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PubMed1985

A complete computerized program for nutritional management in the neonatal intensive care nursery.

A computerized program in BASIC, which integrates the infant's fluid and nutritional requirements per gestational age and weight with the infant's postpartum age, was developed using the Apple II Plus microcomputer, dual floppy disks, and an Epson printer. Daily requirements of fluids, proteins, fat, CHO, vitamins, minerals, and trace elements are computed. For reference, the program displays the composition and indications for intravenous and hyperalimentation solutions, mature human milk, and 14 commercial formulas. Safety limits to prevent overload or deficient formulations are strategically displayed, warning the physician about possible complications and gradually orienting him toward achieving adequate nutritional balance in the patient. The nutritional intake, weight, and other important clinical variables are stored and retrieved for future evaluation. The flexibility of the program allows for modifications in intravenous and oral composition according to clinical requirements. The program improves the efficiency of the arduous daily formulation of nutritional needs, reduces the possibility of human error, facilitates the calculation process, diminishes time spent on the calculations, and increases the ease of nutritional data retrieval and the development of output programs.

Birth Weight↗
PubMed2003

A formative evaluation in maternal and child health practice: the Partners for Life Nutrition Education Program for pregnant women.

OBJECTIVES: This paper describes the formative evaluation of the Partners For Life Program that was developed to change dietary behavior of low income pregnant women in the Mississippi Delta region. METHODS: A diverse group of nutrition/health professionals, adapted the Expanded Food and Nutrition Education Program's (EFNEP) methodology for pregnant patients in the local Women, Infants, and Children program who were receiving maternity care at the county health department. Formative evaluation activities included gathering data to determine 1) whether a new nutrition curriculum, modeled after EFNEP could be created, 2) whether peer educators could be recruited and trained to deliver the intervention, 3) whether pregnant women could be recruited to participate in the new program, 4) whether a pilot test of the new intervention would produce short-term impact in nutrition knowledge and dietary behavior, and 5) reactions of pregnant women on the usability of the new program. Data were gathered through use of the Program Implementation Index, focus groups, and a retrospective record review. Pilot test assessments included tests of nutrition knowledge and self-reported changes in dietary behavior. RESULTS: The formative evaluation demonstrated both positive and negative outcomes. Positive data included 1) successful recruitment and training of the peer educators to deliver the intervention; 2) successful recruitment of the targeted population for the pilot study; 3) complete information on project questionnaires and measuring forms; and 4) among those who completed the program, a statistically significant improvement in nutrition knowledge and dietary behavior. Two negative aspects in this formative study were 1) the Program Implementation Index quantitatively showed that the program experienced problems retaining participants it recruited and 2) deviation of the timeframe for intervention delivery. Program length was identified as the primary reason for participant attrition. CONCLUSIONS: It is important for program developers to use results from formative evaluations to make changes in problem areas prior to implementation of a full-scale impact evaluation.

Advisory Committees↗
PubMed2002

Outcomes of continuous process improvement of a nutritional care program incorporating TTR measurement.

Early assessment of protein calorie malnutrition (PCM) can improve the outcome for hospitalized patients by allowing the initiation of nutrition support if required. In addition, monitoring nutritional status during the hospital stay can identify a decline in or improvement of PCM so that alterations to treatment regimens can be made if needed. The visceral protein albumin is the traditional laboratory indicator of PCM. In the past decade another protein has been lauded as a superior marker that can be used in conjunction. We undertook several studies to test the effectiveness of TTR as an aid in nutritional assessment. We found TTR to be a sensitive measure of nutritional status, allowing for earlier assessment and intervention, thus reducing length of stay and other hospital associated costs. Based on these findings, our hospital generated and implemented a multidisciplinary nutrition care program. Transthyretin is an integral portion of this program; levels are determined on admission and repeated twice weekly until discharge.

Biomarkers↗
PubMedDate not supplied

Content analysis of the use of fantasy, challenge, and curiosity in school-based nutrition education programs.

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.

Child↗
PubMed1996

Effect of participation in congregate-site meal programs on nutritional status of the healthy elderly.

OBJECTIVE: This study was designed to evaluate whether participation in a congregate-site meal program influenced the nutritional status of a group of healthy elderly. DESIGN: Nutritional status, as defined by dietary intake and biochemical indexes, was assessed in free-living persons (aged 60 to 89 years) who either did (n = 70) or did not (n = 65) participate in the meal program. Three-day mean intakes of 17 nutrients and serum levels of 13 indexes of nutritional status were measured. STATISTICAL ANALYSES: Multifactorial analysis of variance was used to determine differences in nutrient intake data and biochemical indexes between the groups. By means of correlation analysis, relationships between income and main outcome measures were examined. chi 2 Analysis was used to determine differences in response to categorical variables of the questionnaire. RESULTS: In general, dietary intakes of participants did not differ significantly from those of nonparticipants, nor did the meal provided at the site significantly affect the overall dietary intake of participants. Mean biochemical indexes of nutritional status were within normal ranges for participants and nonparticipants, except for iron. However, 26% of the population consumed diets that may place them at risk for nutritional inadequacy. CONCLUSIONS: Mean dietary intake data and biochemical indexes of nutritional status suggest that the congregate-site meal program did not significantly affect the nutritional status of the population surveyed. Additional studies focusing on the nutritional intake and status of low-income, ethnic minority, and socially isolated participants in the congregate-site meal program are needed to assess which populations are at risk for nutritional deficiencies.

Aged↗
PubMed1989

Nutritional impact of acquired immune deficiency syndrome: a unique counseling opportunity.

The acquired immune deficiency syndrome (AIDS) presents a challenge for dietitians. Changes in the immune system have a potentially detrimental effect on nutritional status as a result of conditions such as anorexia, infection, diarrhea, and drug side effects. Conversely, poor nutrition status may adversely alter the immune systems. Dietary guidelines for the management of these conditions and additional obstacles are discussed. When counseling patients with AIDS, the dietitian needs to be aware of and sensitive to alternative therapies, to evaluate their effectiveness, and to assist in determining their place in the patient's treatment. Psychosocial factors that could influence nutritional status, such as dementia, unemployment, and isolation, must also be taken into consideration. A nutrition program has been established to address the needs of AIDS patients at AIDS Project Los Angeles-Necessities of Life Program (APLA-NOLP), a food distribution center. The goal of the program is to maintain or improve the client's nutritional status by providing education and counseling. The nutrition program has been enthusiastically received, and the outcome of the program on the nutritional status of the participants is currently under study. The dietitian is in a unique position to intervene by providing resource information, food preparation tips, and individualized nutrition plans. It is imperative that the dietitian become familiar with the AIDS disease process and its implications for nutritional status to be considered an expert in the nutrition management of such patients.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Ecologic study of children's use of a computer nutrition education program.

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.

Adolescent↗
PubMed2007

Health and nutrition education program in primary schools of Crete: changes in blood pressure over 10 years.

OBJECTIVE: To examine the long-term effects of the 'Cretan Health and Nutrition Education Program' on blood pressure. SUBJECTS: A representative population of 176 pupils (85 from the intervention schools and 91 from the control schools). DESIGN: Blood pressure, dietary, anthropometrical and physical activity data were obtained at baseline (academic year 1992-1993) and at follow-up examination (academic year 2001-2002). RESULTS: The findings of the current study revealed that the increase over the 10-year period in systolic (SBP) and diastolic blood pressure (DBP) was higher in the control group (CG) than in the intervention group (IG) (P=0.003 and P<0.001 respectively). Regarding dietary indices, the IG were found to have a significantly higher intake of potassium (P=0.018) and magnesium (P=0.011) compared to the CG. Furthermore, the decrease in body mass index (BMI) z-score observed in the IG was found to differentiate significantly from the increase observed in the CG (P=0.042). On the contrary, the increase in leisure time, moderate to vigorous physical activities (MVPA) observed in the IG, was found to differentiate significantly from the decrease observed in the CG (P=0.032). Intervention's effect on SBP was mediated by changes in MVPA (beta=-0.20, P=0.030) and BMI (beta=0.19, P=0.048). Similarly, intervention's effect on DBP was mediated by changes in MVPA (beta=-0.18, P=0.048), BMI (beta=0.26, P=0.007) and magnesium intake (beta=-0.20, P=0.048). CONCLUSION: The findings of the current study are encouraging, indicating favorable changes in blood pressure, micronutrients intake, BMI and physical activity over the 10 years of follow-up and 4 years after program's cessation, thus providing some support for the effectiveness of school-based health education programs in successfully tackling certain chronic disease risk factors early in life.

Adolescent↗
PubMedDate not supplied

Outcomes of continuous process improvement of a nutritional care program incorporating serum prealbumin measurements.

It has been reported that the risk of protein-calorie malnutrition (PCM) for hospitalized patient populations can be as high as 50%. Left undiagnosed. PCM can lead to serious consequences, including increased morbidity and mortality. Visceral protein albumin is the traditional laboratory indicator of PCM. In the past few years, however, several other visceral proteins have been lauded as superior markers. We undertook several studies to test the effectiveness of using one of these, prealbumin, as an aid in nutritional assessment. We found prealbumin to be a sensitive measure of nutritional status, allowing for earlier assessment and intervention, and thus reducing length of stay. Based on these findings, our hospital has generated and implemented a multidisciplinary nutrition care program that meets the 1995 Joint Commission on Accreditation of Healthcare Organizations Nutrition Care Standards. Prealbumin testing is an integral portion of this program; levels are determined on admission and repeated semi-weekly until discharge. Use of this program has led to improved patient care and financial benefit to the hospital.

Adult↗
PubMed1989

Nutrition intervention program in a prenatal clinic.

Pregnant women who are underweight for height and gestational age are at risk of delivering infants weighing less than infants born to women of standard weight. This study demonstrated that a nutrition intervention program geared toward these high-risk women improved infant outcome. A group of 57 underweight and failure-to-gain pregnant women (treated) who received extensive nutrition counseling and follow-up from a nutritionist throughout their pregnancy was compared with a similar group of 52 underweight pregnant women (control) who received no counseling. Women in the treated group gained significantly more weight during their pregnancy than did controls. The treated women also delivered infants who averaged 300 g heavier than those born to the control group, a statistically significant difference. Other factors reported to compromise infant outcome such as ethnic background, income status, age, and smoking did not significantly affect infant birth weight.

Birth Weight↗
PubMedDate not supplied

Programs that mitigate the effects of poverty on children.

This article reviews six federally funded in-kind public assistance programs that are intended to mitigate the effects of poverty on low-income children by providing access to basic human necessities such as food, housing, education, and health care. The evidence suggests that, while each program can be improved, these programs do achieve their basic objectives. In general, food stamps, the Special Supplemental Food Program for Women, Infants, and Children (WIC), and school nutrition programs are successful at providing food assistance to low-income children, starting with the prenatal period and continuing through the school years. The Food Stamp Program provides food assistance nationwide to all households solely on the basis of financial need and is central to the food assistance safety net for low-income children. The WIC program has helped reduce the prevalence of iron-deficiency anemia in infants and children and has increased intakes of certain targeted nutrients for program participants. The school nutrition programs provide free or low-cost meals that satisfy the dietary goals of lunches and breakfasts to most school-age children. The Medicaid program has extended health insurance coverage to millions of low-income children. However, many children remain uninsured, and children enrolled in Medicaid do not have the same access to medical care as privately insured children. Relatively little is known about the effects of Medicaid on children's health status. For Head Start, empirical evidence suggests that participating children show enhanced cognitive, social, and physical development in the short term. Studies of the longer-term impacts of Head Start are inconclusive. Although housing assistance improves housing quality and reduces housing costs for recipients, there is a large unmet need for acceptable, affordable housing among poor families. Important gaps remain in our knowledge of the effects of these programs on the well-being of children. Questions regarding a program's effects over time on health and developmental outcomes particularly need more study.

Adolescent↗
PubMed1997

Twenty years of WIC: a review of some effects of the program.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) began in 1974 after a 2-year pilot program. WIC links food assistance and nutrition education to health care for at-risk persons. The program had approximately 344,000 participants in 1975 and has grown to provide services to nearly 6 million participants. Infants born to women who participate in WIC during pregnancy tend to have a slightly higher mean birth weight than those born to women who were eligible but did not participate in WIC. Higher birth weight has been associated with a slightly higher mean gestational age. The prevalence of low birth weight and very low birth weight among infants and the prevalence of iron deficiency anemia among toddlers and preschool children is lower for those participating in WIC than for those not participating in WIC.

Anemia↗
PubMed1998

Nutrition support programs for young adult athletes.

After graduating from college and entering the work force, young adult athletes often struggle with the task of fueling themselves optimally for top performance and weight control. The stresses and time constraints of work, family, and social responsibilities often result in eating fast foods on the run. These young adults can benefit from nutrition education programs in the worksite, at health clubs, in the community, and via the media. Dietitians who specialize in sport nutrition have particular appeal to these athletes, who are struggling to each well, exercise well, and stay lean yet put little time or effort into their food program. This article includes two case studies of young adults and the dietary recommendations that taught them how to make wise food choices, fuel themselves well for high energy, and control their weight.

Adult↗
PubMed1997

Lower-fat menu items in restaurants satisfy customers.

OBJECTIVE: To evaluate a restaurant-based nutrition program by measuring customer satisfaction with lower-fat menu items and assessing patrons' reactions to the program. DESIGN AND SETTING: Questionnaires to assess satisfaction with menu items were administered to patrons in eight of the nine restaurants that volunteered to participate in the nutrition program. One patron from each participating restaurant was randomly selected for a semistructured interview about nutrition programming in restaurants. SUBJECTS: Persons dining in eight participating restaurants over a 1-week period (n = 686). STATISTICAL ANALYSES PERFORMED: Independent samples t tests were used to compare respondents' satisfaction with lower-fat and regular menu items. Two-way analysis of variance tests were completed using overall satisfaction as the dependent variable and menu-item classification (ie, lower fat or regular) and one of eight other menu item and respondent characteristics as independent variables. Qualitative methods were used to analyze interview transcripts. RESULTS: Of 1,127 menu items rated for satisfaction, 205 were lower fat, 878 were regular, and 44 were of unknown classification. Customers were significantly more satisfied with lower-fat than with regular menu items (P < .001). Overall satisfaction did not vary by any of the other independent variables. Interview results indicate the importance of restaurant during as an indulgent experience. CONCLUSIONS: High satisfaction with lower-fat menu items suggests that customers will support restaurant providing such choices. Dietitians can use these findings to encourage restaurateurs to include lower-fat choices on their menus, and to assure clients that their expectations of being indulged are not incompatible with these choices.

Adult↗
PubMed2006

Correlates of mood changes in obese women initiating a moderate exercise and nutrition information program.

This 20-wk. study assessed relationships of mean difference scores on measures of self-efficacy and self-concept with scores for overall mood in 44 obese women who initiated a moderate exercise and nutrition information program. Simultaneous entry of changes in Physical Self-concept, Exercise Self-efficacy, and Body Areas Satisfaction scale scores into a multiple regression equation explained a significant 38% of the variance in changes in Total Mood Disturbance (R2 = .38, F3,40 = 8.09, p < .001).

Adult↗