Food regulations as obstacles to success in nutrition intervention programs.
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Effective nutrition support programs for college athletes.
This paper presents an overview of the Husky Sport Nutrition Program at the University of Washington. This program is a component of the Department of Intercollegiate Athletics Total Student-Athlete Program, an NCAA-sponsored CHAMPS/Life Skills Program that provides life skills assistance to student-athletes. Successful integration of a sport nutrition program requires an understanding of the athletic culture, physiological milestones, and life stressors faced by college athletes. The sport nutritionist functions as an educator, counselor, and administrator. Team presentations and individual nutrition counseling provide athletes with accurate information on healthy eating behaviors for optimal performance. For women's sports, a multidisciplinary team including the sport nutritionist, team physician, clinical psychologist, and athletic trainer work to prevent and treat eating disorders. Case studies are presented illustrating the breadth of nutrition-related issues faced by a sport nutritionist working with college athletes.
Adult↗
Needs and preference assessment for an in-home nutrition education program using social marketing theory.
Nutrition education programs for elder caregivers (CG) and their elder care recipients (CR) are important in preventing malnutrition. Using Social Marketing Theory, this study assessed the needs and preferences for nutrition education in elder CGs and their CRs in Guilford County, NC. Thirty-two pairs of community-residing elder CGs/CRs and three focus groups (FGs) participated. Health and diet questionnaires were administered to all CGs/CRs during in-home interviews. CGs/CRs and FGs evaluated nutrition education materials. Questionnaires were analyzed using SPSS v9. Ethnograph v5.0 was used to code the interviews regarding the education materials. The CGs were middle age (58.9 years), overweight (BMI = 28.8) Caucasian women. The CRs were old (79.4 years), overweight (BMI = 26.0) Caucasian women. Identified malnutrition risk factors of CGs and CRs included inadequate fluid and dietary intake, polypharmacy, and chronic disease. Identified nutrition needs and education preferences of CGs/CRs were similar. Perceived nutrition education preferences of the FGs did not reflect the interests of the CGs/CRs. This information is being used to revise the education materials and develop an in-home nutrition education program for CGs and CRs in Guilford County, NC.
Aged↗
Growth pattern of overweight preschool children in the Siouxland WIC program.
Demographic, nutritional, and anthropometric data were collected from 134 preschool children enrolled in the Siouxland Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). All children were diagnosed as overweight between the ages of 8 months and 3 years. Weight and length/height z-scores were calculated for birth measurements and for postnatal measurements up to 3 years. The main hypothesis involved stability of weight and length/height z-scores between successive WIC visits. Average changes in z-scores between measurements were calculated and tested for significance using paired t-tests. Multiple regression analysis was used to test relationships between changes in weight z-scores and demographic/nutritional characteristics. The overweight group had a higher percentage of Hispanic children than the total Siouxland WIC population. Overweight children were also significantly different in terms of birthweight, monthly household income, number in the house, and mother's education level. The children displayed a large average increase in weight z-scores between birth and 8 months (P < 0.001). Weight z-scores also increased significantly between 12 and 30 months. Length z-scores increased significantly between 18 and 30 months but remained lower than weight z-scores. Initial weight, sex of child, breastfeeding, and household size were significantly related to changes in weight z-scores among overweight children. Results of recent studies suggest that rapid weight gain in infancy may increase the risk of overweight during later childhood.
Analysis of Variance↗
Dissemination and use of a school-based nutrition education program for secondary school students.
Program dissemination and implementation represent critical components of effective school-based health promotion interventions. This study examined the dissemination and implementation of a nutrition teaching program, Nutrition For Life, in New York State secondary schools. Some 1,312 health, home economics, and physical education teachers in junior and senior high schools provided information through random sample mail surveys. Logistic regression procedures examined teacher and school characteristics associated with receipt and use of the program. Overall, 50% of junior high school and 33% of senior high school teachers received the program and three-quarters of these teachers used it. At both levels, home economics teachers were more likely to receive and use the program than health teachers. Peer-led teacher training workshops organized through an existing community-based network provide an effective and efficient mechanism for disseminating nutrition teaching programs.
Adolescent↗
Nutrition communication program: a direct mail approach.
A nutrition communication model (7) provided the framework for developing and evaluating a mass communication program for families with young children. A three-way interactive communication system via direct mail combined some of the attributes of interpersonal communication with the efficiency of mass-mediated communication. This interaction within the family and between the family and the nutrition communicator was expected to enhance the probability of improvement in nutritional knowledge, attitudes, and practices. The nutrition program took a holistic approach in order to develop an understanding of basic concepts important for making decisions about diet and food selection. Results from audience lists showed that the communication strategy led to desired interaction, particularly within the family reference group. Family discussion occurred frequently, and the amount of feedback was moderate. Attention paid to the messages was good for fathers and very good for mothers. As measured two weeks after program completion, nutrition knowledge increased significantly, and six of nine measured behaviors changed in the desired direction. In addition, one-third to one-half of the participants reported specific changes in food practices. The nutrition communication program was generally effective. The evidence of behavioral changes shows that it is possible to influence food practices with a mass communication program. These results support the belief that the limited effects of mass-mediated programs have been due at least in part to the way the channel has traditionally been used.
Communication↗
[Resume of activities in the Program of Education in Diet and Nutrition EDALNU program)].
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Diet↗
Factors associated with attendance in a voluntary nutrition education program.
PURPOSE: This paper examines factors associated with attendance in a National Cancer Institute-funded randomized trial of nutrition education to increase fruit and vegetable consumption among women served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). SETTING: The study took place at 16 WIC sites in Maryland. SUBJECTS: The participants were 1528 women who were enrolled in WIC or who had children enrolled in WIC, were > or = 18 years of age, and planned to continue enrollment at that WIC site for at least 6 months (68% of eligible women approached agreed to participate). INTERVENTION: Women received personal invitations, letters, and telephone reminders from peer educators encouraging their attendance at three bimonthly nutrition sessions. MEASURES: Demographic data were collected in a baseline survey. Attendance data and telephone and address changes were also collected. The postintervention survey included a question regarding reasons for nonattendance. Focus groups were also held to ascertain reasons for attendance or nonattendance. Chi-square tests of trend and multiple logistic regression, adjusted for within-site correlation, were used in statistical analyses. RESULTS: Fifty-four percent of enrollees attended at least one session. Multiple logistic regression analysis showed increased odds of attending with higher age, breast-feeding, and/or knowledge of the recommendation to eat five or more servings of fruits and vegetables daily. There were decreased odds of attending for pregnant women who already had children. There were nonsignificant trends toward decreased attendance among unmarried women compared with married women and among blacks compared with nonblacks. Reasons given for nonattendance included withdrawal from WIC, moving, conflicting activities, negative feelings about nutrition education, and lack of transportation or child care. CONCLUSIONS: The results suggest that numerous barriers hinder participation in nutrition programs aimed at low-income women. These barriers should be considered by health care professionals when planning intervention programs. Overcoming these barriers presents a major challenge.
Adolescent↗
Testing mediating variables in a school-based nutrition intervention program.
This study identified mediators of a school-based nutrition intervention for 4th graders and their parents. Nine variables were tested for satisfying 4 conclusions necessary to establish mediation of intervention effects on changes in fruit and vegetable consumption (FVC) in 4th graders (N = 1,676). FVC was measured in children by the use of 24-hr dietary recalls. Mediators were assessed by the use of questionnaires completed by children and parents. All 4 conclusions were met for positive outcome expectancies. Knowledge, self-efficacy, and parent consumption satisfied the first 3 conclusions for mediation but the mediating effects were not statistically significant (Conclusion 4). Future mediational analyses and the creation of a national database of mediators are crucial for increasing strength and efficiency of school-based nutrition programs.
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The pregnant adolescent. A review of nutritional research and programs.
Avialable nutritional research on pregnant adolescents shows that suboptimal food intake is common. Multiple social, psychologic, and economic problems may mitigate against attainment of adequate nutritional status. Use of supplements will raise the level of some nutrients, but in reported studies, their use by girls was erratic, and routine use is not favored by many practitioners. Results of nutritional counseling are mixed. Multidisciplinary programs, usually providing comprehensive prenatal care while enabling girls to continue their education, have been instituted in many areas, reflecting a changed attiude of school officials toward the pregnant adolescent. Most of these programs include the nutrition classes, counseling, or services valuable to mother and child; however, they do not reach all pregnant adolescents and are not a panacea guaranteeing adequate nutrition for them. More research and a national policy to provide optimal nutrition for all pregnant women, including the adolescent, are needed.
Adolescent↗
Chile's national nutritional supplementation program for older people: lessons learned.
Demographic changes in developing countries have resulted in rapid increases in the size of the older population. As a result, health-care budgets face increasing costs associated with the declining health and function of older people. Some governments have responded to this situation by designing innovative programs aimed at older people. One such program, implemented by the government of Chile, distributes an instant food mix fortified with vitamins and minerals to all persons over 70 years old who are registered by the national health service. The national health service covers approximately 90% of the older population. The program specifically targets nutritional vulnerability and micronutrient deficiency, which are common among poor older people in Chile. We present here the findings of a one-year investigation into all aspects of Chile's program for the elderly. The research included in-depth interviews with policy makers and program implementers, focus group discussions with user groups, analysis of the micronutrient content of the nutritional supplement, and telephone interviews of a random sample of older people. The results demonstrate that there can be a considerable degree of self-targeting within national programs; programs need to be sufficiently flexible to permit periodic protocol change; user groups must be consulted both before and during program implementation; and the design of an effective program evaluation must be in place before program implementation. It is hoped that these results will be useful to policy makers and implementers planning programs aimed at improving the health and function of older people.
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[Current nutrition supporting programs of the population in the USA].
In this work main programs of nutrition-supporting in the USA were presented as a part of national and local social and health policy. Following programs were reviewed namely: FSP (The Food Stamp Program), NSLP (The National School Lunch Program), SBP (School Breakfast Program), SMP (The Special Milk Program), WIC Program (The Special Supplemental Food For Women, Infants and Children), SFSP (The Summer Food Service Program). The level of monthly income per person (no more than 130% of poverty line) is the condition for participation in every program. Some programs (e.g. FSP) are addressed to all citizens, who are fulfilling income criteria, whereas other (e.g. WIC, SBP) are available to selected population groups only. Assistance within these programs may occur in various forms (e.g. food stamps for family, possibilities in using of low cost meals, free of cost milk for school children). Authors suggest to utilize some of US experience in nutrition-supporting programs also in Poland.
Health Promotion↗
Design considerations for multidisciplinary continuing nutrition education programs.
A multidisciplinary group of nutritional care providers was surveyed to assess degree of agreement on the relative importance of various areas of nutrition knowledge. A 35-item nutrition content area survey was mailed to a stratified, random sample (n = 400) of the American Society for Parenteral and Enteral Nutrition (ASPEN) membership representing dietitians, nurses, pharmacists, and physicians. Through the use of modified Delphi survey, respondents rated each content area as 'essential,' 'useful,' or 'nonessential' for inclusion in a proposed test to assess nutrition knowledge. Respondents from all disciplines agreed that they should be knowledgeable in 22 of the 35 content areas. Chi square tests were used to assess significant response differences among disciplines. Systematic differences were primarily between dietitians and pharmacists. The study results provide direction to multidisciplinary continuing nutrition education program planners regarding appropriate content for combined discipline programs as well as for those more discipline-specific.
Animals↗
Outcomes from a school-based nutrition education program alternating special resource teachers and classroom teachers.
This study modified a successful nutrition program to improve its transferability and potential for institutionalization. Specific aims were to determine: 1) if 16 nutrition lessons taught alternately by special resource teachers (SRT) and classroom teachers, could produce outcomes equivalent to 24 SRT lessons; and 2) teachers' reactions to the program. The quasi-experimental design used classrooms (19 treatment and 19 comparison) in matched schools. Surveys and plate waste measured children's outcomes, and classroom teachers were observed and interviewed. Treatment students showed greater knowledge and self-efficacy scores and consumed 0.36 more servings of fruits and vegetables at lunch. Behavioral differences between groups were greater when SRTs provided all instruction. Teachers supported the program and anticipated teaching more nutrition on their own, but noted serious structural barriers. Findings support the need for long-term contact to induce behavior change and the advantage of using teachers specifically trained in nutrition and experiential education.
Attitude to Health↗
The association of prenatal nutrition and educational services with low birth weight rates in a Florida program.
Nutrition services and education, provided as components of normal prenatal care, have a key role in preventing preterm delivery and low birth weight (LBW). To determine the influence of these components on a woman's risk of having a LBW infant, the authors examined groups of patients who were receiving the services. Bivariate analyses were made of 9,024 prenatal charts of single births. Most women received nutrition education, prescriptions for nutrient supplements, screenings for anemia, and dietary assessments. A greater proportion of the women at high risk received the interventions than did women at lower risk. The presence of educational components and assays for anemia were associated with a lower risk of a LBW delivery in the total group and in the high risk groups.
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Assessment of the Mission Nutrition nutrition education program.
In 1998, Dietitians of Canada and the team of registered dietitians at Kellogg Canada Inc. partnered to develop Mission Nutrition, a national bilingual nutrition education program that provides curriculum-based resources to teachers. The main objectives of this study were to measure the awareness and utility of the Mission Nutrition program among elementary teachers, and to identify opportunities to enhance the Mission Nutrition resources to increase use. A ten-minute telephone survey was conducted with a representative sample of 203 elementary school teachers. A sub-sample of 20 teachers then participated in a more in-depth 30-minute telephone survey. A need for increased promotion of the Mission Nutrition program was identified on the basis of the 22% awareness among teachers participating in the initial interview. All teachers who had used the educator guides and student activity sheets reported that they would use them again. Teachers found that the Mission Nutrition materials were well-researched and contained useful activities relevant to students. The findings indicate that, to be most effective, nutrition education resources should be provided in a ready-to-use format and integrated with core curricula. Teachers also suggested that materials should include fresh ideas to engage students at different grade levels, and ways to involve parents. Dietitians are ideally positioned to work collaboratively with educators to develop these types of nutrition education resources.
Adult↗
Biennial survey of physician clinical-nutrition training programs.
This is the fourth survey of physician clinical-nutrition training programs. As in previous reports, current fellowship training programs were identified, descriptive information obtained, and program content surveyed. In addition, a questionnaire developed by the American Board of Nutrition Committee on Fellowship Training Programs was used to determine the degree of emphasis given to content in the areas of basic nutrition science, clinical applications, and research training. Among the 38 programs identified, uniform ratings of importance were found in all major topic areas. There was also uniformity in most subtopics, with minor exceptions. As expected, in the area of nutrition in the life cycle, pediatric training programs emphasized infancy and childhood whereas medical-surgical programs emphasized adulthood and aging. Alcoholism was emphasized in medical-surgical training programs whereas cystic fibrosis and inborn errors of metabolism were emphasized in pediatric programs. Nutrition in burn patients received minor emphasis in all programs. The overall uniformity of curricular content in training programs confirms the contention that clinical nutrition has a defined clinical scope and should be considered for establishment as a recognized subspecialty in American medicine.
Education↗
It just really clicked: participant-perceived outcomes of community nutrition education programs.
OBJECTIVE: To understand participant-perceived outcomes of community nutrition education programs by low income adults. DESIGN: A grounded theory approach using qualitative interviews. SETTING: Rural and urban communities in New York State and Pennsylvania. PARTICIPANTS: 18 current and past participants in nutrition education programs for low income adults. PHENOMENA OF INTEREST: Participants' perceived outcomes of community nutrition education programs. ANALYSIS: Qualitative analysis derived from the constant comparative method. RESULTS: Participants described program experiences in three linked thematic areas: (1) a range of motives for program enrollment; (2) current roles, challenges and resources as program contexts; and (3) participant-perceived outcomes experienced throughout the program that were linked to their motives for enrolling. Short- and medium-term outcomes, especially social outcomes, were important to participants; positive experiences were linked to later behavior change by participants, even among those who did not initially report change. CONCLUSIONS AND IMPLICATIONS: Participant-perceived outcomes and program satisfaction were linked to enrollment motives and modified by whether participants' current worlds provided resources to put learning into practice. Participant inputs such as enrollment motives and resources should be included in planning models, assessed at multiple points, matched to expected program outcomes, and used to guide teaching.
Adult↗