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1.
Adaptation of a culturally relevant nutrition and physical activity program for low-income, Mexican-origin parents with young children.
Kaiser, L, Martinez, J, Horowitz, M, Lamp, C, Johns, M, Espinoza, D, Byrnes, M, Gomez, MM, Aguilera, A, de la Torre, A
Preventing chronic disease. 2015;:E72
Abstract
Latino children experience higher rates of obesity than do non-Latino white children. Family-centered nutrition interventions can slow the rate of weight gain in this population. NiƱos Sanos, Familia Sana (Healthy Children, Healthy Family) is a 5-year, community-based, participatory research study that targets rural Mexican-origin farmworker families with children aged 2 to 8 years in California's Central Valley. Adaptation of a culturally relevant obesity prevention program involved qualitative research to tailor key obesity prevention messages, pilot testing and implementation of key messages and activities at family nights, and continual modification to incorporate culturally innovative elements. Of the 238 families enrolled, 53% (125) attended the recommended minimum of 5 (of 10 possible) classes during the first year. A university and community partnership can guide development of a culturally tailored obesity prevention program that is suitable for reaching a high-risk Mexican-origin audience through cooperative extension and other public health programs.
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2.
Practice-based evidence of effectiveness in an integrated nutrition and parenting education intervention for low-income parents.
Dickin, KL, Hill, TF, Dollahite, JS
Journal of the Academy of Nutrition and Dietetics. 2014;(6):945-950
Abstract
Research identifying associations between parental behaviors and children's food and activity choices and weight suggests that the integration of parenting and nutrition education holds promise for promoting healthful eating and activity in families. However, translational research leading to sustainable interventions lags behind. Development and testing of interventions within actual program contexts is needed to facilitate translation to full-scale implementation. Therefore, the goal of this pilot study was to develop and test an integrated nutrition and parenting education intervention for low-income families within the Expanded Food and Nutrition Education Program in New York State. During a 21-month period, low-income parents of 3- to 11-year-olds were recruited through usual programmatic channels by nutrition program staff to participate in a series of eight workshops delivered to small groups. A validated self-administered questionnaire was used to assess behavior change outcomes among 210 parents who completed the program. Mean scores improved significantly for most behaviors, including adult fruit and vegetable intake; adult and child low-fat dairy and soda intake; and child fast-food intake, activity, and screen time (P<0.001). Many parents reported eating together with children at program entry, leaving little room to improve, but about 20% reported at least a 1-point improvement (on a 5-point scale). The most frequent change was reducing how often children ate fast food and was reported by >50% of parents. Design and testing through practice-based research can facilitate development of interventions that are both feasible and likely to improve eating and activity behaviors among low-income families.
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3.
Physician-directed primary care intervention to reduce risk factors for type 2 diabetes in high-risk youth.
Cotton, B, Smith, A, Hansen, I, Davis, C, Doyle, A, Walsh, A
The American journal of the medical sciences. 2006;(3):108-11
Abstract
BACKGROUND The incidence of type 2 diabetes in youth is increasing at an alarming rate. The purpose of this pilot study was to determine whether a nutrition and physical activity intervention in an urban primary care office is feasible and effective in decreasing risk factors for type 2 diabetes in high-risk youth. METHODS A one-group pretest/post-test design was used. Participants were recruited from existing patients in a primary care facility serving low-income children. Inclusion criteria included body mass index (BMI) over the 85th percentile for age and a fasting glucose-insulin ratio (FGIR) less than 6. Thirty-six African-American patients, 9 males, 27 females, average age 12.4 years (range, 8-18) participated in a 12-week nutrition and physical activity program. Measurements included fasting glucose, insulin, FGIR, lipid profile, blood pressure, and BMI. BMI and laboratory values were tested for significant differences before and after intervention using paired t-tests. A P-value of <.05 was considered statistically significant. RESULTS On average, patients attended 8.3 of 24 physical activity sessions, 2 of 3 nutrition sessions and 1.5 of 3 planned clinical sessions. Twenty-six of 36 patients completed follow-up laboratory tests. Mean FGIR improved significantly from baseline (3.6 +/- 1.2 to 4.6 +/- 2.8; P = .043). CONCLUSIONS A nutrition and physical activity intervention for overweight children can be conducted in an urban primary care setting and may decrease laboratory evidence of insulin resistance, a risk factor for type 2 diabetes. Making the program accessible by public transit and scheduling the sessions at convenient times were important factors.
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4.
The impact of a school-based nutrition education intervention on dietary intake and cognitive and attitudinal variables relating to fruits and vegetables.
Anderson, AS, Porteous, LE, Foster, E, Higgins, C, Stead, M, Hetherington, M, Ha, MA, Adamson, AJ
Public health nutrition. 2005;(6):650-6
Abstract
OBJECTIVE To assess the impact of a school-based nutrition education intervention aimed at increasing the consumption of fruits and vegetables. DESIGN The intervention programme increased the provision of fruits and vegetables in schools and provided a range of point-of-purchase marketing materials, newsletters for children and parents, and teacher information. Curriculum materials at age 6-7 and 10-11 years were also developed and utilised. Evaluation was undertaken with groups of younger (aged 6-7 years) and older (aged 10-11 years) children. Methods included 3-day dietary records with interview and cognitive and attitudinal measures at baseline, with follow-up at 9 months, in intervention and control schools. SETTING The work was undertaken in primary schools in Dundee, Scotland. SUBJECTS Subjects comprised 511 children in two intervention schools with a further 464 children from two schools acting as controls. RESULTS Children (n=64) in the intervention schools had an average increase in fruit intake (133+/-1.9 to 183+/-17.0 g day(-1)) that was significantly (P<0.05) greater than the increase (100+/-11.7 to 107+/-14.2 g day(-1)) estimated in children (n=65) in control schools. No other changes in food or nutrient intake were detected. Increases in scores for variables relating to knowledge about fruits and vegetables and subjective norms were also greater in the intervention than in the control group, although taste preferences for fruits and vegetables were unchanged. CONCLUSIONS It is concluded that a whole school approach to increasing intakes of fruits and vegetables has a modest but significant effect on cognitive and attitudinal variables and on fruit intake.
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5.
Impact of diet-related cancer prevention messages written with cognitive and affective arguments on message characteristics, stage of change, and self-efficacy.
Quintiliani, LM, Carbone, ET
Journal of nutrition education and behavior. 2005;(1):12-9
Abstract
OBJECTIVE To determine if participants reading messages matched to a preferred style of message argument respond more favorably than participants reading unmatched messages. DESIGN Randomized trial using telephone and in-person surveys and cognitive response interviews. SETTING University campus. PARTICIPANTS Of 125 initially interested, a convenience sample of 100 university employees completed the study (female: 88%, white: 94%, mean age: 43.7). INTERVENTION(S): Participants read 2 print messages written with cognitive (COG) (fact based) or affective (AFF) (story based) arguments. MAIN OUTCOME MEASURE(S): 7-point Likert scale ratings of message appeal, understandability, persuasiveness, and relevance according to classification into 1 of 4 message groups: COG-AFF (mismatched to affective), AFF-COG (mismatched to cognitive), COG-COG (matched cognitive), and AFF-AFF (matched affective). ANALYSIS 1-way analysis of variance (P < or = .05) and systematic review of qualitative interviews. RESULTS The COG-AFF group consistently gave the lowest ratings to the affective messages and the AFF-COG group generally gave high scores compared with other message groups. Participants also expressed a desire for more factual information. CONCLUSIONS AND IMPLICATIONS A combination of cognitive and affective arguments may be appealing to subjects with an affective preference but disliked by individuals who prefer only a fact-based approach. Argument format may be an important message design consideration.
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6.
The impact of a nutrition education intervention on main meal quality and fruit intake in people with financial problems.
van Assema, P, Steenbakkers, M, Rademaker, C, Brug, J
Journal of human nutrition and dietetics : the official journal of the British Dietetic Association. 2005;(3):205-12
Abstract
BACKGROUND As part of a course teaching household budgeting, a nutrition education intervention was provided to people with financial problems. The present study aimed at assess the effects of this intervention on the nutritional quality of their main meal and fruit intake, and to collect process information on intervention participation, reactions and opinions. METHODS For the effect study, a quasi-experimental multiple pre and post-test control group design was used. Telephone dietary recalls were conducted with 35 people in the intervention group and 39 people in the control group. Observations, personal interviews and written questionnaires were used to collect the process data. RESULTS A significant reduction in saturated fat intake during the mail meal was found. Also, an intervention effect was found for fruit juice consumption, but not for daily fruit intake or vegetable intake during main meal occasions. CONCLUSIONS The process data revealed some improvements that should be made to the intervention, such as providing more individualized information and tailored recipes.
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7.
Efficacy of an E-mail intervention for the promotion of physical activity and nutrition behavior in the workplace context.
Plotnikoff, RC, McCargar, LJ, Wilson, PM, Loucaides, CA
American journal of health promotion : AJHP. 2005;(6):422-9
Abstract
PURPOSE The purpose of this study was to evaluate a 12-week workplace e-mail intervention designed to promote physical activity and nutrition behavior. DESIGN A pre- and post-test design was conducted to compare the effects of e-mail messages between intervention and control groups. SETTING Five large workplaces in Alberta, Canada. SUBJECTS Employees with access to a personal e-mail address (N = 2121) were randomly assigned to an intervention (n = 1566) or a control group (n = 555). INTERVENTION Physical activity and nutrition messages were based on social-cognitive theories. The intervention group received one physical activity and one parallel nutrition message per week for 12 weeks. The control group received no weekly messages. MEASURES Each participant completed self-report measures of physical activity and nutrition related to knowledge, attitudes, and behaviors 1 week before (time 1) and 1 week after (time 2) the intervention. RESULTS The intervention group was more efficacious at time 2 on measures of self-efficacy, pros, cons, intentions, and behavior related to physical activity. This group also reported more favorable changes in practicing healthy eating, balancing food intake with activity level, cooking meals with techniques to reduce fat, and avoiding eating high-fat foods. Effect sizes for all significant differences were small. CONCLUSION E-mail is a promising mode of delivery for promoting physical activity and nutrition in the workplace. Further theoretically driven studies are needed.
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8.
Interventions to enhance physical and psychological functioning among younger women who are ending nonhormonal adjuvant treatment for early-stage breast cancer.
Scheier, MF, Helgeson, VS, Schulz, R, Colvin, S, Berga, S, Bridges, MW, Knapp, J, Gerszten, K, Pappert, WS
Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2005;(19):4298-311
Abstract
PURPOSE To conduct a clinical trial to determine if an educational intervention and a nutritional intervention could enhance physical and psychological functioning among younger women completing treatment for early-stage breast cancer. PATIENTS AND METHODS Younger women (50 years of age or younger, N = 252), within 2 months of having completed active nonhormonal adjuvant therapy, diagnosed with stage 0, I, or II breast cancer with 10 or fewer positive lymph nodes were randomly assigned to a three-arm clinical trial. Women in the control arm of the trial received standard medical care. Women in the two active arms received either an educational intervention, designed to provide information about their illness and enhance adjustment, or a nutritional intervention, designed to promote a more healthy diet. Primary end points included mental functioning, physical functioning, and depressive symptoms. Women were assessed before random assignment, 4 months later (immediately post-intervention), and 13 months later (9 months post-intervention). RESULTS Participants assigned to the two active treatment arms had significantly less depressive symptomatology and better physical functioning by 13-month follow-up (differences between the two active arms were nonsignificant). These effects were primarily accounted for by changes in intrusive thoughts, concerns regarding cancer recurrence and mortality, self-concept perceptions, and self-efficacy expectations. CONCLUSION Tailored psychosocial interventions can be effectively designed to enhance adjustment among younger women who are completing nonhormonal adjuvant therapy.
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9.
Attitudes and barriers to dietary advice aimed at reducing risk of type 2 diabetes in first-degree relatives of patients with type 2 diabetes.
Brekke, HK, Sunesson, A, Axelsen, M, Lenner, RA
Journal of human nutrition and dietetics : the official journal of the British Dietetic Association. 2004;(6):513-21
Abstract
OBJECTIVE To evaluate the attitudes to and adoption of dietary advice in nondiabetic first-degree relatives of patients with type 2 diabetes and to examine barriers to adherence. DESIGN One-year controlled intervention study, where treatment group (n=73) received lifestyle education. Attitudes towards dietary advice, change in dietary habits and importance of potential barriers to adherence were evaluated by questionnaires. Nondiabetic relatives (25-55 years; males and females) of individuals with type 2 diabetes were recruited. Education was based on current nutrition recommendations and aimed at improving dietary fat quality, increasing intake of fruit and vegetables, with additional advice to reduce dietary glycaemic index (GI). MAIN OUTCOME MEASURES Attitudes and importance of barriers were classified by the intervened subjects into four categories ranging from 'No problem' to 'Yes, definitely a problem'. Dietary adherence was monitored by food frequency questionnaire at baseline and after 1 year. RESULTS Participants were generally in favour of advice aimed at improving dietary fat quality. Attitudes towards advice to reduce GI varied widely. Food selection changed in accordance with predefined dietary goals. 'Forgetfulness', 'low availability in lunch restaurant' and 'lack of ideas for cooking' were barriers to adherence. CONCLUSIONS Dietary advice aimed at reducing risk of type 2 diabetes was generally positively received and adopted in subjects with heredity for the disease. The most prevalent barriers reported are potentially modifiable.
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10.
Assessing intervention effects in a school-based nutrition intervention trial: which analytic model is most powerful?
Janega, JB, Murray, DM, Varnell, SP, Blitstein, JL, Birnbaum, AS, Lytle, LA
Health education & behavior : the official publication of the Society for Public Health Education. 2004;(6):756-74
Abstract
This article compares four mixed-model analyses valid for group-randomized trials (GRTs) involving a nested cohort design with a single pretest and posttest. This study makes estimates of intraclass correlations (ICCs) available to investigators planning GRTs addressing dietary outcomes. It also provides formulae demonstrating the potential benefits to the standard error of the intervention effect (sigma(delta)) from adjustments for both fixed and time-varying covariates and correlations over time. These estimates will allow other researchers using these variables to plan their studies by estimating a priori detectable differences and sample size requirements for any of the four analytic options. These methods are demonstrated using data from the Teens Eating for Energy and Nutrition at School study. Mixed-model analyses of covariance proved to be the most powerful analysis in that data set. The formulae may be applied to any dependent variable in any GRT given corresponding information for those variables on the parameters that define the formulae.