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Biomedical subjects

J Brug

Publications and source records attributed to J Brug.

At least 55 records · Page 3Linked to original sources
PubMed1999

Computer-tailored nutrition education: differences between two interventions.

The impact of two computer-tailored nutrition education interventions was assessed and compared in a randomized trial among 315 subjects with a pre-test-post-test comparison group design. Respondents in both the experimental and the comparison group received feedback tailored to their consumption of fat, fruit and vegetables. Respondents in the experimental group received additional psychosocial feedback tailored to their attitudes, perceived social support and self-efficacy expectations towards reducing their fat consumption and increasing their consumption of fruit and vegetables. A significant reduction in fat consumption and increase in the consumption of fruit and vegetables were found in both the experimental and the comparison group between pre-test and post-test. Respondents in the experimental group more often indicated that the feedback they received was interesting and easy to understand. Respondents in the comparison group more often reported having reduced their fat consumption because of the feedback they received. No significant differences in consumption of fat, fruit and vegetables were found at post-test between the experimental group and the comparison group. These results do not support the hypothesis that additional psychosocial information is an essential component of effective tailored feedback. The results indicate that tailored feedback might be effective in inducing dietary changes.

Adult↗
PubMed1998

Nationwide implementation of guided supermarket tours in The Netherlands: a dissemination study.

The purpose of this study was to assess adoption, implementation and maintenance of a guided supermarket tour program of nutrition education by Dutch Public Health Services (PHSs), and the factors associated with program dissemination. A first questionnaire was sent to all 60 PHSs, and measured program adoption, perceived program attributes, and characteristics of the adopting organization and person. A second questionnaire was only sent to adopting PHSs, and measured extent and success of implementation, intentions to continue the program, and characteristics of the main implementing person. Of the 59 PHSs who responded, 30 adopted the program and 17 implemented it sufficiently. Perceived program complexity, social influence within the PHS toward program participation and existence of a separate health education department were predictors of adoption. Perceived program complexity was also a predictor of extent of implementation. The number of health educators within each PHS was a predictor of sufficient implementation. It was concluded that adoption and implementation of the program was reasonable, considering the limited dissemination strategy. Dissemination might have been more successful if the program had been less complex and required less effort, if positive social influence had been generated, and if specific attention had been given to PHSs without a separate health education department.

Attitude of Health Personnel↗
PubMed1998

Fat Watch: a nationwide campaign in The Netherlands to reduce fat intake--process evaluations.

Fat Watch was a four-year campaign carried out in cooperation with retailers and industry, aiming at a reduction of fat consumption by 10% among the Dutch population. Mass media and supermarkets were the main conveyers of the message. Supermarkets participated well in the first (53%) and in the third year (51%), but to a lesser extent in the second year (36%). Campaign awareness in the target group (household shoppers for food) was relatively high in the first year (60%), but dropped in the next two years (40% and 32%, respectively). Combined with prominent mass media messages and with promotional activities of food products by suppliers, supermarkets seem a good channel for dissemination of nutrition information. Fat Watch has proved that cooperation of governmental, industrial and retail organizations for several years with respect to nutrition education activities is possible in the Netherlands.

Diet Surveys↗
PubMed1998

Fat Watch: a nationwide campaign in The Netherlands to reduce fat intake--effect evaluation.

In the Netherlands, the nationwide Fat Watch campaign aiming at a reduction in fat consumption was organized from 1991 onwards. This study describes the effects of the first three consecutive campaign years on attention to fat, diet and health, attitudes, self-efficacy expectations and intentions related to dietary fat reduction, and self-rated fat intake. Data were collected each year according to the Solomon design, by telephone interviews among about 1200 consumers responsible for household purchases. Campaign awareness was high in each campaign year, but a decrease in campaign awareness was found after the first campaign in 1991. The 1991 campaign was primarily aimed at getting the attention of the Dutch public for the fat-reduction message and indeed resulted in increased attention. The second campaign year resulted in small but statistically significant positive changes in attitudes, which was the specific target of the 1992 campaign. Intention to buy low-fat food products was also significantly increased. The 1993 campaign failed to realize the targeted increases in self-efficacy among the study population, but a significant campaign effect on intentions was found. The evaluation of all three campaigns indicated that the Dutch underestimate their personal fat intake and this has been identified as an important barrier to a further reduction in fat consumption. Making subjects aware of their personal fat consumption will be given priority in future campaigns.

Bias↗
PubMed1998

The impact of computer-tailored feedback and iterative feedback on fat, fruit, and vegetable intake.

A randomized trial was conducted to study the impact of individualized computer-generated nutrition information and additional effects of iterative feedback on changes in intake of fat, fruits, and vegetables. Respondents in the experimental group received computer-generated feedback letters tailored to their dietary intake, intentions, attitudes, self-efficacy expectations, and self-rated behavior. After the first feedback letter, half of the experimental group received additional iterative feedback tailored to changes in behavior and intentions. The control group received a single general nutrition information letter in a format similar to the tailored letters. Computer-tailored feedback had a significantly greater impact on fat reduction and fruit and vegetable intake than did general information. Iterative computer-tailored feedback had an additional impact on fat intake. The results confirm that computer-generated individualized feedback can be effective in inducing recommended dietary changes and that iterative feedback can increase the longer term impact of computer-tailored nutrition education on fat reduction.

Adult↗
PubMed1997

Consumption of fruit and vegetables: how to motivate the population to change their behavior.

This study reports the discrepancy between two methods to assess fruit and vegetable consumption in a Dutch adult population (N = 367). The consumption of fruit and vegetables was assessed by using a food frequency method (the number of grams of fruit and vegetables subjects ate every day) and by assessing subjects' own estimates of their fruit and vegetable intake. Besides the behavior, intention and determinants were measured using a theoretical model including attitude, self-efficacy and social influence to eat fruit and vegetables. Results showed that there were large differences between the self-rated and estimated objective consumption of fruit and vegetables. Subjects rated their own intake as much higher than their estimated actual intake. Furthermore, multiple regression analyses showed that the determinants predicted the self-rated consumption much better than the estimated consumption.

Adult↗
PubMed1997

Are awareness of dietary fat intake and actual fat consumption associated?--a Dutch-American comparison.

OBJECTIVES: To compare dietary fat intake, the accuracy of individuals' awareness about their fat intake, and sociodemographic and psychosocial correlates of awareness, in Dutch and American samples of employed adults. A discrepancy between objective dietary intake data and subjective self-evaluation of dietary fat consumption has been recognized in the past and might undermine healthy diet promotion interventions, and this is important because people who believe that their diets are healthful are less likely to be interested in making changes. Further, international comparisons have not been examined to date. DESIGN: Data collected for the baseline surveys of the 'Healthy Bergeijk' study in the Netherlands and the 'Working Well Trial' in the United States were compared. SUBJECTS: Working adults from a Dutch community health intervention study (n = 768) and an American worksite health promotion trial (n = 15,440). MAIN OUTCOME MEASURES: Objectively assessed dietary fat intake, measured by food frequency questionnaires, and subjective ratings of fat intake (self-rated fat intake). RESULTS: Findings show that the Dutch respondents had higher objectively assessed fat intake and lower subjective ratings of fat intake (P < 0.001). American respondents perceived their diets as higher in fat, more often stated their intentions to reduce fat intake, and were slightly more likely to make realistic estimates of their dietary fat. Dutch subjects were significantly more likely to underestimate their fat intakes. In both samples, women were most likely to underestimate their fat consumption and the most educated persons were most likely to be realistic. CONCLUSIONS: A substantial proportion of adults, both in the United States and the Netherlands, lack accurate awareness about how much fat they consume, though errors tend to be in opposite directions in the two countries. This study is an important first step toward broadening our international understanding of human dietary behavior for disease prevention.

Adult↗
PubMed1997

Validity and reliability of self-reported exposure to environmental tobacco smoke in work offices.

Environmental tobacco smoke (ETS) is an occupational carcinogen. Large companies often examine ETS exposure by employee surveys. However, reliable and valid self-report measures have been lacking. This study compared validity and reliability of various self-report measures. One hundred and seven nonsmokers from 11 Dutch worksites were interviewed. Three self-report measures were correlated with nicotine concentrations collected with area monitors in nonsmokers' offices. Nicotine concentrations averaged 12.7 micrograms/m. The item "How much tobacco smoke, on average, is there during a day in your work office?" correlated highest with nicotine concentrations (r = 0.65; P < 0.001) and produced the lowest standard error of measurement. It was concluded that this simple self-report item may be a valid measure to assess the reach and effectiveness of worksite smoking policies.

Adult↗
PubMed1997

Results of a community-based campaign to reduce fat intake.

In 1992, a community-based 'Fat Watch' campaign was held in the city of Alkmaar in the Netherlands. The campaign was implemented within the framework of the nationwide mass-mediated 'Fat Watch' campaign (1991-1994), which aimed at a 10% reduction in fat intake among the general Dutch population. The intervention was carried out as a pilot project to study the effectiveness of strategies and activities, and to apply them subsequently in more cities. The campaign aimed primarily at the active involvement of intermediaries. Effects of the campaign were studied by telephone questionnaires among about 500 respondents, before and after the campaign in both the experimental and a control community. The questionnaire was based on the 'attitude, social influence, self-efficacy' (ASE) model. The results showed that 56% of the respondents were aware of a campaign in their community and that the campaign was positively evaluated by those familiar with it. After the campaign, self-rated fat consumption was significantly higher. No differences between the experimental and control community were found regarding attitude, social influence or self-efficacy expectations towards a reduction in fat consumption or intention to buy low-fat food products. However, as opposed to the control community, there was a significant decrease in actual fat consumption between pre- and post-test in Alkmaar. Furthermore, after the campaign, significantly more respondents in the experimental community intended to eat lower-fat food products and reported a behavioral change in the last six months. It was concluded that the campaign was quite successful as far as campaign awareness was concerned, but that it did not result in substantial change of behavior. The limited decrease in fat consumption observed should be interpreted with care.

Analysis of Variance↗
PubMed1997

Nutrition education interventions in a community setting: 2 Dutch examples.

This article presents the results of two studies among participants of two Dutch nutrition education interventions, i.e. a self-help program and a living room group session. Both interventions aim to reduce fat intake in the general population and were developed as part of the Dutch community health project 'Healthy Bergeyk'. The objectives of the studies were to assess number of participants, participant characteristics, use of the self-help program, participant satisfaction and self-reported effects. Telephone interviews and written questionnaires were completed by inhabitants after participating in the interventions. The results are encouraging and the interventions seem to be useful as part of community projects.

Adult↗
PubMed1996

The validation of a test to measure knowledge about the fat content of food products.

The objective of the study was to develop and validate a 21-item nutrition knowledge test to measure people's knowledge of the fat content of food-products. After pretesting and provisional development, the test was administered twice to study test-retest reliability. Furthermore, various sub-populations with expected differences in nutrition knowledge completed the test in order to study the construct validity of the questionnaire. The subpopulations consisted of lay-people (N = 81), students of human nutrition and dietetics (N = 108), and professional experts (N = 79) on human nutrition. The internal consistency and uni-dimensionality of the test were determined by calculating the KR-20 statistic and the log-likelihood ratio statistic for the Rasch model. Pearson's correlation and gross misclassification between T1 and T2 were calculated to assess the test-retest reliability. Analysis of variance was used to test for differences in mean knowledge scores between subpopulations. Test-retest reliability was found to be sufficient (R = .85). The internal consistency was moderate (KR20 = .68). According to the Rasch model, two items had to be removed from the test before the log-likelihood ratio statistic of the Rasch model indicated that knowledge about the fat content of food products as assessed by the questionnaire is a uni-dimensional construct. The differences in mean knowledge scores between the subpopulations were significant (p < .01) and in the expected direction (experts > students > lay people). It can be concluded that the test is a reliable and valid instrument to measure knowledge about total fat content in food products and that the Rasch model is a comprehensive method to indicate the reliability of nutritional knowledge tests.

Analysis of Variance↗
PubMed1995

Psychosocial determinants of fruit and vegetable consumption.

Psychosocial correlates of fruit and vegetable consumption were studied in an adult Dutch population (n = 367) based on the ASE model of attitudes, social influence and self-efficacy. Attitudes were a summation of beliefs about taste, different health consequences, and costs in time and money. Social influences were measured through the social stimulation respondents expected to get from important others to consume adequate amounts of fruit and vegetables and by asking the subjects about the behaviour of important others. Self-efficacy reflected the respondents' ability to consume adequate amounts of fruit and vegetables in various situations. Self-efficacy and attitudes were consistently and significantly associated with consumption of boiled or otherwise heated vegetables, of salads, and of fruit. Furthermore, respondents reporting low consumption of these food groups had lower self-efficacy expectations and less positive attitudes than subjects with relatively high consumption of fruit and vegetables. It is concluded that nutrition education aimed at stimulating fruit and vegetable consumption should focus especially on changing attitudes and self efficacy expectations.

Adult↗
PubMed1995

Differences in cancer incidence and mortality among socio-economic groups.

OBJECTIVES: In this article studies on the association between socioeconomic status (SES) and risk for cancer at different sites are reviewed. METHODS: The review is restricted to studies conducted in affluent societies, after 1970. Only studies using income, education and/or occupation as SES indicators are included. RESULTS: A more or less consistent positive association between SES and cancer risk was found for colon and breast cancer. More or less consistent inverse associations were found for lung, stomach, oropharyngeal and esophageal cancer. Inconsistent associations were reported for cancer of the rectum and pancreas. Possible explanations for SES differences in cancer risk are discussed with special emphasis on lifestyle variables related to cancer risk. CONCLUSIONS: It is concluded that it is still unclear whether the reported associations can be (partially) attributed to lifestyle related risk factors for cancer such as smoking, nutritional habits, drinking habits and reproductive factors.

Breast Neoplasms↗
PubMed1992

The reliability and validity of a Dutch questionnaire on fat consumption as a means to rank subjects according to individual fat intake.

In this paper a short, 25-item, telephone-administered questionnaire, designed to rank individuals according to their dietary intake of fat, is presented. Based on two studies of 52 and 639 men and women, respectively, its relative validity regarding a 7-day diet record and its reproducibility are discussed. A Pearson correlation of 0.59 was observed between fat intake estimated by 7-day diet records and fat score derived from the short questionnaire. Gross misclassification, defined as disagreement between the two fat consumption assessments beyond an adjacent tertile, was 15.4%. A Pearson correlation of 0.71 was calculated by a test-retest procedure. It is concluded that the Dutch short questionnaire on fat consumption is a rapid, simple and inexpensive method that can very well be used in nutrition education research to rank individuals according to their dietary fat intake.

Adolescent↗
PubMed1992

Indicators of iodine status among adults. Dutch Nutrition Surveillance System.

To evaluate the iodine status of Dutch adults we used three different iodine status indicators, namely urinary 24-hour iodide excretion (I/24 h), iodide/creatinine ratio in 24-hour urine samples (I/Cr) and 24-hour iodide excretion per kilogram body weight (I/kg). Additionally, the habitual daily iodine intake was calculated. Men had higher mean I/24 h and mean iodine intake than women. No differences between men and women were found for mean I/Cr and mean I/kg. Relatively high (greater than or equal to 18%) prevalences of low values for the different iodine status indicators were found, especially for I/24 h. The intraindividual variance for all three indicators was high. Risk assessment regarding iodine supply, based on urinary iodide excretion, depends on the indicator used, and therefore caution is called for when drawing conclusions. Our results do not argue against the usage of I/24 h as iodine status indicator. More research is needed to solve the question whether iodine requirement depends on such factors as body size, body composition and physical activity.

Adult↗
PubMed1992

Iodide excretion before and after revision of goiter prophylaxis (Dutch Nutrition Surveillance System).

To assess the iodine supply in The Netherlands after the revision of the goiter prophylaxis measures (Bread Act of 1982, with an increase of iodine content of bread salt) the data of a nationwide survey among Dutch elderly people conducted in 1984/1985 were analysed. Iodide excretion in 24 h urine samples was used as the main iodine status indicator. The data were compared with data on iodine nutriture obtained among an elderly population in The Netherlands before the revision of goiter prophylaxis. High prevalences (greater than or equal to 37%) of low iodine excretion (less than 0.78 mumol/24 h; 100 micrograms/24 h) were found for Dutch elderly people. Mean urinary iodide excretion was 0.95 mumol/24 h (121 micrograms/24 h) for men and 0.79 mumol/24 h (100 micrograms/24 h) for women which is low, especially among women, in comparison with the United States recommended dietary allowance (118 mumol/day = 150 micrograms/day). Consistent positive associations of iodide excretion were found with urinary potassium and sodium excretion, bread consumption and total iodine intake. Bread, as the iodine carrier chosen for goiter prophylaxis in The Netherlands, was found to be the main dietary iodine source. No improvement in iodine nutrition was found among the elderly studied in 1984/1985 in comparison with an elderly population seen in 1981. Therefore, it is concluded that the present measures regarding goiter prophylaxis in The Netherlands might be of limited effectiveness.

Aged↗
PubMedDate not supplied

The impact of a computer-tailored nutrition intervention.

BACKGROUND: Nutrition education tailored to individual characteristics of people might be more effective than general nutrition education. Nowadays, the use of computers makes individualized feedback available for larger groups. METHODS: The impact of tailored nutrition information on changes in fat, vegetable, and fruit consumption was tested in a randomized trial among 347 employees of a major oil company. Respondents in the experimental group received computer-generated feedback letters tailored to their personal dietary behavior, attitudes, perceived social influences, self-efficacy expectations, and awareness levels. Respondents in the control group received general nutrition information. RESULTS: Respondents in the experimental group decreased their fat consumption significantly more than the control group between baseline and posttest. A significant effect of tailoring was also found for changes in attitudes and intentions toward reducing fat intake and increasing fruit and vegetable consumption. Furthermore, respondents in the experimental group were more satisfied with the nutrition information they received and more often reported changing their diet or intention as a result of the information. CONCLUSIONS: It is concluded that computer-tailored nutrition information is a promising means of stimulating people to change their diet toward dietary recommendations.

Analysis of Variance↗