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PubMed2000

Nutrition intervention group program based on preaction-stage-oriented change processes of the Transtheoretical Model promotes long-term reduction in dietary fat intake.

OBJECTIVE: To develop and evaluate the long-term effectiveness of an intervention program, based on preaction-stage-oriented change processes of the Transtheoretical Model of Behavior Change, that could be delivered in a group setting to help participants lower dietary fat intake. DESIGN: An enhanced version of the nonequivalent control group experimental design was used. Entire sections of an undergraduate introductory nutrition science course were assigned to an experimental, pretest/posttest control, or posttest-only control group. Daily fat intake and stage of change of the experimental and pretest/posttest control groups were determined at the pretest and posttest and 1-year later at a follow-up test. Every 1 to 2 weeks during the study, stage of change of the experimental group was assessed. Daily fat intake of the experimental group was assessed at study midpoint. Daily fat intake and stage of change of the posttest-only control group was determined at the posttest. Pretest results were used to place participants of the experimental and pretest/posttest control groups in either the preaction stage (i.e., precontemplation, contemplation, or preparation) or the action/maintenance stage. SUBJECTS/SETTING: The sample consisted of 38, 30, and 42 undergraduate students who were assigned to the experimental, pretest/posttest control, and posttest-only control groups, respectively. INTERVENTION: The experimental group participated in a group-based, dietary fat intake intervention that included a series of 11 lessons taught over a 14-week period. Each lesson was based on 1 or 2 of the preaction-stage-oriented change processes of the Transtheoretical Model. MAIN OUTCOME MEASURES: Data were evaluated to determine the effects of the intervention program on long-term dietary fat reduction and stage of change progression. STATISTICAL ANALYSIS PERFORMED: Analysis of variance, repeated-measures analysis of variance, and paired t tests. RESULTS: For pretest and posttest dietary fat intake scores, stage and time were significant, and there was a significant time-by-stage interaction. Time was significant for pretest and posttest stage scores. Subjects in the preaction-stage experimental group significantly increased their mean stage of change and reduced their fat intake between the pretest and posttest; these changes persisted for 1 year. Pretest/posttest control group participants who began in a preaction stage also significantly increased their mean stage and reduced fat intake by the posttest, but these changes did not endure until the follow-up test. APPLICATIONS/CONCLUSIONS: This intervention program produced an enduring, significant reduction in mean dietary fat consumption and a significant progression in mean stage of change of subjects in the experimental group who were in the preaction stage. It may be appropriate to design group interventions to use preaction stage processes rather than the more traditionally used action and maintenance stages change processes.

Adolescent↗
PubMed2005

[Implementation of State Policy in healthy nutrition of the population of the Russian Federation on the regional level: building-up regional policy and programs. Methodical aspects of development and implementation. Part 2. Recommendations were made development and realization of regional policy and programs in the healthy nutrition of the population].

Recommendations were made development and realization of regional policy and programs in the healthy nutrition of the population.

Food Supply↗
PubMed1993

Conceptual framework for nutrition surveillance systems.

This article describes the evolution of nutrition surveillance as an intervention strategy and presents a framework for improving the usefulness of nutrition surveillance programs. It seems clear that such programs' impact on nutritional well-being will depend increasingly on their ability to reach and influence decision-makers. Therefore, it is important to consider political and social forces, and also to realize that if a program is too decentralized or too far removed from key decision-makers, its ability to influence resource flows may be limited. It is of course important that the surveillance information provided be appropriate and of good quality. Therefore, the data collected should be analyzed to ensure they are accurate and representative. Once that has been done, relevant findings should be presented in a readily understandable form designed to meet the intended recipients' information needs. Such findings should also be disseminated to all important decision-maker constituencies, including external donors of nutrition assistance and the general public.

Caribbean Region↗
PubMed2000

[Evaluation of a state social program including a nutritional component implemented in the city of Cordoba for the elderly. 1999].

Actually the nutrition programmes had become into a fundamental resource for people living in low social conditions, to cover their feeding requires. The elderly retired persons with high socio-economic vulnerability are the direct beneficiaries of a social programme that includes a nutritional intervention executed by the PAMI. OBJECTIVE: Evaluate the ProBienestar programme at Córdoba Capital city during 1999. MATERIAL AND METHOD: Descriptive and transversal study. TARGET GROUP: Older aged persons from 60 years old or more (n = 330) and assistance units (n = 26) TECHNIQUES: Survey observation VARIABLES: Focal criterions, accessibility, food assistance nutritional quality, socio-economic status, nutrition specialists participation, beneficiaries satisfaction assessed into the following dimensions "satisfaction with the including requirements", "food assistance regularity", "adjustment to the beneficiaries food consumption standard", "food quality". RESULTS: The beneficiaries are between 60 and 74 years aged; most of them are widows and separated women that live with their sons or/and daughters or/and grandchildren. The most are owners of the house they live in. There is a different opinion between beneficiaries and assistance units' responsible at the moment of establish the including criterions. The food assistance is regular and geographic and administrative accessible. There is some difficult by the way of the older aged beneficiaries to recall the food aid boxes. The nutritional quality of the complement for one-person box was assessed as good, while for the two-persons boxes the quality downs. It is adequate to the food consumption standard of the older aged beneficiaries. CONCLUSION: The satisfaction degree of the beneficiaries is high. (73%).

Aged↗
PubMed1999

[Evolution of the weight-height and weight-age relationship in children 3-6 years of age receiving preschool care in Sorocaba (SP), Brazil].

The nutritional status of Brazilians has improved over the last three decades. Still, little is known about the role played by nutritional assistance programs that public institutions and philanthropic organizations provide for low-income preschool children, who face greater nutritional risk. Therefore, we carried out a quasi-experimental study to evaluate the nutritional impact of the municipal preschool nutritional assistance program in the city of Sorocaba, São Paulo, Brazil. Over the course of a year, we performed quarterly measurements of weight and height on 444 children, whose ages ranged from 3 months to 6 years. In this population, 164 children were assisted by the preschool nutritional program (intervention group), and 280 children were not (nonintervention group). The children in the nonintervention group were identified by a special census for that purpose; they did not attend the preschool but lived nearby. After obtaining informed consent and carrying out a pretest, professionals and university students interviewed the mothers of the participating children, following standard techniques and conditions. Anthropometric measurements were done by teams of two interviewers, one of whom was a permanent member of the team, using equipment calibrated by the appropriate regional technical organization. The correspondence between the first measurement and subsequent measurements was evaluated by stratifying the population into three groups by z scores for weight-for-age and for weight-for-height, using U.S. National Center for Health Statistics reference curves. The z score groupings were established at the beginning of the study for three different age groups: younger than 24 months, 24-36 months, and older than 36 months. The two study groups (intervention and nonintervention) were similar sociodemographically, with the following exceptions: maternal employment (more of the mothers of children in the intervention group had jobs outside the home); age (children in the intervention group were significantly older); nutritional status (it was worse in the intervention group); and prevalence of hospital admittance (it was higher in the intervention group). After just the first three months of the study, 32% of the children in the intervention group had moved to a higher nutritional stratum, whereas only 13% of children in the nonintervention group had shown improved nutritional status. The difference in favor of the intervention group increased with the length of the intervention and was higher among older children. These results show that the preschool nutritional assistance program helped to improve the assisted children's nutritional status.

Age Factors↗
PubMed2003

A video lesson series is effective in changing the dietary intakes and food-related behaviors of low-income homemakers.

OBJECTIVE: To examine the relative cost-effectiveness of a self-administered video series in delivering nutrition education to low-income homemakers. DESIGN: A quasi-experimental design was used, with subjects randomly assigned to traditional lessons (Traditional Group) or video lessons (Video Group). SUBJECTS/SETTING: 108 subjects were recruited, with 93 nonpregnant, low-income, female homemakers completing the study (response rate = 86%). Subjects had recently enrolled in the Expanded Food and Nutrition Education Program, or the Food Stamp Nutrition Education Program, and had a videocassette recorder and telephone. INTERVENTION: Both groups received 12 lessons from the Eating Right Is Basic Series, 3rd edition, with the Traditional Group being taught in face-to-face sessions and the Video Group receiving self-administered, video-lesson packets. OUTCOME MEASURES: Dietary intake and food behaviors were assessed at pre and post intervention with 24-hour recalls and a 14-item checklist. STATISTICAL ANALYSES: Chi(2) and t tests were used to compare the groups on demographics and pre-intervention dietary factors. Multiple analysis of variance was used for comparisons of change from pre to post intervention. RESULTS: Significant improvements were observed in both groups for fruits, calcium, and vitamins A and C. The Video Group improved on fiber intake (P<or=.005). The groups did not differ on dietary or behavior change (P=.2357). Duplication and implementation costs of the video series totaled 4,820 dollars, or 36% of the traditional lesson cost of 13,463 dollars. APPLICATIONS: Both methods achieved similar improvements in diet and behaviors, but the video method was less expensive. The video series seems to be a cost-effective method for delivering nutrition education to low-income homemakers.

Adolescent↗
PubMed2001

The efficacy of home based progressive strength training in older adults with knee osteoarthritis: a randomized controlled trial.

OBJECTIVE: To test the effects of a high intensity home-based progressive strength training program on the clinical signs and symptoms of osteoarthritis (OA) of the knee. METHODS: Forty-six community dwelling patients, aged 55 years or older with knee pain and radiographic evidence of knee OA, were randomized to a 4 month home based progressive strength training program or a nutrition education program (attention control). Thirty-eight patients completed the trial with an adherence of 84% to the intervention and 65% to the attention control. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index pain and physical function subscales. Secondary outcomes included clinical knee examination, muscle strength, physical performance measures, and questionnaires to measure quality of life variables. RESULTS: Patients in the strength training group who completed the trial had a 71% improvement in knee extension strength in the leg reported as most painful versus a 3% improvement in the control group (p < 0.01). In a modified intent to treat analysis, self-reported pain improved by 36% and physical function by 38% in the strength training group versus 11 and 21%, respectively, in the control group (p = 0.01 for between group comparison). In addition, those patients in the strength training group who completed the trial had a 43% mean reduction in pain (p = 0.01 vs controls), a 44% mean improvement in self-reported physical function (p < 0.01 vs controls), and improvements in physical performance, quality of life, and self-efficacy when compared to the control group. CONCLUSION: High intensity, home based strength training can produce substantial improvements in strength, pain, physical function and quality of life in patients with knee OA.

Aged↗
PubMedDate not supplied

Development of a tool to assess psychosocial indicators of fruit and vegetable intake for 2 federal programs.

OBJECTIVE: Development of an evaluation tool of psychosocial constructs for use by participants in 2 federal programs, Food Stamp Nutrition Education and the Expanded Food and Nutrition Education Program. DESIGN: Cross-sectional data from a longitudinal study. PARTICIPANTS: Limited-resource women (n = 111) living in low-income communities. MEASURES: Test-retest reliability, internal consistency, ethnic differences, convergent validity. ANALYSIS: Spearman rank order correlation, analysis of variance, principal components analysis. RESULTS: Reliability coefficients ranged from a low of r = .18 (not significant) to r = .74 (P < .0001). Two items were deleted for not meeting criteria for reliability and 2 for redundancy. Ethnic differences at baseline were significant for 1 item. Domain constructs loaded on 4 to 5 factors for the biopsychosocial framework. Estimates of convergent validity of 9 constructs led to the deletion of 3 (ie, perceived barriers, social support, and perceived norms), with retention of perceived benefits, perceived control, self-efficacy, readiness to eat more fruit, readiness to eat more vegetables, and perceived diet quality. As an estimate of convergent validity, the final version of the tool with 6 constructs remaining showed significant correlations with indicators of diet quality: serum carotenoid values (r = .38, P < .001); hypothesized nutrients calculated from the mean of 3 24-hour dietary recalls (vitamin C, r = .47, P < .0001; vitamin A, r = .39, P < .0001; folate, r = .37, P < .0001; beta-carotene, r =.31, P < .001; and fiber, r = .46, P < .0001); fruit and vegetable servings (r = 0.55, P < .0001); Healthy Eating Index (r = .27, P < .05); and a fruit and vegetable behavioral scale (r = .60, P < .0001). CONCLUSION AND IMPLICATIONS: This systematic process yielded a fruit and vegetable evaluation tool useful for practitioners and researchers. This is the first validation study of this type to estimate convergent validity with 5 indicators of diet quality, including a biomarker.

Adult↗
PubMedDate not supplied

The Memorial Meal Mates: a program to improve nutrition in hospitalized older adults.

A common problem among older hospitalized patients is inadequate nutritional intake. The Memorial Meal Mates project was developed to address this problem. College-aged volunteers were provided a 3-hour in-service taught by an interdisciplinary team. During a 2-month period, the Memorial Meal Mates fed 34 patients, who were compared with 34 other patients fed by nursing staff. The mean intake of the Meal Mates group was 58.88%, compared with the mean intake of the control group of 32.45%. Patients fed by the volunteers nearly doubled their intake over those fed by nursing staff.

Aged↗
PubMed1999

A tailored multimedia nutrition education pilot program for low-income women receiving food assistance.

This article describes the development and pilot evaluation of a tailored multimedia program to improve dietary behavior among 378 low-income women enrolled in the Food Stamp program in Durham, North Carolina. After randomization to intervention or control groups, participants completed a baseline survey and were resurveyed 1-3 months post-intervention. Measures included dietary fat intake assessed using a brief food-frequency questionnaire, stage of change, knowledge of low-fat foods, self-efficacy and eating behavior questions. The computer-based intervention consisted of a tailored soap opera and interactive 'info-mercials' that provided individualized feedback about dietary fat intake, knowledge and strategies for lowering fat based on stage of change. At follow-up, intervention group participants had improved significantly in knowledge (P < 0.001), stage of change (P < 0.05) and certain eating behaviors (P < 0.05) compared to the control group. Both study groups had lowered their reported fat intake markedly at follow-up (P < 0.001), but did not differ significantly from each other. A majority of participants rated the program as very helpful and were interested in using a similar program in the future. The findings of this pilot study suggest that computerized tailored self-help health promotion programs may be effective educational interventions for lower income and minority populations.

Adult↗
PubMed1980

Nutrition-education research: an interdisciplinary evaluation and review.

An interdisciplinary evaluation approach was developed to analyze and compare school nutrition education programs systematically. Theoretical models from education, preventive medicine, health education and statistical evaluation were applied to 22 studies published between 1968 and 1978 to judge program impact on nutrition knowledge, behavior, and attitudes. Six studies reported XS and SDs for control and experimental groups. Effect sizes, showing average treatment effect in standard deviation units, were calculated for those six studies. It can be concluded that the more interdisciplinary criteria a study fulfills, the more likely it is to influence knowledge, behavior, and attitudes.

Adolescent↗
PubMedDate not supplied

Employee advisory boards as a vehicle for organizing worksite health promotion programs.

PURPOSE: The purpose of this article is to describe the "employee advisory board model" applied in the Treatwell program, a worksite nutrition intervention program. DESIGN: The employee advisory boards of five of the seven intervention worksites participating in the Treatwell program were surveyed. Results were compared with results of employee surveys conducted in these five worksites. SETTING: The five worksites included in this study are among 16 participating worksites from Massachusetts and Rhode Island. SUBJECTS: Of the 95 board members represented in the five worksites, 88% responded to the survey. This article also presents results from the 698 respondents of the five intervention worksites where the board surveys were conducted. INTERVENTION: The boards in each worksite participated in planning, promoting, and implementing this program in each worksite. MEASURES: Respondents to the board survey were asked about their participation on and satisfaction with the board and factors they thought contributed to its effectiveness. A survey of all employees included information on demographics and program participation. RESULTS: Board members reported that they were highly satisfied with the board's functioning. Board member hours spent on Treatwell activities were directly related to the proportion of employees aware of the program. (r = .82). The boards' effectiveness was limited by conflicting priorities between the job and board responsibilities. CONCLUSION: The employee advisory board model provides promise for increasing worker awareness of worksite health promotion programs through enhanced worker ownership.

Adult↗