Journal of Nutrition Education

Published by Elsevier
Print ISSN: 0022-3182
The purpose of this study was to determine sources and types of information about child feeding practices that were received by 62 mothers with children aged 2 to 54 months. Each mother participated in 10 or 11 in-home interviews. Data analyses included chi-square testing for differences in information sources over time and content analyses to develop information themes. As sources, citations for professionals and magazines decreased, with no significant changes for relatives over time. After 24 months, newspapers, television, and friends were reported more frequently than earlier. Mothers reported multiple and concurrent information sources over time. Thus, nutrition educators have concurrent and multiple opportunities to disseminate nutrition information.
To determine the usefulness of variables from psychosocial models of health behavior in explaining fat-related dietary behavior among a sample of Chinese Americans. A survey questionnaire was administered to a convenience sample of Chinese Americans and analyzed for descriptive statistics and relationships among variables. Participants were 600 healthy individuals, ranging from 25 to 70 years of age, living in New York City. Demographic factors, degree of acculturation, food preferences, and 13 social psychological scales derived from the Theory of Planned Behavior, the Healthy Belief Model, and Social Cognitive Theory. Dependent measures assessed were intention to reduce dietary fat and behaviors related to the selection of reduced-fat diets. Descriptive statistics, Pearsons' correlation coefficients, t-tests, one-way analyses of variance, and multiple regression analyses were used. Attitude, overall health concern, and self-efficacy accounted for 58% of the variance in behavioral intention for the entire sample. Attitude, perceived barriers, and self-efficacy accounted for 19% of the variance in the prediction of dietary fat reduction behaviors. In general, a gradient was seen in the increased predictiveness of each regression model by degree of acculturation of the immigrants to American culture: predictiveness (R2) for behavior ranged from 15% for the least to 34% for the most acculturated. Acculturation was significantly related to declines in the influence of habit and of social norms. These effects were not seen by length of residency. Nutrition educators should assess the degree of acculturation of groups with whom they work and recognize that the degree of acculturation impacts the relative importance of various psychosocial variables in fat reduction behaviors.
Field gleaning, or harvesting crops after the commercial harvest, has been promoted as a way to increase food security; however, the effectiveness of gleaning programs is not well documented. The purpose of this research was to explore the impact of gleaning on individual gleaners and the community by documenting total amounts gleaned, individual uses of produce, and self-reported benefits and barriers to gleaning. During the 1997 season, approximately 50 gleaners participated in the Pierce County Expanded Food and Nutrition Education Program Gleaning Project; 29 participated in an intensive 4-week study to track use of produce by gleaners. Onsite weighing of gleaned produce revealed that of the 110,000 pounds gleaned by these 50 gleaners from Pierce County farms and orchards during 1997, 85,000 pounds (77%) were donated to local emergency food programs; 25,000 pounds (23%) were taken home by gleaners. Of the produce taken home by the 29 study participants, an estimated 9% was used fresh, 48% was preserved for later user, and 43% was shared with others. During a combination of telephone and in-person interviews, gleaners reported using more fresh produce and sharing knowledge about gardening and food preservation. The most important benefits of gleaning were "stretching my food budget" and "helping provide food for the community." Detailed exploration of the impact of gleaned produce on dietary patterns and use of validated food security measures is warranted considering the volume of produce used fresh, preserved for later use, and given away by gleaning participants.
The family mealtime environment has great potential to affect the eating behaviors of youth in the family. It is difficult to determine the important elements of a healthy mealtime environment because a valid assessment of the family environment is so difficult to obtain.The objective of this study is to examine the level of agreement between adult and adolescent perceptions of the family mealtime environment and adolescent mealtime behavior.A telephone survey was used to query adult and adolescent family members about how they perceive the family mealtime environment and the adolescent's mealtime behavior. A convenience sample of 282 adult/adolescent pairs from four schools in the Minneapolis/St. Paul area completed the telephone surveys. Frequencies of responses and the associations between the adult and adolescent responses are presented. Pearson correlations and regression were used to examine the level of association between adult and adolescent responses. Mixed-model regression was used for the continuous variables, and mixed-model logistic regression was used for the dichotomous variables. This study showed very little concordance between adolescent and adult responses. Only one question regarding arguments about eating during mealtime showed concordance. Adults and adolescents living in the same household seem to have different perceptions of the family mealtime environment and adolescent eating patterns. Researchers need to be aware of and concerned with the validity of the use of self-report for descriptions of family mealtime. They also need to be aware of the difference in adult and adolescent perceptions and consider these differences when designing messages for the family.
The purpose of this article is to report on baseline intakes of 1874 third-grade children representing a subsample of the Child and Adolescent Trial for Cardiovascular Health (CATCH) cohort. Intakes were assessed using a single, food record-assisted, 24-hour recall. The sample is unique in that it is drawn from four states and includes students from various ethnic backgrounds. Nutrients of interest include total energy, sodium, dietary cholesterol, and percent of energy from total fat and saturated fat. At baseline, third-grade students were consuming above nationally recommended levels of energy from fat, saturated fat, and sodium. The CATCH findings show a mean energy intake of 2031 kcal with significant differences by sex. Significant differences by site were seen for percent of energy from total fat, saturated fat, and dietary cholesterol. Children from Minnesota consumed the lowest proportion of energy from total fat and saturated fat while children from Texas had the highest proportion of energy from total fat and saturated fat. Intake of dietary cholesterol was lowest in Minnesota and highest in Louisiana. Nutrient differences by ethnic group were seen only for energy, with African Americans having the highest energy intake and Hispanics having the lowest energy intake. The number of meals consumed from school food service significantly influenced children's nutrient, intake; children consuming two meals from school food service had significantly greater intakes of energy, saturated fat, and dietary cholesterol compared to students consuming one or no meals from school food-service. The results are compared to other national nutritional surveys of children.
The objective of this study was to investigate the meanings of "healthy" and "unhealthy" eating and the importance of healthy eating among adolescents. Twenty-five structured focus groups were conducted. These focus groups consisted of 203 adolescent girls and boys enrolled in three senior high schools and one junior high school. The variables measured were adolescents' self-report of perceptions of healthy and unhealthy eating and their descriptions of the importance of healthy eating to adolescents. Data analysis was done by general content coding and specific content coding. Adolescents have a significant amount of knowledge regarding healthy foods and believe that healthy eating involves moderation, balance, and variety. Despite this knowledge, they find it difficult to follow healthy eating recommendations and frequently consume foods that they perceive as unhealthy. Barriers to healthy eating include a lack of time, limited availability of healthy foods in schools, and a general lack of concern regarding following healthy eating recommendations. These findings suggest that healthy eating messages based on the Dietary Guidelines for Americans are reaching adolescents, but interventions are needed that assist adolescents with the translation of this knowledge into healthy behaviors. Interventions should help make healthy eating easy for youth to apply and explain the consequences of unhealthy eating in terms that they value, stressing meaningful short-term benefits.
The objective of this study was to investigate adolescents' perspectives about the environmental impacts of food production practices and whether these perspectives are related to their food choice. Food choice was operationalized as consumption and purchase of organic foods and locally grown foods. A survey questionnaire was administered to a convenience sample of adolescents and analyzed for descriptive information and relationships among variables. Subjects were 651 ethnically diverse, urban and suburban high school senior students in a major metropolitan area. Variables of an Expanded Theory of Planned Behavior were measured including beliefs, attitudes, perceived social influences, motivation to comply, perceived behavioral control, self-identity, perceived responsibility, behavioral intention, and behavior. Descriptive statistics, Pearson correlation coefficients, and stepwise multiple regression analyses were used. Surveyed adolescents did not have strong or consistent beliefs or attitudes about the environmental impact of food production practices. Cognitive-motivational processes were at work, however, since their perspectives were significantly correlated with behavioral intentions and food choice behaviors. Behavioral intention was best accounted for by attitudes and perceived social influences (and perceived responsibility for organic food), and behavior was best accounted for by behavioral intentions, beliefs, and perceived social influences (and self-identity for local food). There is a need to make salient to adolescents the environmental impact of food production practices through both cognitive and experiential approaches.
The purpose of this study was to develop a substantive theory expressing the meanings couples associated with eating fruits and vegetables. This inductive qualitative study was based on a grounded theory approach and employed the constant comparison method of data analysis. Data were collected using semistructured individual interviews and a life history approach. Ten adult couples, aged 20 to 60 years, with and without children, all of whom were born in North America, were recruited using modified snowball sampling. Two overarching themes emerged. The "should syndrome" describes a morality concerning fruit and vegetable consumption arising from a tension between the low status of these foods in participants' childhood homes and their contemporary idealized status. The creation of couple gastronomies expresses couples'efforts to construct their own food norms and practices within a context of changes in social norms and fruit and vegetable availability. The substantive theory, making choices that balance their lives, conveys the dynamic processes involved in participants' fruit and vegetable choices. Future research will determine the transferability of the "should syndrome" and new couples' receptiveness to trying new fruits and vegetables. Understanding the changing contexts of food choice may help nutrition professionals better support healthful eating.
This article reports on lessons learned from using comparison and substitution tasks to assess consumers' ability to apply food guide messages. The study evaluated the usability of the Northeast Regional Food Guide (NERFG), which provides instruction on healthful diets of local foods in season. The tasks showed that the NERFG is useful for daily life decisions. Lessons learned were that the scores on tasks need to better differentiate between groups. The validity and reliability of the tasks should be established in future research. The use of tasks may also be appropriate for educational purposes.
This article describes some of the approaches used and challenges encountered conducting nutrition education research in junior high schools. The Teens Eating for Energy and Nutrition at School (TEENS) study recruited 16 schools and over 3800 seventh graders to participate in an intervention to increase students' intakes of fruits, vegetables, and lower fat foods for the purpose of reducing their future risk of cancer. The TEENS intervention included a classroom curriculum as well as a school environment and family component. This article describes some of the issues faced in the design and implementation of the study including recruiting schools and teens, maximizing the number of students within each intervention school exposed to all components of the intervention, and implementing elements of nutrition education in a classroom setting. The methods used to meet these challenges and the success of the methods attempted are described.
Evaluation is important for accountability, for planning, and for learning how to continuously refine and improve nutrition education with low-income families. The tools described in this special issue are intended to provide a resource to such evaluations. The special issue grew out of a series of USDA working groups to identify evaluation tools for nutrition education with low-income families.* I express my thanks to the many individuals who contributed to this effort.
Nutrition education programs and social marketing campaigns frequently focus on low-income audiences with the goal of improving dietary intake and quality, weight management practices, and physical activity. The impact of nutrition education can be assessed by measuring change in relation to any or all of these broad variables. Unfortunately, little information is available concerning the reliability, validity, and sensitivity to change of measures used to assess these constructs with low-income audiences of adults and adolescents. This article reviews the literature and discusses the types of available measures that have been used and evaluated for the above audiences. It describes specific measures used to assess total diet, consumption of food groups from the Food Guide Pyramid, and behaviors related to weight management and physical activity. Overall, this review suggests that there is a critical need for additional development and evaluation of dietary quality measurement tools for low-income and minority audiences.
A multimedia touch-screen kiosk was used to assess food safety knowledge and convey food safety principles to 93 high school science teachers and 165 students. The kiosk program based on the FightBAC messages informed users of correct responses and reasons for the response. Teachers correctly answered more questions than students; however, for the areas of hand washing, sources of foodborne illness, and handling of leftover foods, at least 40% of both students and teachers provided incorrect answers.
A variety of nutrition education interventions and social marketing initiatives are being used by the Food Stamp Program to improve food resource management, food safety, dietary quality, and food security for low-income households. The Social-Ecological Model is proposed as a theory-based framework to characterize the nature and results of interventions conducted through large public/private partnerships with the Food Stamp Program. In particular, this article suggests indicators and measures that lend themselves to the pooling of data across counties and states, with special emphasis on systems, environment, and public policy change within organizations at the community and state levels.
The objective of this research was to examine how consumers use health-related food endorsements on food labels. Three endorsement programs were examined: those of the two major retailers in the United Kingdom, Tesco and Sainsbury's, and the "Pick the Tick" program of the National Heart Foundation of Australia. The main methodology used was protocol analysis. This involves the subject "thinking aloud" while performing a task--in this case, (a) shopping normally and (b) shopping "healthily" for foods on a predetermined list--to generate a protocol. Each subject was also interviewed to investigate reported use of endorsements. Subjects were a quota sample (N = 44) of shoppers representative of the U.K. and Australian populations. Information about the subjects, the protocols, and interview data were analyzed quantitatively; the protocols were also analyzed qualitatively. Sainsbury's and Australian shoppers never used the endorsements when shopping but Tesco shoppers did, albeit rarely. Tesco shoppers used the endorsement in complex ways and not just as a trigger to food selection. They sometimes used the endorsement to reject endorsed foods. Subjects claimed to use the endorsements even though the protocol analysis revealed no actual use. There are features of the Tesco endorsement program that make it more helpful to consumers than the other programs.
To develop and validate scales to assess perceived benefits and barriers (decisional balance) for increasing fruit and vegetable consumption. A cross-sectional mail and telephone survey was conducted. A total of 1200 Chinese households were randomly selected from the Singapore residential telephone listings, and 71% responded to the mail survey; 390 males and 406 females participated (mean age = 39.3). Decisional balance, stage of change, and fruit and vegetable consumption were measured. Using a split-half sample approach, developmental sample responses were analyzed by principal-components analysis and validation sample responses by confirmatory factor analysis. Analyses of variance were used to examine stage differences in decisional balance. Principal-components analysis indicated two components representing benefits (or pros) (Cronbach's alpha = 0.86) and barriers (or cons) (alpha 0.79) of change. Confirmatory factor analysis strongly supported the two-component structure (Goodness of Fit Index = 0.97). There was a shift from cons to pros being more important across the stages. The increase in pros across the stages of change (p < 0.0001) corresponded to a medium effect size, and the decrease in cons (p < 0.01) corresponded to a small effect size. Decisional balance scales may be used to guide interventions to influence fruit and vegetable consumption.
The study objective was to quantify interpretations of the term "balanced meals" used in food security status assessments. Telephone interviews included 77 charitable food recipients in Hawaiì. After participants first responded to the question of whether they could afford to eat balanced meals, they next defined what a "balanced meal" meant. Qualitative responses were categorized into common themes. Forty-one (53%) indicated that a balanced meal consisted of at least three food groups.Thirty-one (40%) indicated something other than three food groups; five (6%) had no idea what a "balanced meal" meant. The findings question the validity and reliability of responses to "balanced meal" food security indicators in Hawaiì.
This study was conducted to identify factors that influenced milk-drinking behaviors of elementary school children in North Texas. Ten focus groups with a total of 41 children aged 6 to 11 years were conducted using a grounded theory approach. Based on the principles of Social Learning Theory, milk preferences and health beliefs were identified as personal factors that influenced drinking. Cafeteria rules, milk flavor, product packaging, modeling by adults, and shared experiences were environmental factors. The data suggest that school cafeterias can capitalize on their unique position to offer milk-drinking opportunities that children can share to combine nutrition education with sensory experience.
An instrument was designed to determine relationships between constructs of the Expanded Health Belief Model and to identify characteristics of college students who successfully manage their diabetes. The Diabetes College Scale was developed to measure attitudes and behaviors pertinent to diabetes management and college life. It was tested for content validity, test-retest reliability, and internal consistency. Data were collected from college students using a cross-sectional design. Campus health care providers were invited via electronic mail to administer the survey to students with Type I diabetes. Ninety-eight questionnaires were mailed to interested providers, of which 86 (88%) were returned. Mean scores for attitude constructs, seven behaviors, and two outcomes were measured. Twenty-six experts established content validity. Instrument reliability was evaluated using paired t-tests, Cronbach's alpha, and correlation coefficients. Correlation coefficients and stepwise multiple regression analysis evaluated relationships among variables measured. Intention and emotional response were strong predictors of exercise, whereas health importance and intention were predictive of testing blood sugar. Situational factors and emotional response were substantial barriers to optimal diabetes self-care. College health care providers should address these areas in providing services to this population. Additional testing of the instrument is also recommended.
The Cooperative Extension Service has been a key partner in the design, implementation, and evaluation of school nutrition training. To evaluate the effectiveness of their training and the effects of response shift bias on outcomes using a self-report measure, 162 foodservice staff from eight rural schools participated in this food-handling behavior study. Nutrition staff were assigned to one of two treatment groups or to the control group. Two different evaluation designs (pretest/ post-test and then/post) were used. The then/post design asks participants to first report their behavior or understanding as a result of the training (post) and then to retrospectively report this behavior before the training. The then/post evaluation design provided more significant change data than did the traditional pretest/post-test design, indicating that a response shift occurred. Such differences in evaluation findings suggest that the educational benefit of such training may be underestimated when using the traditional pre/post evaluation design.
Past evaluation research has documented improved nutritional outcomes resulting from participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). However, these evaluations have not examined the program from the clients' perspective, nor have they examined the independent effect of the nutrition education component. The purpose of this study was to quantitatively and qualitatively examine client satisfaction with the nutrition education component of the California WIC program. The methodology consisted of two phases. During phase I of the study (the quantitative component), participants completed Client Satisfaction Surveys immediately following attendance of one nutrition class. During phase II (the qualitative component), four focus groups were conducted. All subjects were participants in the California WIC program. Client Satisfaction Surveys were completed by 2138 participants, and the focus groups included 29 participants. Results from both phases of the study indicated that client satisfaction with the nutrition education component of the California WIC program was high. Between 80% and 95% of participants responded positively to five satisfaction questions, and focus group participants unanimously agreed that the nutrition education was an essential component of the program. Hispanic participants were more likely than non-Hispanic Caucasians, Asians, or African Americans to respond positively to three of the five satisfaction questions. For two of the questions, the frequency of positive responses increased as age increased and decreased as education level increased. A small segment of clients reported some dissatisfaction by responding negatively to one or more of the satisfaction questions (4% to 20% of respondents). Some suggestions for improvement were made by survey respondents. Identification of some WIC participants who are not completely satisfied with the nutrition education that they have received, paired with differences in satisfaction across demographic variables, suggests the need for a personalized approach to WIC nutrition education.
The objective of this research was to document the extent to which elements of fantasy, curiosity, and challenge are used in existing nutrition education materials. A content analysis of 30 nutrition education curricula designed for elementary and middle-school grades was conducted. Print curricula, computer software, videotapes, and puppet shows were included in the sample. The use of challenge, curiosity, and fantasy, as defined in the Theory of Intrinsically Motivating Instruction (TIMI), was assessed in each curriculum. Approximately half of the curricula included elements of challenge, curiosity, or fantasy. All of the nonprint curricula and 30% of the print curricula incorporated these characteristics. Curiosity was most frequently used in these curricula, followed by fantasy and then challenge. The TIMI provided a useful theory to examine the instructional approaches frequently used in school-based nutrition education programs. Nutritionists may apply concepts from the TIMI to the design of future curricula so that these programs are interesting and entertaining for their target audience.
This qualitative research describes some of the social organization of the American nutrition profession set in place by an apparent competition between two kinds of knowledge-a science-based knowledge and another more experimental knowledge drawn from practice. The methodological approach is constructivist and uses the theoretical framework of sociologist Dorothy Smith. Multiple data sources include: interviews and bibliographic data from 23 purposefully selected subjects who taught or studied in a graduate-level Nutrition Program at Teacher College, Columbia University from 1937 to 1992; administrative reports of the Program; faculty writings; dissertations approved by the program; the author's twenty-five years of experience in the nutrition profession; and a series of diagrams drawn to interpret and describe the data. Subjects recounted their varied professional experience during the 55-year period as a part of a larger study. The research traces changes in the relationship between nutrition science and practice as shaped by underlying sciences (food, agriculture, nutrition and health), related industries (food and health care), and culturally-bound gender ideals. Data analysis was based on recommended strategies for an inductive, interpretive, ethnographic case study. Subjects identified three forms of the construct of food-as nutrients, as marketable products, and as nurturance. This research suggests that the nurturing properties of food, the knowledge this generates, and the practitioners associated with nurturance are vulnerable and risk disappearance inside the profession, due to a history of resistance to this aspect of our discipline. The author recommends collaborative research between nutritionists and historians, sociologists and others to bring forth a more critical history of this profession.
The purpose of this research was to describe the context created by students as they worked in groups on a nutrition computer-assisted instruction (CAI) program. Students worked on the program in groups of three. Observational methods were used to collect data from students in two sixth-grade classrooms that were part of an experimental program designed to restructure the educational process. Thirty-two students, from 12 groups, were observed as they completed the program. The groups were assigned by the teachers according to standard principles of cooperative learning. Students completed "Ship to Shore," a program designed specifically for this research. The program required three to five 50-minute classroom periods to complete. The objectives of the program were to change children's knowledge structure of basic nutrition concepts and to increase children's critical thinking skills related to nutrition concepts. We collected observational data focused on three domains: (1) student-computer interaction, (2) student-student interaction, and (3) students' thinking and learning skills. Grounded theory methods were used to analyze the data. Specifically, the constant-comparative method was used to develop open coding categories, defined by properties and described by dimensions. The open coding categories were in turn used in axial coding to differentiate students' learning styles. Five styles of student interaction were defined. These included (1) dominant directors (n = 6; 19%), (2) passive actors (n = 5; 16%), (3) action-oriented students (n = 7; 22%), (4) content-oriented students (n = 8; 25%), and (5) problem solvers (n = 5; 16%). The "student style" groups were somewhat gender specific. The dominant directors and passive actors were girls and the action-oriented and content-oriented students were boys. The problem solvers group was mixed gender. Children's responses to computer-based nutrition education are highly variable. Based on the results of this research, nutrition educators may recommend that nutrition CAI programs be implemented in mixed gender groups.
Effect of the college course on the acquisition and retention of knowledge domains. Data presented are mean ratios of test scores to baseline scores. Error bars represent standard deviations. The asterisks indicate significant differences between the mean ratios of the intervention and control groups. 
The objective of this study was to test the hypothesis that a nutrition course that stresses fundamental principles of human physiology, energy metabolism, and genetics helps prevent weight gain during the first 16 months of college life. A randomized control trial was conducted from January 1997 to May 1998 using volunteers. Forty female college freshmen participated in the intervention (college course, n = 21) and control (no course, n = 19) groups. The intervention was a one-semester nutrition science college course. Body weight, nutrient intakes, and knowledge were measured at baseline, the end of the intervention (4 months from baseline), and 1 year later (16 months from baseline). Statistical analysis was conducted using a repeated-measure analysis of variance. Higher Body Mass Index (BMI) students (BMI > 24) in the intervention group (n = 11) reported lower fat (p =.04), protein (p =.03), and carbohydrate (p =.008) intakes compared with the higher BMI students in the control group (n = 6). Dietary changes reported by the higher BMI intervention students were associated with the maintenance of baseline body weight for 1 year in contrast with the higher BMI control students who gained 9.2 6.8 kg (p =.012). The findings suggest that nutrition education emphasizing human physiology and energy metabolism is an effective strategy to prevent weight gain in at-risk college students.
Key informants' perceptions of nutrition and health needs in their southern rural communities were assessed prior to nutrition intervention planning. This cross-sectional survey used in-person interviews. A sample of 490 individuals from 12 professional and lay roles in 8 community sectors in 36 counties in Arkansas, Louisiana, and Mississippi was chosen. Factor analysis was carried out on reported food, nutrition, and health problems and contributing factors. The General Linear Models procedure identified within- and between-subject effects for factors. Tukey's post hoc tests identified differences between sectors and states. Frequencies and weighted rankings were computed for health problems. Key informants rated individual-level factors (food choices, education, willingness to change, health behavior) as more important than community-level factors (food and health care access, resources) with regard to nutrition and health problems and contributors to problems. The number one health problem was hypertension. Key informants are knowledgeable about nutrition and health problems, contributing factors, and available resources. Individual factors were perceived as more important contributors to nutrition and health problems providing valuable information for planning nutrition interventions.
In response to welfare reform and the Food Stamp Nutrition Education Program's (FSNEP) goal of increasing clients' self-sufficiency, a literature review and small exploratory study were conducted to gain insight into a potential approach that would go beyond current nutrition education methods. Interviews with 17 FSNEP participants showed a widespread willingness to share food-related skills that others wanted to learn, some interest in cooperating on food-related projects, and frequent cases of social and geographic isolation. Based on these preliminary findings, we suggest the development and evaluation of nutrition education programs that appreciate and build on existing abilities of participants, provide opportunities for self-directed learning and activities, and build social support, social networks, and trust among participants while linking them to the broader community.
The objective of this study was to discover and understand women's perceptions of stability and change in their orientations to food and nutrition during a time of physical, social, and psychological transitions. A 10-year follow-up to a 1988 study was conducted. PARTICPANTS/SETTINGS: Seventeen women from a 1988 study in a semirural county in New York participated. They were well-educated, Caucasian mothers, aged 44 to 75 years in 1998. Semistructured, qualitative interviews in 1988 and 1998 were analyzed using grounded theory analysis. The 1998 and 1988 interviews with the same women were compared to understand patterns in orientations to food and nutrition. The life-course perspective was a conceptual guide. Most women in this sample described consistent orientations to food and nutrition at interviews 10 years apart. Even in the face of expected and unexpected changes in healthy, social environment, and roles, 14 of the 17 women perceived that their thoughts, beliefs, and strategies related to food and nutrition had been consistent across 10 years. The few women who perceived that they had changed orientations attributed changes to debilitating disease and transitions in work and family roles. Perceptions of consistency in their orientations to food and nutrition through midlife and older age among these women may be signs of stable trajectories that influence their response to nutrition education and their approach to dietary change.
This study compares consumers' self-perceived diet quality with calculated diet quality to assess the degree of consumer misperception regarding one's own diet quality and to identify factors associated with such misperception. The perceived diet quality was measured by consumers' self-perception of the overall healthfulness of their diet. The calculated diet quality was measured by the Healthy Eating Index, a 10-component indicator of overall diet quality developed from 3 consecutive days of 1-day 24-hour dietary recall and 2-day diet record. Measures of perceived and calculated diet quality were obtained for a sample of 2862 household meal planners/preparers from the 1989-90 Continuing Survey of Food Intake by Individuals and the Diet and Health Knowledge Survey. Dietary misperception was assessed by classifying respondents based on categories of perceived and calculated diet quality into three groups: optimists, realists, and pessimists. Bivariate statistical tests and multivariate logistic regression were used for comparing the characteristics of optimists with the other two groups. An estimated 40% of the population of household meal planner/preparers were optimists who perceived the quality of their diets to be better than their calculated diet quality. In multivariate analysis, household size, gender, education, smoking status, perceived health status, importance of nutrition in grocery shopping, and belief about the need for dietary change were found to be significant predictors of being optimistic about diet quality. Nutritionists and health professionals need to be aware of this misperception and alert dietary optimists about their false perceptions of diet quality.
The objective of this study was to examine the beliefs and perspectives among people with type 2 diabetes mellitus about dietary requirements, food selection and eating patterns, and attitudes about self-management practices. Semistructured, in-depth interviews explored participants' experiences with diabetes prior to their diagnosis, participants' understanding of the guidelines for the nutritional management of diabetes, how participants applied their understanding of dietary guidelines to daily food selection and eating patterns, and the social and personal themes influencing participants' food selection and eating patterns. Interviews were conducted with members of a convenience sample of 45 men and women diagnosed with type 2 diabetes for at least 1 year. ANALYSES PERFORMED: Interviews were coded using a conceptual matrix derived from participants' statements. Common characteristics were grouped, and broad themes were identified. Eating patterns were influenced by participants' knowledge of diabetes management. Challenges that participants encountered when applying nutrition recommendations were linked to their prior eating practices. Dietary self-efficacy, social support, and time management were identified as mediating variables that can influence dietary behaviors. Diabetes nutrition education programs should increase awareness of eating history, spousal support, and time management practices. Future research should include the refinement and validation of a nutritional management model of diabetes.
ABSTRACT Nutrition education for low-income audiences often focuses on building skills in food shopping and food resource management to help families receive the best nutrition from the resources they have available. However, empirical evidence for the effect of food shopping practice on dietary quality has been limited. This article presents new analyses from two studies that found an association between food shopping practices and diet quality. Logistic regression of data from 957 respondents from the 1996 National Food Stamp Program Survey found that food shopping practices were significantly (p </= .05) associated with the availability of nutrients in the food the households used during a week. Similarly, analysis of baseline data from 5159 women from selected counties of states who participated in the Expanded Food and Nutrition Education Program found that food shopping practices were significantly (p </= .05) associated with increased consumption of nutrients as measured through a single 24-hour recall. These findings suggest that food shopping practices are an important area for nutrition education with low-income audiences.
To describe how a sample of women in the Women's Health Initiative Dietary Modification Trial (WHIDM) labeled a healthy eating pattern and to compare these labels to their dietary maintenance. Participants completed a food frequency questionnaire and were divided into two maintenance groups, based on the percentage of energy derived from fat in their diets. Individual, semistructured interviews with the same subjects elicited information on labels they use to describe a healthy eating pattern. Subjects were 100 postmenopausal women, 50 to 79 years of age, free of breast and colorectal cancer, and participating in a dietary intervention that consisted of 20% or less energy from fat. Percentage of energy from fat in the diet and labels used to define a healthy eating pattern. Multivariate analysis. The label "consistent/patterned" was a predictor of dietary nonmaintenance (p <.05). Future studies should use this information to re-educate nonmaintainers on compliance issues.
Extensiveness represents the amount of information gathered in qualitative research. This study examined sample extensiveness in qualitative nutrition education research. Retrospective analysis was performed on articles published in the Journal of Nutrition Education (JNE) from 1969 to 1999 (Volumes 1 to 31). Content analysis was used to code articles and the studies they reported as units of analysis. Articles were coded to determine whether they included one or more studies using qualitative research and, if so, the types of qualitative studies performed, the sample extensiveness of each study, and mention of sample extensiveness limitations in the article. The statistics used were univariate (counts, percentages, means, medians, modes, ranges) and bivariate (chi-square, correlations). Of the published JNE articles, 71 (8%) used qualitative methods, and most (85%) qualitative articles were published in the 1990s. Some (19%) of these articles reported using multiple qualitative methods. The 30 studies using individual interviews interviewed an average of 45 people (range 15-155). The 38 studies using group interviews averaged 15 groups (range 1-180) and 141 people (range 9-900). Ten studies used observation/fieldwork, and eight used other types of qualitative research, with mixed [corrected] patterns of sample extensiveness in those studies. Few articles made specific statements about limitations based on sample extensiveness. Sample extensiveness in qualitative research in JNE varied considerably. Future qualitative research would benefit from more explicit attention to sample extensiveness.
To explore the influence of administrative aspects of a nutrition education program with peer educators delivering the program. Telephone interviews with peer educators trained to deliver La Cocina Saludable, a nutrition education program for Hispanics. Open- and closed-ended questions. Abuelas (grandmothers) recruited and trained as peer educators for the program. The sample included peer educators no longer teaching (22%), currently teaching (30%), and who never taught after training. Motives and incentives for becoming peer educators, challenges for peer educators, and reasons peer educators withdrew from the program. Descriptive statistics were used to analyze quantitative data from the closed-ended questions. Qualitative analysis was applied to data from open-ended questions. Working with community and learning about nutrition were prime motivators. Recruiting participants and coordination of classes appeared to be major challenges. Personal issues and traveling in a large geographic area were cited as the main reasons for quitting. The effectiveness of using peer educators for La Cocina Saludable may be improved through empowerment, additional training, a structured and equitable reimbursement system, and assistance to carry out administrative tasks.
Top-cited authors
Christine M. Olson
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Isobel R Contento
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  • University of Georgia
Kathryn M Kolasa
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Leslie A Lytle
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