Formative assessment using social marketing principles to identify health and nutrition perspectives of Native American women living within the Chickasaw Nation boundaries in Oklahoma

The promotion of healthy breakfast and snacks based on the social marketing model: a mixed-methods study

BACKGROUND

Skipping breakfast and replacing it with non-nutritious snacks are progressively increasing among adolescents. This study aimed to develop an educational intervention based on the Social Marketing Model and evaluate its effects on healthy breakfast and snack consumption among female adolescent students.

METHODS

This mixed-methods study was conducted in 2016-2019 in two phases. In the first phase, a qualitative study was conducted through directed content analysis in guidance schools in Khorramabad, Isfahan, and Tehran, Iran, to explore factors affecting breakfast consumption. The results of this phase were set in the benchmarks of the Social Marketing Model. In the second phase, a randomized controlled trial was conducted based on the benchmarks of the Social Marketing Model on 94 students randomly recruited from guidance schools in Khorramabad, Iran.

RESULTS

The findings of the qualitative phase were categorized into the benchmarks of the Social Marketing Model, namely the social marketing mix, the intended behavior, internal and external competing factors for behavior modification, theoretical concepts related to the behavior, and the role of supporters. In the quantitative phase, the univariate analysis showed significant between-group differences concerning the product, price, promotion, and behavior (p < 0.05).

CONCLUSION

Healthy breakfast and snack consumption can be promoted through making acceptable the tastes, costs, preparations, and consumption places of breakfast and snack.

TRIAL REGISTRATION

The trial was registered in the Iranian Registry of Clinical Trials (code: IRCT20170201032347N1 ). The trial was registered in 11/07/2018 and is accessible on the Iranian Clinical Trial Registration website.

Implementation Science and Nutrition Education and Behavior: Opportunities for Integration

Implementation science (IS) is the study of approaches designed to increase adoption and sustainability of research evidence into routine practice. This article provides an overview of IS and ideas for its integration with nutrition education and behavior practice and research. Implementation science application in nutrition education and behavior practice can inform real-word implementation efforts. Research opportunities include advancing common approaches to implementation measurement. In addition, the article provides suggestions for future studies (eg, comparative effectiveness trials comparing implementation strategies) to advance the knowledge base of both fields. An example from ongoing research is included to illustrate concepts and methods of IS.

Food Safety Knowledge, Attitudes, and Behaviors of Native American Families with Young Children: A Mixed Methods Study

Children are at increased risk for foodborne illness due to underdeveloped immune system. Limited research has been reported on food safety knowledge of Native American families with children 10 years of age and younger. This study was conducted to determine the food safety knowledge, attitudes, and behaviors of the main food preparer in these families by collecting quantitative and qualitative data simultaneously in a mixed method approach. A food safety knowledge survey created using FightBAC!™ concepts was administered prior to focus groups discussions held in Native American communities using a script based upon the Health Belief Model. Quantitative data were analyzed using SPSS. Qualitative data were coded by three reviewers independently and then compared jointly for themes. Over three fourths of participants (n = 102) were female with an average age of 38.3 years. Over one half of participants were unemployed (54 %), lived on reservations (54 %), and 86 % had a high school degree or higher level of education. The following four themes emerged from the eight focus groups (n = 66): food can make one sick, I am not in control when others handle food, I know how to safely prepare foods for my family, and I do not have time or best equipment (for food safety). Mixed method analysis revealed that participants were aware of the severity and susceptibility for foodborne illness but were confident in preparing foods safely for their family. A food safety education program for Native American food preparers with young children is needed to prevent foodborne illness (FBI) in this population and promote safe food handling practice.

Promoting Physical Activity Among Native American Youth: a Systematic Review of the Methodology and Current Evidence of Physical Activity Interventions and Community-wide Initiatives

Promoting physical activity using environmental, policy, and systems approaches could potentially address persistent health disparities faced by American Indian and Alaska Native children and adolescents. To address research gaps and help inform tribally led community changes that promote physical activity, this review examined the methodology and current evidence of physical activity interventions and community-wide initiatives among Native youth. A keyword-guided search was conducted in multiple databases to identify peer-reviewed research articles that reported on physical activity among Native youth. Ultimately, 20 unique interventions (described in 76 articles) and 13 unique community-wide initiatives (described in 16 articles) met the study criteria. Four interventions noted positive changes in knowledge and attitude relating to physical activity but none of the interventions examined reported statistically significant improvements on weight-related outcomes. Only six interventions reported implementing environmental, policy, and system approaches relating to promoting physical activity and generally only shared anecdotal information about the approaches tried. Using community-based participatory research or tribally driven research models strengthened the tribal-research partnerships and improved the cultural and contextual sensitivity of the intervention or community-wide initiative. Few interventions or community-wide initiatives examined multi-level, multi-sector interventions to promote physical activity among Native youth, families, and communities. More research is needed to measure and monitor physical activity within this understudied, high risk group. Future research could also focus on the unique authority and opportunity of tribal leaders and other key stakeholders to use environmental, policy, and systems approaches to raise a healthier generation of Native youth.

Explaining nutritional habits and behaviors of low socioeconomic status women in Sanandaj: a qualitative content analysis

INTRODUCTION

Health and behavior are closely related subjects because disease is typically rooted in individuals' unhealthy behaviors and habits. This study aims to identify women's nutritional habits and behaviors in order to design interventions to promote nutritional literacy.

METHODS

This qualitative research is part of a mixed method (quantitative-qualitative) study, conducted based on content analysis. Data were collected using semistructured interviews, group discussions, and in-depth interviews with married women, aged 18-50 years, who were referred to four health care centers in Sanandaj in 2013-2014.

RESULTS

Nutritional habits and behaviors of participants were classified into two categories: representation of nutritional behavior based on consumption pattern and representation of nutritional behavior based on consumption method. For the former, eight consumption pattern subcategories were formed: meat, dairy, fast food, local foods, fruits and vegetables, soft drinks, and oils. The latter (representation of nutritional behavior based on consumption method), included two subcategories: consumption method in line with health and consumption method inconsistent with health.

CONCLUSION

Results of this qualitative study provide a solid foundation for development and designing interventions to nutritional literacy promotion based on needs. The designed intervention to healthy nutritional behavior should be based on empowering women and providing facilitator factors of a healthy diet. While designing this study, with a holistic perspective, individual and social aspects of a healthy diet should be taken into account.

A formative evaluation of social media campaign to reduce adolescent dating violence

Background

The Emory Jane Fonda Center implemented the Start Strong Atlanta social marketing campaign, “Keep It Strong ATL”, in 2007 to promote the development of healthy adolescent relationships and to foster the prevention of adolescent dating abuse among 11-14 year olds.

Objective

A formative evaluation was conducted to understand whether messages directed at the target audience were relevant to the program’s relationship promotion and violence prevention goals, and whether the “Web 2.0” social media channels of communication (Facebook, Twitter, YouTube, Flickr, Tumblr, and Pinterest) were reaching the intended audience.

Methods

Mixed methodologies included qualitative interviews and a key informant focus group, a cross-sectional survey, and web analytics. Qualitative data were analyzed using constant comparative methodology informed by grounded theory. Descriptive statistics were generated from survey data, and web analytics provided user information and traffic patterns.

Results

Results indicated that the Keep It Strong ATL social marketing campaign was a valuable community resource that had potential for broader scope and greater reach. The evaluation team learned the importance of reaching adolescents through Web 2.0 platforms, and the need for message dissemination via peers. Survey results indicated that Facebook (ranked 6.5 out of 8) was the highest rated social media outlet overall, and exhibited greatest appeal and most frequent visits, yet analytics revealed that only 3.5% of “likes” were from the target audience. These results indicate that the social media campaign is reaching predominantly women (76.5% of viewership) who are outside of the target age range of 11-14 years.

Conclusions

While the social media campaign was successfully launched, the findings indicate the need for a more focused selection of communication channels, timing of media updates to maximize visibility, balancing message tone and delivery, and incorporating differentiated messaging for the target audiences. Collaboration with parents and community partners is also emphasized in order to expand the campaign’s reach and create more channels to disseminate relationship promotion and dating violence prevention messaging to the intended audience.