The purpose of this study was to examine the perceptions of low-income, rural mothers regarding their need for nutrition and physical activity education and the role of technology in addressing those needs. Quantitative and qualitative research was combined to examine the nature and scope of the issues faced by this target population. Women who were currently receiving food stamps and had children in nursery school to eighth grade were recruited through a state database to participate in a telephone survey (N = 146) and focus groups (N = 56). Low-income, rural mothers were aware of and practiced many health behaviors related to nutrition and physical activity, but they faced additional barriers due to their income level, rural place of residence, and having children. They reported controlling the fat content in the food they cooked and integrating fruits and vegetables but showed less interest in increasing fiber consumption. They reported knowing little about physical activity recommendations, and their reported activity patterns were likely inflated because of seeing housework and child care as exercise. To stretch their food budget, the majority reported practicing typical shopping and budgeting skills, and many reported skills particularly useful in rural areas: hunting, fishing, and canning. Over two-thirds of the survey respondents reported computer access and previous Internet use, and most of those not yet online intended to use the Internet in the future. Those working in rural communities need to consider technology as a way to reach traditionally underserved populations like low-income mothers.
"As anticipated, 60% or more did not have a 4 year college degree, were either overweight or obese and expressed dissatisfaction with their weight. Internet access was an inclusion criterion, however usage frequency was high (i.e., 77% accessed the internet several times a day), and paralleled other studies with low-income persons [19,20]. ecSI/LI scores and proportion identified as eating competent were strikingly similar to other studies with low-income participants [3,7,26]. "
[Show abstract][Hide abstract] ABSTRACT: Background
Eating competence (EC) has been associated with positive health outcomes such as reduced cardiovascular risk and higher diet quality. This study compared reported physical activity and EC in 512 low-income women participating in an online program that included a physical activity lesson and assessed response to this lesson.
Educational intervention and surveys were completed online. EC was assessed with the Satter Eating Competence Inventory for Low-Income (ecSI/LI).
Participants were mostly white, <31 years, overweight/obese (60%), and food insecure (58%). EC was higher for those who self-reported being physically active (30.1 ± 8.3 vs. 24.9 ± 8.1; P<0.001) and were active for ≥ 30 minutes/day (29.9 ± 8.3 vs. 26.3 ± 8.6), even with age, weight satisfaction, and BMI controlled. EC of obese physically active persons was higher than normal weight, but physically inactive women. The physical activity module was well received with responses unrelated to time involved or physical activity level.
Low-income women were interested in learning about physical activity and responded positively to online delivery. Overall EC levels were low, but higher for physically active women, supporting efforts to enhance EC. Additional research is needed to determine if EC is associated with responses to physical activity education.
BMC Women's Health 03/2013; 13(1):12. DOI:10.1186/1472-6874-13-12 · 1.50 Impact Factor
"There is evidence suggesting computer-tailored and Web-based interventions can effectively promote healthy eating habits (Alexander et al., 2010; Kroeze, Werkman, & Brug, 2006; Norman et al., 2007; Oenema & Burg, 2001; Wantland, Portillo, Holzemer, Slaughter, & McGhee, 2004), and some low-income participants prefer the Internet to other methods for nutrition education (Bensley et al., 2006; Silk et al., 2008; Wantland et al., 2004). Access to the Internet is becoming less of a barrier to low-income households; 50-75% reportedly have access (Atkinson et al., 2007; Bensley et al., 2006; Silk et al., 2008). Online education also holds the promise of on-demand, convenient delivery that can be customized to individual learning needs and pace using a growing assortment of multimedia tools (Alexander et al., 2010; Trepka, Newman, Huffman, & Dixon, 2010). "
[Show abstract][Hide abstract] ABSTRACT: Delivering nutrition education using the Internet could allow educators to reach larger audiences at lower cost. Low-income adults living in a rural community participated in focus groups to examine their interest in, experience with, and motivators to accessing nutrition education online. This audience described limited motivation in seeking formal nutrition education. However, they were interested in relevant, compelling tools emphasizing cooking and saving money. The likelihood of using the Internet for food/nutrition information was influenced by website characteristics. The insights from the study will help educators design online tools that capture and sustain the interest of low-income clientele.'s Supplemental Nutrition Assistance Program-Education (SNAP-Ed) aims to increase the likelihood that low-income participants will select healthy food within limited budgets. Such efforts are relevant considering low-income households have a greater prevalence of nutrition-related health conditions than higher income households (Centers for Disease Control [CDC], 2010; USDA, 2009). However, nutrition educators face delivery challenges, particularly in rural areas, that may include a lack of participant interest, long travel distances or undependable transportation, time/schedule conflicts, and/or social barriers (Atkinson et al., 2010; Bensley et al., 2006; Brunt, 2008; Damron et al., 1999; Richardson, Williams, & Mustian, 2003).
"This may raise concerns regarding sample representativeness because low-income woman without internet access may differ systematically from our respondents. However, recent findings suggest that the internet is available to low-income audiences [25,50,51]. Surveys were administered in English, which prevented individuals unable to read English from participating. "
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to evaluate the construct validity of a version of the ecSatter Inventory (ecSI), a measure of eating competence (EC), as adapted for use in a low-income (LI) population.
Females (n=507), aged 18 to 45 years, living in households with a history of participating in the Supplemental Nutrition Assistance Program completed a web-based survey that included the ecSI for LI (ecSI/LI) and valid measures of cognitive and affective eating behavior, food preference and practice, and food preparation.
Most correlations and differences between eating competent and non-eating competent categories and among EC tertiles were compatible with hypothesized relationships. ecSI/LI scores were positively related with self-reported physical activity, food acceptance, fruit and vegetable intake, and food planning/resource management. ecSI/LI scores were negatively associated with body mass index, dissatisfaction with body weight, tendency to overeat in response to external or emotional stimuli, and indices of psychosocial attributes related to disordered eating.
The ecSI/LI is a valid measure of EC for low-income females and provides a tool for researchers and educators to assess intervention outcomes and further explore the EC construct.
International Journal of Behavioral Nutrition and Physical Activity 04/2011; 8(1):26. DOI:10.1186/1479-5868-8-26 · 4.11 Impact Factor
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