the meanings that Indian adolescents attribute to foods. Adolescents (n = 29) were asked to free list foods eaten outside and inside the home. Different adolescents (n = 65) were asked to pile sort and rank 30 foods identified during the free lists according to which foods are the most prestigious, traditional, routine, and advertised on television. We found that adolescents overwhelmingly believed nontraditional foods to be the most prestigious. Nonlocal foods, both from foreign countries and other regions of India, as well as foods eaten outside the home, were also considered prestigious.     

A Comprehensive Examination of the Determinants for Food Risk Perception: Focusing on Psychometric Factors,Perceivers’ Characteristics,and Media Use

Risk characteristics within a psychometric paradigm have been of major concern in studies of food risk perception. This study compared the influence of psychometric factors, perceivers’ characteristics (i.e., risk attitude, trust, and favorability of the country of origin), and that of the news media on the levels of food risk perception. The interaction of news media with the other two factors was also examined. A nationwide survey (n = 1,500) was conducted. The foods under investigation were Chinese processed foods and Japanese seafood imported to South Korea. In both cases, hierarchical multiple regression analyses revealed that psychometric factors had the greatest influence on food risk perception, followed by perceivers’ characteristics and media use. In addition, our results showed that the effect of perceived benefit and dread in Chinese food were salient only for those with little media use. The implication of the interaction effect on food risk perception is discussed in terms of accessibility and limited capacity of information processing.     

‘The study has taught me to be supportive of her’: empowering women and involving men in microbicide research

Recognising that women often have little control over most HIV-prevention methods, including condoms, researchers have made efforts to develop new bio-technological interventions, such as microbicides, that could allow women greater autonomy in HIV-prevention decision making. In many situations, women are unable to negotiate condom use with their partners, meaning that they could be better protected through the use of an effective microbicide. This paper uses qualitative data from the Microbicide Development Programme 301 (MDP301) microbicide trial in Johannesburg, South Africa. Data is taken from in-depth interviews with male partners of female trial participants (n = 28), six focus-group discussions involving male partners of trial participants (n = 4) and female participants (n = 2). Data show that men's involvement in microbicide research ranges from a disinterest in trials to the desire to actively take part in and promote research that affects the health of themselves and their partners. Results showed that some participants were reluctant to disclose trial involvement and product use to their partners, making identifying men as potential research participants problematic. This paper considers how to involve men in microbicide research without undermining women's sense of empowerment and ownership of the trial and the product that is being tested.     

Cognitive Bridging: Using Strategic Communication To Connect Abstract Goals With The Means To Achieve Them

Three studies test several mechanisms of cognitive bridging, or how a strategic communication message functions to connect the abstract goal of an individual with the specific means to achieve the goal. Across all of the experiments (n = 276, n = 209, n = 145), it was demonstrated that participants who received an induced bridging mechanism were more likely to produce cognitive bridging outputs and report more abstract responses than participants who did not receive a bridging technique. We do not find the same pattern of results among participants who received an integrated bridging technique. Taken together, these studies provide evidence that how abstractly or concretely an individual is thinking can be influenced by abstraction cues planted within a strategic message, providing promise for messaging efforts at the moment of decision. In other words, the level of abstract thinking an individual is carrying into an exposure situation is possible to change using cues within the message itself. This is the first article to juxtapose the induced and integrated mechanisms of cognitive bridging.