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ABSTRACT: Purpose: The association between preference for and intake of fruits and vegetables was examined among Albertan children. Methods: Data used were collected as part of a provincial population-based survey among grade 5 children in Alberta. Intake of two fruits and five vegetables was assessed using the Harvard food frequency questionnaire, and preference for individual fruit and vegetable items was rated using a three-point Likert-type scale. Random effects models with children nested within schools were used to test for associations between fruit and vegetable preference and intake. Results: A total of 3398 children aged 10 to 11 years returned completed surveys. Children who reported a greater liking for fruits and vegetables also reported significantly (p<0.001) higher intake. On average, children who liked a food a lot ate 0.5 to 2.7 more weekly servings of the food than did children who did not like the food. Conclusions: These findings suggest that focusing on interventions designed to increase taste preference may lead to increased fruit and vegetable intake among children. Introducing children to unfamiliar fruits and vegetables through taste testing may be an effective and practical health promotion approach for improving dietary habits.
Canadian Journal of Dietetic Practice and Research 01/2013; 74(1):21-7. · 0.81 Impact Factor
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ABSTRACT: In 2008, the Alberta government released the Alberta Nutrition Guidelines for Children and Youth (ANGCY) as a resource for child care facilities to translate nutrition recommendations into practical food choices. Using a multiple case study method, early adoption of the guidelines was examined in two child care centres in Alberta, Canada. Key constructs from the Diffusion of Innovations framework were used to develop an interview protocol based on the perceived characteristics of the guidelines (relative advantage, compatibility, complexity, trialability and observability) by child care providers. Analysis of the ANGCY was conducted by a trained qualitative researcher and validated by an external qualitative researcher. This entailed reviewing guideline content, layout, organisation, presentation, format, comprehensiveness and dissemination to understand whether characteristics of the guidelines affect the adoption process. Data were collected through direct observation, key informant interviews and documentation of field notes. Qualitative data were analysed using content analysis. Overall, the guidelines were perceived positively by child care providers. Child care providers found the guidelines to have a high relative advantage, be compatible with current practice, have a low level of complexity, easy to try and easy to observe changes. It is valuable to understand how child care providers perceive characteristics of guidelines as this is the first step in identifying the needs of child care providers with respect to early adoption and identifying potential educational strategies important for dissemination.
Maternal and Child Nutrition 10/2012; · 1.61 Impact Factor
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ABSTRACT: OBJECTIVE: To examine the association between frequency of assisting with home meal preparation and fruit and vegetable preference and self-efficacy for making healthier food choices among grade 5 children in Alberta, Canada. DESIGN: A cross-sectional survey design was used. Children were asked how often they helped prepare food at home and rated their preference for twelve fruits and vegetables on a 3-point Likert-type scale. Self-efficacy was measured with six items on a 4-point Likert-type scale asking children their level of confidence in selecting and eating healthy foods at home and at school. SETTING: Schools (n 151) located in Alberta, Canada. SUBJECTS: Grade 5 students (n 3398). RESULTS: A large majority (83-93 %) of the study children reported helping in home meal preparation at least once monthly. Higher frequency of helping prepare and cook food at home was associated with higher fruit and vegetable preference and with higher self-efficacy for selecting and eating healthy foods. CONCLUSIONS: Encouraging children to be more involved in home meal preparation could be an effective health promotion strategy. These findings suggest that the incorporation of activities teaching children how to prepare simple and healthy meals in health promotion programmes could potentially lead to improvement in dietary habits.
Public Health Nutrition 05/2012; · 2.17 Impact Factor
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ABSTRACT: Low intakes of calcium and vitamin D increase the risk for osteoporosis, bone fracture, and other health problems. This study aimed to examine the calcium and vitamin D intakes of Canadian-born Chinese (CBC) and Asian-born Chinese (ABC) in Edmonton, Canada, and to identify usual food sources of these nutrients. We hypothesized that CBC would have higher intakes of calcium and vitamin D than ABC and that the food sources of these nutrients would differ by region of birth (Canada vs Asia). Two in-person multipass 24-hour dietary recalls were administered for 1 weekday and weekend day for 81 healthy ethnically Chinese aged 18 to 58 years. The risks for calcium and vitamin D inadequacy were calculated as were the contributions of specific foods to calcium and vitamin D intakes. Calcium intake was 781 ± 337 mg/d for CBC and 809 ± 369 mg/d for ABC (P = .737). Vitamin D intake was 3.8 ± 3.4 μg/d for CBC and 5.0 ± 3.9 μg/d for ABC (P = .158). Respective risks for calcium and vitamin D inadequacy were 36% and 98% for men and 78% and 100% for women. Dairy contributed most to the calcium (43%) and vitamin D (52%) intake of participants. For ABC, soybean products contributed to 8.1% of calcium, whereas fatty fish contributed to 16.7% of vitamin D. For CBC, red meats contributed to 11.1% of vitamin D. Dietary intakes of calcium and vitamin D need to be increased in Chinese Canadians through the promotion of dairy and culturally relevant sources of these nutrients.
Nutrition research (New York, N.Y.) 03/2012; 32(3):177-84. · 1.20 Impact Factor
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ABSTRACT: To explore the barriers associated with the adoption of the Alberta Nutrition Guidelines for Children and Youth in schools according to characteristics of the innovation (guidelines) and the organization (schools).
Cross-sectional telephone survey.
Schools in Alberta, Canada. Principals from 357 schools.
Barriers to adopting the nutrition guidelines.
A 19-question telephone survey, including open- and closed-ended questions, was used to obtain information regarding schools' characteristics and barriers to adopting the guidelines. Qualitative data were coded according to common themes a priori, based on constructs from the Diffusion of Innovations framework.
Schools reported many barriers related to the relative advantage, compatibility, and complexity of adopting the guidelines. Parents' resistance to change and cost were the key reported barriers. Lack of knowledge, student preferences, the physical location of the school, and barriers related to the provision of healthful food were also reported.
Disseminating guidelines without providing adequate support for their implementation may not promote change within the school setting. School nutrition initiatives need to involve the parents and have access to sufficient financial and human resource support.
Journal of nutrition education and behavior 11/2011; 44(2):114-22. · 1.36 Impact Factor
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ABSTRACT: In June 2008, the Alberta government released the Alberta Nutrition Guidelines for Children and Youth. We evaluated the awareness of and intent to use the guidelines in Alberta schools, and sought to determine whether organizational characteristics were a factor in adoption of the guidelines.
Randomly selected schools from across Alberta completed a 19-question telephone survey, which included open- and closed-ended questions about the schools' characteristics, the priority given to healthy eating, awareness of the guidelines, and the schools' intent to use the guidelines. Of the 554 schools contacted, 357 (64%) completed the survey.
Overall, 76.1% of schools were aware of the guidelines and 65% were in the process of adopting them. Fifty percent of schools identified healthy eating as a high priority and 65.9% reported making changes to improve the nutritional quality of foods offered in the past year. Schools that were larger, public, and urban, and had a school champion and healthy eating as a high priority were more likely to be adopting the guidelines.
Most schools were aware of the nutrition guidelines and many had begun the adoption process. Identifying a school champion may be an important first step for schools in terms of adopting health promotion initiatives.
Canadian Journal of Dietetic Practice and Research 01/2011; 72(3):137-40. · 0.81 Impact Factor
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ABSTRACT: A web-based cross-country survey of renal registered dietitians (RRDs) was launched. It was used to assess whether or not their clinical practice in identifying and treating protein-energy malnutrition (PEM) in adults with end-stage renal disease (ESRD) and dialysis was based on current nutrition practice guidelines (NPGs). The survey included questions on strategies, timelines, and markers used for the identification and treatment of PEM. Fifty-nine RRDs responded (21%). Sixty-seven percent did not base clinical practice on NPGs, while 33% indicated they followed the guidelines. Of those who followed guidelines, 76% use the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative nutrition guidelines. Strategies used to identify and treat PEM were not related to duration of RRD experience in nephrology, but were significantly different between guidelines users and non-users. Guideline users commonly used key nutrition treatment strategies that included enteral/parenteral nutrition and medication therapy. The clinical practice of RRD is typically based on expert opinion/consensus, rather than on evidence-based practice guidelines (EBPG). It remains unclear if differences in RRDs' adoption of clinical guidelines influences patient outcomes, particularly in the treatment of PEM. Up-to-date EBPG need to be developed for the identification and treatment of PEM in patients with ESRD.
Canadian Journal of Dietetic Practice and Research 01/2010; 71(1):27-32. · 0.81 Impact Factor
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ABSTRACT: We sought to determine the variables influencing the adoption of practice-based guidelines by Canadian renal registered dietitians (RRDs) for the identification and treatment of protein-energy malnutrition (PEM) in adult patients with chronic kidney disease on dialysis.
A web-based, cross-country survey was distributed to 288 RRDs via the Canadian Association of Renal Dietitians. The survey consisted of open-ended and close-ended questions addressing variables (facilitators and barriers) influencing RRDs' adoption of evidenced-based practice guidelines (EBPGs), along with questions related to practitioner practice (focused on organization, practitioners, and patients).
Seventy-four (51 full and seven partial) RRDs responded to the survey (for a 25% response rate); 16 responses not meeting the inclusion criteria were excluded from data analysis. Whereas 97% of respondents reported guideline utilization in daily practice, only 24% (n=14) used all of the recommendations within the EBPGs used by RRDs for the identification and treatment of PEM in adults on dialysis. The most commonly cited reasons for using EBPGs were perceived clinical benefits to the patient, and the applicability of guideline recommendations to daily practice. The most common barriers to the adoption of EBPGs were organizational (lack of time or staff and healthcare team support) and practitioner-based (practitioner-perceived conflicts regarding the evidence).
The variables influencing RRDs' adoption of EBPGs were multifactorial (organizationally focused, practitioner-focused, and patient-focused). The development of up-to-date EBPGs for the identification and treatment of PEM in adult patients is urgently needed. The examination of these variables is important to ensure that EBPGs are feasible, applicable, and evidence-based.
Journal of Renal Nutrition 09/2009; 20(4):235-42. · 1.57 Impact Factor
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ABSTRACT: Obesity in childhood has become a major public health concern because of increasing rates of overweight and obesity. To address this epidemic, effective dietetic interventions must be developed. We examined parent/caregiver and/or patient reasons for not returning for follow-up clinical care in the Alberta Health Services, Edmonton Area's Nutrition Services Pediatric Weight Management Program (NS PWMP) in Edmonton, Alberta.
A qualitative telephone survey was developed to identify reasons for non-return to the NS PWMP. Face validity was evaluated by five pediatric registered dietitians (RDs).
The survey was administered to parents/caregivers of children or adolescents aged 2.5 to 14.2 years (n=21) who attended fewer than two appointments in the NS PWMP. The major reasons for non-return included physical barriers (scheduling, parking, location), organizational barriers (clinic environment), and program educational content (type of educational tools, the focus of lifestyle education on the individual rather than the family, physical activity interventions, and appropriateness of information for the parent or child).
Development and delivery of effective dietetic interventions for children and adolescents at risk of overweight and obesity may be achieved by emphasizing skill building within the child and the family. Analysis of child and family feedback on clinical RD services is critical to optimization of care in a pediatric weight management program.
Canadian Journal of Dietetic Practice and Research 02/2009; 70(2):89-94. · 0.81 Impact Factor
