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van den Bekerom L, van Gestel LC, Schoones JW, Bussemaker J, Adriaanse MA. Health behavior interventions among people with lower socio-economic position: a scoping review of behavior change techniques and effectiveness. Health Psychol Behav Med 2024; 12:2365931. [PMID: 38903803 PMCID: PMC11188964 DOI: 10.1080/21642850.2024.2365931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 06/04/2024] [Indexed: 06/22/2024] Open
Abstract
Background Behavior change interventions can unintendedly widen existing socio-economic health inequalities. Understanding why interventions are (in)effective among people with lower socio-economic position (SEP) is essential. Therefore, this scoping review aims to describe what is reported about the behavior change techniques (BCTs) applied within interventions and their effectiveness in encouraging physical activity and healthy eating, and reducing smoking and alcohol consumption according to SEP. Methods A systematic search was conducted in 12 electronic databases, and 151 studies meeting the eligibility criteria were included and coded for health behavioral outcomes, SEP-operationalization, BCTs (type and number) and effectiveness. Results Findings suggest that approaches for measuring, defining and substantiating lower SEP vary. Current studies of behavior change interventions for people of different SEP do not systematically identify BCTs, making systematic evaluation of BCT effectiveness impossible. The effectiveness of interventions is mainly evaluated by overall intervention outcomes and SEP-moderation effects are mostly not assessed. Conclusion Using different SEP-operationalizations and not specifying BCTs hampers systematic evidence accumulation regarding effective (combinations of) BCTs for the low SEP population. To learn which BCTs effectively improve health behaviors among people with lower SEP, future intervention developers should justify how SEP is operationalized and must systematically describe and examine BCTs.
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Affiliation(s)
- Loes van den Bekerom
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague/Leiden, the Netherlands
| | - Laurens C. van Gestel
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
| | - Jan W. Schoones
- Directorate of Research Policy, Leiden University Medical Center, Leiden, the Netherlands
| | - Jet Bussemaker
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague/Leiden, the Netherlands
- The Institute of Public Administration, Leiden University, Leiden, the Netherlands
| | - Marieke A. Adriaanse
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague/Leiden, the Netherlands
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
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Kearsey JL, West E, Vairinhos N, Constable N, Chu A, Douglas N, Charlton K. Evaluation of a Nutrition Education and Skills Training programme in vulnerable adults who are at high risk of food insecurity. J Hum Nutr Diet 2024; 37:418-429. [PMID: 37964660 DOI: 10.1111/jhn.13264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/28/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND In Australia, the prevalence of food insecurity increased by 1.5% between 2014 and 2016 and 2018 and 2020 due to effects of the COVID-19 pandemic. OzHarvest offers a 6-week Nutrition Education and Skills Training (NEST) programme to adults at risk of food insecurity. NEST provides 2.5-h weekly cooking workshops on simple, healthy and affordable meals. This study aimed to determine the immediate (post) and longer-term (6 months) impacts of participation in NEST. METHODS A quasi-experimental study with pre-post surveys (n = 258) and 6-month follow-up surveys (n = 20) was conducted from June 2019 to July 2022. Survey results were obtained from NEST programme participants (≥18 years) from six major Australian cities. RESULTS Participants demonstrated immediate improvement in nutrition knowledge (p < 0.001), food preparation behaviours (p < 0.001) and confidence and self-efficacy (n = 222; p < 0.001). Intake of discretionary foods decreased (p < 0.001), whereas fruit, vegetable and water intake increased (p < 0.001). Food security improved from 57% to 68% immediately after the completion of the programme (p < 0.001). Participants demonstrated longer-term improvements in nutrition knowledge (p < 0.001), cooking confidence (n = 8; p = 0.03), food preparation behaviours (p = 0.003) and increased vegetable (p = 0.03) and fruit intake (p = 0.01). CONCLUSIONS Participation in OzHarvest's NEST programme results in short-term improvements in food security levels and dietary behaviours. Over the longer term, these changes were sustained but to a lesser degree, indicating that systemic changes are required to address underlying socio-economic disadvantages.
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Affiliation(s)
- Jade L Kearsey
- School of Medical, Indigenous and Health Sciences, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Elisha West
- OzHarvest Melbourne, Port Melbourne, Victoria, Australia
| | - Nelia Vairinhos
- School of Medical, Indigenous and Health Sciences, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | | | - Angelica Chu
- OzHarvest Sydney, Alexandria, New South Wales, Australia
| | - Nigel Douglas
- OzHarvest Sydney, Alexandria, New South Wales, Australia
| | - Karen Charlton
- School of Medical, Indigenous and Health Sciences, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Sindhu S, Madaiah M. Impact of educational intervention in promoting KAP of food label information to make healthier food choices among adolescents in Bangalore City. J Family Med Prim Care 2023; 12:1371-1378. [PMID: 37649776 PMCID: PMC10465025 DOI: 10.4103/jfmpc.jfmpc_2266_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/29/2023] [Accepted: 04/05/2023] [Indexed: 09/01/2023] Open
Abstract
Background Increasing adolescent obesity, a reason for the onset of adult chronic diseases, has become an important public health priority. Food choices are impacted by the growing availability of processed and pre-packaged meals, the rise in eating out compared to eating at home, low nutrition literacy, and the inability to evaluate calorie and nutrient information. Objective The objective is to assess the current knowledge, attitude, and practice (KAP) of the adolescents regarding food label information to make healthier food choices, to improve their KAP regarding the same through health education using pictorial representation, and to evaluate the effectiveness of the health education. Materials and Methods An educational intervention study was performed among 200 adolescent students (13-15 years) in selected schools in Bangalore city. Health education was given using materials like charts, models, and posters in an interactive way. Pre-KAP and post-KAP were assessed using questionnaires. Results The study comprised 145 (72.5%) girls and 55 (27.5%) boys with the mean age of 14.02 years. Only 102 (51%) were having knowledge that food labels must be read irrespective of health issues or disease. Only 81 (40.5%) calculated the total nutrient intake before taking food items before intervention, which was increased to 147 (73.5%) post intervention. Conclusion The results of the present study successfully proved that nutritional educational intervention by pictorial representation was feasible and successfully improved the understanding and use of food label information for making healthier food choices among adolescents.
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Affiliation(s)
- S Sindhu
- MBBS Student, M V J Medical College and Research Hospital, Hoskote, Bangalore, Karnataka, India
| | - Madhusudan Madaiah
- Department of Community Medicine, M V J Medical College and Research Hospital, Hoskote, Bangalore, Karnataka, India
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The relative importance of primary food choice factors among different consumer groups: A latent profile analysis. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2021.104199] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Maugeri IP, Brimblecombe J, Choi TST, Kleve S, Palermo C. For whom and under what circumstances do nutrition-education cooking interventions work: a realist synthesis. Nutr Rev 2021; 79:479-493. [PMID: 32443146 DOI: 10.1093/nutrit/nuaa021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To explore for whom and under what circumstances nutrition-education cooking interventions affect nutrition outcomes in adults. METHODS A realist synthesis was undertaken. The CINAHL, Ovid Medline, Scopus, and Web of Science databases were searched for literature published between 1980 and 2019, using the terms "cook" and "intervention" and their synonyms; 5759 articles were identified. Grey literature was sourced for further additional program context. A total of 23 articles (n = 11 programs) met inclusion criteria for analysis. Program data were coded in duplicate for context, outcome, and mechanism configurations, and used to build a refined program theory. RESULTS Nutrition-education cooking interventions targeted at low-socioeconomic-status and marginalized populations produced a range of positive nutrition outcomes. Outcomes were observed when the program involved hands-on cooking and a skilled facilitator coupled with individual self-efficacy, knowledge gain, family support, and an expectation of positive health outcomes. CONCLUSION These findings highlight key program components to achieve improvements in nutrition and important recommendations for nutrition-education cooking interventions.
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Affiliation(s)
- Isabella P Maugeri
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
| | - Julie Brimblecombe
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia.,Honorary Fellow of the Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Tammie S T Choi
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
| | - Sue Kleve
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
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Pooler JA, Srinivasan M, Wong K, Blitstein JL. Food Skills Education and Low-Income Adults' Healthy Food Choices. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2021; 43:89-94. [PMID: 33757331 DOI: 10.1177/0272684x211004941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Cooking Matters food skills education program equips low-income families with the skills and knowledge to shop for and cook healthy meals within budget and time constraints. AIMS To explore whether participation in Cooking Matters is associated with healthier food choices using a 6-item scale, comprised of a variety of food categories. METHODS Cooking Matters participants (n = 332) and a comparison group (n = 336) completed surveys at baseline, 3-, and 6-month follow-up. RESULTS Cooking Matters participants experienced greater improvements in healthy choices overall (p < 0.0001) and for each of the six underlying items at 3 month follow-up. Improvements were sustained at 6-month follow-up overall and for all categories, except low-fat milk (p = 0.1168). DISCUSSION Participation in Cooking Matters was associated with improvements in overall healthy food choices across a variety of food groups and maintained at 6-month follow-up. Enabling healthy food choices is an important step toward improved diet quality.
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Affiliation(s)
- Jennifer A Pooler
- IMPAQ Health, IMPAQ International, LLC, Columbia, Maryland, United States.,Altarum Institute, Ann Arbor, Michigan, United States
| | - Mithuna Srinivasan
- IMPAQ Health, IMPAQ International, LLC, Washington, District of Columbia, United States
| | - Karen Wong
- Share Our Strength, Washington, District of Columbia, United States
| | - Jonathan L Blitstein
- Public Health Research Division, RTI International, Research Triangle Park, North Carolina, United States
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Nutrition labels' strengths & weaknesses and strategies for improving their use in Iran: A qualitative study. PLoS One 2020; 15:e0241395. [PMID: 33126236 PMCID: PMC7598474 DOI: 10.1371/journal.pone.0241395] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 10/13/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study aimed to explain the strengths and weaknesses of the Traffic light label (TLL) and nutrition facts label (NFL) and the strategies for improving their use in Iran, based on the perspectives of different stakeholders, including mothers, food quality control experts (FQC), nutritionists and food industry experts. METHODS We conducted 10 Focus Group Discussions (FGDs) with 63 mothers, 10 semi-structured interviews with FQCs, 1 FGD with 6 nutritionists and 1 FGD with 8 food industry experts. To clarify some of the questions that arose from the interviews, the researcher interviewed three policy makers who had sufficient information about the TLL. The discussions and interviews were transcribed verbatim and MAXQDA10 software was used for coding. RESULTS The most important findings of this study based on different stakeholders' perspectives were as follows: mothers believed that nutrition labels reduced the consumption of high-calorie products, although they found the TLL to be easier to understand than the NFL because of its red color. However, their weaknesses were their incompatibility with culture and the lack of trust in the information provided by manufacturers. FQCs pointed out the possibility of changing formulations and the appropriateness of the traffic light for patients, but like mothers, they believed that the labels did not suit the governing culture. Further weaknesses were, misleading the consumer, problems in the colorings reported by different laboratories, and different approaches adopted by regulatory experts. The simplicity of understanding TLL for the general public has been suggested by some nutritionists. Nevertheless, the multiplicity of colors of the TLL was the most important weakness presented by nutritionists and food industry experts and the failure to implement nutrition labels was another issue raised by experts. To improve the use of nutrition labels, notification via media especially television, community education and culture building were suggested by all stakeholders. CONCLUSIONS The findings of this study underscore the importance of implementing the policy of nutrition labeling in Iran. Mothers and nutritionists believed TLL to be more appropriate for the public to understand, however, FQCs and food industry experts believed that NFL was more suitable in guiding consumers toward healthy food choices. Education and information dissemination via media on interpretive TLL may affect consumer behavior toward food purchases.
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West EG, Lindberg R, Ball K, McNaughton SA. The Role of a Food Literacy Intervention in Promoting Food Security and Food Literacy-OzHarvest's NEST Program. Nutrients 2020; 12:E2197. [PMID: 32718054 PMCID: PMC7468773 DOI: 10.3390/nu12082197] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 01/02/2023] Open
Abstract
Food literacy interventions are widely implemented to improve the food security and health of low-socioeconomic adults. The purpose of this study was to conduct an inquiry into the value of OzHarvest's six-week NEST (Nutrition Education and Skills Training) program in promoting food security and food literacy, and to identify the barriers and enablers that participants experienced in sustaining food security, and in utilising their food literacy skills beyond the program. A descriptive evaluation study with pre-post surveys (n = 21) and post-program interviews (n = 17) was conducted, with a convenience sample of NEST program participants living in Sydney, Newcastle, and Melbourne, Australia. Participants demonstrated improvements in food security status (p = 0.030), cooking confidence (p = 0.001), food preparation behaviours (p = 0.006), nutrition knowledge (p = 0.033), vegetable consumption (p = 0.043), and a reduction in intake of sugar-sweetened beverages (p = 0.017), and salty snack foods (p = 0.011). The interviews revealed that participants learned to stretch their food budgets and make meaningful changes to their food utilisation (a key dimension of food security). Interviews also identified enablers (e.g., social support) and barriers (e.g., health conditions) to achieving food security. Acknowledging the need for a multi-faceted approach that also addresses upstream determinants, interventions like NEST may play a role in promoting food security and food literacy.
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Affiliation(s)
- Elisha G. West
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3220, Australia; (R.L.); (S.A.M.)
| | | | - Kylie Ball
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3220, Australia; (R.L.); (S.A.M.)
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Identifying Who Improves or Maintains Their Food Literacy Behaviours after Completing an Adult Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124462. [PMID: 32575889 PMCID: PMC7344971 DOI: 10.3390/ijerph17124462] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 01/21/2023]
Abstract
Food Sensations for Adults is a free four-week nutrition and cooking program that teaches low- to middle-income individuals food literacy. This research aimed to compare demographic characteristics of participants who completed the program’s follow-up questionnaire three months after program completion and assess whether food literacy and dietary behaviour changes were improved or maintained. Statistical analysis methods used factor scores of the plan and manage, selection, and preparation domains to examine mean self-reported changes in food literacy. Tertile stratification methods calculated changes in participants who had low, middle, and high end-of-program food literacy scores, and multivariable regression analysis explored the associations. The follow-up results (n = 621) demonstrated a statistically significant factor score increase in plan and manage (3%) and selection (7.2%) domain scores, and a decrease in the preparation score (3.1%), and serves of consumed vegetables (7.9%), but were still significantly higher than at the start of the program. At follow-up, participants with low food literacy at the program end significantly improved their follow-up domain scores for plan and manage (60%) and selection (73.3%), and participants with moderate or high food literacy at the program end maintained their follow-up scores. A food literacy program can support adults to improve and maintain their food literacy behaviours and maintain dietary behaviour change; therefore, strategies to support this continued change must be considered.
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Wademan J, Myers G, Finch A, Dhaliwal SS, Scott J, Begley A. A Recipe for Success? A Nutrient Analysis of Recipes Promoted by Supermarkets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114084. [PMID: 32521672 PMCID: PMC7312900 DOI: 10.3390/ijerph17114084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/27/2020] [Accepted: 06/03/2020] [Indexed: 11/16/2022]
Abstract
Recipe use impacts eating habits, yet there is limited research investigating the nutritional quality of recipes. Supermarket recipe magazines command large readerships, with over 4 million readers for each of the two major Australian supermarket publications. Assessing the nutrient content of featured recipes is therefore of public health interest. The nutrient content of 312 main-meal recipes from Coles® Magazine and Woolworths Fresh® were analyzed and compared against a traffic-light system for classifying nutrients of concern in chronic disease. Nutrient content was compared across recipe type (standard, advertorial and celebrity) and between recipes with and without health or nutrient claims. Overall compliance with the traffic-light criteria was low, with less than half of recipes meeting the target. Advertorial recipes had a higher energy (p = 0.001), saturated fat (p = 0.045) and sodium (p ≤ 0.001) content per serve, and per 100 g for sodium (p ≤ 0.001) compared to standard and celebrity recipes. Recipes with claims had greater compliance to the nutrient criteria (p < 0.001) compared to those without. These findings support previous research highlighting the poor nutritional quality of published recipes from a variety of sources.
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Affiliation(s)
- Jasmin Wademan
- School of Public Health, Curtin University, Perth, WA 6102, Australia; (J.W.); (S.S.D.); (J.S.)
| | - Gael Myers
- Cancer Council Western Australia, Level 1, 420 Bagot Road, Subiaco, WA 6008, Australia; (G.M.); (A.F.)
| | - Anne Finch
- Cancer Council Western Australia, Level 1, 420 Bagot Road, Subiaco, WA 6008, Australia; (G.M.); (A.F.)
| | - Satvinder S. Dhaliwal
- School of Public Health, Curtin University, Perth, WA 6102, Australia; (J.W.); (S.S.D.); (J.S.)
- Duke-NUS Medical School, National University of Singapore, 8 College Rd, Singapore 169857, Singapore
| | - Jane Scott
- School of Public Health, Curtin University, Perth, WA 6102, Australia; (J.W.); (S.S.D.); (J.S.)
| | - Andrea Begley
- School of Public Health, Curtin University, Perth, WA 6102, Australia; (J.W.); (S.S.D.); (J.S.)
- Correspondence: ; Tel.: +61-8-9266-2773
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Stephens LD, Smith G, Olstad DL, Ball K. An evaluation of SecondBite ® 's FoodMate ® , a nutrition education and skill-building program aimed at reducing food insecurity. Health Promot J Austr 2019; 31:468-481. [PMID: 31560805 DOI: 10.1002/hpja.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/29/2019] [Accepted: 09/22/2019] [Indexed: 11/09/2022] Open
Abstract
ISSUE ADDRESSED Enhancing food skills and nutrition knowledge may help promote healthy eating among people who are food insecure. FoodMate® by SecondBite® , an 8-week nutrition education and food hamper program, focuses on developing food skills and independence among Australians at risk of/experiencing food insecurity. This study aimed to explore participants' perceptions of and experiences with FoodMate® over a long-term (up to 2 years) follow-up. METHODS For evaluation purposes, SecondBite® previously collected data from participants prior to (T1) and following completion (T2) of FoodMate® . This paper reports results from semi-structured telephone interviews conducted in a follow-up study (2016/2017, T3) among 19 adults enrolled in FoodMate® programs delivered in Victoria and New South Wales within the previous two years. Data were analysed using inductive thematic analysis of responses to T3 open-ended questions, and descriptive analysis of closed-ended question responses (T1 vs T2 vs T3). RESULTS Major qualitative themes included program enjoyment; perceived positive long-term program impact on participants' eating and related attitudes and skills; barriers to cooking; suggested program modifications; and impact on others. In descriptive quantitative analyses, participants' diet; confidence to cook using basic ingredients, follow simple recipes and try new foods; cooking and food-related skills; social engagement and life satisfaction all improved between T1 and T3. CONCLUSIONS Overall, FoodMate® was well-received and associated with long-term positive changes in a range of outcomes. Wider implementation among vulnerable groups should be considered. SO WHAT?: Future health promotion initiatives could adopt FoodMate® to increase food skills and knowledge among adults experiencing food insecurity.
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Affiliation(s)
- Lena D Stephens
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Geoff Smith
- Third Horizon Consulting, Melbourne, Australia.,Pat Cronin Foundation, Balwyn East, Australia
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kylie Ball
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Jongenelis MI, Talati Z, Morley B, Pratt IS. The role of grandparents as providers of food to their grandchildren. Appetite 2019; 134:78-85. [DOI: 10.1016/j.appet.2018.12.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 11/29/2018] [Accepted: 12/17/2018] [Indexed: 12/16/2022]
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Prevalence of Dietary Behavior and Determinants of Quality of Diet among Beneficiaries of Government Welfare Assistance in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030501. [PMID: 30754683 PMCID: PMC6388226 DOI: 10.3390/ijerph16030501] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/24/2019] [Accepted: 01/31/2019] [Indexed: 11/16/2022]
Abstract
Diet, as a modifiable factor for good health maintenance, reduces the risk of numerous non-communicable chronic diseases and prevents premature death. The aim of the study was to examine the prevalence of a dietary behavior and to find out what the determinants of diet quality among the low socio-economic status population are. The studied sample consisted of 1710 respondents. Only 3% of the beneficiaries had healthy dietary habits. Unhealthy dietary habits dominated in all the study group regardless of the subjects' level of education (p < 0.001). Higher odds of unhealthy dietary habits were reported among the respondents with primary, vocational, and secondary education than among the respondents with high education (for the primary education OR = 11.10; 95% CI: 5.86⁻21.01; p ≤ 0.001; for vocational education OR = 10.54; 95% CI: 5.79⁻19.18; p ≤ 0.001 and for secondary education OR = 5.83; 95% CI: 3.48⁻9.79; p ≤ 0.001). The unhealthy dietary behavior prevalence among beneficiaries of government welfare assistance in Poland is much higher than in the general population. Since only educational level is a determinant which is significantly correlated with the unhealthy dietary behavior, promotion of a healthy diet among disadvantaged individuals should be focused on this factor.
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Noy S, Patrick R, Henderson-Wilson C, Nuttman S, Ryan I. New frontiers in community initiatives to increase vegetable consumption. Health Promot J Austr 2018; 30 Suppl 1:52-61. [PMID: 30238617 DOI: 10.1002/hpja.207] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 01/17/2023] Open
Abstract
ISSUE ADDRESSED Public health concerns about insufficient consumption of vegetables across all demographics in Australia have led to 20 years of behaviour change interventions ranging from social marketing to interactive small group programs, with modest results. To maximise health promotion intervention outcomes, practitioners need up-to-date information that helps them navigate the complexity of food systems and eating behaviours. METHODS This scoping review of Australian and international research, including peer-reviewed and grey literature, provides a picture of health promotion nutrition interventions, as well as other initiatives that may promote increased vegetable consumption. Search terms related to nutrition and vegetable consumption, type of intervention or initiative, for example, campaign; and consumer values and behaviour. A wide range of data sources were used including scholarly papers, market research reports and publicly available websites of community organisations (eg, OOOOBY). A broad food systems typology was developed to provide a framework for the review. RESULTS The review finds an emerging group of community-driven initiatives within local food systems that appear to have positive impacts on vegetable consumption. These initiatives sit within a multi-faceted approach to health and well-being that is consistent with the tenets of the Ottawa Charter for Health Promotion, including community engagement, social justice and sustainability goals. CONCLUSIONS More research into the impact of these new frontiers is needed, but our preliminary findings point to the potential for health promotion practitioners to collaborate on local/community food system initiatives that are not motivated primarily by health goals, but have the potential to deliver multiple health and environmental outcomes. SO WHAT?: This review demonstrated community-driven initiatives around local food systems show the most promise in promoting vegetable consumption and addressing the determinants of health. Health promotion efforts to encourage food security and healthy eating could be strengthened through collaborations within these new frontiers.
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Affiliation(s)
- Sue Noy
- School of Life and Environmental Sciences, Deakin University, Geelong, Vic., Australia
| | - Rebecca Patrick
- Faculty of Health, School of Health and Social Development, Deakin University, Geelong, Vic., Australia
| | - Claire Henderson-Wilson
- Faculty of Health, School of Health and Social Development, Deakin University, Geelong, Vic., Australia
| | - Sonia Nuttman
- Faculty of Health, School of Health and Social Development, Deakin University, Geelong, Vic., Australia
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Moore SG, Donnelly JK, Jones S, Cade JE. Effect of Educational Interventions on Understanding and Use of Nutrition Labels: A Systematic Review. Nutrients 2018; 10:E1432. [PMID: 30287766 PMCID: PMC6213388 DOI: 10.3390/nu10101432] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 09/26/2018] [Accepted: 09/28/2018] [Indexed: 11/16/2022] Open
Abstract
The potential for nutrition labels to impact on population health is dependent on consumer ability to understand and use this information. Consumer understanding of this information varies across sociodemographic groups and with different label design formats. Labeling legislation requires consumer education on how to use nutrition labels, and recent mandatory changes to the Nutrition Facts Panel (NFP) are underway to improve comprehensibility. This review aimed to evaluate if educational programs can improve understanding and use of nutrition labels. Database searches were performed to identify interventions which delivered education on nutrition labels with outcomes measuring aspects of comprehension or use. A total of 17 studies were selected for review, including nine randomized and eight cohort studies. The majority of studies were conducted in the United States Study participants included school aged children, older adults, and those with diabetes within a range of intervention types involving taught sessions or web-based education. Whilst outcome measures were heterogenous, all studies reported a statistically significant improvement in one or more outcomes of participant understanding or use of nutrition labels. Aspects such as general nutrition knowledge, health literacy, and program delivery format warrant attention in future research. Education which optimizes comprehension and use of nutrition labels may have the potential to improve the impact of this information on dietary health.
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Affiliation(s)
- Sally G Moore
- School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
| | - Judy K Donnelly
- School of Health and Social Sciences, Leeds Trinity University, Leeds LS18 5HD, UK.
| | - Steve Jones
- School of Health and Social Sciences, Leeds Trinity University, Leeds LS18 5HD, UK.
| | - Janet E Cade
- School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
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Abstract
OBJECTIVE The current short communication aimed to provide a new conceptualisation of the policy drivers of inequities in healthy eating and to make a call to action to begin populating this framework with evidence of actions that can be taken to reduce the inequities in healthy eating. DESIGN The Healthy and Equitable Eating (HE2) Framework derives from a systems-based analytical approach involving expert workshops. SETTING Australia. SUBJECTS Academics, government officials and non-government organisations in Australia. RESULTS The HE2 Framework extends previous conceptualisations of policy responses to healthy eating to include the social determinants of healthy eating and its social distribution, encompassing policy areas including housing, social protection, employment, education, transport, urban planning, plus the food system and environment. CONCLUSIONS As the burden of non-communicable diseases continues to grow globally, it is important that governments, practitioners and researchers focus attention on the development and implementation of policies beyond the food system and environment that can address the social determinants of inequities in healthy eating.
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Pollard CM, Mackintosh B, Campbell C, Kerr D, Begley A, Jancey J, Caraher M, Berg J, Booth S. Charitable Food Systems' Capacity to Address Food Insecurity: An Australian Capital City Audit. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061249. [PMID: 29895801 PMCID: PMC6025598 DOI: 10.3390/ijerph15061249] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/29/2018] [Accepted: 05/31/2018] [Indexed: 11/16/2022]
Abstract
Australian efforts to address food insecurity are delivered by a charitable food system (CFS) which fails to meet demand. The scope and nature of the CFS is unknown. This study audits the organisational capacity of the CFS within the 10.9 square kilometres of inner-city Perth, Western Australia. A desktop analysis of services and 12 face-to-face interviews with representatives from CFS organisations was conducted. All CFS organisations were not-for–profit and guided by humanitarian or faith-based values. The CFS comprised three indirect services (IS) sourcing, banking and/or distributing food to 15 direct services (DS) providing food to recipients. DS offered 30 different food services at 34 locations feeding over 5670 people/week via 16 models including mobile and seated meals, food parcels, supermarket vouchers, and food pantries. Volunteer to paid staff ratios were 33:1 (DS) and 19:1 (IS). System-wide, food was mainly donated and most funding was philanthropic. Only three organisations received government funds. No organisation had a nutrition policy. The organisational capacity of the CFS was precarious due to unreliable, insufficient and inappropriate financial, human and food resources and structures. System-wide reforms are needed to ensure adequate and appropriate food relief for Australians experiencing food insecurity.
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Affiliation(s)
- Christina M Pollard
- Faculty of Health Science, School of Public Health, Curtin University, GPO Box U1987, Perth 6845, Australia.
| | - Bruce Mackintosh
- School of Agriculture and Environment, The University of Western Australia, 35 Stirling Highway, Crawley, Perth 6009, Australia.
| | - Cathy Campbell
- Faculty of Health Science, School of Public Health, Curtin University, GPO Box U1987, Perth 6845, Australia.
| | - Deborah Kerr
- Faculty of Health Science, School of Public Health, Curtin University, GPO Box U1987, Perth 6845, Australia.
| | - Andrea Begley
- Faculty of Health Science, School of Public Health, Curtin University, GPO Box U1987, Perth 6845, Australia.
| | - Jonine Jancey
- Faculty of Health Science, School of Public Health, Curtin University, GPO Box U1987, Perth 6845, Australia.
| | - Martin Caraher
- Centre for Food Policy, City University of London, Northampton Square, London EC1V 0HB, UK.
| | - Joel Berg
- Hunger Free America, 50 Broad Street, Suite 1103, New York 10004, NY, USA.
| | - Sue Booth
- College of Medicine & Public Health, Flinders University, GPO Box 2100, Adelaide 5000, Australia.
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18
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Abstract
OBJECTIVE To determine whether a cardioprotective dietary intervention based on UK dietary guidelines was more expensive than a conventional UK diet. DESIGN Cost analysis of food records collected at baseline and after a 12-week dietary intervention of a cardioprotective diet v. conventional UK diet. SETTING A randomized controlled dietary intervention study (CRESSIDA; ISRCTN 92382106) investigating the impact of following a diet consistent with UK dietary guidelines on CVD risk. SUBJECTS Participants were healthy UK residents aged 40-70 years. A sub-sample of participants was randomly selected from those who completed the cardioprotective dietary intervention (n 20) or the conventional UK dietary intervention (n 20). RESULTS Baseline diet costs did not differ between groups; mean daily food cost for all participants was £6·12 (sd £1·83). The intervention diets were not more expensive: at end point the mean daily cost of the cardioprotective diet was £6·43 (sd £2·05) v. the control diet which was £6·53 (sd £1·53; P=0·86). CONCLUSIONS There was no evidence that consumption of a cardioprotective diet was more expensive than a conventional dietary pattern. Despite the perception that healthier foods are less affordable, these results suggest that cost may not be a barrier when modifying habitual intake and under tightly controlled trial conditions. The identification of specific food groups that may be a cost concern for individuals may be useful for tailoring interventions for CVD prevention for individuals and populations.
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Abstract
OBJECTIVE To identify the features of a nutrition education programme for disadvantaged adults deemed most attractive and useful by participants. DESIGN A two-year, multi-method, qualitative evaluation of pre and post data collected from programme participants. Data were imported into NVivo10 for coding to facilitate a thematic analysis. SETTING Western Australia. Participants Individuals attending the Western Australian FOODcents nutrition education programme that is designed to provide knowledge and skills needed to consume a healthy diet on a budget. Focus groups were conducted several weeks after course completion (five groups, forty-seven participants), observations were conducted during FOODcents sessions (thirty-one observation episodes, 237 participants), and open-ended questions were asked in pre-post hard-copy surveys administered in sessions (n 927) and an online survey administered on average six weeks after course completion (n 114). RESULTS The course attributes that were found to be especially important to participants were: (i) user-friendly, practical information that could be immediately translated to their daily lives; (ii) experiential learning that involved direct contact with food products; and (iii) opportunities for social interaction. These aspects of nutrition education were described as being highly influential in the decision to participate in the course, the application of the information in their subsequent food purchase and preparation activities, and their word-of-mouth communications with others about the course. CONCLUSIONS Incorporating aspects of most importance to participants into nutrition education programme delivery and promotion may increase joining rates, enjoyment, satisfaction with course content and, ultimately, the uptake of recommended behaviours.
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Ball K, McNaughton SA, Le HN, Abbott G, Stephens LD, Crawford DA. ShopSmart 4 Health: results of a randomized controlled trial of a behavioral intervention promoting fruit and vegetable consumption among socioeconomically disadvantaged women. Am J Clin Nutr 2016; 104:436-45. [PMID: 27413129 DOI: 10.3945/ajcn.116.133173] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 05/27/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Behavioral interventions show potential for promoting increased fruit and vegetable consumption in the general population. However, little is known about their effectiveness or cost-effectiveness among socioeconomically disadvantaged groups, who are less likely to consume adequate fruit and vegetables. OBJECTIVE This study investigated the effects and costs of a behavior change intervention for increasing fruit and vegetable purchasing and consumption among socioeconomically disadvantaged women. DESIGN ShopSmart 4 Health was a randomized controlled trial involving a 3-mo retrospective baseline data collection phase [time (T) 0], a 6-mo intervention (T1-T2), and a 6-mo no-intervention follow-up (T3). Socioeconomically disadvantaged women who were primary household shoppers in Melbourne, Australia, were randomly assigned to either a behavior change intervention arm (n = 124) or a control arm (n = 124). Supermarket transaction (sales) data and surveys measured the main outcomes: fruit and vegetable purchases and self-reported fruit and vegetable consumption. RESULTS An analysis of supermarket transaction data showed no significant intervention effects on vegetable or fruit purchasing at T2 or T3. Participants in the behavior change intervention arm reported consumption of significantly more vegetables during the intervention (T2) than did controls, with smaller intervention effects sustained at 6 mo postintervention (T3). Relative to controls, vegetable consumption increased by ∼0.5 serving · participant(-1) · d(-1) from baseline to T2 and remained 0.28 servings/d higher than baseline at T3 among those who received the intervention. There was no intervention effect on reported fruit consumption. The behavior change intervention cost A$3.10 (in Australian dollars) · increased serving of vegetables(-1) · d(-1)CONCLUSIONS: This behavioral intervention increased vegetable consumption among socioeconomically disadvantaged women. However, the lack of observed effects on fruit consumption and on both fruit and vegetable purchasing at intervention stores suggests that further investigation of effective nutrition promotion approaches for this key target group is required. The ShopSmart 4 Health trial was registered at www.isrctn.com as ISRCTN48771770.
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Affiliation(s)
- Kylie Ball
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, and
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, and
| | - Ha Nd Le
- Population Health Strategic Research Centre, Deakin Health Economics, Deakin University, Geelong, Victoria, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, and
| | - Lena D Stephens
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, and
| | - David A Crawford
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, and
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